Throwing the gorgeous bunch of flowers in the bin, I took one look at my ‘celebrate’ balloon and popped it.
Then I retreated to my hospital cubicle and burst into tears.
Yes, I may have passed my clinical exams and graduated from medical school but I couldn’t have felt less in the mood to celebrate. Because I wasn’t at my ceremony, in my cap and gown, or out for lunch with my loved ones.
I was sectioned, in a psychiatric ward.
Most people don’t expect doctors to experience mental health crises: we look up to medical professionals and want them to be unflappable and infallible. Yet, as I discovered, doctors have vulnerabilities too… and the stigma they feel when they fall ill can be devastating.
When I first started medical school in 2001, I was your typical student – middle class, high-achieving, and involved in extracurricular activities, including playing in a church band.
During this time, I undertook a placement in a psychiatric unit. I remember seeing a group of patients gathered in one corner of the canteen. Seated with the doctors at the other end, I felt untouchable.
Then, in my fourth year, my mental health began to deteriorate. The first signs of a problem were unexplained back pain and fatigue, which led to a gradual withdrawal from academic and social commitments.
Then, aged 23, I began to lose interest in things I’d previously enjoyed, like classical music and reading. I became tearful and low in mood, before hitting utter hopelessness.
A few months later, my aunt asked me if I thought I was depressed. It brought a mixture of relief and panic. This thing had a name and might be treatable. But I was starting fifth year at medical school – surely doctors didn’t get depressed?
After going to see my own GP, I received a formal diagnosis of depression, but I felt ashamed and determined that my friends mustn’t find out.
Although I continued to do well in my studies, my thoughts darkened, and my appetite vanished. My demeanour and weight loss made my illness impossible to conceal.
In January 2007, I was admitted to a psychiatric ward because of severe depression and weight loss. A few days later, I wanted to leave, but was sectioned because I had spoken of suicidal thoughts.
When I graduated, in July, after doing my exams as an inpatient, I felt unable to celebrate when I was so far from being able to work as a doctor.
At this point, I’d been diagnosed with major depressive disorder with an atypical eating disorder. I was experiencing thoughts of suicide, was on heavy medication and had disengaged from talking therapy.
This had to be rock bottom, I thought. Little did I know I was going to plunge to far lower depths.
A year after graduation, I was no longer in hospital but not making much progress and definitely still unfit to work as a doctor. In fact, I was unable to work at all.
I felt as if my peers had left me behind, and stigmatised by some who walked past me without making eye contact or excluded me from social events.
When I tried to talk to one former friend, she said, ‘It’s a bit awkward now, isn’t it? – now that you’re a psychiatric patient…’ I felt rejected and relegated to the professional scrapheap.
Though I was based in the UK, an opportunity to have intensive mental health treatment in the United States arose – funded in part by an American charitable trust and in part by my family.
There, I found hope through the rediscovery of my Christian faith, and it was also where therapists started to say that I was dealing with more than just depression.
They were proved right when, a year later, back at home in the UK, new symptoms emerged. Elated in mood, with racing, unintelligible speech and a burst of creative behaviour, my psychiatrist told me that I had bipolar disorder.
I was prescribed lithium, and I did well for a year. More support became available to me, and I felt that I knew what I was dealing with at last.
‘I can handle this,’ I thought. With no license to practise clinically as a doctor, I successfully completed a postgraduate course in Medical Education at this point.
I knew that bipolar disorder was classified as a ‘severe and enduring mental illness’ and that this would carry greater stigma than depression, but I got a job teaching anatomy where I could use the title ‘Doctor’, and this helped me to regain a positive sense of self.
I thought I was recovering, that life was slowly getting back on track – but then, in 2011, came a rapid descent into psychosis.
Psychosis is a detachment from reality, characterised by hallucinations and delusions. For me, it involved three distinct phenomena – each of them terrifying.
First, I became aware of an ‘evil presence’ lurking behind my left shoulder. I couldn’t bear to look round at it, but I was 100% certain that it was there: I could feel its dark energy.
Secondly, I would see shadowy pterodactyl-like creatures flapping around my head, laughing mockingly at me. I came to call them my ‘tormentors’. I would shout, ‘Stop it! Stop it!’ at them but they only teased me more. I’d cower in a corner on the floor, nose to my knees, arms crossed over my head.
Thirdly, I became aware of messages being transmitted directly into my brain via the ‘network in the fourth dimension’. I didn’t recognise these thoughts as my own and believed God had chosen me to receive them. That my psychiatrists were trying to drug me so that I could not bring truth to light.
I’d never felt so alone.
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My brain had once been my greatest asset, but now I was hallucinating and too distrustful to work with those trying hardest to help me.
Thankfully, I had some patient, gentle doctors and nurses who convinced me that I needed antipsychotic medication to dampen the excessive dopamine activity in my brain. Eventually, we found that haloperidol, an antipsychotic, worked well.
After 18 months, my diagnosis was updated to schizoaffective disorder, a mental disorder in which a person experiences a combination of symptoms of psychosis and mood disorder. This was difficult to swallow. That ‘schizo-’ prefix felt even more stigmatising, and I knew of no schizoaffective person who functioned normally in society.
In 2016, I was referred to a Recovery College in my Health Trust, where peer specialists, with lived experience of mental illness, taught that recovery was for all – not in the sense of ‘cure’, but in having a life worth living.
Although I might never be completely free from the symptoms of schizoaffective disorder and I would most likely always need drugs, I could become fulfilled and find meaning.
I began to pursue this for myself. I attended courses in areas such as mindfulness and managing low mood, and I invested heavily in my strengths and interests so that the negatives in my life – including stigma – held less power.
Over time, I built a ‘Wellness Recovery Action Plan’ with tools including mindfulness, breath work, and intense exercise. I drew more intentionally on support from my husband, family, and friends. I continue to use this plan to this day.
My faith became an important source of strength, too. Skills drawn from cognitive and dialectical behavioural therapies equipped me for the inevitable bumps in the road.
So, when I went through a period of depression last year, I was able to use mindfulness practices to weather the worst waves of sadness. By then I knew that every emotion passes, and I only ever needed to cope with one moment at a time.
I never did go on to work as a doctor, but I’ve been able to use my medical knowledge in the books and articles I’ve written, which has helped to mitigate my sense of loss.
Four years on from my last psychotic episode, I’m a wife and mum. I still struggle with depression, but my life is undeniably worth living.
Sometimes, people still recoil when I mention my schizoaffective disorder; sometimes I feel I am treated as though I am less intelligent or even as though I might pose a threat.
But through my writing, I am working to promote education and empathy, which helps me to cope with this.
My story highlights that anyone can develop psychotic illness – but also that there is life after diagnosis.
With greater understanding, we can combat stigma together, and point sufferers towards hope.
Need support for your mental health?
You can contact mental health charity Mind on 0300 123 3393 or text them on 86463.
Mind can also be reached by email at [email protected].
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