Jessica (“Jessi”) Gold, MD, MS, is a psychiatrist who specializes in the mental health of healthcare workers, women, and college and graduate students.
Dr. Gold sees patients at:
Barnes-Jewish Center for Outpatient Health
4901 Forest Park Ave., Suite 441
St. Louis, MO 63108
Please call 314-286-1700 for an in-person or video visit
What happened in the course of schooling to influence you to choose your specialty of psychiatry?
When I was a pre-med, I also studied anthropology. I was fascinated by the human aspect of medicine, the story telling and the writing aspect of anthropology. I ended up getting a masters in anthropology, as well.
Before I went to medical school, I worked in Washington D.C. in health policy, and as an intern in Geneva, Switzerland at the World Health Organization. I was trying to understand the global landscape and national landscape of health policy and the ways healthcare affected us at all levels.
When I went to medical school I knew I liked the brain, story-telling, as well as policy and advocacy. My dad was a psychiatrist and I tried not to become a psychiatrist … because my dad was a psychiatrist, and initially liked neurology. But I was drawn back to psychiatry because all of my interests overlapped there.
Psychiatry is a place where we have the most time with patients and where patients’ stories form the ways we treat them. You can see 100 people with the same diagnosis, but the way we get to that diagnosis and understand it in that particular person can be very different. It is not completely based on a person’s biology, it may be based on social or psychological circumstances — there is just so much more to it. That made it impossible for me to do anything else, and that’s how I landed in psychiatry.
What brought you to Washington University?
When I was looking for jobs after residency, Washington University was a place that was open to ‘me being me’. My interests outside clinical medicine included advocacy, writing and integrating mental health into the greater sphere of the national landscape. It was important to me that they knew and accepted this, and WashU actively encouraged all of it.
The psychiatry department here is a national leader in research and clinical care, as well as very forward-thinking in many aspects of medicine. It was really important that I worked somewhere that was a leader.
This department lets you be an individual, but also helps you along the way and that is what brought me here.
Which aspect of your practice is most interesting?
I’m most interested in people. I do what I do because I like the human aspect of my practice. People spend time with me and tell me things that they’ve never told anyone before — and trust me with it.
People have all these preconceived notions or fears about mental health, and I get to be someone who dispels them. I can make it less scary and help people feel safe in a space that they thought was going to be terrifying.
In my practice, I have the privilege to listen to people and their stories– this is what I find most interesting and what keeps me excited to go to work every day.
How has COVID-19 affected your practice?
The two major patient populations I see the most are health care professionals and college students. The mental health of both populations has significantly been affected during COVID.
There are lots of reasons for it, and they make sense. The college-age population has had worsened mental health long before COVID. And the transitions of COVID, the not knowing if they were coming back to college in person and the isolation of studying remotely, has been really hard for them.
This age group is often forgotten because they are not kids and they’re not quite adults either on their own independently, either. I really enjoy working with them and advocating for them.
We work on emphasizing strengths and coping skills to help them find hope and tolerate what has turned out to be a much longer period of time than anyone expected during this extended pandemic.
It has been hard in a lot of ways because there are so many psychological and social aspects of the pandemic that can’t be fixed with medication. I can provide support and some therapy, I can sit with them and I can listen. I’m definitely a safe place for people to turn for support, but it’s been a hard year, for sure.
Health care professionals’ jobs look a lot different than ever and the risk to their mental and physical health is significant. The things they see every day are heavier, and they’ve been expected to sustain a level of intensity at work that has been more traumatizing than ever before.
At the same time, they have the same stressors as everyone else – such as juggling child care from home and remote learning for their school-age children. It’s been really hard, and my job is to encourage them to get help in order to cope with all of these compounding stressors.
I am also Director of Wellness Engagement and Outreach. This means I do a lot of interviews and writing for the popular press about mental health as a form of advocacy. I also do talks around campus and the hospital about mental health. I try to destigmatize it and talk about the importance of getting help when you need it. I really enjoy doing this, but also do it because both populations I see, college students and health care workers, have a really high need, but don’t necessarily always get care.
Health care workers are notorious for not seeking help. My message to them is vulnerability is a strength, not a weakness to be ashamed of. I encourage people to get help early – not when then are in crisis.
Has telehealth been a help to your practice?
I’ve been doing video visits (telehealth) since the pandemic started. It’s different for sure, but it is definitely convenient for people.
Some mental health symptoms are actually barriers to picking up the phone to make an in-person appointment in the first place. With depression, a person can have anxiety or lack of motivation, and these symptoms interfere with seeking care. So being able to stay at home, open your computer and talk to a doctor can be very helpful in lowering the barriers to seeking help.
Are there any other new developments in your field that you are excited about?
I’m excited about the treatments that may offer a road to faster results. At Washington University we have transcranial magnetic stimulation (TMS). In TMS, a briefly pulsed powerful magnetic field is used to re-energize deficient brain circuits involved in treatment-resistant depression.
I like it as a treatment option for my patients who have tried medications and have not had a lot of success. A lot of my patients have done really well with it.
Anti-depressants can be frustrating at times, and it is nice to have other options. People are sad when they come to us, and one of the hardest things about being a psychiatrist is the treatment we now have to offer can be quite slow. Medication can take six to eight weeks to take effect, at a minimum. As a clinician, that is really hard. You wish you had a magic pill that worked in days, not weeks.
There is still a lot to learn about the brain and this means there is a lot of room for new discoveries in psychiatry. The use of psychedelics (psilocybin, the active ingredient in magic mushrooms) is very interesting and promising, and so is ketamine. When I look towards the future of psychiatry, we don’t completely understand all of the mechanisms yet — but there is a lot of promise, and that’s also cool.
Where are you from?
I was born in New Jersey, but spent most of my years growing up in North Florida. I went to boarding school at the end of high school, back in New Jersey. I went to college in Philadelphia (Penn), and spent time in Switzerland, Washington D.C., then medical school in Connecticut (Yale), residency in California (Stanford) and finally here.
People might ask me what my problem is, and why I like to move so much! I found that medical training had distinct moments where you get to move every four years. If you don’t have reason to stay, it is kind of nice to move on.
It’s been nice to see different medical cultures, get a little bit of different training, and learn from different people in different environments. I’ve always really liked traveling, so it’s been fun to do that, as well.
Which particular award or achievement is most gratifying?
In residency, I won the Gold (not actually named after me!) Foundation Humanism and Excellence in Teaching award from the medical students at Stanford.
The students chose which residents they felt cared about them the most and were the most helpful teachers. That was the award I was most proud of because it meant I stood out as a teacher, but was also someone the students felt they could turn to for support. The award was only given to six residents out of the approximately 700 residents and fellows in the whole program.
More recently, a friend of mine, who is a journalist, nominated me as a CBS Frontline hero. They gave me shout-out on CBS. That was very cool.
What is the best advice you’ve received?
The best advice I’ve received is that doctors are human too. Recognizing we are allowed to have feelings, wants, needs and opinions. We need to be able to ask for assistance, and take time off work when necessary. Also, we might be affected by the difficult situations our patients are experiencing — and that’s okay.
I’m a big proponent of doctors going to therapy for themselves. I go to my own therapist, and it is important for patients to know that their own doctor is taking care of his or her self. Patients are sharing their deepest, darkest secrets and most challenging life situations with someone — and that person can handle it because that person also has someone they can turn to.
In psychiatry, we follow the Carl Jung concept that you have to understand the darkness in yourself, to understand the darkness in others. This is important to being a better therapist and human. You have to understand why you react to something in order to be a better support for your patients. I pass this advice on to others, as well.
If you weren’t a doctor, what would you like to be doing?
I am partially doing it now as a writer and consultant. I enjoy writing – I find it relaxing and use it as a coping skill. As a contributor to Forbes, New York Times, Washington Post, Self and InStyle magazines (among others), I write about a variety of topics related to mental health. I also have pretty big social media platform.
For a very long time, the face of mental health was old men in bow ties. People couldn’t relate with the message that was being sold, so they just put off getting help. We are trying to make psychiatry a little less scary.