Lisa Ekselius: Inside the mind of a psychiatrist

“I really love international football. At any time, I could sit down in front of a match like Mexico versus Ghana, and find a fascinating beauty in how clearly the different nations’ cultures and temperaments emerge!”

Yes, there is undoubtedly much inside the mind of Lisa Ekselius, professor and senior physician in psychiatry, which was also the title of the lecture she gave on 20 October when she stepped onto the stage of Grönwallsalen to accept the 2017 Rudbeck Award, Uppsala University’s most prestigious distinction in medicine. The statement from the Uppsala Doctors Association touches upon Lisa Ekselius’ “comprehensive and excellent research” as well as an “unparalleled capacity to help others flourish”.

“It has yet to sink in that I should be considered among the troop of outstanding researchers who have received this distinction before me. At the same time, I am of course incredibly pleased and honoured to be considered for such a fine award, and above all, I see it as validation of all the work our research group has done to bring psychiatry in Uppsala to where we are today.”

In the not-too-distant past, mental illness was permeated by shame, something which society did its best to hide. Treatment centres were situated far from urban cores, sometimes in the midst of nature, but always out of sight. Today, the situation has changed. At the entry to Uppsala University Hospital, visitors are met by the impressive exterior of Psychiatry House. The initiative stirred strong emotions, but with a few years under its belt, it is now considered to have found a place in the hearts of Uppsala residents.

“It’s an incredible asset, where we can truly gather all the experts and work in direct connection with the hospital’s other specialists. That benefits research, the clinic, and above all, patients, and it makes me equally happy every time I go to work,” concludes Lisa Ekselius.

However, the sky above the ‘House of Psychiatry’ (Psykiatrins hus) is not entirely cloudless. Nationally, psychiatry still risks being a neglected discipline in medical care and research, especially when funding is being allocated. On a broader plane, an ounce of mistrust is also expressed at how the allocated resources are used, something which even happens in Uppsala.

“The fact that mental illness is still stigmatized and that as care providers and researchers, we are unable to gain society’s full trust poses major challenges for us. We simply need to be more visible, and I see this year’s Olof Rudbeck Day, with its focus on our field, as an important investment in ongoing mass education. The brain is a complex creation; it is the bodily function that most distinguishes us from other mammals. That makes its illnesses difficult to research, but the MRI now gives us better opportunities than ever before, and we can expect enormous amounts of new information about both healthy and sick brains in the near future.”

Personally, Lisa Ekselius has dedicated her research to personality disorders, focusing on a common condition in which the patient has such trouble adapting to events and surroundings that it results in social or work-related disabilities. Patients with this diagnosis also show a tangibly higher level of mortality connected to both natural and unnatural causes, a situation whose gravity is growing due to the current lack of proven treatments. “We need more information in order to get an overall grasp on the diagnosis, define preventive factors, and to create a system to clearly discern who is at risk. Once we have found the right path, it will contribute to more effective patient prioritization and better work.”

One condition for functioning psychiatry is mutual trust and close collaboration between the patient and psychiatrist. It is also necessary to get patients to take part in research on the causes of diseases, and Lisa Ekselius and her research group have successfully created an academic biobank to which patients may contribute.

Despite the extra burden it entails, the majority choose to submit samples and thus support the research. An evaluation among the “Young Adults” patient group confirms that they also view the initiative very positively. “We have many years of hard work behind us, but focusing on the opportunities has fostered the necessary joy and energy. Today, we begin to reap the rewards of our endeavours, which is incredibly inspiring. If I can just stay healthy, then I will gladly work to age 67. However, I don’t have the slightest concern about ‘letting go’: our group includes several young, competent researchers and clinicians who will do an outstanding job of leading this development further.”