“It can happen to anyone”

Due to various personal stresses, I snapped halfway through the year. For the first 6 – 7 months of CT1, I thought I was doing a great job balancing personal difficulties (being the sole support for a partner with a significant mental illness and being the sole support for my mother who did took my decision to stand my him very badly) with exams and CMT jobs and I thought I was keeping it together very well. It’s ironic that we met at university during my psych block which I skipped a lot of because I did not think it was important. When it all fell apart it was the analogy of the straw that broke the camel’s back. Work was a little bit more stressful that week – one day all the nurses where I worked were new, a family was difficult on call and my partner was getting more and more unwell. I had lost faith in my partner’s GP. My only friend in the area had just moved away (being essentially a carer in a new deanery meant no time for friends/ hobbies – esp. with exams and a medical rota). I did and said the wrong things, my partner left and to this day, I have little idea of how things are for him. The experience brought up a bad childhood experience and basically, I felt like the worst human being on the planet.

I tried to take my life, choosing a method I thought was fatal – ingestion of a toxic substance, but I couldn’t go through with it, it was too painful so I stopped and talked to a friend (who I knew from Uni and did not work in the same deanery) and revised for my exam. This was at the weekend. I went to work on Monday, convincing myself I was fine and determined to get on with life as normal but I was a bit late. My consultant asked to speak to me, I thought it might be because I was late, I was in for a shock. My friend had emailed the deanery. Turns out my head of school, training programme director etc were all in the speciality I was working in at the time. At the time I could not believe someone had done such a thing and I was very embarrassed. I had to go and see occ. health. I was allowed to stay in my speciality a a few weeks longer, unbanded and miss changeover.

Due to denial and in fear of being judged, I downplayed everything and said I was fine. I did everything that it suggests on those “dealing with depression” leaflets and more. I took care of my appearance, actively made friends, exercised, smiled, built on my procedural skills and did loads of CBDs and CEXs. I also did my on call. But inside I was suffering. I couldnt sleep or eat. I started crying at home, I cut myself in every non-visible area until I bled and I looked in the mirror, feeling sick, thinking I was a useless human being. Things got worse and worse and I kept having intrusive thoughts of “you are a terrible person, you don’t deserve a thing”, especially at home. I tried to revise but I could do about one question every two days. Then one weekend, I wrote a goodbye letter, started planning how I’d hang myself in a few months having tied up all lose ends and had a practice run to see what it’d feel like. Of course, I had seen my GP to keep occ. health happy, but these are very personal things and I could not open up to my GP – also, why would I? After all, I had planned to end my life, so why tell him?

I was continually tired and felt like my mind was a fog. I could barely think. In clinics, I would have to write down a list of questions before I saw the patient, check and recheck and then call the patient in. On the ward, I’d go through results with my FY1 and ask him to recheck and go through everything with the consultant at the end of the day if it was a bad day. My very simple audit, I could not do alone – when I was alone, the thoughts got the better of me, so I asked one of the FY1s if they wanted to help. Then slowly the fog began to clear as I opened up to my new friends very slightly and as I prayed. I love the phrase – “when God closes a door, he opens a window”. By complete co-incidence, I bumped into two people from my uni who were friends at the time but were also working in this deanery. Now I feel closer to my normal self. There is a long way to go. I have arranged counselling after a friend told me it worked for her. The depression is situational and I dont think SSRIs will fix it, but I intend to be honest with occ. health because I want the help to fix this.

The whole experience has made me realise mental health is as important as physical health. As an FY2 in GP, I never understood why people had time off from work due to depression, surely working helps, right? But sometimes your brain needs a rest so it can adequately process emotional trauma. My month of an easy ward job helped my mind heal. Mental illness is just that – an ILLNESS. You need to look after yourself a bit more – just as you would if you had the flu. You need to get treatment: the bio-psycho-social thing is true: Bio: pills if you need them and eating well/ resting, Psycho: CBT/ counselling/ friends/ looking at how people got through similar or worse and survived (Google is great), Social: hobbies and friends, good relationships at work.

As doctors, we really need to stop making negative comments about the person that rocks up on MAU having taken 5 paracetamol or the person with functional issues. At my worst, one day I had severe, probably functional, neck pain – I was in tears. In FY2, I nearly failed the year. This year, in this deanery, my consultants seemed so much more human – the best advice I had – if you cant do it, tell someone. Supervisors need to be realistic, give trainees tips on how to get through the bad times and help them if they are struggling – pick up the slack, let them have a rest, convince them there is no shame in counselling etc and convince them you’ve seen it before. If it hadnt been for my very negative FY2 experience, perhaps this year could have been easier. And never say to a trainee “perhaps you shouldnt be a Dr”. Would you say that to someone with a physical illness? Probably not. You’d make reasonable adjustments. The same goes here.

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