Why dwell on the past when you don’t have to? Especially when the past was less than happy, and better put aside. Many years ago, as a junior trainee psychiatrist, I wrote an article about my experiences as a psychiatric patient, and showed it to some senior colleagues. I have never forgotten the words of one, who advised me against seeking publication, saying better to leave it until I was old and grey. I took his advice – how could I do otherwise? – but it sat uncomfortably. But I worked on through the years, and finished my training. From time to time I wrote about what happened, and one day I did publish an article. It opened a door – people talked to me about my illness, told me about their own, and still to this day people have contacted me, while clasped in the grip of their own torments.
The selfish bottom line is that it helps me. It clarifies things, puts them in some sort of order. But I hope that it can help others too. I am not free of my illness, and it has never become something of the past. It is a spectre that follows me, and, regularly yet unexpectedly, knocks me back to a place where I never want to go. Naming it ought to render it more benign, but it doesn’t – psychotic depression, bipolar disorder, frightening words that set one apart.
But I have been very lucky – I have been well enough between episodes of illness to attain my desire to become a psychiatrist, and I know how fortunate I am. But sometimes I balance tentatively between these two perspectives, doctor and patient, and I don’t know where to turn. I don’t know who I am. I have to be one or the other, but memories leak from each. There are sudden moments, walking about my daily life, when it hits me – which side am I on, what am I? There is still stigma about mental illness, and sometimes health professionals are equally guilty. But their lives are shrouded with stress, with difficult working conditions, with the inner knowledge that sometimes we just can’t help. There can be blame and culpability – first health professionals to patients, leading inexorably to the reverse. Hurt patients are angry – I know, I was very angry in my first years of illness.
I want to write about what happened to me, and how – indeed why – I then became a psychiatrist. I want to find out what I think, rather than avoid it. I want to think about psychiatry and mental health, and the people who live with it, on both sides.