I Graduated

The title of this post is self-explanatory but I finally graduated university this month. It’s taken me three and a half years of study (+ a year off) but I got here in the end. If you’d have told me it would take this long when I started, I would have laughed. Yet, I’m okay with it.

I’ve learnt so much about the world and myself and I can’t wait to go onto further study (fingers crossed I get in somewhere good). I survived a pretty gruelling degree at one of the top universities and my marks weren’t even bad. It was difficult but I did it and I finally feel like I’ve achieved something.

It didn’t always look like this would become reality but I’m proud to have pushed through and gotten here despite having to take time off for my health. Some dreams are worth fighting for and this was mine.

Life is not a race, and if you’re patient, you’ll get where you want to be.

The End of an Era

I have big news: I officially finished my university degree today! I sat my last exam and am the proud owner of a Bachelor of Science (majoring in Psychology) or I will be when I graduate in a month.

There were times when I didn’t think I’d get here. It’s taken a long time, in fact it’s four and a half years since I started a three year degree. However, only three and a half years were spent studying because I had to defer for a year in the middle due to my health. I’m a little ashamed at how long it’s taken me but I didn’t expect to get as ill as I did. Right now, I’m just proud that I made it. I stuck it out despite everything else that was happening and I really did enjoy my degree. It shows that life isn’t a race, everyone is on their own journey.

I’ve learnt so much, I’ve challenged myself and developed skills I didn’t expect to have. I’ve dabbled in creative writing, linguistics, biology, chemistry, history and philosophy. The depth of knowledge I have gained is far richer than I set out for it to be. Most of all, I found a field that excites me and that I love: psychology. I found where I am meant to be.

I’m glad that I chose this course. I’m glad I kept going even when it was challenging. It’s made me a better, stronger person. Now, here’s to bigger and better things! Never stop trying to achieve your dreams, even if you don’t get there you’ll fall amongst the stars.

On Completing University Part-time

At the beginning of my degree, if I’d been asked if I would ever go part-time with my course, I would have certainly said ‘no’. Yet, that’s not how things occurred and after my first year, I did drop a subject (still considered full-time) and then later took a leave of absence for a year. Unsurprisingly, my views about going part-time have changed.

University can be full on and I found myself drowning in coursework and exams, and for a while forgot who I was as a person. It’s important to have a balance between studying, work, and things that you find enjoyable. My problem was that I was too focused on grades and living up to my peers, and therefore wasn’t enjoying it.

The best thing I ever did was take time off. The notion of completing an undergrad in three years is changing and I’ve come across a lot of people who are choosing to do it over four or even five! You are not weak or abnormal for choosing to take that little bit longer during your studies and you may actually be better off. Spending more time on fewer subjects means you will have a better chance at getting those HDs and be able to enjoy university life more.

If you need to take longer than usual to finish your studies, that is okay. It is perfectly normal. You are not worth less than your peers. You are not doing anything wrong. You are not expected to complete them in a set time. I wish someone had told me when I first started because I may have been able to have had a better quality of life during the beginning of my studies.

How I Write My Notes Now

1. I used to organise my notes on the computer as seen here, but found that it was difficult for me to remember them and I am the type of learner who needs to physically write my notes out.
2. The method that works best for me now involves printing off the lecture slides, writing on them during lectures and then organising them in folders. I tend to have one folder for two subjects so two folders per semester. This has changed a lot to how I previously took my notes, which you’ll see was primarily computer-based. I also take a plastic document folder to all my classes for loose pieces of paper which go into my folder when at home. Then during SWOTVAC, I rewrite my notes into a spiral notebook and/or cue cards and mindmaps.

It’s taken me a long time and a lot of trial and error to work out what works for me but now I have and it’s become almost automatic. You need to find a method that works for you and for the subject you are studying because everyone learns differently.

A History of Psychiatry in 5 Objects

1. 400-500 BC: Humorism

Figure 1: Humorism

Humorism was an early theory for the mechanisms of the body. Hippocrates (400-500BC) stated that illness was caused by an imbalance of four humours; blood, phlegm, yellow bile, and black bile (Stelmack and Stalikas 1991, 257), an idea that reigned until the 17^th Century (Bos 2009, 29). Galen (Hague 1991) later linked blood to a sanguine disposition (hopeful); yellow bile to a choleric one (easily angered), phlegm to a phlegmatic one (calm, neutral); and black bile to melancholia (sadness). It was understood that imbalances could be adjusted with physical treatments, such as bloodletting and emetics that would remove a humour that was in excess (Androutsos et al 2008, 32), and bleeding and vomiting were evidence that the imbalance was rectified.

Humorism provided a holistic view of wellness that acknowledged the importance of both physical and environmental factors, such as diet and exercise (Telles-Correia and Marques 2015). It was predominately a departure from supernatural ideology and the role of the gods, in favour of the concept that physical and mental health were intrinsically linked (Bos 2009, 31). Bos (2009, 29) believes the decline is linked to a parting from a focus on character in favour of alternative theories. Nevertheless, the idea of balance remains prevalent.

2. From the 17^th C: The Asylum

Figure 2: Bethlehem Hospital 1714

The concept of locking up the insane began in the late 17^th Century (Porter 2002, 51-52). The Asylum was an institution based on moral therapy; the premise that psychology and compassion could be used to treat severe mental illness (Rosenblatt 1984). Prior to this, individuals were largely kept in the community (Porter 2002). One of the earliest hospitals was Tuke’s York Retreat (1796) (Rosenblatt 1984, 246), which echoed the theory of Pinel breaking patient chains (Porter 2002, 58). Both advocated for routines, pleasant surrounds and to abolish restraint.

The asylums were self-contained yet isolated, with architecture that was part of the treatment (Porter 2002, 62). Early on, conditions varied greatly and following outrage at abuse of patients like William Norris at the Bethlehem Hospital (1814), a move was made towards regulation through the Mad House Act of 1828 (Wiles 2016). However, due to overpopulation, patient care declined and by the 1890s more were leaving dead than cured, influencing consequent deinstitutionalisation (Wiles 2016, Porter 2002, 64).

Originating as a place of refuge, asylums were a sign and place of progress (Porter 2002, 65). While it is argued that moving the focus from the body to the mind merely meant switching repression type (Foucault, 1988, 266), this does not warrant overlooking the introduction of compassion, hope and a person-central approach (Shorter, 1997, 4).

3. 1939: Electro-Convulsive Therapy

Figure 3: Australian ECT Machine (Melbourne Museum 2017)

Electro-convulsive therapy (ECT) is arguably the greatest discovery of psychiatry, and the most effective and empirical treatment (Shorter and Healy 2007, 2).

Replacing chemical alternatives such as metrazol and insulin, both dangerous and less successful, it is a form of shock therapy (1935; Shorter and Healy 2007, 6) which was based on Meduna’s idea that schizophrenia was an antagonist of epilepsy. The concept was to treat symptoms by disrupting brain activity through seizures, coma or loss of consciousness (Piotrowski and Guerra 2016). The development of the Bini-Cerletti ECT machine was motivated by the desire to find a safer treatment.

4. 1951: The First Antipsychotic (Chlorpromazine)

Laborit’s and Rhone-Poulence’s discovery of Chlorpromazine (1951), the first antipsychotic, was a precursor to the rapid development of the psychopharmacology industry (Ban 2007).

It was initially used with general anaesthesia to sedate and prevent shock(Carpenter and Davis 2012, 1168) and when trialled on patient Jacques Lh. undergoing ECT, an improvement of psychiatric symptoms was observed (Ban 2007). This was replicated by Deniker and Delay, who announced in Luxemburg that Chlorpromazine reduced psychosis symptoms(Carpenter and Davis 2012). Following this, Chlorpromazine saw the wards of asylums grow calm as noisy schizophrenic patients became quieter and more docile (Elkes and Elkes, 1954, 560), thus reducing violence and the number of hospitalised patients. Hence, despite some side effects like tardive dyskinesia, it became regarded as a miracle drug (Ban 2007, Carpenter and Davis 2012)

Following moral therapy’s failure, antipsychotics offered the possibility of a scientific and medical approach that shifted the location of clinical care(Carpenter and Davis 2012, 1168). It wasn’t long before advertisements began marketing Chlorpromazine at not only schizophrenia, but also emotional instability, hiccups and cancer (APA 1956, 2; APA 1958), highlighting the lack of understanding of the mechanisms of the drug. Over time the uses became more specific and psychopharmacology grew rapidly and chlorpromazine prompted the development of the dopamine hypothesis (Carpenter and Davis 2012, 1170).

5. 980- The Diagnostic and Statistical Manual of Mental Disorders-III

Figure 6: DSM-III

The third edition (1980) of the APA’s DSM (Diagnostic and Statistical Manual of Mental Disorders), was revolutionary for the diagnosis and treatment of mental illness (Decker 2013, xvii).

The DSM-III influenced psychiatry’s shift from an aetiological and psychoanalytic focus, towards descriptive classification (Decker 2003, xvi). Neo-Kraepelinian in nature, (Tsou 2016), it emphasised symptoms and course and aimed to provide clear and valid definitions (APA 2017). This was influenced by the 5-axis system implemented by Spitzer, who advocated for biological ideas (Decker 2013, 315-317). The manual was larger than it’s predecessors and involved the caveats that the criteria were not completely discrete, and should only be used by psychiatrists (APA 1980), for whom it became convenient shorthand.

The DSM-IIIs flaws can be seen through attempts of subsequent editions to rectify mistakes, such as homosexuality’s removal in 1973 (Cooper 2004, 6) and some argue that it has not managed to progress beyond description (Tsou 2016). The criteria were not as clear or evidence based as intended, and symptom thresholds excluded many people from diagnosis (Cooper 2004, 5-22). Nevertheless, the DSM-III was a milestone document due to its descriptive diagnostic categories and the support for which it gave to the disease model (Decker 2013). It was the first DSM to become widely used by professionals and provide a uniform method of diagnosis (Tsou 2016).

The results of electrically induced seizures in a patient called Enrico X, were presented at the 3rd International Neurological Congress (1939), with a reported significant reduction of symptoms (Shorter and Healey 2007, 43), from which ECT rose to popularity in the 1940s. Early on, seizures would result in physical harm and this led to the development of muscle relaxants and use of anaesthetics (Piotrowski and Guerra 2016).

Despite initial popularity, in the 1980s antipsychiatry and politics resulted in rapid decline in the use and reputation of ECT, damage that is still being reversed today (Shorter and Healey 2007, 145). ECT’s development is significant as it is an empirical treatment that can produce rapid responses to acute symptoms of psychosis and depression (Shorter 1997, 3).

 

Going into my final year of study

This year will be my fourth year completing my undergraduate degree. I started it straight out of high school and have now completed two full years of study. It’s difficult knowing that many of my classmates have graduated and sometimes that makes me feel left behind, but other times it doesn’t bother me too much. I may have taken longer but I needed to due to my health and I believe that my grades have been much higher than what they would otherwise be. So in some ways, my peers have surpassed me but in other ways, they have not. Slow and steady wins the race as they say but this is my personal experience and what works for me might not work for others.

This year I am completing two full-time semesters and one winter subject that I need to make up. I am majoring in psychology and this means that I have two core subjects plus some elective psych subjects to do. I am excited because this means that I finally get to go more in-depth in clinical psych and neuroscience, areas which I deeply enjoy. However, I am also scared about what this means because at the end of this year my degree will be finished. Then I have to choose where I want to go from there. Will I continue with honours? Will I complete my masters? And in what and where? I’m anxious even thinking about it. I am just as uncertain about my future as I was when I had just finished high school.

I hope that this year I can do well with my grades and get into something that makes me happy and that I’m passionate about. I want to do well but I also want to stay mentally and physically well. I think I am finally learning to balance and manage my illnesses with other commitments. It’s taken me a long time but I’m heading in the right direction and that gives me hope.

Identity and career confusion

I have a confession to make. For so long I’ve been determined to complete my science degree and pursue psychology as a a career. I was certain that this was what I wanted and was going to do. Now… I’m not so sure.

I was forced to take a leave of absence at the end of last year and have tried to go back twice since then but haven’t managed to. I’ve been off for a year and still have a year and a half of a three year degree to go. I want to finish it, I do. I just don’t know if I can handle the pressure or if it’s the right course for me. If I could go back and tell my 17 year old self anything it would be to decide what I wanted to do then. because at least if I didn’t like it I’d know by now.

I chose science because I was indecisive and it left options open but what I didn’t consider was whether a high pressure environment was the right choice for me. It wasn’t. Don’t get me wrong, I love my university but I wonder whether the pressure contributed to my declining mental health.

Right now I’m still not sure what I want to do. I guess that’s a common thing. It’s hard to plan out the rest of your life when there is so much uncertainty and I think it’s unfair that there is this expectation of young people coming straight out of school to know what they want to do.

This all has left me feeling disheartened and confused.

I’ve been considering doing a course in nursing or teaching, both which can be done as masters after my bachelors or I could choose to start a new bachelors degree. There’s also the option of completing a short course at tafe for 6 months and going back to university study at the beginning of next year.

The honest truth is I still don’t know what I’m going to do. Whatever decision I make, I feel like it’s not going to be the right one. I know I have to make one but at the moment it feels impossible.

Small steps are sometimes the biggest

Tomorrow I start back at university. It will be the first time in over 7 months that I’ve sat in a classroom and I’d be lying if I said I wasn’t terrified. I’ve been hyperventilating and breaking out into tears all week because it just feels like to much and I’m worried I won’t be able to cope. I even considered deferring again or dropping out completely but studying is what makes me happy and hopefully this year is going to be different.

first time back on campus during o-week wishing this was butterbeer

I’m in the (lengthy) process of registering with the disability department and developing an adjustment plan that will be sent out to all my lecturers. This means that if I need extra time or support the way to get it will be much simpler. Despite uni being the place that first referred me to mental health services, I still have not disclosed to them that I suffer from mental illness. In part this was because I don’t feel like I deserve any extra help and also, because I feared that having my diagnoses listed on my record would have negative consequences for my future. But I’ve realised that this doesn’t mean I have to use the support just that it is there and to my relief I haven’t been asked any specifics about what I’m diagnosed with, just what will help me in my studies.

One thing I am struggling with, is that I’m going back to uni on Monday x kg heavier than I was a year ago. I am embarrassed and uncomfortable in this body but I know deep down that the increase is a good thing. With this weight comes better concentration and mental capacity and hopefully the strength to cope with studying again. Last year I though I was fine and while my bloods reflected that, I was exhausted and looked like death. Every day I had to get out of bed was hell because physically my body was weak and compromised. And while I hate admitting it, so was my cognition. No one really knows how I lasted that semester because I was running on empty and despite what I thought at the time, it did catch up to me just not in the way I would have expected (insert many hospital and crisis admissions).

Now I know I still have weight to gain. I know that things could easily go downhill and I know I still have far to go. But I’m willing to fight this time. I’m willing to look after my health so that I have a chance at making this work. I’m not ashamed of my body or my history. With health comes strength and nothing is taking my studies away from me again. I’m going to make uni work this time.

Aside from the above, some other changes in my life have occurred. My old case manager left which (excuse me being dramatic here) pretty much broke my heart and I don’t think I’ve come to terms with the fact that I will never be able to talk to her again.  I was assigned to a new one and we seem to be getting along. I have also begun seeing my gp regularly again and am on the waiting list for an eating disorder program. Small things but with a big impact all the same.

 

On being a mentally ill psych student

It takes a certain type of person to be attracted to helping others.

I don’t believe people can be drawn to the psychology field without at least a small part of them wanting to make a difference. Like teaching or nursing, this isn’t a profession that you go into for the money. If it were purely for financial gain or prestige then there would be more surgeons and lawyers. That’s not to say that people who enter those fields don’t do so because they want to help people, but rather that the wages associated with psychology don’t necessarily equate to the required effort and education.

It is no secret that like attracts like and when questioning the reasoning behind your desire to help people, lines can be blurred. Some people believe that the only reason anyone studies mental illness is so that they can fix themselves but I don’t believe this is true. Yes ,it can be helpful to understand why you are the way you are and how you become the person that you did but it’s also difficult.

It can be discerning to listen to ignorant comments from other students and even some lecturers who don’t understand because they’ve never experienced what you have. It’s hard not to want to stand up in a rage and yell because what they’re saying is wrong. It’s hard having to sit through explanations of your own symptoms and even discover ones you didn’t know you had. But some say that’s the nature of studying psychology. It’s a science that can be immediately applied to every day life and people will relate to certain things whether they are mentally ill or not.

It can also be triggering and confusing. You start to question your own upbringing and wonder whether your illness’ are valid since you don’t fit ‘x’ criteria. But having a good understanding of yourself is crucial to  becoming a good psychologist and can only help you, help others.

The important thing here is to acknowledge that you can’t fix yourself. If you are struggling with your own issues the best thing you can do is seek professional support and the sooner the better. To be a good clinical psychologist  you don’t need to be mental illness free (especially as many illness are lifelong) but it is essential that they are managed. Mental illness is treatable and you would be a hypocrite and highly unprofessional if you were to treat patients without dealing with your own issues.

Please don’t be afraid of your own history impeding your ability to become a good mental health professional. With lived experience comes great empathy and unique insight that not all possess. You know what it is like to be ill and to seek treatment. You’ve been on the other side of the system and have some understanding of what is and isn’t helpful. It is not necessary to have suffered to become a good health professional but it can be used to your advantage and the skills you learn while studying psychology can be applied to many different fields.

Yes, I am mentally ill and studying psychology but no, I will not let that stop me from becoming a great psychologist and you shouldn’t either.

Where has the year gone? -things I’ve learnt

It’s an odd feeling, waking up and realising it’s October and that Christmas is just around the corner. I can still remember the nervous excitement I had at the start of the year. A lot has changed since then, and a lot hasn’t changed. I’m still the same person with the same values and the same priorities, I still get incredibly anxious about using public transport and I still spend too much time watching netflix instead of studying. There have been some little changes; my newfound love for veganism and botany, and some things that have been constant; converse I’m looking at you. But what has been great about this year is that I’m enjoying learning, putting myself in new and scary situations and am opening myself up to new opportunities.

It’s okay to not be okay. This is only something that I’m starting to realise now.  I’m also beginning to come to terms with the fact that asking for help is a good thing. I’ve spent many a night wishing that I was ‘normal’ and could manage things on my own but nobody is perfect and asking for help is something we all need to do at times. Whether it be from a friend, family member, stranger, coworker, tutor or doctor.

You can fail your way to success. Each time you fall down, you learn from it and you become a stronger person. I recently received my first truly ‘bad’ mark since starting university and by that I mean throw your laptop across the room and pull out the ice-cream and tissues bad. But it’s okay, I like ice-cream. I didn’t intend to tell you this but hey, I won’t be the first or last to have failed something at uni. I got a mark of 36% on an assignment (worth 5% I don’t even know why I was upset) that I was sure I would get at least a H2A on and it made me doubt whether I deserved to be a student, but I do deserve to be where I am and one bad mark is nothing in the grand scheme of things. I just might have to work a little harder. If Steve Jobs and Bill Gates can drop out and still do amazing things then there is hope for the rest of us.

You are not the person you were yesterday. This year I have kept finding myself stuck in similar situations and it was only once I’d thought about it 2 million times that I realised, that what had changed was my opinion about the whole thing. Sometimes we do stupid things twice but the person we are when we do them isn’t going to be the same and we don’t have to do these things. We can choose not to.

Honestly, 2015 has been a little up and down for me (so far) but I’m proud to say that I’ve come further than where I was a year ago. I’ve changed from the clumsy, naive, western suburbs girl who somehow stumbled into this prestigious uni, to a slightly less naive, clumsy adult who still needs help to make her own medical appointments. One thing at a time (:

I know it’s only October but it’s been a year since I finished high school and it all feels like a dream. I hope you are all well, and feel free to contact me or comment on my posts at any time x 

-S