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When my depression started it was the most physical event of my life, the sensation was like a sharp knife cleaving my brain in half and the feeling of being drained through the soles of my feet.
I was a GP at the time and had been feeling increasingly stressed for the previous 12 months or so, with a plethora of fleeting, yet consistently unpleasant and worrying physical symptoms – mostly gut-related.
I took six months off to deal with my depression in 1986. Everyone in my practice was wonderfully supportive and understanding and I learned a lot about what matters in life.
Relationships and actions had no meaning, leaving only an increasingly exhausted will and lifeless body to force through the motions of day-after-day pointlessness. It also felt like a bereavement, because I had lost my fun-loving and compassionate self.
My psychiatrist was brilliant. His first intervention was a home-visit the very day I had to stop work on which he gave me a huge non evidence-based hug (he was a bear of a man) and told me he had every hope of my excellent recovery.
He said: ‘We will help you put your armour back on, Chris,’ and I knew even in the depth of my sheer fear and hopelessness, that he meant it. I was given hope and the expectation of recovery right from the start.
His support was unstinting and regular. He treated all his patients like this, with frequent visits and cups of tea and diverting conversations about medical dissidents in Russia.
My community psychiatric nurse, Tony, visited me every day, often for up to an hour during the first weeks, once again, tea, biscuits and a walk round the garden were de rigueur.
Recovery takes time and as is often stated is a journey not a destination. In terms of my life and work since 1986, I have learned that you get experience the day after you need it. This is precisely why caring and experienced others are so important in all our lives, especially during periods of distress and illness when our own resources can desert us.
I left general practice in 1999 to work in the mental health third sector, becoming chair of Depression Alliance and setting up the charity Primary Care Mental Health and Education.
I have enduring concern for the health and wellbeing of medical students, doctors and their training in the interventions and practices that will help them to look after themselves for life. Sometimes I wonder if I went into medicine to sort myself out; I do view my ‘version’ of depression as not just a cluster of symptoms or syndrome, but a necessary catharsis to enable ‘me’ to throw out a lot of unrequired junk. I have been even more productive since, which is why I believe that every life is precious and there is always hope.
I hope that as you read this, you will reflect on your own health and its importance to your life and work.
It was my experience of depression that led me to do what I did next in life and I cannot over-emphasise enough the importance of feeling held by compassionate and competent people at such a time. This is why I support the U Can Cope NHS Change Day pledge (see below).
If we can help the most vulnerable in their hour of need and our training and services are designed to help us to do so, then we can help anyone.
Chris Manning is chair of the faculty for mental health at the College of Medicine, a charity which promotes holistic, patient-centered healthcare, and director of UPstream Healthcare.
He was writing in favour of the pledge made for NHS Change Day on March 3 by the U Can Cope campaign, which is supported by Connecting with People, an organisation that provides free online resources and training in building emotional resilience, mental health awareness and suicide awareness.
The pledge says: ‘I pledge to develop my wellbeing and emotional resilience and encourage those around me to do the same.’
Dr Manning can be contacted at: [email protected]
I'm a young junior doctor recovering from a prolonged, severe depression that started in medical school and finally crushed me last year, such that I resigned my F2 post half way through the year. I decided to resign rather than take what I expected would be at least several months of sick leave as I didn't want to burden my colleagues who were already on an understaffed rota, expecting the trust to pay for a replacement with my would-be salary. This didn't happen.
After a year out of work, finally finding a medication that helps me and having CBT, I'm trying to find out about how to get back to work. I'm left in limbo, where no-one will give me advice on how to get back into training (this is how I ended up on the site today, looking once again for guidance and finding none), but the staff-grade jobs I can get will not further my career as they don't have the required tick-boxes. I've been pushed from pillar to post at every organization I try to contact. The foundation programme doesn't even have a phone number you can call "due to the amount of enquiries we receive on a daily basis"!
My medical school left me to coast along even when I went to them and explicitly begged for help and support (fobbing me off on the over-stretched university counselling service). They gave me little information about the foundation programme and did not advise me that I could request a post near to my family due to the risk of worsening my depression by loss of my support network until after I was assigned my post and it was too late. UKFPO sent me to a corner of the country hundreds of miles away from all my friends and family. I have been bullied by seniors and fellow medical students/juniors, regularly belittled throughout medical school and foundation training and found it utterly demoralizing to see poor practice swept under the carpet rather than investigated and learned from.
At this stage, I am highly likely to quit medicine entirely. Why would I pursue a career where, surrounded by so-called caring professionals, only a few individuals ever realized that I was “not waving but drowning”; where I'm so unvalued that none of the organizations responsible for doctors and their training will give me advice on how to get back into training after serious illness; where I daily worked hours of unpaid overtime to do the best by my patients only to get abuse from my consultant the next day for failing to record in notes one data point from an irrelevant blood test?
Like Dr Mohamed and ND above, I feel it's a terrible waste of my knowledge and skills, but if no-one will help me, what choice do I have? If only more people thought like Chris Manning. Many of the best doctors I've encountered have suffered from mental illness at one time or another. The way things stand, the less self-confident (cocky) and more empathetic medical students and juniors are being lost to an uncaring system. Survival of the fittest in action, where the traits selected against are empathy, mental illness and humbleness.
A bit late in the day........well done Chris! Good to hear your story! I am back at work again after another 6 year gap due to a combination of depression and leaving the speciality I am most suited for - A&E. I am back there again and really enjoying it!
Thanks for sharing your experience.
Sorry to read about ND and S but am glad you wrote
There is no doubt that a person who is on the" wrong" side of the empathy bell curve will find the job more stressful..... when you have the disposition to feel things so acutely its like having 10 antennas all picking up all the different signals in the area.
It is sad , that the very characteristics which might attract you to medicine, might be the very ones which lead to you leave the NHS. It is worrying if the empathic doctors/nurses get burnt out and leave. We all know that we need a mix (of types of people, as well as skills) to create an efficient team in any workplace.
I would like to say that I recently had an episode where I got stressed and was signed off with low mood. I spoke quite openly about it. It was quite amazing how many people took me aside and told me that either they were on antidepressants or a member of their family was. I would never have guessed . .... it made me realise that people still don't speak openly ....but also that people who are lucky enough to get support early, go on to have really successful careers ...
So fingers crossed ..... and thanks again Chris for starting this
Depression is caused by a wide range of issues. A chemical imbalance in the brain helps cause it. Stress is another major factor in depression. Daily life brings stress, period. Depression does not play favorites. It's a disease for rich people and for poor people. All the types of depression have similar symptoms. Dramatic shifts in personality and up and down mood swings are some. The advent of sleeplessness is another sign of depression. Helpless feelings or feelings that the future holds no hope are signs. When everyday life becomes a chore, that's depression. But the depression afflicted has hope.
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