Let’s Talk

January 25 is Bell Let’s Talk Day.

One day a year the world comes together to help end the stigma of mental illness.

One day a year, a large corporation donates $0.05 for every tweet and hashtag that says “#BellLetsTalk” towards funding mental illness.

Meanwhile the province I live in is underfunding mental health across the board.  I can’t get a delusional/psychotic patient timely access to a psychiatrist without sending him to the ER or placing him on a Form 1 (ie involuntary 3 day hold).  I can’t get the chronically depressed and suicidal middle-aged woman a psychiatrist to follow her and manage her 3 psychotropic medications.

So yeah, let’s talk about mental illness.

Why don’t psychiatrists actually do what they are trained to do?  Why don’t they follow patients and see those that need weekly psychotherapy? Why doesn’t the Government adequately fund mental health?

How about we talk about mental illness every day of the year and not just one day?

Let’s talk.

Eighteen.

She walked outside all alone, thinking. It was a foggy evening; you couldn’t see the sky except for clouds of white. It was damp. The air had a musty smell. At times she found it hard to breathe yet the air had a refreshing quality. She was out here to think and to reflect. That’s what they told her to do. Think about yourself, who you are, who you want to be. Now if that wasn’t a killer question, she didn’t know what was. What a crazy thing to ask of an eighteen year old. Think about yourself?  For eighteen years she was told to think of others first, not of herself, so wasn’t this now being selfish? Maybe. This was a time to reflect on one’s self. And what a perfect time – away from home, school pressures and friends. Ha! What friends? She wasn’t social with anyone from this group she was with. Anyone else she hung out with was at another place. Although this was an opportune time to think alone and to be alone, she couldn’t help but feel alone.   Oh, she could have switched and gone with the others but something held her back. She didn’t want to be part of a group; she wanted time to think on her own. But yet she hated being alone and not with the group. Confusing, eh? She wanted to be alone but felt lonely being alone. She thought about this while leaning against a dead oak tree. She shifted her feet, leaning on the right, and then leaning on the left, kicking branches and leaves around, all the while thinking.

But thinking about what? Oh, nothing in particular – her life, school, friends (or lack thereof), mom, dad, family and God. God. Wasn’t that what she was supposed to focus on? Is God in her life? Does she want God in her life?

Questions, questions, questions. Where were the answers? What were the answers? Who knew? Certainly not this young girl with her leather jacket done up and hands shoved into her pockets.

“It’s awful cold out here”, she muttered to herself.

“Duh, it’s the beginning of November. You expect it to be 90 degrees?”

“You be quiet,” she chastised her other self. She’d been hearing from this other eighteen-year-old girl in her head. Who was this person? Was she God? Was it God talking in her own voice? If so, why didn’t she say something more productive?

It was awful cold out there. She decided to go back inside into the warmth. As she walked back to the building she could hear muffled giggles from other areas of the grounds and silently wished she were laughing too. This was supposed to be a time to be with your buddies and laugh and have a good time. And she also knew it was a time to reflect, but who really and honestly did that? Only one person it seemed – herself. Everyone else giggled and talked about their boyfriends and stuff that was important to them. What did she have to giggle about?

How she hated feeling sorry for herself. It wasn’t worth it and it was counter-productive. She tried to think happy thoughts. She tried to recall happy memories and there were many but memories are different from reality. Oh sure, they were once reality but no one ever thinks that while reality is happening. It doesn’t matter how strong a memory is; you can never recall the original feelings. Somehow it just doesn’t come close.

So as she was trying to think happy thoughts, these memories came back but proceeded to depress her. She missed those days she recalled. She missed the person that she saw when she saw herself. She wondered where that person went. What happened to her? Where did she go? Had she ever really left? That was the big question. Had this happy-go-lucky girl just vanished? Or was she still there somewhere, only buried deep inside?

Questions. Questions. Questions. She wanted to find that girl again – the girl from her memories. Was it possible? Or did someone like that only come around once in a lifetime? She hoped not. It wouldn’t have been fair.

She wanted to be happy again. At that particular moment, she wasn’t. She wanted re-affirmation that she was special and worth knowing. But does anyone ever get to really know that? She doubted it, because then everyone would have high opinions of themselves and the last thing the world needed was another stuck up and snobby individual.

Why wasn’t life simple anymore? Had it ever been?

She thought of a song just then, it was called “Keep The Faith”. She guessed that the whole point to this retreat was just that – keeping the faith, or finding it.

#letstalk

I deal with mental illness on a daily basis in my family practice. Having been treated myself for depression and post-partum depression I am well aware of the stigma that still exists. Mental illness is real.

I am not okay.
My life is good.
I have no reason to be depressed.
I feel so alone.
No one understands me.
The voices are so loud.
I think I need help.

Today, let’s talk about mental illness. It’s closer than you think.

Let’s Talk.

Day 28 – January Daily Blog Posting Month

bfmh14-copy-e1388959797718

Today is Bell Let’s Talk day.  It is a yearly campaign to raise awareness and money for mental health initiatives.  Last year, over $5 million dollars was raised.

I’ve been honest here about my struggles with depression and postpartum depression after the birth of my first child.  It was a very dark time for me, one that should have been a happy time.  For the rest of my life, I will remember my first maternity leave, not because I was ecstatic to have my little girl, but because I struggled daily to get out of bed and be happy she was here.

I got better when I finally admitted there was something wrong.  I went through 16 weeks of intense, weekly Interpersonal Therapy and learned a lot about myself as a mother, as a wife, as a physician, as a woman.

In a lot of ways, experiencing PPD was a good thing; for one, it made me a better family doctor.  It allowed me to empathize with the moms in my practice and to recognize the early signs of depression, especially in the postpartum period.

Mental illness is rampant in our society and the stigma is only slowly being lifted.  I hope that more days like today and stories like mine help ease it just a little bit.

 

January blahs.

January has always been a “blah” month for me.  After all the lead-up and hyper over Christmas (especially now having children), January comes with a brutal hangover.   Suddenly, the reality of days on end of eating huge meals, sweets, chocolate, not to mention copious amounts of wine at family functions, catches up to you when you put on your work pants and they are just a bit more snug than they were a week ago.  There’s the task of taking down the Christmas tree, and explaining to the kids why the tree is out on the curb waiting for the garbage man to pick up.  There’s 10 days of having to entertain your child while she is off school.  Really, there is only so much Play-Doh I can handle.  There’s the late, late nights with husband watching Taxi Driver, the entire Lord of the Rings and Alien trilogies, which by the way, is a lot of fun.  Oh, and did I mention I was also working and covering two other practices?  Yeah, so no wonder I greeted January with one measure of fatigue, two measures of new flab and a measure of low mood.

I’ve been quite grumpy for the past week or so, mostly because I don’t know how to say no.  I agreed to cover for my two colleagues during the holidays – paid, of course.  We have an arrangement where we pay each other for lab review and patients seen.  We are all paid a salary, so we get paid whether we see our patients or not.  So, when a colleague is on vacation for 10 days and getting paid for it, I’m at the office seeing their folks.  I agreed to it, so I have no one to blame but myself.  It was busy.  One afternoon, I saw 24 patients (when I usually see that many in a full day), and the other morning I saw 16.  I got tired.  And grumpy.

It’s also winter.  Really?  Yes, it is!   I don’t remember the last time I felt the sun on my face.  Which might also explain the horrific acne these days.  TMI?   So, while at Costco the other day, I decided to finally take some of my own advice and start taking some Vitamin D – you know, just to make sure the advice I’m doling out is actually correct.

Vitamin D is a fat soluble vitamin.  It is present in a few foods, can be synthesized in our skin by natural sunlight, or taken as a supplement.  Vitamin D has to go through certain biochemical processes to become active and useful in our body.  There is some metabolism through the liver and the rest is done through the kidney.   (To read more – go here).  Vitamin D is important in maintaining adequate calcium levels in our body, as well as phosphate.  To put it simply, vitamin D helps make our bones stay strong.   Insufficient levels of vitamin D in children can lead to rickets, and in adults to brittle bones. But vitamin D has other important functions –  these include functions in cell growth and immunity, as well as reducing inflammation.

Many of my patients take vitamin D, for many different reasons.  I recommend it for all the children in my practice as well as the post-menopausal women, and I usually tell the patients who are struggling with depression (especially in the winter) to also take extra vitamin D.   I’m finding more and more people (men and women, alike) are taking vitamin D.  Apparently it’s the go-to supplement these days.  Did you know it can fight 3 different forms of cancer?? <insert eyeroll here>

In any event, I decided it was time to take some of my own advice.  A few days ago I started taking 2000 IU of D3.  To my genuine surprise, I was amazed at how quickly I started to feel better.  Yes, likely a placebo effect, but who cares?  Suddenly, after 10 days or more of darkness and bleak mood, the sunshine is back.

Oh, and did I mention that I am nearing the 10km running milestone?  For a few weeks now, I have been increasing my running distance by 1km per week.  Yesterday, I ran 8.2km.  It felt great.  I’m a little sore today, but it’s that good kind of soreness. Exercise really is nature’s best medicine.  I need to remember that on the dark days.

The Parenting Post.

Yup, I’m going to go there.

Lately I’ve seen a lot of debates popping up on my FB wall feed about styles of parenting.  Let me rephrase that – heated debates.  Recently there was an article written by the mom on the bench to the helicopter mom at the park.  It was obviously meant to be tongue-in-cheek and humorous.  It clearly struck a nerve with some people, just read the comments section.  Personally, I thought it was brilliant.

Never in human history, I think, has more been written about parenting and styles of parenting than in the last decade or so.  I have no basis for this theory, it’s just a gut instinct.  An initial Google search for “parenting styles” came up with several links describing these four styles:

And lets not forget the best of all – “helicopter”.

I’m not going to review them, you can do that yourself.  I think it’s a load of horse shit, to be perfectly honest with you.  Raising children, being a “parent”, isn’t something you can define, nor should you label it.  Its common sense, no?  Did our parents have books on how to parent?  Actually, now that I think about it, I’m pretty sure my mom had a book by Dr. Spock.  But that’s it.  One book.  Nowadays? THOUSANDS of books, not only on parenting styles (“Know Your Parenting Style”, “Parenting with Love and Logic”, ) but oh my god, books about the different kinds of children (“The Out-of-Sync” child”, “The Explosive Child”, “Living with the Active Alert Child”, “Nurture by Nature”).   Unless the child has a genetic (ie chromosomal) disorder, is developmentally delayed or has had birth trauma causing the behaviour issue, I say leave the kid alone and allow them to develop.   (Obviously, I’m not lumping in the small percentage of children with severe behavioural problems here.)

I sound grossly unsympathetic.  I truly don’t mean to.  I am just frustrated with how I see my generation turning out.  Suddenly, I’m surrounded by parents (mostly in my practice) who are obsessed with micromanaging everything from the pregnancy, to the kind of birth they want, to debating if cloth or disposable diapers is better,  to following their kid around on the playground.  [And don’t even get me started on the insanity around breast-feeding and making new mothers feel guilty 2 minutes after their child is born if they are scared or don’t want to nurse.  Seriously?]

When did we suddenly need a book to tell us a) what kind of parent we are and b) what kind of child we’re raising?  It makes us seem completely stupid.  Tribes in Africa don’t have these kinds of issues – these, first world problems.  Our species has survived two millenia without a “how-to” manual, and I think we’ve done pretty well, thank you very much.  To survive another two millenia, well, I’m not sure we’ll make it.  There’s nothing natural about how kids are being raised these days.  It’s all about fitting your kid or your parenting style into a pre-fashioned mold.  Frankly, I think it’s creating a crop of depressed and stressed out parents who are struggling to cope with their stressed out, anxiety ridden children.  It’s fucking sad.

I’m so gonna get flamed now.  But I feel better having gotten this off my chest.  If you made it this far, and don’t hate me, then maybe I am doing something right.