I’m a doctor, and I have a mental illness
There you go, I wrote it. Nobody died. The world didn’t end, and I didn’t start hyperventilating. But why did I find it so hard to write?
For the past six years I have experienced episodes of depression and anxiety. Throughout medical school I took antidepressants and had difficult times, but generally I functioned normally, and only required some intervention from my general practitioner. But last year I reached a crisis point, and I have decided to share my story.
I had been working as a foundation year one doctor in an emergency department. After the initial trepidation, I loved it. One day, a patient who had attempted suicide was admitted. Listening to that patient’s story triggered painful memories that I had buried long ago. Three days later, when at home and away from the distraction of work, I had a mental breakdown.
In less than a week, I had changed from a well functioning junior doctor to “borderline psychotic”—the psychiatrist’s words, not mine—paralysed by fear, unable to sleep, eat, or speak properly. I struggled to determine what was real, and had terrifying, intrusive thoughts.
A few weeks later, I opened up about what I’d been through in my past. I told my parents, who then contacted the psychiatrist who was looking after me. I was immediately rediagnosed as having post traumatic stress disorder.
I had intense trauma based psychological therapy and was put on a concoction of drugs. I could not see a way out. I convinced myself that I’d never be able to return to work and have the career I’d worked so hard for. I felt that I would be judged or seen as weak and unable to cope. In fact, the harshest judgment I experienced was my own. I realised that I was approaching my illness differently from how I would do for a patient in the same position.
Why do people in the medical profession do this? Why do we resist opening up and judge ourselves differently from our patients? Perhaps we need to live up to certain expectations set by us and by society. Maybe it is that we don’t like to admit to being unwell because it is our job to look after others, and our patients rely on us. Or could it be fear of intervention from the General Medical Council and the negative impact that would have on our careers that stop us from opening up about our problems? Today’s litigious society has developed a certain degree of paranoia in us about our day to day practice: perhaps it is this that prevents us from admitting that we might not always be 100% capable. But it doesn’t matter why. The point is, something needs to change. An estimated one in three doctors have mental health problems at some point, yet we seem so afraid to deal with it, which is extremely hypocritical.
My experience was acute and unexpected, but most mental health problems exist under the radar. Medical students and doctors should be encouraged to seek help early and not be embarrassed or afraid to admit to mental health problems. Medical schools, the UK Foundation Programme Office, and the NHS provide help and support. The only way to break the cultural stigma within the profession, however, is for more doctors with mental health problems to speak up, and to show that seeking help does not make you a less competent doctor. Negative outcomes are far more likely to occur by trying to carry on without the right support instead of opening up about your problems.
My recovery has not been straightforward, and there were setbacks along the way. It took almost six months—and a lot of hard work—for me to return to my job. My supervisors and the occupational health department have gone out of their way to make my transition back as smooth as possible, and I cannot thank them enough. I have spoken to only a few colleagues about my illness, partly because it is difficult to talk about, and partly because I am never sure how to explain it. But those I have spoken to about it have been supportive. I know that because I survived these past months I can survive anything.
It is often said that you should treat others as you would like to be treated yourself. So why do we doctors treat ourselves differently from those we treat? Perhaps it’s about time we took our own advice.Anonymous,
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.
- British Medical Association. Doctors’ health matters. 2007.
Cite this as: Student BMJ 2015;23:h2819