Wednesday, 10 September 2014

The Black Dog Bites

A few years ago, whilst I was still at medical school, I wrote a post about various mental health issues I'd had over the years. There are ups and downs and these issues become more or less prominent a part of my life at different times. Today, the internet tells me that it's World Suicide Prevention Day, and for this reason I find myself thinking a little more about the black dog.

I wish I were as eloquent as the chap who made this lovely video, but I'm afraid I'm not, so I just find myself rambling and hoping that perhaps something I write makes a little sense.

As many people reading this will be aware, I'm now on a specialty training programme in paediatrics. I'd be lying if I said it was always easy, but on the whole I love it. However, it does mean I frequently meet teenagers who have similar problems to those I had at their age (and, to an extent, continue to have). This is something which I will always find difficult.

Back when I was on my adolescent psychiatry placement, I found myself wondering whether I would ever be completely recovered. I've now concluded that I won't. That may sound negative, and I suppose at times it feels negative, but there's also a bit of relief in admitting that I may never be 100% "better", and that it's ok not to be ok.

As I get older, I get better at recognising what triggers off my lowest moments. Although I can't always do much about them, it's helpful to know that they are there. Currently, I spend some of my time in a job where I do little more than observe. This is really difficult for me, as my mind isn't kept as busy as it likes to be, and I therefore find myself overthinking and drifting into negativity. Whilst this is frustrating, it's also good that I know it's partly the lack of intellectual stimulation which is problematic as it means I can at least attempt to find solutions (in true Learnaholic style, these solutions are at present an MSc dissertation, a systematic review and helping to organise a conference). I've also never been very good at adapting to changes - from crying in playschool when my milk was in the wrong colour cup to feeling nauseated when our high school French teacher said we could sit in different seats as a "treat" - I've always liked routine, so a 350 mile move and a new job was always going to be tough. There's a certain amount of help in just realising that actually, most people would find that hard and that it's ok for me to feel a bit out of sorts for a while.

Interactions with (especially teenage) patients who are having mental health difficulties are always going to be tough for me. One of the things I struggle most with is that I can't hand on heart promise that it gets better - and for that I feel inexplicably guilty. Guilt is, oddly, a very prevalent part of depression for many people. The ironic "you have nothing to be depressed about" comments are unhelpful for many reasons, not least that I *know* I have a good life and already feel guilty that I'm not full of the joys of spring without someone else mentioning it.

Once again I find myself having typed a stream of consciousness which may or may not make any sense, but having retweeted the link to my initial mental health-related post, I felt like a follow-up was overdue. This post wasn't meant to be all doom and gloom, although it seems to have turned out that way. I need to emphasise some of the positive things going on too. I graduated from medical school, completed my foundation training and got a place to train in the specialty of my choice. I'm 2/3rds of the way through a master's degree. I live independently. I am, on the whole, not doing too badly. 10 years ago, I didn't think I would ever get here. I guess, all things considered, I'm doing ok. 


  1. How do you balance work so you don't get burnt out? Working with people recently discharged from hospital...I eventually felt like I was sucked dry and had nothing left to give. Like you I have depression and like with it - I think it gives me a greater empathy with some clients, but there is also the danger that their problems can get too much.

    1. That's a good question, and one I don't really have an answer to. Keeping up with the simple things - eating well, getting enough sleep, getting some exercise - really helps though.


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