Monday, 12 November 2018

Being a doctor with depression

It’s 3:12am on a Friday morning and I’m sat here writing this because I can’t sleep, and I’m hoping that writing this will help take some things off my mind.

I haven’t written on my blog for many, many months, purely because I have felt so good, up until a couple of months ago.

It all started on the first Wednesday in August, a day us medical folk often term ‘Black Wednesday’, due to the fact that most of the junior doctors will start new rotations that day. I had just finished my first year as a doctor, and was excited to move on - I felt good at my job and knew that I needed a new challenge. And A&E, my next rotation, would provide just that.

A couple of weeks into my job on A&E, the novelty started to wear off. I started to feel a niggling anxiety whenever I thought about work, which turned into a full on panic whenever I got near the building. I felt physically sick and couldn't stop crying, and really felt unwell whenever I went to work.

I took a couple of days off and was referred for counselling, which shed some light on the situation. It turns out that my personality and work ethic just aren't suited to A&E. For me to have job satisfaction and feel like I have done a good job, I need to get to know my patients and have a good rapport with them. I also need to feel like I have done everything I possibly can to make them better. This suited me on the wards as I was able to get to know all of my patients, but in A&E you have to see patients as quickly as possible, and can only really do emergency management for them, which includes giving them urgent treatments, referring them onto different specialties within the hospital, or sending them home with medication and reassurance. This is obviously a very important part of the healthcare system, and I take my hat off to those doctors that choose to work in the Emergency Department for the rest of their career, but it is an area of medicine that just doesn't suit me or my needs.

The A&E rota is also unrelenting - I often work 70 hour weeks and switch between day and night shifts erratically. I also have lost my weekends, working every other one, as well as often being on evening shifts in the week. It is a really unsociable rota, and I don't think it has helped in how I have been feeling.

With 4 months to complete on A&E, I knew I needed to push through so that I could pass my FY2 year and be able to train in whatever specialty I choose in the future. I had been put in a situation that I wasn't suited to, but I needed to make the best of it. With every single patient that I have seen during my time in the Emergency Department, I have tried to do the best that I could for them. This may have meant that I have been slower in reviewing patients, but it has made me feel safer and more satisfied with the situation. I have also made lots of plans to see my friends, family and boyfriend wherever possible, to have something to look forward to during a long week at work. And I have tried to take each day at work as it comes, rather than looking ahead and panicking about the amount of time I have left at work.

This worked for a while for me. However the past week I have begun to feel very depressed. Previous to this week it was more anxiety that was troubling me - the anxiety around making a mistake; discharging people home; or just generally worrying about not doing a good job on A&E. But the last few days it has been depressed thoughts and a low mood that has plagued my mind. I have felt really heavy, like there is something dragging me down, and have cried at the smallest of problems. I have felt exactly the same as I did a couple of years ago, when I was in the midst of depression, and cannot put my finger on what is making me feel so down. I feel depression quite physically, and have hardly slept the past few days, and have felt really achy and unwell.

I was worried by my lack of concentration and interest in things, so I have taken some days off work as sick days. I was scared that if I went into work I would make a mistake (or break down in front of a patient, which would have been embarrassing and unprofessional). Plus I have felt really unwell, and I realised that I need to stop feeling guilty for taking days off for the good of my mental health.

I have come home to my parents' house in the countryside for a few days, as I felt like I needed some fresh air and a hug from my mum. I have started to feel quite a bit better, which I guess shows that work is the main cause for my worsening mental health, and I needed a few days away to give myself some TLC.

The main reason I am writing this is because I want to show that doctors can become unwell, physically and mentally, just as much as other members of the public. In fact, it has been proven that a third of doctors have a mental illness and are at higher risk of suicide. Being a doctor is often very stressful and has a high amount of pressure, so it isn't surprising that many of us suffer with our mental health.

I move on from A&E onto GP in a couple of weeks, and I'm really looking forward to the transition as I think I am much more suited to being a GP - in fact, I think it is the career path that I will likely choose. Although A&E has affected my mental health, it has probably made me a better doctor and it is an experience that I will definitely learn from. I also realise that I need to take the time to look after myself, and working erratic shifts doesn't really suit me. I'm going to continue to do my best for the last few patients that I review in the Emergency Department, and will make the most of my last couple of weeks there (but will be very relieved to move on and will definitely not miss the annoying 4pm-2am shifts!).

Hannah x

Tuesday, 27 February 2018

Comfort Food by Julia Bettelheim

Hello. Hi. It's me, after over 5 months of silence!

What's my excuse? Well, I guess work has been getting in the way really. I get back from work and I'm so tired - the last thing I want to do is sit down and write a lengthy blog post. Being a first year doctor is really hard and really exhausting. I've been struggling a little recently with how often I'm working and worrying about decisions I've made at work when I get home, not being able to switch off and therefore not sleeping very well. I'm also generally quite busy in the evenings, so finding time to sit down and write is a bit difficult.

Anyway, onto why I'm writing this post...

I was kindly contacted and asked whether I wanted to receive a copy of Comfort Food by Julia Bettelheim. I have actually really got into buying cook books recently and trying out different recipes, so I was quite excited to have a read through and see what I could rustle up.

Comfort Food was written by Julia, who works in catering and hospitality, as she compiled lots of different recipes over the years and put them into the form of a cook book. The book is paperback and is not too thick, and basically does what it says on the tin - it contains lots of recipes for hearty food that I often find myself craving after a long day at work, or during the cold winter months.

It is split into 9 chapters - soups, light meals, main meals, cakes, desserts, tray bakes, muffins & cupcakes, biscuits and cookies, and England, Ireland, Scotland and Wales. All of the recipes are set out really clearly and are easy to follow. This is definitely a great book for a culinary beginner, but more advanced cooks may find some of the recipes slightly obvious (eg 'chicken and avocado baguette').

I'm not a massive baker so the cakes section is a little bit lost on me. However the tray bakes section caught my eye - I would definitely like to have a go at making Julia's 'malteser fudge slice'. A lot of this book is comprised of baking, but there are still a fair few main meals with easy to follow instructions and simple ingredients.

One of the only downsides about this book is that there aren't that many photographs. My favourite cook books are those with a photo alongside each recipe, but most of the recipes in this book don't have a photograph. However the recipes are all relatively simple, so I guess a picture is not needed quite so much.

I would definitely recommend this book to any culinary beginners that want some simple recipes that are easy to follow and would make some great dinner party staples. I have a few recipes that I'd like to try out, and it's always great to be able to make a simpler but delicious meal after a long day at work!

Monday, 11 September 2017

Having a routine is great for my mental health

I think that a lot of people may consider that having lots of excitement in your life would be best for your mental well-being - having something to look forward to, like a holiday, or something exciting and exhilarating like a skydive to bring your endorphin levels up. And all of those things are important, but I have found that having a routine has actually been one of the best things for my mental health.

I guess the mundane parts of life could, quite possibly, make someone depressed if they really did not enjoy their job. However I have found that having a routine and having to get up to go to work has really helped me. I am sleeping better than I ever have since I left school, and I've got into a routine that I really enjoy. I go to bed at a similar time every night (ahem, about 9.30pm...) and I have my relaxing time in the evenings just chilling in my flat, when I'm not socialising with friends. I also have my morning routine perfected and I usually make my lunch the night before and plan my outfits ahead, which really helps to make the mornings easier for a self-confessed night owl.

I also feel like I've got a purpose to get up for in the mornings, and I generally have not struggled to get myself into work. I'm also not too ashamed to admit that I quite enjoy the mundane parts of being an adult - cleaning my flat, washing my clothes, changing my bed sheets. I'm sure that will probably wear off quite soon, but I've found that I've really worked out what sort of time and which days is best for me to complete these tasks, and when I've planned ahead like that I really don't mind doing them.

I'm not saying that I don't want some excitement in my life, because I really do find that is good for my mental health too. But on a day-to-day basis, having a routine has been really great for me and has especially helped me get into a decent sleeping pattern. I think the fact that I'm enjoying my job has really helped, as I don't dread waking up the next day. It's just really nice to wake up in the mornings with a purpose, knowing that I'm going to help someone that day in one way or another :)
You will be amazed at how things fall magically into place once you let go of the illusion of control.

Sunday, 3 September 2017

How I'm managing my mental health as a doctor

One of the things that I was worried about when I started working as a doctor was how I was going to manage my mental health. I knew that I would be working long hours and have some difficult situations to deal with, and I wasn't sure how I was going to cope with that. As a student I struggled to do a 5 day week, so I was really apprehensive about the weeks that I would have to work for 8 days in a row.

However, amazingly, my mental health has been so good recently. Work has given me a focus that I haven't had before and has got me into a routine, which in turn has really helped my sleeping pattern and meant that I actually get to sleep fairly quickly after getting into bed. I also haven't struggled too much with getting up in the mornings and going to work, even on my 7th or 8th day in a row, as I know that I need to be in and I have a purpose that I didn't necessarily have as a medical student. I am enjoying being part of a team and having responsibilities, and that really helps me to get out of bed in the mornings.

My depression has always been high-functioning, and my mental health has always been better when I am busy and have a focus - for example, around exam time. I think being a doctor is possibly the perfect career for me because I am constantly busy and don't have much time to think about other things - plus helping others makes me feel great and I have enjoyed most days at work so far.

The harder days at work are those when I lose one of my patients or when we are short-staffed. Thankfully I haven't actually had any of my patients pass away so far, but one of them that I looked after for quite a while and had become quite attached to had to be transferred to another hospital, and that was quite an emotional day. I think it's quite good to have normal human emotions in these situations as it means you care about your patients, but at the same time you have to remain professional and strong in front of the patient. When I got home that evening I ended up crying to my mum, but I managed to stay composed in front of the patient and tried to do my job as best I could. There have, however, been quite a few days when there are a lack of doctors in my team in and that means that my work load is much higher, and those days have been hard. I had one of those days halfway through an 8 day week and was so tired that I got slightly upset in front of one of my seniors as I just felt like I needed to go home, but she was very understanding and helped me to work through my emotions.

I guess the most important thing is that I haven't felt depressed for the past month that I've been working as a doctor. I have had a few days where I have been upset, but that is completely different to feeling depressed and was a normal human emotion to some bad days at work. I've found that getting enough sleep has really helped me to function (I really notice it the next day if I've had less than 8 hours!), and I've also had lots of evenings to myself to just chill, eat food and watch Netflix. I have really enjoyed living by myself because it has given me the freedom to have time on my own when I need it, but also have friends over whenever I feel like I need more support or just want some company.

The most important things that are maintaining good mental health for me at the moment are lots of sleep, good food, relaxing evenings, seeing friends socially and chats to my mum. So far I'm really enjoying my life as a doctor - it is hectic sometimes but I wouldn't have it any other way!
No one has the right to judge you, because no one really knows what you have been through. They might have heard the stories, but they didn't feel what you felt in your heart.

Monday, 28 August 2017

A life catch up

Soooo... Long time no blog!

I haven't blogged for quite a long time and it's purely because I've been so exhausted and haven't had the motivation to log on here and write. I worked 8 days in a row last week and the thought of getting home and blogging really wasn't very attractive.

Work is still going well and I'm still enjoying it, but I have been really tired recently. I love being part of a team and having responsibilities, and I also enjoy being busy, but there are some more difficult parts of the job, such as losing patients and the long hours. Last weekend I worked 8am-9pm and didn't have a break all day - I didn't even get time to go to the toilet!

I'm still getting into the swing of my new lifestyle and I'm not quite sure where my blog fits into that yet. I feel like I hardly have any time to myself, let alone to sit down and write about how I'm feeling. I do want to continue to blog because I love it and it has helped me out a lot in the past, but I also don't want the pressure of feeling like I have to sit down and write every day like I used to do, because that's when I start to fall out of love with blogging.

Expect more blog posts from me in the future - but just not too frequently!

Oh and if you're wondering where the cute dinosaur planter is from, I got it from Morrisons and it was only £5. You're welcome.
The comeback is always stronger than the setback.

Tuesday, 15 August 2017

A much better day

Today has been 2896987587x better than yesterday!

As we had already completed the ward round with our patients yesterday, we were much more aware of their needs and what we needed to provide for them, so that made today's ward round much quicker. We also had completed a lot of tasks for those patients yesterday, especially the more sick ones or those that would be going home soon, so we had less work to do today.

And I managed to take blood from a patient with fairly difficult veins, which made me feel much better about the whole blood taking situation!

We were able to finish the ward round with plenty of time for lunch (and a quick pep talk from the F2 on my team), and I found that my jobs were done and the list was updated by about 3.30pm. Which left me time to be able to help my fellow F1s out with their jobs, and still leave just after 5pm. It was overall a much easier and more satisfying day than yesterday.

But the best part of my day was probably when I was walking out of the hospital to get to my car. An excited/nervous new dad was on the phone shouting "THE BABY IS COMING!!!" and it made me smile so much - it reminded me of the best parts of my job and why I love medicine so much, which is exactly what I needed after yesterday.

Hannah x

Monday, 14 August 2017

Sometimes I question why I chose to become a doctor

On days like today, when I seemed to be working for hours on end and everything went wrong and nothing went right, I question why I chose to become a doctor.

Today both of our seniors were away so myself and another junior doctor had to do a ward round to see all of our patients. Some of these patients were quite unwell, and as we are junior we didn't feel comfortable managing them by ourselves. Everything took that little bit longer because we were checking and double-checking everything, as we didn't have our seniors to rely on. Then I had to go and take blood and I missed three times, which was so frustrating. By this point it was 3pm and I hadn't had chance to even think about lunch - by the time I was able to grab a sandwich I had to sit at a computer to write a discharge letter while I was eating it. Everything just seemed to take a long amount of time, and I felt like I didn't even get a minute to go to the loo or have a drink (until my pounding headache reminded me that I had a bottle of squash in my bag). I ended up finishing about 6.15pm, which wasn't as bad as it could have been, but I still ended up doing a 10 and a half hour day. To sum it all up, it was a very long, difficult day that I don't wish to repeat any time soon!

Sometimes I think about quitting and getting a normal 9-5 job, where I know I could leave at 5pm on the dot and not have to worry about work afterwards. Sometimes I am really envious of my friends and family that have 'normal' office jobs and are able to lead a separate personal and professional life. Medicine becomes a lifestyle that you cannot easily escape when you are a doctor, and sometimes I resent that.

It's days like today that I have to reflect on the positive aspects of my job. The reason I'm a doctor is because I wanted to help people, I love learning, and it just seems to fit to my personality and who I am. When I started medical school everything just seemed to fall into place, and I knew it was the right career for me. And I do love it. Most days the job satisfaction is incredible, especially when I feel like I've really made a difference to a patient or their family. Even if that's just being able to get them home quickly or sort out their first meal after an operation.

I always knew that being a doctor would bring really difficult days, but I guess I could never prepare myself for how hard it could sometimes get - and I bet today wasn't half as bad as some of the days I will face in the future. Today I felt like I was letting the patients and my team down, even though I was working to the best of my abilities. I did feel like having a little cry when I was in the treatment room gathering all of the equipment together to try and take blood yet again!

But I got through it, and I know that tomorrow will probably be a better day. After all, I am still learning a lot of things, and skills like blood taking will just come with practice.

Hannah x