Invisible Disabilities in Veterinary Medicine 

By Naveesha Kaur Shergill
Chair of IVSA’s Standing Committee on Wellness

Brain Sketch

According to the Invisible Disabilities Association[1], invisible disability is “a physical, mental or neurological condition that is not visible from the outside, yet can limit or challenge a person’s movements, senses, or activities”. However, this does not mean that someone with an invisible disability is less abled. In fact, many people with this disability are known to have professional careers, social lives and families.

Society tends to automatically picture a wheelchair anytime the word ‘disability’ is said but that is where we stand corrected because invisible disabilities have a wide range of symptoms[2] such as debilitating pain, fatigue, dizziness, cognitive dysfunctions, brain injuries, learning differences and mental health disorders, as well as hearing and vision impairments.

Mental health disorders such as anxiety and depression are categorized under invisible disabilities as it is not observable but unlike other disabilities that you can actually see, having an invisible one sometimes forces you to be subjected to judgement. Being a part of the veterinary community, we all know the struggles of being in this profession regardless if you are a student or a working professional. Back in 2014, there was a survey[3] conducted anonymously through the Veterinary Information Network (VIN) whereby out of the 11,000 U.S. veterinarians surveyed, it was found that 9% had current serious psychological distress, 31% had experienced depressive episodes and 17% had experienced suicidal ideation since leaving veterinary school. These numbers are staggering yet years later, there still is lack of education in our community and without education, people are not able to understand. For instance, when you see someone on a wheelchair you do not expect them to be able to reach the top shelf but with an invisible disability, people expect you to be able to do so effortlessly and criticize you when you are not able to. 

With that being said, it is not just depression and anxiety that many in the veterinary community are challenged with because there is one hidden neurological condition that had been diagnosed in a vet student. The National Health Society (NHS)[4] states that Multiple Sclerosis (MS) is “a condition that can affect the brain and spinal cord, causing a wide range of potential symptoms, including problems with vision, arm or leg movement, sensation or balance”. Some other symptoms[5] include fatigue and a decreased performance in learning and thinking. While MS is a life-long condition with no known treatment, it is possible to overcome it, just like one vet student did. Jodi Edwards[6] was diagnosed with MS in the midst of vet school but long before that, she was fighting her own battles. Prior to vet school, Jodi was put under an immense amount of pressure to help with her family’s restaurant business and was also battling through depression. Despite that, she never gave up until one day Jodi made a huge accomplishment by getting accepted into vet school in her 30’s but all that changed when she started experiencing the symptoms of MS such as intense pain, difficulty walking and leg numbness. She went through a series of tests before finally being diagnosed with Multiple Sclerosis. Jodi was forced to use a wheelchair and could only walk short distances but she was determined to start walking again so she underwent challenging physical therapy and through that, found her passion – running.

Besides Jodi, another person who has experienced invisible disabilities is Jessica Hirsch[7]. Jessica was like any other college freshman until one day she sustained a concussion that changed her life. She started experiencing symptoms like nausea, dizziness, migraines, joint and muscle pain, difficulty concentrating and much more. She decided to meet with a specialist to find out what was wrong with her and was diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS)[8], Hypermobile Ehlers-Danlos Syndrome (hEDS or EDS Type 3)[9] and Mast Cell Activation Syndrome (MCAS)[10]. As part of her treatment, she had a chest port for intravenous fluid therapy that had to be done three times a week but Jessica still suffered with migraines and neck pain. It was in January 2020 when Jessica was referred to a Dr. Fraser and was diagnosed with Cranio-Cervical Instability (CCI)[11], Chiari Malformation[12], and Foramen Magnum Stenosis[13]. Her brainstem had kinked at a dangerous angle and she was warned that even the most minor fall could cost her life. Although she was determined to finish her semester, the symptoms just became too severe to cope with and was interfering with her studies so finally in July 2020, she underwent a successful surgery.

Having an invisible disability is definitely not a walk in the park and comes with its own challenges[14]. You become victim of scrutiny when you park in the handicapped spot but do not require a wheelchair to be mobile. At work or in university, your colleagues or classmates may accuse you of being lazy when all you are doing is taking a break because with a hidden disability, nobody understands just how much effort goes into day to day activities. Not only is this mentally and emotionally draining but you start to question yourself - am I really disabled? The future[15] of invisible disabilities require a lot of conversation in order to end its stigma. This means something as basic as talking about your hidden illness goes a long way because you are doing your part in ensuring that people are being actively educated on this topic and most important, understand how you feel.

References:

 

1., 2. Disabled World. (2020, September 10). Invisible Disabilities: List and General Information. Retrieved from https://www.disabled-world.com/disability/types/invisible/

 

3. Notes from the Field: Prevalence of Risk Factors for Suicide Among Veterinarians — United States, 2014. (2015, February 13). Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6405a6.htm

 

4.,5. NHS website. (2020, August 12). Multiple sclerosis. Nhs.Uk. https://www.nhs.uk/conditions/multiple-sclerosis/

6. HealthCentral. (2020, October 13). Home. Health Central. https://www.healthcentral.com/experience/ms-journey-jodi-edwards

 

7. J. (2020, August 29). my story. DisabledDVM. https://www.disableddvm.com/post/my-story

8. Postural orthostatic tachycardia syndrome | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program. (2017). National Center for Advancing Translational Sciences. https://rarediseases.info.nih.gov/diseases/9597/postural-orthostatic-tachycardia-syndrome#:%7E:text=Postural%20orthostatic%20tachycardia%20syndrome%20(POTS,eased%20by%20lying%20back%20down.

9. Hypermobile EDS and hypermobility spectrum disorders – The Ehlers-Danlos Support UK. (2017). Ehlers-Danlos Support UK. https://www.ehlers-danlos.org/what-is-eds/information-on-eds/hypermobile-eds-and-hypermobility-spectrum-disorders/#:%7E:text=Hypermobile%20Ehlers%2DDanlos%20syndrome%20(hEDS,exactly%20how%20frequently%20it%20occurs.

10. J. (2020b, December 17). Do I Have Mast Cell Activation Syndrome (MCAS)? Dr. Nicholas L. DePace, M.D., F.A.C.C. https://franklincardiovascular.com/do-i-have-mast-cell-activation-syndrome-mcas/

11. Craniocervical Instability. (2016). The Zebra Network. http://thezebranetwork.org/craniocervical-instability#:%7E:text=Craniocervical%20Instability%20(CCI)%2C%20also,upper%20spinal%20cord%2C%20and%20cerebellum.

12. Chiari malformation - Symptoms and causes. (2019, September 12). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/chiari-malformation/symptoms-causes/syc-20354010#:%7E:text=Chiari%20malformation%20(kee%2DAH%2D,brain%20and%20forcing%20it%20downward.

13. Ok, M. S. (2019, August 1). Foramen Magnum Stenosis and Spinal Cord Compression in Achondroplasia | Anesthesiology | American Society of Anesthesiologists. ASA Publications.

https://pubs.asahq.org/anesthesiology/article/131/2/396/18103/Foramen-Magnum-Stenosis-and-Spinal-Cord

14. P. (2019, August 27). Invisible Disabilities Pose Challenges Too. Paradigm Treatment. https://paradigmtreatment.com/challenges-invisible-disabilities/

15.  Fabian, R. (2018, October 1). What is Invisible Illness? (+ How to Explain it to Others). Talkspace. https://www.talkspace.com/blog/what-is-invisible-illness-how-to-explain-it-to-others/