Thursday, 6 February 2014

Time to Talk

In October I tweeted a bit about mental health and fitness to practice. I had a lot of responses. Mental Health problems are very common in doctors and medical students, but we are really, really bad at talking about it. There are so many reasons for that, but a big one is fear.

 I promised myself a couple of years ago, when I recovered from an episode of severe depression that nearly killed me, that I would not let myself stay silent out of fear anymore. It's hard for me to post this today. Much easier to talk about mental health problems that are in the past - not the grey that is currently enveloping my brain making me feel stupid and worthless and horrible. Playing that 'just wait 6 weeks' game to see if the SSRIs will work their magic this time around. I'm afraid it's going to get bad again. I keep having dreams about the last time, the worst time, when noone would listen until it was almost too late. Grateful that this time I have a lovely GP who listens and cares and jokes with me.

When I started uni the wording around what constitutes a fitness to practice issue seemed vague and that caused a lot of anxiety - would self harm be an automatic fitness to practice concern? My eating disorder? I was once confidently told by a trainee psychiatrist that putting me on anti-psychotic medication as an adjunct to my anti-depressants would mean that the GMC would not register me, fullstop. It's not true, but I was terrified I would be ending my career before it had started. When the only way of getting straight answers is to 'confess', it is little wonder that myths spread.

For the record, there are doctors working with mood disorders, anxiety and panic disorders, psychosis, personality disorders and eating disorders, amongst other conditions. None of these conditions automatically means that you are not fit to practice. The most important thing is that you seek help and you engage with treatment - both for you and because that is a big part of what defines fitness to practice. I have been in and out of treatment since the age of 13 and probably will be for the rest of my life. There is no shame in that. There is no shame in asking for the help you need.

This is not to say the profession is perfect. People still face discrimination during the admissions process, med schools are not good at making adaptations for disabled students and you will find that a lot of your colleagues have very negative attitudes towards patients with mental health problems. It's getting better, and it will keep getting better - as we get better at talking about our experiences and challenging our colleagues.

If you are struggling, right now, there are people who can help. Firstly, please feel free to comment here, email me at disabledmedic[at]hotmail[dot]co[dot]uk or DM me on twitter @disabledmedic. Occupational Health departments often offer counselling for staff and I have included some support organisations for doctors and medical students below. Please reach out. You are not alone. You don't deserve to feel this way. You are worth helping. We can do this together.

Doctors Support Network
-          Confidential support group run for doctors and students with mental health problems by doctors who have experience mental illness themselves.
-          There is a helpline 0844 395 3010 (opening hours on website) and an internet support forum as well as meetings and newsletters.

BMA Counselling and Doctor Advisor Service
-          Counselling helpline : 08459 200 169 (landline - 01455 254 189) available 24/7 365
(Confidential and can choose to remain anonymous)
-          Doctor Advisor Service : Call 08459 200 169 (landline: 01455 254 189) and ask to speak to a Doctor Advisor – you will be given someone’s contact information and hours of availability

Sick Doctors Trust
-          Support for and by doctors and medical students living with drug or alcohol dependence
-          Helpline : 0370 444 5163 (24/7 365) – can remain anonymous
-          Email :

British Doctors and Dentists Group
is a mutual support society for doctors and dentists who are recovering, or wish to recover, from addiction to or dependency on alcohol or other drugs.