Today is World Mental Health Day. I’ve spoken before about my own personal experiences before. I’m a big fan of people talking about and ‘normalising’ mental health issues. How much you share is, as with any medical condition, up to the individual. Moreover, I strongly believe it should lead to empowerment and not (self-) victimisation: in many cases, at least non-chronic ones (and excluding, to an extent, certain conditions), it is within the realm of your own power to help heal yourself. I find this liberating.

With that in mind, I thought I’d open up a little…

I’ll start by saying, “I’m fine.” I think we all say that, don’t we? Honestly, mostly I really am. I haven’t been depressed through this but I have been intermittently sad as you’d understand. My own health is ok and I’m generally very fortunate.

For those that have read my blog or followed my instagram posts though, you may have noticed over the past year or so that I have been somewhat sporadic or non-existent. To say there has been a lot going on would be an understatement. To sound slightly cruelly grateful, most of what has been going on hasn’t actually happened to me. It’s just happened around me. I don’t want to go into specifics but to summarise very broadly, in the last year and a half or so:

• several close family members have become unwell, some more critically than others. Some have improved but sadly, some will not
• a number of close friends have become unwell or have gone through incredibly traumatic situations. Again, most will thankfully be ok but some of those will bear scars in one way or another
• I’ve had at least 4 out-of-hospital situations where I was the only doctor present. For the record, I’m not specifically trained in out of hospital medicine or trauma. Thankfully (sometimes miraculously), all have been fine in the end to my knowledge. I’ve had friends/family with an experience to the contrary
• 2 patients that I cared very much for passed away
• there’s been a breakdown in some interpersonal relationships
• to top it off, several pets have died

Throughout this, I was still working full-time. At one point, it became ‘the norm’ to have 2-3 new ‘events’ per week, whilst the others were still ongoing. It’s only really in the last few months that this has ‘stopped’ being the case. And like I say, none of this was really happening to me and so my sympathies were definitely directed to all of the people this was actually happening to. Not that many of them warranted ‘sympathy’ as such, because they were ‘strong’ or ‘fighters’… (I suspect I’ve said this before but as an aside, someone once said that when, for example, facing cancer, the dialogue around it can be more harmful at times. “It’s not a fight, it’s a disease,” they said. “And if I lose my “battle” I am not a loser or weak, it has just been a fact of life.” I’ve often been careful since to limit my use of this phrasing with patients unless they use it first.)

So yeah… I’m fine.

Right?

Well, yeah… but I have to admit, it has been somewhat… stressful. I found myself, and close friends/family also going through this, working on ‘just getting on with it.’ I’m good at compartmentalising- I don’t see my own stresses as the responsibility of my patients or colleagues to bear. As a result, I did shut down a bit. I’d work on keeping a smile on face but at home I’d find that I was engaging in unhealthy behaviours and my sleep became disturbed or erratic. I stopped exercising. I did what I could do to just keep afloat and be there for the people who needed me, much as my other close relatives were doing. I’m from a large family and I’m getting older- we all become unwell given enough time and there are enough people in my family alone to make this quickly significant.

And like I say, it wasn’t really happening to any of us that were well or healthy. It was just happening around us. We’re fine.

But I have to say, now that things are ‘settling’ to an extent (some of the family/friends are, of course, still going through troubling times unfortunately), I look back now and realise where I did well and where I could have done better. So I thought I’d reflect and share for others going through significant life events.

Several key things for surviving difficult/stressful times

Addressing the negatives:

• Tell your colleagues: I have a great bunch of work friends and bosses around me and when I finally felt able to talk about it more, they were SO quick to cut me slack, offer support to make sure I passed my competencies throughout the year, and offer me leaves of absence when I needed to take it. Honestly, they were brilliant
• Cut out unnecessary stuff: unfortunately, this had to take the form of leaving off my blog and instagram, saying no to extra projects and prioritising what needed to be done to ensure I stayed afloat and well for my patients
• Monitor your bad behaviours… and when able, work on improving them: sometimes, it’s just NOT the time to start a new exercise regime even when you feel flabby (sometimes though, it really IS so play it by ear). Either way, don’t put pressure on yourself; and when things get better, change one thing at a time if possible
• Don’t expect to be back to normal as soon as things start to ‘settle’: a friend of mine recently told me that their relative was told to expect it to take up to a year and a half to fully recover after stressful events. A quick google scholar look cites anything from weeks to 2 years. That time lag may be due to the type of event, previous experiences and individual coping mechanisms. But it is NOT due to ‘weakness’ or ‘strength’
• Tell who you need to as you need to, but tell someone: a number of my lovely friends have apologised to me for ‘not being there’ but I didn’t tell them!! I’m a generally positive person and it felt like it was getting unbelievable to be telling anyone what was occurring to be honest. I also didn’t want to ‘moan’ or bring others down, particularly when I hadn’t spoken to them for a while. And I had little positive/happy news to give them. But I did have a small group of people, mostly those immediately around me, who were aware of what was happening. That was important to ensure I was ok, and importantly, safe to look after my patients (which I was, which I take as a good sign in itself)

Positive thoughts:

• Do take leaves of absence: I held off for a long time. I wanted to ‘save’ it for the appropriate time. This is a bit daft- but as I say, I had good guidance from colleagues and we worked it out between us so that I managed to be where I needed to be
• Practice kindness: I made a point of keeping what was going on mostly to myself (rightly or wrongly) but I was also keen to remember that everyone at some point has a ‘full bucket’ and may be doing the same. As I was able to open up more, many told me their own stories of the past year too. Remember to be kind when someone seems oddly irritable or distracted- there may be a reason you don’t know
• Celebrate the positive: lots of good stuff also happened, particularly towards the ‘end’ of the tougher times- some friends/family got better, some continue to improve, some passed exams, some got new jobs/careers (including myself). Life sometimes sucks but it is a precious gift to be valued. Practise gratitude (there are good studies on the mental health benefits of doing this). Don’t feel guilty for celebrating the good amongst the bad- it’s crucial
• Just generally, don’t feel guilty: my family and I often tell ourselves “someone else has it much worse, and manages” but whilst that’s true, don’t downplay your own tough times (anyone who knows me will laugh at this statement because it’s TOTALLY what I do, but I’ve been grateful to those that have said this to me!!)

 

So yeah… I am fine. And I’m really proud of myself and my friends/family for what we have achieved and endured during this difficult year and a half. On World Mental Health Day, I know that not everyone would have managed to get through what we have without suffering significant mental health issues. One paper I looked at on ‘resilience’ mentioned that sometimes, that’s simply just due to experience. In my case, I think that’s true. I constantly checked in with myself to make sure I was healthy enough, I monitored my own behaviours and moods and thoughts, and I cut myself slack when I needed to. I also watched over others to ensure they were doing the same. In fact, I’m lucky to have been surrounded by family/friends (some obviously also going through this, some having it worse) and we worked hard to support and monitor each other. Thanks to all of them.

There’s no recipe or design for this stuff: always seek help if you need it.