Medical school, Medicine, Mental Health, Relationships

Why I Stopped Writing

For the few followers of my blog, all of whom I am incredibly grateful for – you may have noticed that I stopped writing for almost 3 months. You may also be wondering why. When I started this blog, I aimed to write something at least every week, and I think I did pretty well (apart from the time I was severely unwell and overdosed). Writing has always been a great way for me to de-clutter my thoughts, rationalise my ideas and to release some emotion whilst attempting to help somebody out there. Before my blog, I wrote in my diary almost religiously from the age of about 10, and it did wonders to help me deal with a lot of things I was experiencing. But from time to time, I lose momentum and stop writing for months at a time.

The main reason I usually do that is because I want to do all I can to run away from my thoughts and feelings, rather than try to understand them. We’ve all probably experienced it – it’s when you have so much on your plate that even thinking about a problem, or facing an issue becomes too emotionally draining. Rather than feeling relieved, I start to feel extremely upset. So that turns me away from writing and I go into my “pretend-everything-is-fine” mode. There are pros and cons of this of course. On the one hand, I am able to give myself a false sense of security that everything is fine when it is in fact very far from fine. But on the other hand, pushing things to the back of your mind also causes it to build up slowly over time, until you eventually burst. That part isn’t really too fun.

Also, for the past few months, life happened – I had all my exams to do but with zero concentration and hypersomnia (excessive sleeping) as side effects of my medication; family troubles; financial struggles; friendship struggles; rejections from job interviews; yet another rejection from a romantic interest (I might tell you about these one day, should you be interested); my rejections of romantic interests in me (life is funny) – you name it. Everything happened at once. And obviously that meant my mental health was at an all time low again with my anxiety levels sky high and the return of suicidal thoughts. Wa-hey.

However, I can happily say that some of those things mentioned above have improved since. For example, I somehow managed to pass third year and am going into my fourth year of medical school in a few months’ time (yay!). Also, amongst the thousands of rejections, I did manage to find a short part-time job to give me a financial boost. And my anxiety levels are generally lower, though I’m still struggling with them immensely even now that most of the external factors are gone.

It has literally taken me 3 weeks to convert my thought of wanting to write again, to actually writing again, despite having plenty of time to do so. So you can imagine to what extent my motivation is lacking. I’ve also become very bad at remembering to take my medication which really messes me up because I keep switching from insomnia to hypersomnia and also gives me nightmares. My moods are also all over the place. It’s all a bit dishevelled really but I’m hoping that this will all change with a bit of positive thinking.

Here’s to mental health and writing.

 

Anxiety, Medical school, Medicine, Mental Health, Reality, Stress

The Magic of Creativity

Most days, I don’t feel like I have the energy or motivation to do anything but curl up on my sofa, binge-watch trashy TV and mindlessly munch on processed junk until I fall asleep and the cycle repeats itself. So when I went to my first CBT (cognitive behavioural therapy) session a few months ago and the therapist suggested I engage in enjoyable activities and rekindle my hobbies, I honestly thought, “what rubbish”. I felt so drained of energy that even getting to the CBT session in my pyjamas was an achievement for me.

My turning point was definitely in the weeks following my suicide attempt. After seeing the effect that it had on my family and friends, I was determined to get better and get out of the vicious cycle of depression I was stuck in. I decided that even if I felt life was not worth living for me, it was definitely worth living life for those who loved me. And yes, I knew life was not going to be all flowery – in fact, ever since my attempt in November, things have most definitely not been going my way or in my favour – but it was worth going on for the few minutes that I made my baby sister smile, or for the moments I spent cradled in my mother’s arms, or for the times that my friends tried cheering me up with their banter. So I decided that it was time for me to start getting up from that sofa. It was going to be anything but easy, but with the support from friends and family, I could do it.

The first thing I decided to do was to try and rekindle my hobbies as my therapist had suggested long ago. For me, art and singing have always been my favourite activities – they were both hobbies I’d pretty much given up on because I didn’t feel as if I had the willpower or motivation to do them. So I decided to audition for a singing part at a society-run university play (which required much support and encouragement from a good friend of mine) and ended up getting the part. I also decided to get back into sketching and painting which, I have to say, has been INCREDIBLY effective at providing me with a productive form of distraction when I’m feeling low.

On days that I feel extremely depressed, time doesn’t seem to pass. It’s difficult for me to pick up a pencil or to practice my singing, but once I start, it gets easier and easier. It gives me something to focus on, and I don’t even realise how quickly time flies. Sure, right now it doesn’t really help with my procrastination issue, but one step at a time. The logic is that if our daily average enjoyment levels increase to a sustainable degree, then motivation also increases and the possibility of achievement does too.

It’s always difficult to take the first step, and progress is not nearly as quick as we’d like, but I guess every little helps. I’m not back to my extra-motivated, focused, organised, efficient self yet (nowhere near it, in fact), but at least I’m spending a little less time moping on my sofa staring at the TV screen. And maybe one day, I’ll even be able to get back to being productive with my work and feel more of a sense of achievement.

Anxiety, Medicine, Mental Health, Stigma

Am I Insane?

I ask myself over and over again, “Am I insane? Am I crazy? Am I unstable?” As strange as it sounds, I am haunted by myself. The thoughts that run like obsessions through my mind and my gradual estrangement from ‘normality’ make me question my sanity. I often scare myself so much so that I cower away in the corner of my room and keep repeating to myself prescriptively “I’m ok, I’m ok, I’m normal, I’m ok,” rocking back and forth as comfort, in my attempt to convince myself that I am not insane. Counterproductive? Maybe.

There are a few reasons why I often feel as if I’m going insane. The first has to be my constant struggles with suicidal thoughts. Every day, they creep up on me insidiously, especially when I am alone, and they keep getting stronger and stronger, until they develop into well-thought out plans. The temptation to implement the plans becomes unavoidable, and just as I am about to do it, I stop. I re-think and play devil’s advocate. I think about my family and friends. I think about the knock-on effects. I step back. Then it happens all over again, like a video on repeat.

The thoughts and planning tire me out so much, that I feel completely exhausted. It’s as if I am constantly fighting myself, and it takes its toll. It disrupts my normal concentration, I always feel drowsy and weak, and my motivation drops even more than it’s normally low level. Often after these episodes, when I just about avert the implementation of my suicidal ideation, I break down completely.

With severe depression and anxiety also comes increased irritability and mood swings. I often lash out at the people closest to me, for the smallest reasons. I may say some hurtful things without thinking, and I immediately regret doing so. I apologise, but we can never take our words back, and I feel even more angry at myself for being so incompetent. I just feel as if I am no longer in control of myself. I don’t know how I will react, I don’t know where my thoughts will take me, I can’t do anything that anyone expects of me, I can’t even predict if I’ll still be around a few hours later, or if I’ll end up taking my life before then.

Although not as bad as some sufferers, I have had brief episodes of auditory and visual psychosis in the past which terrified me and made me more convinced that I had essentially ‘gone mad’. It’s scary because sometimes I no longer know if something is real or if I’m just imagining it. This haunts me for sure.

What doesn’t help is also being made to feel alienated because of my mental health. I don’t like being branded or being treated differently, because it makes me feel abnormal. The stigma in society relating to mental health problems is what fuels this alienation. I am lucky to have friends who do their best to treat me like myself whilst being sensitive at the same time. It makes a massive difference to not be shunned but understood. But of course, not everyone is like that. My friends are all medical students which make them naturally compassionate and understanding compared to the rest of the population.

Today, I was at my Medical Ethics and Law lecture on the Mental Health Act 1983, and we were taught that patients with ‘mental disorders’, such as schizophrenia, depression, anxiety, personality disorders, etc, are not to be considered competent of making their own medical decisions, and may need to be ‘sectioned’ if they are deemed to be inappropriately refusing treatment. Reading this made me feel as if I was an incapable outcast. Although I am depressed and anxious, I would always want to have the right to decide what happens to me, even if it doesn’t quite synchronise with the widely accepted definition of ‘my best interests’. I strongly feel that should I be in the position where I need to make a medical decision for myself, I am able to understand both sides, know the consequences of my actions and am prepared to take any risks with either opting or refusing certain treatment. Basically, I still have competence. To be stripped of that right simply because of my mental health state seems wrong to me.

Maybe I am insane. Or maybe we should re-define insanity.

 

Please note: If you are feeling low or thinking about suicide, please contact the Samaritans helpline on 116 123. They are open at all times and are there to listen.

Anxiety, Medical school, Medicine, Mental Health, Reality, Stigma, Stress

First impressions of CBT

A few months ago, I was referred by my GP to the IAPT service which provides talking therapy for patients suffering from depression, anxiety and severe sleeping disturbances (I suffer from all three unfortunately). After telephonic assessment in August, I was deemed suitable to receive Cognitive Behavioural Therapy (CBT) which is aimed at altering the way people think in order to prevent harmful behaviour or distressing physical symptoms. Yesterday was my first appointment, and to be honest, I was quite nervous about the experience, despite having had 8 counselling sessions at my university already. I was also quite cynical of CBT because of some negative feedback I’d heard from people, so it took quite a lot of motivation for me to give it a try. My main rationale for trying CBT was that I couldn’t get any worse than I was now, so there would be no harm in trying, and  even if there was the smallest possibility that my quality of life could improve and I could potentially stop my continual suicidal thoughts, it was worth a try.

Just to give you a bit of background, I was formally diagnosed with severe depression and anxiety in March this year. I also suffer from insomnia and regular nightmares which often wake me up in sweats. I was prescribed Sertraline in March – a form of SSRI anti-depressant – and even after six months on the maximum dose possible, my condition did not improve but worsened*. Recently, I have been started on a different type of antidepressant, an SNRI, called Venlafaxine, but it is too early days to know how efficient it has been. It is only understandable however that despite my efforts, and medication and counselling, I wasn’t getting better. So when I received a phone call last week to arrange an appointment, I was kind of relieved that there were still other things left for me to try.

It took me about an hour to find the right place yesterday for my CBT appointment. It was in the most inconspicuous location with poor accessibility and getting lost in the dark only made me more anxious. I don’t know if it was this hospital in particular or if this applies to all mental health hospitals, but it was really difficult to find (despite my usual poor navigation skills!). I suppose it may be intentional so that patients don’t feel embarrassed walking inside for fear of stigma from the general public who may see them walking in. Once I did go inside the building, I felt like I was inside one of the really old hospitals they show you in horror movies. I took a photo which you can see at the top of this post, but it was terrifying to walk inside. I could not see anyone around, the ‘reception’ was closed off with newspaper coverings all over the window, the lighting was eerily dim, the signboards were out-of-date and I was lost once again. After walking around for ages, often just going around in circles, I managed to find somebody in the hospital who was kind enough to direct me to the right place. However, I have to point out that more needs to be done to improve the aesthetics of mental health departments and hospitals, especially because the patients going in are already in a very anxious state of mind, and as research has shown, environments can influence heavily on the mental health of people. I feel that the poor state of mental health departments is a consequence of the severe lack of funding towards mental health by the government. I strongly feel that this MUST be addressed.

On the other hand, after meeting my therapist, I have to say that I was made to feel extremely comfortable. She had a spark in her which made me feel as if things could get better for me, and she reassured me that she would work through my problems with me throughout the forthcoming sessions. I found her to be extremely helpful and caring and I really do look forward to our sessions in the future. Yesterday was an assessment and summary of how things were going to work, and I will see her again for a formal session in 2 weeks’ time. Maybe things will change for the better, we just have to wait and see.

If you have any comments or suggestions, please feel free to leave a comment as I would love to hear them!

* Please note: Just because an anti-depressant did not work for one individual does not mean it will not work for another. Everyone is different and often it is a ‘trial and improvement’ process. My mother has been on low dose Sertraline for her depression and anxiety and it has worked wonders for her, whereas it has had little effect on me. 

Consultants, Intimidation, Medical school, Medicine, Mental Health, Pressure, Stress

Consultant-induced Consternation

Before starting my clinical placements for my third year at medical school, I’d heard horror stories of terrible consultants, but I never expected to feel intimidated by my own. Although the vast majority of consultants at my hospital are incredibly helpful and  supportive, I have been made to feel like rubbish by a particular consultant unfortunately. Thankfully for me, the situations were not nearly as traumatic as some of the things I’ve heard, but it did nonetheless damage my self-esteem a good deal.

As outlined previously, I have been suffering from severe depression and anxiety this past year, and I have been finding it difficult to cope with the stress of my hospital placement which is a 2-hour journey from home. Most days, by the time I reach the hospital, I am in a mess, having had a 2-hour journey to feed, nurture and breed my anxiety levels, so getting on with the rest of the day (approximately 8 hours) is a real struggle. Because of my severe low moods, when I get home from placements, I have no energy or motivation to read up on conditions and cases so I look like an absolute idiot when I’m questioned by the consultant the following day.

Therefore, it is understandable for my consultant to feel quite frustrated at me for not meeting up to his expectations. However, he had been informed of my situation beforehand, so if anything, I would have appreciated it if he could be mildly sensitive towards me.  One Monday afternoon, he was particularly annoyed at me for not being able to answer all his questions correctly, and he remarked – “If you don’t remember everything I’ve just told you the next time I see you, I will personally speak to your college and bar you from studying medicine again.” Ouch. Other comments included things like, “you don’t deserve to be a medical student” and “I have no idea how you got into medical school”. 

I do appreciate that my consultant may have had a waning patience because of his tiredness from excruciatingly long shifts, but if the professionals for whom sensitivity is in the ‘required’ section of the job description start doing the exact opposite, it is quite surprising to say the least. Most medical students have very little self-esteem, if any, and to receive demotivating remarks from consultants really makes us question whether we’re good enough. I am not alone in this – many of my friends at med school have shared very similar stories of being felt bullied by the consultant.

Personally, I had great difficulty in coping with the aftermath of these remarks, and felt completely useless and inadequate. I contemplated giving up on medicine because ‘what’s the point if I’m not good enough’. It was because of my family and friends that I didn’t give up and tried my best to keep going. But I still feel so anxious when I am around this consultant, because of his naturally patronising disposition.

At one point, I felt that I needed to talk to my consultant about how I felt, so I took the initiative of writing up an email requesting him to be patient with me because I was trying my best, even though my best wasn’t the same as my best from a few years ago. Fortunately, his response to my email was supportive and the next time I saw him, I could tell he was really trying hard to be sensitive (though it was very obviously forced), but that was enough for me to keep on going. It hasn’t stopped me from fearing his intimidation, but at least I have made him aware of my perspective, which will hopefully make things improve in the long run. Of course, if it doesn’t, I know who I can take it up with, but I hope it never comes to that!

Junior doctors' contract, Medicine, Mental Health, Patient care, Reality, Stress

Coming to terms with Medical School

Studying at medical school had always been my dream, and I’d envisioned that finally achieving my goal would reward me with an eternal feeling of accomplishment and satisfaction. However, I couldn’t be further from the truth. I felt like my entire life thus far had been tirelessly spent on getting to this exact point in time, and once I had arrived there, I had no idea what I was doing anymore. It was almost… anti-climatic.

Most of my time, I felt lost and confused. I wasn’t sure why I was at medical school, and realised that all the tough competition I’d endured to get myself there was apparently only so I could do it all over again at medical school. And the prospect of maintaining the same level of endurance to do well and pass my exams for the rest of my life, in my pursuit to become a doctor made me feel exhausted. I was surrounded by insanely intelligent students from all around the world, who suddenly made me, the ‘all-A*-pupil’, feel like an absolute idiot. There was no way I could compete with them, and suddenly I went from getting 90% and above in my exams in sixth form, to just about scraping a 40% pass in my medical exams.

To say this whole experience was demotivating, would be an understatement.

After coming to medical school, I finally realised why the admissions process is so bloody difficult. It’s because getting through the workload at medical school is meant to be even more stressful, and the stress of being a doctor surpasses all of that put together. As this realisation hit, I really lost all enjoyment of studying medicine. Sure, it it was ‘a-dream-come-true’ which supposedly should have made me grateful as a lot of people never get there despite their best efforts, but I suddenly envied all those who weren’t studying medicine.

About the same time that I got into med school in 2015, the whole junior doctors’ contract controversy erupted, which made me even more doubtful of my happiness in working as an NHS doctor in 6 years’ time. Would all my efforts be worth it in the end? I robotically sat through my lectures for the first 2 years, fighting the overpowering urge to fall asleep on my laptop. I destroyed my social life before it had even had a chance to bloom so that I could prevent having to fail and retake any of my exams.

Don’t get me wrong – I still loved the idea of being able to be an important part of the medical team to care for patients as a doctor, but I was worried more about the implications the whole process was having and would have on my health and wellbeing. Although the vast majority of doctors are inherently altruistic, doctors do what they do for a living – and realistically not earning enough to purchase simple commodities is frankly depressing. What is even more depressing is not being able to take enough time off work to see family, friends, or even the walls of your own room for days at a time. And the more I learned about the real struggle that junior doctors face in the NHS, the more fearful it made me of my future.

My first 2 years at medical school really dragged me down. I got through them because I felt I had no option, but my motivation had dropped significantly since coming to medical school. What reignited the original interest I had for wanting to become a doctor, was not the draining lectures from 9-5 everyday; it was the experience that I’d had with real patients on wards. During clinical placements, I was able to really connect with the patients I would talk to, and although I was meant to be taking medical histories from them, I confess that most of the time, I was just chatting to them about their interests and having a laugh. And that made me (and still makes me) so happy. Bonding with them makes me see the reward in going through all the hard work I’m doing now. One day, I might be the person who helps bring them back from the jaws of death, or help make them as comfortable as possible whilst they pass away.

That’s what keeps me going now.

 

Introduction, Medicine, Mental Health, Stigma

Medicine, Mental Health and Me

The decline of mental health in medics across the globe has been and still is a growing issue. As two medics studying in the heart of London, we’ve decided that the irony of healthcare providers putting their wellbeing on hold should no longer be a stigmatised issue, but one that is spoken about unashamedly. On this blog we hope to share with you our own experiences in the medical field, our beliefs and our opinions in hopes to break down these walls and make dealing with a declining mental health, as a healthcare professional, easier.

Alongside our insight into the medical field as  first and fifth year medics, we bring with us our personal journeys involving experiences with dysfunctional families, domestic violence, bereavement and sexual abuse which we wish to shed a light on in order to help those who have suffered similar, or more traumatic events, to speak out, without the fear of stigma. As women, especially coloured women of South-Asian descent, we also feel strongly about feminism, women’s rights and overcoming  various cultural barriers involving the stereotyping of women.

We will be writing under the names Arya and Maya bringing you a new article from us each week. We hope that you can join us in our campaign against mental health taboo, gender inequality, abuse and trauma and gain something from it – whether that be a deeper insight into an issue or helping yourself through your own journey.

Please exercise caution when reading our articles since they may contain sensitive and potentially triggering content and please seek help if you find yourself struggling.