"From Both Sides of the Table" is a blog that offers insights and perspectives from both mental health professionals and individuals who have received mental health support. It explores the experiences, challenges, and lessons learned from both sides of the therapeutic relationship.
Dr. Harsimar Kaur is a recently graduated 24 year old doctor currently working in Amritsar, Punjab. She has also lead as a Regional Director for Global Association for Indian Medical Students, State President for Student Network Organization and All India Association of Indian Medical Students, State Co-ordinator and Mental Health Project Lead for Medical Students Network (Student wing of Indian Medical Association). She is also a Lived Experience Youth Advisory Panellist from India (YPAG) for Global Mental Health Databank Project undertaken by Wellcome Trust, UK and the Addiction & Mental Health Youth Advisory Board, Sangath, India.
Harsimar is an aspiring psychiatrist and loves to spend her time around the sea and with her fur babies.
TW: Suicide, Abuse, Medical Harm, Eating Disorder, Self-Harm
When I was first asked to write for this blog around 2 years back, we were in the midst of a pandemic. As a recent final year medical student, I felt all of a sudden plunged into the pandemic with no proper training, and found myself surrounded by very high expectations. I was struggling to fit in both my professional and personal roles, while at the same time I had come face to face with the chronic nature of my mental illness, something that I was still not ready to accept even after 2 decades .
With deteriorating physical and mental health I was barely moving in life and didn't feel that my story deserved a place of its own, more so among the many inspirational stories that I had already read on the blog, until very recently I contemplated sharing a part of my story that currently shapes my identity.
Context
As a third generation doctor in my family, people presumed my career trajectory the day I was born, except that my journey was far from what you call a linear journey. At a very young age my mum would helplessly take me along to her hospital duties since there were no other options available for child care. I remember after a while I got a hang of it: and even started enjoying it. Later I would request my parents to let me accompany them for complicated patient cases and procedures. I think I fell in love for the first time at a hospital, at the mere age of 5 - I fell in love with medicine. More so, I felt safe in hospitals as I later on realised that I was finding excuses to be away from home because of the ongoing abuse.
While I was fortunate enough to be the rare ones to not have any sort of parental pressure regarding my academic choices, I was silently dealing with a lot at home. I was too ashamed to discuss about the issues but resorted to unhealthy copying mechanisms such as self harm and setting very high expectations from myself early on and slogging to meet the desired results. Despite doing exceptionally well at my school, both in academics and sports ,things were far from perfect when I started cutting myself in my 6th grade along with experiencing a myriad of other symptoms- insomnia, anxiety, depression, nightmares and unhealthy eating patterns. I was taken to various doctors who were grappling for a perfect label to fit my atypical presentation of symptoms. Despite all this, I could maintain a really good façade externally, up until things started going from bad to worse after my first suicide attempt.
Challenges
I was around 10 years of age when my suicide attempt landed me in the ER (it wasn't my last attempt either). I had crossed the fine line between self harm and suicide. From here began an equally painful journey of being a mental health user/survivor. To be honest, dealing with the MH system was just as painful and retraumatising as my mental health conditions. From gross human rights violations, including forceful hospitalizations and coercion, to medical abuse, I unfortunately had witnessed it even before I entered my 20s. I was diagnosed with PTSD in 2018 after an inpatient stay at a hospital. I got a diagnosis stemming from the medical abuse, to add to the list of other labels that I had been given over my lifetime. From- "Hospitals is the only home I have known (stemming from my love of medicine)" to getting a full blown anxiety/panic attack every time I would try to enter a hospital premises, I felt devastated, as my safe haven was taken away from me .
Growing up, I had taken up volunteering as and when I found things too overwhelming around me. My repetitive hospitalisations as a child and as a young adult exposed me head on to the plights of millions like me who were suffering and I longed to do something for them. Even though I came from a place of privilege, thinking about my fellow inmates at the institution broke my heart every time. Though I struggled with social interactions with my peers, I could easily bond with my fellow patients and would spend hours listening to their stories. After my last attempt in 2018, I started an initiative at my college for medical students which soon expanded to other medical colleges in Punjab. I even started receiving calls from people across the country. My work soon got recognition and I got offers from various Indian Medical Organisations to lead. I found myself working for a cause that I was passionate about. While all this time, I still wasn't vocal about my lived experience as perhaps I had internalised the stigma. I realised that much of the mental health advocacy was undertaken by people like me with lived experiences.
However, when it came to representation, many of our voices were not taken into account especially when it came to Research and Policy making in the country. I was fortunate enough to network with Shuranjeet whose work with Taraki and Wellcome Trust inspired me to take up a project centering on an intersection of mental health and lived experience and I have been working on this for about 2 years now. Even though I realise that there is so much stigma associated with mental health even among the medical community, I am very vocal about my lived experience as of today. I feel much of my interactions with my patients are shaped to a larger extent by the insights that I have gained from my unspoken struggle with the healthcare system as a user. At the end of the day, nothing makes me happier than my lovely patients thanking me for the way I made them feel both as a patient and as a person first. I believe that I am not my disability but my disability shaped just a part of who I am today.
Hopeful Futures
Last month I happened to meet a former Head of Department of a very reputed department where I was hospitalized as a 10 year old. He had told me how he doubts whether I would even clear my 10th grade, let alone become a doctor. I met him after 14 years and broke down as I reintroduced myself to him after all these years as Dr. Harsimar Kaur .
My mental health struggle is far from over and my journey was certainly not a linear one. I have come a long way but I know I have a far longer way to go. It took me a lot of time to realise that while I was fighting with an invisible illness, I had to unknowingly fight with a lot of structural and systemic issues in the background. As an aspiring psychiatrist, I envision an accessible and equitable trauma informed mental health care sector with lived experiences as a central theme.