Life as a journey: understanding how to treat your own mental illness
It is no secret to doctors of family medicine that patients presenting with mental health complaints make up the vast majority of our workload. Stress, depression and anxiety (of various degrees and combinations) fall under this umbrella. The burden of these complaints on the health system has shot up dramatically since the Coronavirus pandemic, having been allowed to flourish against a backdrop of increasing social isolation, personal loss and uncertainty about the future.
After having literally hundreds of conversations with patients suffering with their mental health I realised that, as their doctor, I was giving them all pretty much the same advice. What’s more, I realised that most of these problems didn’t require a doctor to fix them but rather a basic understanding of the components of our mental well-being. So, after a little bit of inspiration from a senior colleague, I came up with a simple analogy to help us understand how to manage our own mental health; life as a journey.
Life as a Journey
Imagine you’re sitting in a pitch-black cinema room alone, in front of a luminous big screen, watching a short film shot by a drone. In it you observe a car going through the Nevada desert, navigating the twists and turns in the dusty road carved through the mountains. Suddenly you get a close-up shot of the driver. You’re surprised that this is you. In the back seats are your closest family and friends but the passenger seat next to you is empty. This scene depicts all of the basic components of life and closer analysis helps us to uncover the ways in which to fix them when they are broken. Let me break this concept down for you:
The Driver
This is YOU. You are the one at the steering wheel ultimately responsible for where you go in life and how smooth the ride is. Psychology geeks call it having an ‘internal locus of control’; that’s the belief that we are ultimately in charge of our own destiny. People who think that what happens to them in life is controlled by external forces are more likely to suffer from all manners of mental illness. Sure, sometimes bad stuff happens that we can’t predict but we always have options and awareness of this is the first step to empowerment in our mental health journey.
Have you ever heard anyone say “I only learnt to drive once I passed my driving test”? Well that same saying holds true for mental resilience, which we only develop with experience. We start off a bit fragile in life (as a child I remember crying for days when my pet hamster died) but with time and a few bumps and scratches along the way we develop a greater level of mental toughness. Therefore be grateful for life’s hardships — as long as we learn from them we are bullet-proofing ourselves against such problems in the future.
The Road
The road is the path that your life takes. For all of us it will contain bends and forks and each road map will look different. As children we have limited control over our roadmap and are mostly at the mercy of doing the things and going the places our parents do and go. As we get older, we take charge more but the road never stops producing twists and turns: bereavement, failure in its many guises, lost friendships, new careers or job losses, first loves and break-ups. The point is that by knowing ourselves better we can pursue the things that ignite our passions in life (e.g. choose the roads that suit us the best). How then do we get to ‘know ourselves’ I hear you ask? Well, the answer to this existential question deserves it’s own article, but a simple way to approach it would be to analyse your bank balance and the way you spend your free time — the things you spend the most time doing and money on probably represent the roads that you most enjoy driving along.
The Car
The car is our body. How it runs is dependent on how we treat it; do we nourish it with healthy food, turn it on regularly (exercise) and get enough sleep? Do we service it and give it breaks once in a while? Do we upgrade parts of the car that aren’t performing optimally? (e.g. invest in our mental health). Our mental fitness is innately related to our physical fitness; if we’re feeling invincible on the outside we’ll feel more able to take on any mental hurdles we might face. After all, it’s a lot more difficult to get over depression if you’re sleep-deprived, strapped to the couch and fuelled by family-sized crisp packets (we’ve all been there).
The Engine
The engine is our brain. We’re born with a set engine — some of us have the fortune of being blessed with the reliability of a BMW which can take a lot of beating before it starts to malfunction. Others may be less fortunate. The bottom line is that we are all genetically predisposed to being susceptible to or buffering against various types of life stressors. Knowing oneself and therefore in turn one’s mental weaknesses allows ourselves to place various safeguards in place to protect against mental illness. As a natural over-thinker, I’ve found my safeguard in the practice of journaling which helps me to get my thoughts out of my head and ultimately helps me sleep better. Find whatever practices help you and start doing them.
The Passenger Seat
The passenger seat is reserved for the driving instructor that you might need. If we approach a tricky section in the road, we might need to enlist the help of a guide to help us along our way. This could be a good friend or family member, a professional therapist or your own family doctor. Enlisting the help of others should be seen as a strength rather than a weakness. However, they can’t drive the car for you, remember? YOU are the driver. Just as a driving instructor gives a learner driver homework to practice for their next lesson, it’s up to us to practice the techniques we have been taught by our passenger seat occupant.
The back-seat Passengers
The back seat passengers are your associates in life. Make sure that you surround yourself with friends and family who are willing to stick around when times are tough. Ideally, they will also help you through your mental challenges and be there to listen to you when you need them. Loneliness and the risk of committing suicide are inextricably linked. The challenges of the COVID-19 era have pushed many of us closer than ever to this never-event. Scheduling regular chats with friends and family via remote methods or in outdoor spaces has never been more important. Utilising popular networking forums, such as Meetup, for those who feel less well-connected, could be another alternative.
What is the role of antidepressants in mental illness?
Antidepressants can play an important role in people with low levels of the feel-good chemicals (aka neurotransmitters) in their brain. The fuel of the engine, in our case. When the fuel is running low, often signalled by feeling low, having a lack of energy or interest in things for a prolonged period of time, then antidepressants may help. In these cases, pills should be seen as a way of giving the car the ‘umpf’ it needs to learn the mental techniques to get past the trickiest of obstacles. The hope being that in the future we’ll be able to use these same techniques but without the need for artificial assistance again. Of course, please speak to your own doctor if you think you might need this extra help.
What does this mean for me?
If you are feeling overwhelmed or mentally fragile I urge you to picture your life as the journey depicted above. Break down each component to see if there’s anywhere you could be doing more. We should believe that we are in control of our destiny and that we will get mentally stronger with each obstacle we encounter in life. We should pursue the things we value most with the people we value most and avoid driving down the roads of others. You can only expect your body and brain to get you through the dips in life if you nourish and invest in them appropriately. Finally, we shouldn’t be afraid of asking for help along the way.
Disclaimer
This article was not written to replace seeking professional medical advice for mental health complaints nor advocates purely self-help measures in the presence of severe mental illness or psychotic disorders.
Many thanks to Dr Archer of Lostock Medical Centre for providing the inspiration behind this article.
