“you’re never going to be good enough” my teacher told me at 17.

I was 12 when I read teen fiction book ‘Wintergirls’. The storyline focuses on a female teen protagonist who, after losing her best friend to suicide; struggles with being guilt ridden and spirals into her own world of depression, anxiety and eating disorders. This book threw me into the raw and riveting world of mental health; and in a time when these issues seemed ignored and taboo, it gave me a reality check on how important psychological well-being was as it affects not only the sufferer but also the people around them. If you’ve read my previous article, you’ll know this book opened the gate for me to mental health, and in hindsight, to the start of the rest of my life, although I got a little lost along the way…

When I started high school, I did so with one of the highest admission scores. Just minutes from me, it was ranked as fifth best in the country with the results to show for it, and I recall being delighted to attend such a highly reputable school. It was very academic- all the work was to prepare us for the best degrees and professions; natural sciences, biochemistry, dentistry but most notably, medicine. 

I suppose I can’t put a finger on when exactly my interests and focus shifted from psychology to medicine, but I was very influenced by where I was and the people surrounding me. Being such an academic school, students were not only encouraged but expected, and sometimes pressured, to obtain high grades; to the point where those who achieved B’s and lower were looked down upon. As a result, the outlook of lesser-known degrees such as psychology seemed less attractive; and as medical and science-related careers were more promoted; I was slowly indoctrinated to the ideal future everyone else had for me without realising. Throughout our lives, we are asked what we want to be when we grow up- the silly answers are acceptable until we’re expected to decide our futures at 16. Except I didn’t feel like I had a choice. My school and teachers told me what I should have- a great future in medical school. My friends followed the consensus and were happy. My parents wanted me to follow a financially stable path in a medicine. Altogether, I slowly adapted to the idea that what everyone else wanted for me is what I wanted for me; but it wasn’t until a career’s evening in the first year of A-levels that when questioned what I wanted to do and I automatically replied “medicine” that I was fully convinced. 

However, it is one thing to say you want to pursue a career in medicine and another to actively do it. When I started high school, I was a happy and bright student- hard work and academia fitted me well; but the reputation and work ethics always loomed over me and I remember when I received my first B, I was kept behind and asked why. I was humiliated because it felt like being asked why I was stupid, and for the first time, I felt stupid. There was more pressure and I was harder on myself to be as good as what my friends were and what the teachers wanted, to the extent I developed anxiety for tests and getting homework back because I was terrified of being treated as dumb. You can guess what happened- my grades dwindled- rapidly. My mental health plunged and the vicious cycle of pressure, anxiety and failure began. 

I think the darkest years of my life was 16 to 18. I didn’t have friends I would call genuine friends. My grades were the lowest ever. I would wake up every day feeling empty, filled with dread and considered the possibility of ending it all so I wouldn’t have to deal with it anymore. I was tired of seeing low grades and tired of being unmotivated to improve them. I was tired of being disinterested in what I was learning. I was tired of being surrounded by people I didn’t like. But most of all, I was just tired of being tired. I felt weighed down- my heart was heavy and my head was clouded. I tried to pick myself up and work hard in the months leading up to my AS exams, tricking my mind into thinking I was in control when I was the complete opposite, and they went past in a blur. I only remember hoping and praying from the day I finished my last exam to results day that I got the grades for medicine. If it’s what everyone wanted, it’s what I wanted, right? 

You can probably guess what happened- I didn’t get the grades. It was like I hit a wall at 70 miles- bricks exploding, glass shattered, whiplash, bones broken…my entire world fell apart. I was numb, sitting in my own failure at what I thought was rock bottom. My parents and I had a meeting at school to discuss my grades and future, where I stubbornly echoed “medicine” to that question…they didn’t laugh but they might as well have- we all knew I wasn’t going to med-school. I had an ultimatum to pick up my grades or get kicked out, and I chose the former because I had a gut feeling I wasn’t finished, so I went back in September for my final year. The first chemistry lesson back, my teacher kept me behind and asked how I felt about my results; and when I admitted I didn’t know, said “you’re never going to be good enough to do what you want to do”. Remember when I thought I hit rock bottom? When I heard those words from someone who was supposed to be supporting me, the bottom gave way and I kept falling again. 3 years on and I still remember. 3 years on and I still can’t find peace. 

I went home and cried myself to sleep. When I woke up I took some scissors and did what I never thought I’d do. I picked up ‘Wintergirls’ and read again, and a strange feeling passed over me as I related in a new way and it clicked. I went back to school and realised how I felt in psychology lessons. I researched psychology universities and courses. I re-wrote my personal statement. I found some motivation and studied hard again. At the last parent’s evening, when that teacher looked me in the eye and said, “you’ve improved a lot, your efforts have been marked”, my mother smiled. I wished I could have marked their face. 

September 2019, I started university: BSc Psychology. I found friends- something I didn’t really have in high school. I enjoyed the 9AM lectures, excited to learn content I was passionate about, I never had that in high school. My grades flipped from C’s to commendations. I saw the brightest colours I had missed out on for seven years. It’s funny, my university doesn’t know about my academic background and never read my personal statement- the ones in clearing don’t, but I’ve learned that a good match doesn’t depend on this. I found my footing, worked hard and never looked back.

In hindsight, this story is bittersweet but clear. I dreamt of attending my high school and being a doctor, with nothing to support it. It’s okay to give dreams up when you realise it’s not what you imagined. I’ve learnt that an environment of hard work and pressure works sometimes but isn’t for everyone. I’ve learnt being called “stupid” or “not good enough” enough times makes you believe it- I believed everything I was told. It wasn’t until I was seventeen when all the doors shut on me that the right one opened. The worst year of my life was also the best, and if I could go through it all again to get here, I would. All I wanted was the chance to make my own decisions and mistakes, and for the first time, at seventeen, I did. I learned the difference between what other people wanted for me and what I wanted for myself. I know it’s so cliché, but I believe life has a funny way of showing you where you’re meant to be, and what is meant to be will be, and I know I was born to do this.

I’ve known hardships and struggle. I’ve known battling the people I once blindly trusted and I’ve known battling myself. I’ve seen what I thought was rock bottom and I’ve felt the worst betrayal when I fell even further. When giving up was the easiest way out, I lived and fought through it all. Sometimes we have a huge support network when we are vulnerable but other times we just have to put ourselves back together again. I took the best of what I had and turned that into the best of me. I learned, grew harder, saw laugher and happiness come back and found myself again. I’m not 100% healed- there is peace I haven’t and may never find, and forgetting I can’t imagine, but I know progress when I can tell light from dark because I’ve been there and I know what it’s like. 

Be nicer to yourself. Believe in yourself. Trust yourself. Chase your dreams. Don’t give up.

If you were waiting for a sign, this is it. 

Short Poem 1:

I do not fear you

I fear there is truth to what you said.

I don’t want an apology,

I want you to learn from your mistakes instead.

Short Poem 2:

You don’t know how many times I have been back

just hoping to find some peace in it all.

How lovely would it be to not be haunted after all these years?

Maybe in 13 or 30 I can go back-

not to bury memories I no longer want,

but to find comfort in familiarities

in the place I used to call home.

How Do You Heal A Body When The Mind Is Under Attack: Mental Health In The 21st Century

According to the 2013 Global Burden of Disease study, depression is the predominant mental health problem worldwide; closely followed by anxiety, schizophrenia and bipolar disorder. In the same year, there were 8.2 million reported cases of anxiety in the UK alone; and fast forward to 2017 when there were almost 6,000 recorded suicides in Great Britain alone. If we reflect back to the decade between 2003 and 2013; 18,220 of those who struggled with mental health problems committed suicide, making it the most common cause of death in England and Wales. 

With all of this considered, where does mental health and psychological well-being stand in the 21stCentury, and more importantly, why is it still not getting the recognition and attention it deserves? 

I was 12 when I was first introduced to the concept of mental health and psychological well-being. What fascinated me was not only how deep and complex the issues were, but also what seemed like everybody else’s lack of understanding and lack of willingness to attempt to. I vaguely recall my teacher called depression “extreme sadness” while anxiety was explained to me as “being too afraid to do things” and anorexia was branded as “not eating”. My parents who had jobs that couldn’t be further from the field of psychology and mental health had probably never coined these terms had no idea. In fact, I don’t recall mental health issues being talked about. To some extent, they were perhaps taboo. 

I have to hand it to my early teenage curiosity for wandering into territory that no-one wanted to be in, but I wanted to learn about what everyone else appeared to fear because I believed resolving even the most complex and difficult issues started from understanding. I was 13 when I started searching and learning everything from mood disorders to eating disorders and beyond- I don’t remember but can only imagine my search history; and what I learnt should have terrified me out of being curious…but it did the opposite. 

I didn’t know, but this was where it all started- where the roots of my passions grew. At 13, I knew I wanted to know but I didn’t know my interests could be my career. I didn’t realise how much time and energy I was willing to dedicate my career and life to. Because as time passed, this fascinating and frivolously interesting world was my world and the more I learnt, the more I realised mental health was and is, a huge and booming issue; but I didn’t understand why it was so under-rated, misunderstood and stigmatised. I felt the brain was just as important as the body, and that’s when it clicked for me- why has mental health been living in the shadows of physical health for so long, and why is there not more attention given to the illness that is affecting and stealing the lives of this generation? 

Mental health describes the level of one’s psychological well-being, and is the absence of mental illness. Individuals with good mental health are resilient against life stressors and emotional fluctuations to enjoy life and be successful. Treatment of mental illnesses has existed since the 17thCentury, but its awareness only started growing in the past decade or so when recorded rates, hospital admissions and drug prescriptions skyrocketed. Treating physical illnesses has always been the norm but mental illnesses have not received the same amount of respect and attention. 

Care for the mentally ill was very different, almost unimaginable and inhumane as pre- 1950’s treatment consisted of mental institutions with padded cells and straitjackets, and lobotomies (removing brain sections)- all of which were of course, useless and rudimentary. In 1953 the NHS saw nearly half its beds used for mentally ill patients and nearly 40% of the budget on improper care for them- the cry for help that major change was overdue for Churchill’s government to found the Commission integrating mental health services into the community, followed by manufacturing the first successful antipsychotic Chlorpromazine. 

Three years later, mental illness was called to finally be regarded equal to physical illness, achieved only if psychiatric hospitals were operated as similar as possible to normal hospitals. This was succeeded by the 1959 Mental Health Act and conference which revolutionised the perception of mental illness, acknowledging them as normal fluctuations experienced by most to some degree at some point in life. 

This breakthrough mentality change in the 60’s was led by pharmacological advances, allowing mental health to be re-invented and re-established, and problems finally being resolved practically. By 1975, the belief that psychiatry was part of the medical family grew, which drove innovations in mental health treatment; however, followed by its nemesis, the antipsychiatry movement, which brought the sins of psychiatry from an era of ignorance and primitive understanding to light. Some argued while debilitating, mental illness was a normal psychological coping mechanism for irrational life experiences, while others labelled it merely a myth. 

Although ugly, this forced the community to realise most, if not all, mental difficulties have bio-psychosocial elements to consider and tackle to effectively resolve. Antipsychiatry ignited much of the mental health stigma which remains a battle we are fighting today, as well as the psychiatry versus psychology rivalry, but this eventually emphasised the importance of collaboration between medicine and the mind- psychiatry and psychology in mental health.  

Since the sudden discovery of Chlorpromazine, psychopharmacology has been highly demanded as benzodiazepine prescriptions climbed steadily throughout the 1970’s, and SSRI’s increasing threefold from ’95 to ’96 and again between ’06 to ’07. The NHS prescribed a record 74.7 million antidepressants in 2016, a massive 109% increase from 2006; which more than doubled yet again over the last decade. This raises two significant questions: are doctors more lenient with drugs, or has the reduced stigma and increased awareness improved the identification and diagnosis process so psychological problems are tackled more effectively? With better education and newfound open-mindedness, we hope it is the latter.

The Mental Health Foundation believes many mental health problems are preventable and the development of interventions and recovery methods has increased the potential of sustained success. Since mental well-being rapidly garnered public attention, child and adolescent mental health quickly became the elephant in the room; as evidence shows most problems start around this critical time period of development in young people’s lives, but is also their most vulnerable. 

The Adolescent Mental Health surveys covering 1999 to 2004 found 10% of 5-16-year-olds had a clinically diagnosable mental health problem, and decade later, nearly 20% of those 16+ in the UK exhibited anxious or depressive symptoms. In the same year, there was just shy of 42,000 recorded self-harm hospitalisations in England for young people 10-24 years, making its prevalence of under 25’s to be 367 per 100,000- an increase from 330 per 100,000 six years prior. Eating disorders in young people are also double that of any other age in the UK, affecting 165 in every 100,000. 

The extent of mental difficulties in young people is not well known or understood due to lack of knowledge, awareness and regular up-to-date information, but learning that children seeking help from Child and Adolescent Mental Health Services (CAMHS) has more than doubled since 2017 should be eye-opening enough to propagate change. The complication is that today’s generation of young people succumb to the normal pressures of transitioning through child, teen to adulthood; but are also exposed to increasingly negative media information. It is no surprise social trends set by influencers in the public eye catalyse problems- unrealistic and unattainable standards leading common adolescent mental issues including body dysmorphia, eating disorders, depression and anxiety; not to mention unnecessary surgical procedures to attain these ideals. Thus, mental health problems in young people are multi-dimensional and cyclic, and education and awareness should be the first step to acknowledge and target them. 

Mental health is a large and growing problem because it consists of many different issues; one being despite much research data being collected from Western countries so far, it very much concerns the entire world. In 2011, 36 million suffered depression in China, but only 10% accepted treatment. Nevertheless, antidepressant sales peaked at 2.61 billion- a 19.5% increase from the previous year. Bolivia has a National Mental Health Plan promoting awareness and treatment but services are underdeveloped due to limited resources, and statistics found 30% of hospitalisation is from substance abuse and suicide rates are disproportionately high. Furthermore, those suffering mental health problems in Zambia don’t come forward because of cultural stigma- communities still regard it as family misfortune or punishment from God so treatment relies on traditional healers. The scarce research in Africa is perhaps a reflection of the blind eye turned to the problem combined with lack of education, exemplified by a 49% population growth followed by a 52% increase of mental and substance abuse disorders between 2000 and 2015. This urges needs for better education, awareness and further research to target and incorporate interventions holistically.

Another huge issue is the growing gap in rates of mental disorders between men and women. In 1993 young women were twice as likely to display symptoms of common mental health problems- 19.2% compared to 8.4%, which rose to nearly three times as common, 26% compared to 9.1% in 2014. The APMS also found all common problems were more prevalent in women, especially in significance for general anxiety disorder, phobias and panic disorders. Recent research has also attended to a possible relationship between gender, sexuality and mental health as 42% of heterosexuals suffer from depression, compared to 80% of gays/lesbians and 88% of bisexuals, with women consistently surpassing men. 

So back to the question- how do we heal the body when the mind is under attack? I took you through my experience of discovering mental health problems, the history of its treatment, breakthroughs and revolutions in terms of young people, and issues under the umbrella term; all while emphasising the roots of the problem- lack of education, awareness and therefore, stigma. My intention is not to name, blame and shame- I have been passionate about mental health since I was 12, and set out to explain why my passion about the issues in my generation allowed me to decide I never want to make a difference in any other career, and I did. I am not going to sweep things under the rug- alike to antipsychiatry, we are ignorant to what we don’t know, but similarly, I am proud to be part of the generation that are facing problems head-on rather than pretending they don’t exist. We are seeing hope and improvement that generations succeeding us can be happier and healthier, and this article reflects just a scratch on the surface of that. 

Mental health has been in the shadows for too long. With a sound understanding of what it involves and how to treat, we are seeing improved awareness and less stigma, but we need to work even harder. We need to break down the physical/mental health rivalry as the two need to be somewhat equal to have a long-lasting impact, but because the latter is usually put on the back foot, we only worry about the physical part of the person instead of considering the person as a whole. We need to ensure help is offered to everyone who needs it and that it is internalised, to be beneficial going forward. Most importantly, we need to raise the standards of education so mental health is more widely understood, and from a young age to build resilience.

We started at the bottom and now we’re here. But we still have such a long way to go.