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I have struggled with my mental health for most of my life. As a teenager I was diagnosed with anxiety and depression with obsessive compulsive disorder. After many years of intense therapy and CBT, I was finally in a place where my OCD was well controlled, and my mood was stable. I felt able to look forward and think about the direction I wanted my life to take. I decided that I wanted to return to university and study medicine.
Had I considered that medicine was hard and stressful? Yes, I had. However, I felt as though I had the tools to successfully manage stressful situations, that my awareness of my mental health would allow me to navigate this minefield – perhaps more successfully than those who had not faced the difficulties I had in the past. I was strong. I was capable. I felt ready to move my life in the direction that I wanted to go in.
A testing time
Then came the complaint. I won’t go into specifics, but in my first year of study, I had a written complaint made against me. Whilst it was largely the result of a misunderstanding, it was the start of an extremely difficult period of time for me. It once again made me question my self-worth, and the previously strongly held control of my OCD started slipping, little by little. My mood plummeted. I isolated myself from my support network. The rituals which I had virtually eliminated crept back into my life and began to take over once more. By the time I admitted to myself that I really wasn’t coping, I had already dug myself into a new depression.
The fact that I had allowed this to happen, when I knew and chose to ignore the right ways of dealing with my condition, was even more shameful to me. I found it even more difficult to admit to other people that I had slipped this far. This made things even worse. I was supposed to be able to cope. I clearly wasn’t good enough, which meant that I clearly wasn’t good enough to be a doctor either, right? Because I couldn’t admit out loud to struggling, I kept attending lectures and placements and kept up appearances as much as I could. Socially however, I withdrew completely.
Thoughts contemplating self-harm started re-appearing. My grades suffered. I rarely slept for more than an hour or two. I felt completely alone. How could I have been so stupid as to think that I could do this? That I could achieve my goal of being a doctor?
I continued to have to attend placement under the person who had brought the complaint against me and after a particularly bad day of clinical placement, I had finally decided that I just couldn’t continue with the course. I just wasn’t good enough. I was going to leave.
The only issue was that I had a surgical session booked for the next day (we had to complete a certain number of sessions each year), which was to start at 7.15am – far earlier than the office opens to tell them that I wasn’t going to attend. Worried than my non-attendance would impact future students who tried to arrange sessions with the consultant, I decided to go and tell the university I was leaving afterwards.
I am so thankful that I made this decision. It was like a dream. After I arrived, the registrar took me under his wing. He asked me questions, which I was able to answer, and praised me for getting them right. He let me scrub in. The senior scrub nurse praised my scrubbing technique. I got to assist and feel useful, unlike the usual feeling of constantly getting in the way. I then got to spend time with the anaesthetist, who let me intubate the patient and who quizzed me on the drugs they were using – and I knew the answers! I then got to scrub again and help amputate somebody’s foot. For the first time in what seemed like an eternity, I started to question if I was actually more capable at doing this medicine thing than I thought.
I went away and sat on my own in the park. I sat for hours, trying to think rationally about what I was doing. I re-evaluated the state of my mental health and realised that by continuing down the path I was on, I was just digging myself further into the hole that I had promised myself I wouldn’t end up in again. By ignoring the coping strategies I had previously employed, and by breaking the cardinal rule of “you must ask for help as soon as you start to notice that you are struggling”, I had to admit to myself that everything I was thinking about myself and the negative view I had of my capabilities could be, and probably was, the result of mental ill-health rather than an actual reflection of my abilities.
I decided to ask for help.
It was hard, and I cannot pretend it was an easy fix, but with the help of academic and wellbeing mentors, I began to re-employ the techniques which would make things better.
The medical school did not treat me as the failure that I felt I was. They were positive that things would improve and seemed willing to provide the support I would need to allow myself to get better. They did not seem to judge me for being mentally unhealthy, at least not in the way I was judging myself. They just made sure I was being supported to make healthy choices for myself.
It is hard to sit here writing this, realising how close I came to losing my way. In a few months’ time I will be a doctor and it is difficult to imagine my life if I had given up.
I realise more than ever that being mentally healthy is an ongoing battle. I knew before entering medical school that being open and honest about the state of my mental health was the way to keeping healthy. However, I let the shame of losing my way prevent me from following this through. This nearly cost me everything which I have worked so hard, for so many years, to achieve.
I plan to start FY1 by making sure that my educational supervisor is aware of the difficulties I have had and continue to have at times. I know that whilst this might be a difficult conversation to have, having it is not a sign of me being weak or unworthy of being a doctor. Being open and honest will make it easier for me to continue to be mentally healthy as I progress in the career which I genuinely love.
The author is a welsh medical student and has chosen to remain anonymous