“I think I’m finally ready to start medication.”

I don’t notice, but a small pile of fingernails litters the floor at my desk like bones in a long-forgotten graveyard. Unconsciously, I claw at each nail, cuticles raw and bleeding – an anxious habit learned long ago from my mother. I shift uncomfortably in my chair, trying to keep my voice even. I’m prickling with sweat. I’m talking too much, uncomfortable with any moment of silence during this phone consult with my family doctor.

As a physician, counselling patients about mental health is a daily part of my job. Yet, what most people might not know is that physicians, for the most part, suck at being patients themselves. Case in point – it’s taken me over a year to make this dreaded phone call and I’m nervous as hell to speak to my lovely GP about something that is as common in family practice as dealing with a sore throat or an ingrown toe.

For over a year now, I’ve been quietly contemplating starting an SSRI – a class of medications used to treat anxiety. My reluctance, however, was informed by my deeply-rooted, core belief that no problem cannot be resolved by simple hard work, perseverance and a healthy dose of self-sacrifice. Work harder, push through and above all, keep your head down and just keep going. These ideals, ingrained into my childhood consciousness, have certainly served me well in medicine and continue to still do in. Who wouldn’t want a micromanaging, hypervigilant physician with an insatiable work ethic? But after two years of counselling, mindfulness and regular exercise, I was still unable to play.

Yes, play.

For years, all Henry has ever wanted to do with me is play LEGO. His absolute favourite activity, each morning he wakes me with the same plea, ‘Mom, will you play LEGO with me?’. Coffee in hand, I would sit amongst the sea of colourful blocks scattered across his bedroom floor, anxiously scanning the extent of the mess. With Henry’s coaxing, I would pick up a LEGO man and participate, under Henry’s direction in the imagined scene. Yet, always within minutes, without intention, I would abandon the game and find myself sorting the hundreds of LEGO pieces, reattaching minuscule arms onto limbless torsos and corralling escaping blocks back into the bin with the same desperate monocular focus I applied in my work. Disappointed as always, Henry would gravely inform me of his dismay. ‘Mom, you’re not playing,’ he would lament, wandering off to find Alice instead and each time, no matter how shitty of a mother I felt, I could not stop bringing order back to his playful, imaginative LEGO world. In truth, it broke my heart each and every time.

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Smiling kids on the ski hill, photos documenting camping adventures across the Rockies, scenic hikes with picturesque mountainscapes in the background – the feed of photos, as always, tells only one small piece of the story. This past year has been full of excitement, hard conversations, difficult transitions, loss, grief and new adventures. While we are incredibly privileged to have been able to move our family to Kimberley, named the best small town in BC by the CBC, this year of transition for our family has been disquieting, to say the least.

I mourned the loss of our first family home on the shores of Abram Lake – the proprietor of all of our young family memories and grappled with the dissonance I felt when imagining another family flourishing within its frame of cedars, pine and untouched shoreline. The anguish of abandoning our plan to build a fully passive home on the 36 stunning acres stretching before the Norwester mountains on the outskirts of Thunder Bay and the loss of the two years of energy, planning and anticipation attached to this project was particularly painful for Blake. At the same time, I struggled for months with deep feelings of grief and loss of what our decision to move away from my job in Sioux Lookout meant for me as a person and as a physician. If I wasn’t going to be the passionate full-scope, rural family physician toiling away in the trenches in the North, then who was I? And if I’m going to be truly honest, if I wasn’t working in the most challenging capacity that I possibly could, would I still be worthy of my job as a physician? The farcical fear of scarcity – would I be enough if I was just a simple family doctor?

Above all, Blake and I circuitously debated our decisions and how they would affect our kids, our family’s future and our collective happiness. How would Henry and Alice’s lives be different if we stayed in Northwestern Ontario, possibly to their detriment, in order to keep Mom’s dream job alive? We exhausted lists of pros and cons, hashed out financial scenarios in Excel spreadsheets and leaned heavily on our close friends for advice.

As you can imagine, my cuticles have not been pretty over the past year and the rosy picture on social media notwithstanding, I was struggling. Despite doing all of the things I routinely advise my patients to employ in their day-to-day lives to improve and maintain wellness, I felt like I was constantly spiralling, tearful and brimming with fear. I knew I had to finally make that dreaded call to my family physician. I couldn’t help but ruminate on this constant, nagging thought – what if there was just this one thing that never I had the courage to do? This one thing that could be the difference between a mom who could be present, who could be still and who could play?

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Almost six months in and my nails are still ripped to shreds, but I have noticed slow and steady gains. Once this summer, I didn’t have time to fully finish weeding the garden and I just… left it! Can you imagine?! All joking aside, although life still is throwing us curveballs, this summer Blake and I have survived two different moves – one in Sioux Lookout and another from Ontario to BC that required two different cranes, a 40-foot shipping container, two cars and one trailer with our marriage intact. Although we struggle, as all couples do, our ability to manage these rough waters together has massively improved with my step back from the metaphorical ledge. Above all, although I still grapple with the chaos of the playroom, the LEGO dudes continue to be limbless and the LEGO bin is a jumbled mess and despite the disorderliness, I just think I might be ok with it.

As we all navigate transitions this Fall – back to school, maybe a new job, all the while continuing to face financial, political and climate uncertainty in our world, I wish you all the courage to get the help that you might need to be a more stable partner, parent, colleague, family member, friend and, most imperatively, a more grounded you. And if the thought of this brings you to ferociously whittle your nails down like me, remember, doctors are people and patients too. The universality of our collective mental health struggle is real. You are not alone.

https://www.ccmhs-ccsms.ca/mental-health-resources