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Health: being a medic and patient

by
19 April 2024

Sharon Hastings was diagnosed with a severe mental-health condition while studying medicine. Christine Miles asks about her latest book

Sharon Hastings and her husband, Rob, with baby and pets

Sharon Hastings and her husband, Rob, with baby and pets

What inspired your first book, Wrestling With My Thoughts?

I wrote it because I had been diagnosed with — and was living with — a severe mental illness. I had met others, including Christians, who felt that they were the only people living with that, because it wasn’t talked about. Certainly, there weren’t many books from a Christian perspective about severe mental illness: schizophrenia, bipolar disorder, and schizoaffective disorder (which was my ultimate diagnosis).

So, I wrote my story, starting when I was final year medical student, and just before that, when I was first diagnosed with depression.

As a medical student, I found that very difficult. I thought: this doesn’t happen to doctors. I also thought: this doesn’t happen to Christians. Eventually, I was also diagnosed with an atypical eating disorder. When I didn’t eat much, my mood lifted a bit: it was a physiological effect, and I got addicted to that.

I did my finals from a mental-health unit. I grabbed my white coat and stethoscope in the morning, left the ward, and went over to a different hospital, did my exams, and came back to the hospital again, where I was actually a detained patient. But I passed my finals — which was a surprise to most people.

After leaving medical school, and losing the ability to continue with my career, I became very low. A couple of years later, I had a very different episode: I was very, very energised. I actually wrote an 80,000-word novel in less than two weeks.

I went to see my psychiatrist. I was twirling around her room, and immediately I could see her facial expression change. She said: “Sharon, you’re bipolar.”

I got used to the bipolar diagnosis, and actually got a lot more support because of having that severe mental-illness diagnosis. I was put on to mood stabilisers and antipsychotics, and I felt more stable and myself.

But, about 18 months later, I was diagnosed with schizoaffective disorder (a mental illness affecting both mood and thinking, with episodes of mania and/or depression, and psychosis), because I had an episode where my mood was actually normal.

I was not feeling low; I wasn’t manic; but I started to experience a detachment from reality. I had an experience of an evil presence behind my left shoulder. I also was aware of pterodactyl-type creatures flapping around my head, mocking me. I was convinced that I was getting messages from the fourth dimension, and I was very mixed up, because I felt that God was telling me things, but other people were telling me: “You’re unwell, and you’re having this experience.”

From 2015 until 2018, I experienced 15 hospital admissions. I had no more manic episodes, but I had significant episodes of depression and psychosis. I came to the conclusion that it was my lot in life, to live with a severe mental illness, but to live well with it. And it was from that place that I wrote the first book: a kind of an acceptance that I have this illness; I’m a Christian; I’m a doctor, who’s not working as a doctor.

I wanted to share my story, because I wanted others in the same situation to feel less alone. And I wanted the people around them to understand better.

I also wanted the Church to be more aware. I felt as if there was a good conversation in churches about depression and anxiety at that time, and, to some extent, about issues often associated with young people’s mental health, like self-harm and eating disorders. But I hadn’t really ever heard in church mention of schizophrenia, bipolar disorder, etc.

A lot of Christians I met weren’t engaging with church, because they felt stigmatised. But Jesus spent his time with those who were stigmatised, and I felt, that’s where the Church was called to be. I wrote Wrestling With My Thoughts in 2018, and it came out in January 2020.

 

What experiences inspired you to write your new book, Tending To My Thoughts?

In 2016/17, I encountered this new concept in mental-health services: the Recovery College. I think every NHS Trust has one, or they run courses relating to recovery. It’s there for people with severe mental illness, as well as people with depression and anxiety. It doesn’t mean you’re going to be cured, but it does mean you have a better life; a life worth living. Although at that time, I kind of rejected the idea that recovery was possible for somebody who’s been through what I’ve been through.

Then, in 2019, I was admitted to hospital again, under a different psychiatrist. He said: “You’ve had 15 admissions in three years; this has to stop.” I had not considered that this could stop.

We talked about different treatment options. He wanted me to stay in hospital longer than I had done before, and to really achieve stability. I had always been keen to leave hospital as soon as I felt a little bit better, and that was probably not helpful. He actually got me to stay in hospital for four and a half months, and incentivised me to do that by saying, every evening, that I could go home and have dinner and a walk with my husband, Rob.

He also changed my medication. Doctors had been reluctant to give me antidepressants, because they can make you high. I’d not been manic for quite some time; so he put me on a new antidepressant that worked on the melatonin system. That brought about a real improvement. And he increased the antipsychotic dose slightly.

I’d had counselling and different talking therapies previously, but they’d been quite brief interventions — eight weeks, or whatever. When I was being discharged on this occasion, a counsellor agreed to work with me for as long as it took. And, in the end, we worked together for a year. It was about rebuilding my sense of self, because I’d really lost that. I’d been identified so much with having a mental illness that it had just became all of me.

From then, all kinds of things happened. I got a part-time job, and we decided to try for a baby. I became pregnant very quickly. That was also pivotal in my recovery, because I knew I had to do everything in my power to be well.

I was taking courses from the Recovery College again. And I was reading an awful lot about recovery. My mindset had changed, from expecting others to fix me, to wanting to do everything in my power to stay as well as I could myself.

I developed a long-term mindfulness practice, which helped me to manage my depression. It takes away the inevitability of that self-fulfilling prophecy: I feel sick for a few days, therefore, I’m going to end up with this huge episode.

It broke the cycle of that. I was able to see that I might feel better this evening. I might feel better tomorrow. And what am I going to do to help me feel better this evening, or tomorrow?

Many people with severe mental illness have a sense that they’re not going to get better. I wanted to let people know that it can be better.

And I wanted health professionals to see an example of one person — who has been extremely unwell, to the point of having electroconvulsive therapy (ECT), repeated hospitalisations and things — to whom recovery can happen.

 

Where did you feel God was, in all of what was going on?

When I was diagnosed with depression in 2006, I found it hard to reconcile that with my faith, because I felt called to be a medical missionary — especially as the year went on, I was in hospital, and I realised that I wasn’t going to even work as a doctor, never mind work abroad.

In 2008, after going through a couple of difficult experiences in treatment, I felt abandoned. That was before I had got a proper diagnosis, and I felt like I was in no man’s land. I didn’t ever think that God wasn’t there; I just felt that he had lost interest in me.

But then the opportunity came up for me to go to a Christian treatment centre in the United States, and I was blown away by the care and compassion shown to me. In a chapel service early on, I felt like I was in God’s presence, and that I was where I was meant to be. I took the decision to recommit my life to God, and I’ve never looked back. Even though I’ve been in some really dark places, consistently, at moments where my faith is ebbing, there have been glimpses of God.

When I started on the recovery process, I felt like God was at work in my life, too, and changing things in me. In the sense that, like with the health professionals, I would have gone to God saying: “Please do this and this,” I became more more inclined to pray the Serenity Prayer: “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” I was taking more responsibility.

Some of the treatments I’ve discovered along the way have helped me to live in a more Christlike way. I didn’t do a full dialectical-behaviour-therapy programme (DBT), but I learnt DBT skills. I find them really helpful to get a handle on my emotions. Those techniques buy time and give more self-control when feeling emotionally heightened.

 

What do you mean by mindfulness, because there’s lots of mindfulness out there. . .

I’m talking about secular mindfulness that is a Westernised tool in mental health. So, basically, it’s very simple things: when you see a flower, lingering and taking it in — what colour is it? what’s it like, its beauty? — and seeing that as a reflection of God at work in his creative process.

Or of walking by the sea, and really savouring the salt on your lips, the wind in your face, or the sun on your back: really taking it in, drinking in the positives, because the brain is biased towards negativity. If somebody says something negative, or something negative happens, those things register in the brain and stick more easily than positive things.

If someone gives you a compliment, that doesn’t stick as quickly as someone saying something negative to you. So, when you experience something positive in mindfulness, you really soak it up, so that the positives register, and balance out the negatives.

I practice mindfulness movement as well, because I like to move. So, I do yoga. But, when I talk about yoga, I’m talking about the bringing it down to the essential definition of yoga, which is union of breath and movement.

I find it very calming. But the main purpose of a mindfulness practice is bringing you back again to the present moment; so your thoughts are not running off into ruminations about what’s happened that day, or what’s happened in the weeks previously. It’s not planning and analysing what you’re going to do the next day, or how are you going to cope with this episode of wellness, or whatever. You’re just living in the present.

I also practice mindful movement, which is slightly different from yoga, and maybe doesn’t have those same connotations.

 

You talk about having a Wellness Recovery Action Plan (WRAP) to keep you on the recovery journey. Can you explain more?

It’s a recognised tool for recovery. It’s kind of a way of taking back control. It’s a six-part plan. With the WRAP, I’m aware of the things I need to do in the day. I’m aware of signs that things are going off a bit. I’m aware of the triggers that may destabilise me, and I have a set of tools for what to do if those things are there. The WRAP also includes a crisis plan of what to do if you become unwell, and a post-crisis plan of how to get back to where you were before you had the crisis.

It’s very comprehensive, but it’s quite straightforward. It’s starting to become quite recognised across NHS health care, really. They use it with chronic physical illness as well, as a recovery plan and as maintenance plan. For me, the main thing with the WRAP is using the tools to elevate my mood a bit, and when I’m starting to go low.

Recovery is not linear: it’s a journey. There are things that go off at times, but you’ve got the tools to get back on the road again. It’s different to having episodes where you’re just trying to firefight.

Earlier this year, I had a brief episode of hypomania, which is like not quite as high as mania, but needs to be controlled. That came out of the blue. But the thing with recovery mindset, and having people around me knowing what needs to be done to help me, is that we got on top of it very quickly.

 

As a doctor and a Christian, how do you consider “healing”?

I have not been healed. I always usually talk about recovery, not being cured. But there have been healing moments, even in those really unwell times: seeing the leaves dancing through the stained-glass windows in the quiet room of the hospital I was often admitted to; being outside and seeing a bird; friends just popping in. There were times I felt like God was ministering to me in a gentle way, even in very, very hard times.

I realised that, even though life was hard, God was good; that he was holding me and that he was giving me strength to get through each day. And, at that point in time, it really was very much about getting through; about surviving; about getting to the next day, whereas now I’m in a place where I can think more longer term than that, and in recovery context.

I believe that God can heal. I just think that, with severe mental-health conditions, he doesn’t heal, in the sense of curing, very often. I think it’s more about this process of gentle ministry to the soul.

When I look back: from 2015 to 2018, 15 hospital admissions; 2019 to 2024, no hospital admissions. You could look at that and say: “She’s been healed.” But I still have symptoms that I have to live with. And I still have to take medications that have side effects. So, it’s healing, but it’s not healed.

 

What insights do you have into your own condition, having trained as a doctor?

I know a lot about the medications and how they work, and that is helpful. And I knew, before I had my diagnoses, what the conditions were about, and what they meant from a clinical perspective. In terms of having experienced mental illness, I really was very distant from that as a doctor.

I can remember on my psychiatry placement, where I went for a couple of months as a fourth-year student, we would go to the canteen at snack time, and there would be a group of doctors and medical students at one end, and a group of patients at the other. It was very much them and us.

I was very glad to be in the “us”, and I didn’t think I would ever cross to the other end of the cafeteria. But, of course, I did. And it’s a very different learning experience, an illness, from reading a list of symptoms and writing about them in an exam.

It’s certainly been helpful as a writer to be able to have that medical perspective. Explaining diagnoses, explaining how different drugs work, and that kind of thing in the book people find helpful.

And, maybe, I have an advantage in consultations with doctors.

 

How do you think churches can be helpful to those in congregations with mental-health conditions?

They can help by taking a stance to reject stigma, and to have conversations around severe mental illness.

I think, sometimes, people say: she’s got schizophrenia or something, that’s for professionals, and we can’t deal with that in church. But what people with severe mental illness need from a church is not health care, because they’re getting that through their community mental-health team, or whoever’s involved.

What they’re looking for is community, belonging, fellowship, discipleship; — all the things that all Christians are looking for in a church. But it might be that they need a little bit more support to avail themselves of those things. They might need someone to sit with them. Or, it might be that a church service is not a place where they’re able to participate, but they might be able to do a coffee morning.

There are structured things that churches can do. The charity Kintsugi Hope runs well-being groups, and that kind of thing can be really helpful. So, it’s just about including people with severe mental illness.

I’ve been in my current church for ten years. In terms of support with family life, in the early stages, when my son was very small, we were blown away by the support. Certainly, being plugged in and part of a church is a vital ingredient to my recovery. The discipleship, community, sense of belonging — all of those things are important — and the hope that I have, in terms of staying in tune with God’s longer-term plans and knowing that, one day, I will be completely healed — not restored to how I was, but transformed into something even better. That’s important for me.

 

Tending To My Thoughts: A doctor with severe mental illness finds recovery is published by IVP at £11.99 (Church Times Bookshop £10.79); 978-1-78974-454-5.

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