MISDIAGNOSIS
For months I had the diagnosis of ‘major depression’ after suffering burnout and having to call in sick on a very understaffed and stressful elderly care trust-grade SHO job. Due to start GP training, this had to be deferred until I was well enough. But the frustrating thing was that I would ask myself, despite the reassurance of family and friends, ‘When will I ever be well again?’ I had lost all confidence in myself as a person but, worse, also my clinical confidence as a doctor.
This was the beginning of one of my many delusions — genuinely believing I was no longer a doctor, that I had been fired, and would never be a doctor again. These were very distressing thoughts given how long I had trained and how dedicated my life has been to medicine over the past 8 years of my life.
Having ongoing suicidal thoughts but unable to recognise why, I was seen by a psychiatric team. The doctors were adamant that I was not displaying signs of psychosis. This was despite me seeing images of myself on the wall of a train station, and seeing the men at the ticket barriers as policemen with the name badges ‘Moses’ and ‘Jesus’ who wanted to arrest me. These fixed delusions went on for months, getting more and more distressing, and I became convinced that I should be in jail. Despite everyone telling me I had not committed any crime, I would not believe them.
CRISIS POINT AND THE GAP IN MENTAL HEALTH SERVICES WITHIN THE NHS
One weekend while staying with my brother I even ran away from a cricket match, convinced that the screens in the stadium were about to publicly humiliate me and that my only option was to hand myself over to the police. I wandered about and found a police car and tried to explain how much wrong I had done. They called my brother, who came to pick me up. That night my thoughts were so distressing that I was convinced I had only two choices — either I had to be in prison or I should be dead. As I had already tried to hand myself in, I unfortunately felt I had no other option but to self-harm, and sadly took an overdose — luckily not enough to do any long-term damage.
It was only then, after months of suffering with psychosis, that I got the help I needed. I was admitted to A&E and then transferred to an inpatient mental health ward. Initially I was kept as a voluntary patient. Within a few days I started becoming very distressed and I tried to leave the ward. This was the start of the grandiose experiences — in my head this whole experience was a test, and if I was able to successfully diagnose everyone on the ward during this overnight OSCE (my sleep was very much disturbed) then I would be rewarded by being made a consultant in whichever specialty I chose.
I also thought that I had cured all diseases including cancer and HIV. After trying to crack the Da Vinci Code to figure out the codes to the ward I was sectioned and kept in a locked isolation area. At the time I remember feeling violated, with all my human rights taken away from me. I remember having delusions about Nelson Mandela (we had visited Robben Island as a family last year) and I believed that this was my long walk to freedom. I kept thinking that one day very soon I would be released and that there would be crowds of people waiting to thank me for helping to cure cancer and HIV and all other diseases.
REALISATION
Of course, none of this was true, as the reality was that I had been sectioned under section 2 of the Mental Health Act. Initially I contested this as I still felt I needed to be let free and everyone was waiting for me on the outside of this ‘prison’. After a few more days of being held and started on risperidone, the delusions began to fade and I started to realise that I was in a hospital and had been very unwell.
BEING SECTIONED IS SOMETIMES THE BEST THING
My experience shows that, although it took a long time for me to get into the mental health system (and it took a crisis point), being sectioned was the best thing that could have happened to me. The inpatient admission was what was needed to stabilise me from this acute episode of psychosis. This was my first episode of psychosis and, since then, I have been stable on medication and hoped to return to GP training in the not-too-distant future.
I hope this article reduces the stigma around being sectioned and, even though I wanted to contest it then, it was what I needed at the time. Having been through depression and psychosis, I feel I will have more of an understanding of mental illness as a doctor — when I confront it —because I was the patient for so long. I hope my story highlights a first-hand experience of someone who became unwell due to the pressures of working within the NHS, and who stayed unwell due to a lack of NHS resources. However, once I was in the system and being treated, it shows just how great our NHS is.
- © British Journal of General Practice 2018