Getting over the stigma hurdle

One step towards improving our mental wellbeing is learning to admit when we are not feeling well

Today I “attended” the IMO AGM, by which I mean it was transmitting from my laptop while I pottered about tidying up after breakfast, reorganising the knives in the dishwasher and putting on the fifth load of laundry. I glanced at the screen occasionally to watch the wonderful new President Dr Ina Kelly and her colleagues deliver their speeches. The CEO, Susan Clyne, began to present the findings from a recent survey about doctor wellbeing.

She told us that 70 per cent of the doctors who took the time to participate in the survey showed signs of burnout. I stopped moving the plastic plates from the bottom shelf to the top one and looked it up. Some 66 per cent of GPs had been unable to take time off due to difficulty finding locums. Eighty-five per cent of doctors had nine or more hours added to their working week during Covid times. Eighty-seven per cent had to cover out-of-hours shifts on top of that.
What the actual fork.

I abandoned the Weetabix-encrusted bowls and sat in front of the screen, head in hands. Of course I knew all of this to be true. Of course. But I thought about my friends and colleagues, my daily contacts and the faceless names on the hospital letters, and I thought about the pain and hurt in each of their hearts.

Later on in the day, a panel discussed the mental health issues that Covid has triggered in the general population, and in doctors. I asked what is the main barrier which prevents doctors from seeking help for mental distress, and the answer from Dr Íde Delargy was “stigma”. We are too ashamed to say we are struggling.

I have suffered from anxiety since I was a teenager. My first panic attack happened on the way home from Mór Disco one night in First Med. I lost my shit, as they say, but put it down to the €2 Tequila Sunrises. In fact I was scared, and worried and uncertain, and it manifested in physical symptoms of dyspnoea, tachycardia, and headrush. I had subsequent panic attacks in my sleep, which frightened the bejaysis out of me.

It wasn’t until I had a miscarriage in my late 20s that I decided to proactively seek some help for my anxiety symptoms. I looked up the Health in Practice Programme page on the ICGP website and found a therapist who worked nearby. Her house had a red door. I sat on the chair and cried. Occasionally I sobbed and the breathlessness and heart pounding was exactly the same sensation I had felt during the panic attacks.

I had another miscarriage and it happened again. I went back to the red door. When I was diagnosed with advanced cancer it was easier. You’re supposed to lose the nut then. I went to ARC House and sat on the couch and sobbed. A huge lump of fear gathered at my throat and stopped my words from coming out. The kind lady didn’t mind. She waited. And then the words came.

There was a Milligan-esque relief in these counselling sessions – “I told you I was ill.” It was as if my once-silly fears were now legitimised and I had ‘real problems’ to talk about. And yet it wasn’t the imminent death that worried me. It was still the niggling doubts about my social interactions, the internal struggles with my personality foibles, the guilt and doubt about previous behaviours. The desire to be a better person in my dying years, clashing with the fundamental truth that sometimes I am simply mean.

I had a month or two of very low mood after I completed a shedload of chemotherapy. I have developed a number of tricks for combatting anxiety, but I was totally caught short when it came to dealing with depression. It was terrifying, but thankfully it lifted. I attended a mindfulness-based stress reduction course for people with advanced cancer, which helped. I needed to move away from cancer, though, so I haven’t gone back to ARC House for therapy. The red door has been painted blue by its new owners. My wonderful GP has died, but I am building a relationship with my new one. I try to cultivate my self-awareness and keep track of the ups and downs of my mental wellbeing.

I am never ashamed to say that I don’t feel mentally well, or that I am having an off-day. I make myself do the right thing when it comes to going to my GP for bloods and prescriptions (a massive 40 per cent of doctors who completed the IMO survey said they had no GP). I try to talk to other doctors about looking after themselves. What I really want though is for us all to be able to say, without shame, “I don’t feel well.”