Michelle Riba, MD
“The interaction of psychiatric symptoms and disorders and other medical conditions has always been a passion of mine. I believe psychosomatic medicine is a key specialty for clinical care, research, and teaching in the future of psychiatry.”
Michelle Riba fills several diverse professional roles, which is fitting for someone who has a passion for orchestrating collaborations across disciplines. As a clinician, teacher, and researcher, as well as someone keenly interested in co-occurring medical conditions, Riba seeks out points of intersection in medicine that can enhance patient care for both physical and mental health, with the understanding that the lines between body and mind are never well defined when it comes to wellness.
“The interaction of psychiatric symptoms and disorders and other medical conditions has always been a passion of mine,” Riba says. “I see the future of psychiatry as ‘psychosomatic medicine’ and believe this is a key specialty for clinical care, research and teaching. This is the future direction of psychiatry, and I would like to see other areas of medicine integrated into psychiatry to a greater degree.”
Riba, who is an associate director of the Depression Center, notes that not only are depression, sleep issues, anxiety, and substance abuse very common problems and illnesses, but they also frequently overlap with other disorders in cancer and heart disease. This “natural coupling of disorders” requires clinicians to consider patients’ mental and physical health simultaneously.
“I think other clinicians become very worried about treating their patients who may have major psychiatric issues, not realizing that we have good resources to help, that it’s a team effort, and that the psychiatric care can be integrated into primary illness treatment efforts,” she says. Instead of putting emerging psychiatric issues “on the backburner,” those issues can and should be dealt with at the same time as other health problems, she says. “It is a much better approach to patient care.”
“It can be really difficult to make a diagnosis of depression in a patient with multiple health issues, because we don’t know if it is because of the medications, the primary disease or because the patient has a prior or new additional diagnosis of a mental disorder,” Riba says. “Our work is really important because we need to know how these diseases interact and especially how they react to medications and other treatments to make sure we are not giving patients negative side effects.”
“It is essential that we provide the right diagnosis and provide treatment utilizing evidence-based research.”
As a medical student, Riba worked in a hemophilia clinic and became active in advocacy efforts during the 1980s when HIV was just beginning to plague the hemophilia community. She was intrigued by the collaborative care models and shared decision-making among multiple clinicians working together to take care of hemophilia patients across the lifespan. Initially drawn to oncology early in her training but more interested in patient interaction, she moved toward psychiatry with an emphasis on oncology.
Today she is the founding director of the PsychOncology Program, a collaboration between the U-M Comprehensive Depression and Cancer Centers to treat cancer patients who also suffer from depression. There she leads a multidisciplinary group of clinicians who care for the emotional needs of cancer patients and their families; including physicians, nurses, social workers, art therapists, child life specialists and psychologists. In her research, Riba is involved with projects related to screening and treating distress in patients with cancer and other co-morbid medical conditions, as well as other projects looking at patients with other comorbid conditions in addition to depression and anxiety, in particular cardiovascular disorders.
“It is good for patients to know we [UMHS] care about the heart/brain/mind/body and want to provide integrative care. This integrated model of patient focus helps to normalize the emotional aspects because we come to the patient and treat them for depression or anxiety as part of their primary illness,” she says. “Our work has a lot of champions.”
Riba finds tremendous reward in patient care. “Every day, patients and families are appreciative. Every day I have the opportunity to help such great, wonderful patients. I think it’s really quite a blessing for me to be involved in their care. It’s a privilege and honor to be able to help a patient and family members,” she says.
“Every patient has had an impact on me. I think I carry a little bit of every patient with me….Sometimes I just can’t believe I get to do this kind of work and help people in this way. I really love and appreciate what I do.”