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Only Human – Episode 8 – The Bipolar Doc

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We are more than doctors and nurses and paramedics and patients. We are the sum of the stories we tell. Stories that have a beginning, a messy middle and, one day, an ending.

In this series, we want to remind you that we are all ONLY HUMAN.

Becky Platt: 0:01

Welcome to only human, a podcast from Don’t Forget The Bubbles. This is Becky Platt with Henry Goldstein. And these are the stories that reflect the diversity of our community and the multitude of life events that come our way that shape us as professionals. And as humans. My guest today has asked to remain anonymous for this podcast, preferring to be addressed by her Twitter handle The Bipolar Doc, I start off by asking her why

Unknown: 0:29

I go by the Twitter handle The Bipolar Doc. And this is something that I set up about four years ago now, when I was recovering from an episode of mental illness, the handle and the anonymity allow me to speak out openly about mental illness in medicine. Without that, I feel gagged because of the stigma. And it’s a shame that we still work in a culture where that exists. But for now, I remain The Bipolar Doc,

Becky Platt: 0:55

Can you tell me what you think would happen if people knew who you were?

Unknown: 0:59

I worry that I would not get a job, I worry that I would be seen as unreliable, unpredictable, weak, vulnerable, and somehow less of a doctor because of my diagnosis of type two bipolar. And that makes me incredibly sad. And it’s a big weight to carry. But stigma prevails in medicine. And until I feel confident that I can overcome that, and I can be strong enough to advocate for myself, I just feel scared.

Becky Platt: 1:31

It makes me feel sad that Bipolar Doc feels this way. And I wondered what other ways she feels that she can’t be herself as she starts her story.

Unknown: 1:40

I have a history of mental illness and have done since I was a teenager, I was admitted to a psychiatric hospital when I was about 15 with an eating disorder, and I had depression and anxiety. And when I started medical school, I disclosed that I was immediately invited to an occupational health meeting, and sort of felt already like that vulnerability was going to be a hindrance to my career. But I threw myself into my studies and was very ambitious, very conscientious and kind of came out with prizes and awards and medicine became my crutch and my coping strategy. But throughout all of that, I didn’t talk about mental illness. I started my training in paediatrics and absolutely loved it right from the get-go. And that ambition and enthusiasm fueled this inability to say no, and I was taking on more and more and more, and somehow that was creating more and more validation. And the more I succeeded, the more I felt worthy as a doctor.

Becky Platt: 2:49

For a while, Bipolar Doc continued in her career without ever talking about her vulnerabilities. But after giving birth to her second daughter, things changed.

Unknown: 3:00

When my second daughter was born, I had quite bad post-natal depression. And whilst off work, I reached out to my GP and I started therapy, started medication, Then it came to coming back to work after maternity leave. And at this point, I finally thought I have to tell someone about this, I am safe to go back to work, but I need to admit this vulnerability because I need support. And so I explained that the Encore shift I was voted to do on my second day back probably wasn’t a very good idea. And lo and behold, the staffing situation meant that on my second day back I got handed the crash bleep for a new tertiary paediatric hospital. And it broke me. I remember walking along the corridor holding this bleep and finding a cupboard and I dived into this cupboard, and I literally sobbed and I sobbed and sobbed because I felt weak. Everyone around me was coping with this encore shift. And I was in bits. I didn’t feel like there was anybody that I could speak to. So I carried on because that’s what you do. And I did find a brilliant mentor at that time, and she helped support me, but in my mind, there was absolutely no way on earth that I could take time off. And so it snowballed. I became more anxious, my mood deteriorated, became quite low. And the enthusiasm and passion and empathy that I had had in abundance from my patients became replaced with this bitterness and cynicism. And I realised I was burnt out and mentally ill. And that brought shame.

Becky Platt: 4:42

As I listened to Bipolar Docs’ story, I recognise the familiar theme of other interviews in this series, that medicine is such a big part of our identity. And if it’s taken away from us, or we can’t perform it to the best of our ability, we somehow don’t feel complete as humans.

Unknown: 4:59

Then that got to the point where I was under a psychiatrist. And he sort of said, Right, okay, we’ve got a choice where we can carry on. Or we say, right, you need a break, and you have some time off work. And I sobbed. I cried for my patients that I was letting down all of these ones I said, I’ll see you in a few weeks, I tried for my colleagues that I was burdened with all this extra work. But at no point in all of that, did I cry for myself, I couldn’t see that I deserved time off and that I needed time to heal. That was really challenging at that point at which I became the patient. Things definitely got worse before they got better. Three weeks off sick turned into 11 months off sick. And during that time, my psychiatrist realised that I hadn’t really responded, as he would have expected to the antidepressants, the anxiolytics and things. And we started to realise that in and amongst the deep lows, there were actually periods, where I was very creative, very able, and speaking very fast colleagues at work, had said, goodness me your brain works so quickly slow down because people can’t keep up with you. And he began to think that these episodes were actually hypomanic episodes. And so he changed the diagnosis to type two bipolar, which I found really, really hard to swallow initially. But I was started on mood stabilisers, so I take you much gene twice a day. And from that point onwards, I got clarity, my mind quiet and I could see things much more clearly. And at that point, returning to work seemed possible in a way that it hadn’t done up until then I think, I really hadn’t realised how integral being a doctor was, to my identity until this point. And I remember a therapy session where I met the practitioner for the first time. And I introduced myself as I’m a paediatrician. And she said, as I left, that it wasn’t until five minutes before the end of the hour-long session that she realised I had children, because that was the identity I was adopted before anything else. How wrong is that? And now I am, before anything, a mother and a wife. That journey that I’ve been on in the last five years has taught me that, and I’m hugely, hugely grateful for that journey as a result.

Becky Platt: 7:35

I think one of the hardest things to hear actually, is that you could cry for your patients and your colleagues, but you couldn’t cry for yourself. I just wonder why that is?

Unknown: 7:48

I think that stemmed from medical school. I remember this lecture about the GMC, and about the importance of prioritising our patients, putting them first and the concept that I was becoming the patient myself, the concept that I no longer had the caregiving role and I had to accept care from somebody else it felt inherently wrong. My identity as a doctor was being stripped from me, and I no longer knew who I was at all.

Becky Platt: 8:23

I was so pleased to hear that Bipolar Doc’s treatment had allowed her to return to work, but I was curious to know how it felt to return to such a challenging environment after such a traumatic time.

Unknown: 8:37

So thankfully, the point at which I returned was very different. I had a brilliant mentor who was one of the associate Dean’s within the deanery and I access the supported return to training scheme. And through this obtain supernumerary training I wasn’t doing on calls, I was working part-time. And that brought much more supervision, but from a sort of emotional point of view. So the return to work went much better. However, I realised that by this point, I had lost the love. I had mainly lost the love of the NHS. And I felt still quite bitter that the system failed to value those that kept it going, essentially. And I think I felt failed by the system myself as a patient because throughout all of this, I have never been able to access NHS psychiatric treatment. It has all been private because the waiting lists were such despite having suicidal thoughts and being really unwell. I couldn’t get seen and that was really hard. So I decided after a year of proving to myself that I could be a doctor I decided that it was time to think about no longer being a doctor. And if I’m completely honest, I did feel backed into a corner a little bit. My supernumerary funding was going to be removed, the adjustments that had been put in place were no longer really going to be possible if I was going to continue through my paediatric training. And I thought, You know what, I don’t want to feel like I’m being pushed out, I need to take control of this, and I need to choose to leave. So I left in the summer of 2019, to become a primary teacher, which was lovely. But unfortunately, I realised fairly quickly, actually, that primary teaching wasn’t giving me what I needed, and that I began to miss medicine. I missed the humanity of medicine, the unbelievable privilege that we have to be part of people’s lives at a time when they really need the window and the honour that we have to be part of their journey. And I’m realising that there is nothing like that. I know that communication was something that I was good at. Empathy was something that I had in abundance. And it was burnout that made it go away. It wasn’t that I no longer have that skill. And that is what I miss most. I also miss the challenge of medicine, the intellectual puzzles that are involved in diagnosis in clinical decisions, I miss the teamwork and the sense of belonging that we have within those amazing opportunities for collaboration, and negotiation. I just miss medicine,

Becky Platt: 11:45

The way you describe it, and the passion that you have, and particularly what you say about being there in the moments that shaped people’s lives, that is exactly how I feel I can identify so strongly with that. That is quite amazing for me to hear. I was sad to hear that, despite overcoming her challenges with her own mental health, Bipolar Doc had left the profession. But I was also curious to know how she now copes with her mental illness, as well as being a mum, it’s not easy.

Unknown: 12:17

For me, medicine was never the issue, medicine in itself, the inherent clinical nature of medicine, it was juggling everything else, the pressures within the NHS, the peripheral work that is expected of us the audits, the research, the teaching, the supervising all of that, whilst trying to be a good clinical doctor. And then there is life outside of medicine. And it’s when you add in all of that, that I start to become very anxious, I struggle with panic, post-COVID. Having had these periods where you know, you don’t go anywhere for such a long time, I struggle with social anxiety now, and I’m finding it really difficult in train stations, and busy environments, and my children do get a sense of that. My mental health affects them. And that’s something that I find really, really difficult to deal with. But I also hope that my experience will equip them with emotional literacy with an ability to identify their own feelings, we talk very openly about it, they know that I take medication, they know that I have an appointment every week because I have nothing to hide. I want them to grow up in an environment where they can talk about their mental health. And that is something that I do feel proud of.

Becky Platt: 13:38

So you’re equipping your children with that emotional literacy and the ability to talk about mental health as a normal part of life. But it’s actually not something that we’re yet able to do in healthcare.

Unknown: 13:54

No, not at all. And for me, it is so obvious now that we are all human, we are all vulnerable and have our frailty. Yes, not everyone experiences mental illness or burnout. But that’s not even what I’m talking about. I’m just talking about the reaction that we have after the death of a patient so many times I have been to really traumatic resource scenarios where the second we leave that room, it’s sort of brushed off and you return to some slightly more trivial job as though nothing has happened. And nobody then discusses the emotional impact of that. And so I remember driving home after these scenarios, bawling my eyes out thinking why is nobody else upset? What is wrong with me? Why am I like this?

Becky Platt: 14:50

I think the reality is probably most people are upset and probably most people went home and cried in the car, but most people didn’t feel that it was okay to say.

Unknown: 14:58

Yeah, I couldn’t agree more and why do we not have these conversations? Nobody is talking like this. And you know, medical students and junior doctors are coming through the system with this perception that it’s not okay to talk about how we feel after these really traumatic incidents. And I don’t just mean patient deaths. It’s also juggling the pressures of work juggling the router gaps being told that you have to go home in order to come back and cover a night shift. That’s not okay. And it’s all right to say, goodness me, I feel completely overwhelmed. I haven’t slept. I’m really hungry. Please, can you check in and support me? Why is it that we still live in a culture where there are no role models for us?

Becky Platt: 15:51

I think you are that role model.

Unknown: 15:53

Well, I hope so. But sometimes you don’t feel like as one individual, you can change the world. And this is something that I, through talking really hope that it allows other people to share their stories. And the more we share our stories, the more I think culture will be able to change.

Becky Platt: 16:16

I could see how passionate the bipolar doc felt about the dire need to turn the dial on stigma relating to mental health in the medical profession, an opinion that she began voicing as far back as her return to work after her sick leave.

Unknown: 16:31

I began to tell my story initially on a very small scale, it was within the department, I realised that actually I looked around and nobody was really okay. And as I spoke, how to be that on a one to one basis, or I did a couple of sort of informal departmental teaching sessions on wellbeing, using my story as a sort of crutch to do that. People started sharing their stories. And I realised that consultants that I had worked with for years are the trainees around me, nurses, loads and loads of people had their own journeys, had their own emotional struggles. And I had never been alone. Yeah, I had spent all these years trying to hide my own vulnerabilities with this sense of shame, and weakness. And that was strangely empowering. And so that then sort of fueled my passion to speak out. And I remember writing an abstract for our regional paediatric conference. And thinking this is not really worthy of an abstract. This is just my story. And I stood up for the first time in front of about maybe 200 people, and I told my story, and afterwards, the emotional reaction of myself but of everybody in the room was so powerful. And the impact that that story had had made me realise that I have a voice. There are health professionals out there who no longer have a voice. And that could have been me. And I now have a duty to those health professionals who are no longer with us to speak out, because things have to change.

Becky Platt: 18:29

Thanks for listening. You can find more episodes of only human as well as details of events, courses, and other resources at don’t forget the bubbles.com Until next time,

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