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The Blood-brain barrier of mental health: resilience

*DISCLAIMER* this blog talks about domestic abuse, depression and anxiety. Please avoid reading further if you think you will be triggered. 

On the evening of May 12th 2015 I was physically and emotionally abused for the last time by my ex husband. I was kicked and insulted repeatedly. When I asked him to leave he walked out with my labtop. It had my MSc research, and he knew I needed it. Thankfully he returned it back to me after some pleading and negotiation.

I managed to record some of the verbal abuse and forward it to my dad "he has also has hit me again, I've had enough and this time I'm not changing my mind" .

Initially I wasn't upset when I left for good but felt a bit numb, drained and fed up. I felt relief- finally! I've plucked up the courage to walk away and start afresh for good. I felt strong about my decision- moving mountains wouldn't change my mind.

I reasoned with myself that I was never in love and have no on going commitments with him. Once the divorce is finalised I will be free and it will be a clean slate. Now I can focus on my PhD, paediatric oncology and life without domestic abuse and anger. I had spent 7 years coming to terms with the demise of the marriage and simply saw the divorce as 'closing a chapter' in my book.

I started my next chapter moving into shared accommodation but I had no idea that the next 4 years would be even harder then 7 years abusive marriage.

Whilst in the midst of an abusive marriage I felt a range of emotions- happiness, sadness, despair (will this be my life for ever?), anger (why me?), confusion (is it my fault?), resolve ('I will put myself first before the marriage') but I never really felt depressed.

Unexpectedly, depression and anxiety hit me and at times, I strongly felt like I didn't want to live anymore. I would justify why everyone and the world would be better off without me, and started thinking about how to proceed.

Thankfully, working as doctor has enabled me to have insight - I've always known this is 'depression' speaking rather than my true self. I kept myself busy from my thoughts- PhDing, doctoring, running and weightlifting whilst seeking help (antidepressants, counselling, CBT and psychotherapy). I felt the day I stop being busy is probably the day I'd actually give in.

I kept telling myself time is all I need, and one day this would be historical.

Thankfully that time has come. When I look back it feels like a distant memory and it certainly doesn't feel as 'fresh' and as 'real' as it has done. I can reflect on what happened without emotion.

Unfortunately though my depression isn't history (yet). This feels very frustrating and I'm desperately waiting for the switch back to 'normal'.

As I wrote in my previous blog posts, I was diagnosed with dyslexia and dyspraxia one year into my PhD. It came came as a complete shock (although understandable looking back at myself).

Despite the shock I read a lot about the conditions and now understand them better. I've learnt (and now strongly believe) that neurodiversity is to be celebrated.

There are many strengths to having dyslexia (thinking outside the box), ADHD (creativeness), dyspraxia (pattern recognition, 'bigger' picture) and aspergers/ autism (hyper diligence and focus on tasks). I also feel there are benefits to having or experiencing mental heath issues i.e. creativity, kindness and empathy with someone going through something that you may not understand or have experienced.

However, even though I've grown up with cerebral palsy without giving it much thought these new 'labels' felt like the icing on the cake, with everything else going on, my irrational brain struggled to accept it. 

Instead of processing domestic abuse I was now processing being seen as 'disabled' and 'different'. At times I have felt bullied, intimidated, discriminated and stigmatised. Difficult feelings to experience whilst coming to terms with my new 'labels'.

To be honest I'm quite exacerbated and frustrated as to why it is bothering me so much.  I've previously been through similar (and worse) things.

I've experienced racism growing up. I have been beaten up by a gang of girls from school for being a 'f**n p*ki', told to 'stop running funny' by a teacher, and even jokingly told by a consultant 'why are walking like you are a gangsta' whilst imitating my hemiplegic gait (to be honest I felt a bit mean telling the consultant why, they obviously had no idea and was mortified, but its a sensitive issue. I have been told many a times about my 'funny' and 'weird' gait  and I would rather not be known as the 'person who walks funny').

As an FY2 doctor I was racially discriminated against by two supervisors (at the time I was wearing a headscarf). Despite these experiences I had belief in myself, was able to quickly dismiss these unfortunate situations and move on.

However, this time round I have felt 100 times worse. Even though some of my previous experiences have been equally (if not) more difficult to deal with. But, It is the first time I have felt truly singled out, isolated and treated differently.

Reflecting on my experiences I recognise how my confidence has been eroded insidiously overtime and a 'last straw' tipped me over. 

Previously, I would freeze mid presentation and whilst communicating 'I am stupid'. I've felt extreme anxiety writing and articulating directly because of how I've felt about my disabilities. 

Recently, I feel dread thinking about the job I love and have dreamed of doing since the age of 13 -doctoring.

I've questioned everything; my career, whether I am good enough, whether I  deserve to be a doctor.

Positive feedback from patients or health professionals goes over my head as I recall bad  experiences and negative comments said to me. I love my job and I LOVE being a children's doctor. Yesterday I got kisses and cuddles from a child who followed me everywhere whilst I was working (even following me to the loo and waited outside the door!). It was lovely-although I had to extract the child on numerous occasions to finish tasks!.

It confuses me: how can someone love and dread something at the same time?

I've done a lot of thinking and I have realised I can't keep feeling like this. My feelings are slowly destroying me. I will come across difficult circumstances in the future but I worry about something pushing me over the edge.

Looking back-before my melt down, I was proud of the doctor I was.

Right now I don't feel proud.

I am constantly questioning and wondering whether I'm good enough.

However, I've finally had a light bulb (ish) moment (hurrah!) . My reactions are a direct consequence of my depression.

Previously, bad experiences would go over my head.  This time round it has really hurt me and would 'pierce' every little insecurity or doubt I have about myself.

But, I'm glad I have finally realised. It is actually a revelation!

One day, I hope to say "I used to suffer from depression and anxiety", but, I have to accept one of two possibilities

  • My depression is 'reactive'. I.e. I have had some difficult circumstances over the years and as time passes I will feel better and more like my 'usual self'

  • My depression will be life long and it is something I will have to learn to 'manage' indefinitely.

Sobering, but something I have to prepare for.

On the flip side I really think depression is manageable. I'm also glad I've experienced it. I've learnt a lot about myself, am wiser and can empathise better. I hope one day when I will be able to help others because of what I have experienced.  

I've thought long and hard about what to do to help me progress. Should I:

  • Have a fresh start-move to a different city/ move abroad?

  • Continue my career path to become a paediatric oncologist

  • Apply for paediatric haematology

  • Apply for paediatric palliative care

Quit

  • Leave academia for good (after the PhD).

Right now I am none the wiser. But one thing I have realised is that actually, none of these options will fix how I feel (although part of me thinks a fresh start will help) .

However, irrespective of my decision I will have to become 'more resilient' and be prepared to take ownership of  my self care and compassion.

Lately, I have read and heard a lot about resilience. But it is the first time I have truly thought about it.

Depression and anxiety have broken down my barriers. Because of this I am more vulnerable to unfortunate situations.

Before, it was abuse, now it is 'being treated differently',

what will it be next?

I've realised anything can seep through my barriers and what I need to focus on is rebuilding my barriers. rather than the unfortunate situation occuring.

A friend told me that I am in control of my own feelings. If I'm feeling low it is because I am enabling a thought to affect my emotions.

This is SO true- I am only feeling 'discriminated' because I am allowing it to make me feel that way. Before I had the 'power' to stop it, now I don't, but I also don't really know how to fix it. 

Essentially my mental health barrier has become more 'leaky' (like a leaky gut!- had to correlate this blog to my PhD haha).

Basically, I should be allowing the good stuff 'positivity' to seep in to my core beliefs whilst preventing the bad stuff from entering via the 'blood brain barrier' (wikipedia it if you haven't heard of it before).

*But*

How do I regain the 'blood brain barrier' of my inner core to protect my mental health?

I haven't blogged in a while but felt I needed to organise my thoughts and emotions. I'm grateful that this rambling blog post has allowed me to shed clarity on what I am experiencing and because of this I have been able to highlight my most important question to address:

How do I regain my resilience?

 I *may* have found the answer- coaching. 

Watch this space...

I'm going to end my musings with some wise words from the legendary marathon runner (and unofficial philosopher) Eliud Kipchoge:

"If you don't rule your mind, it will rule you".


 

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