We Need to Open Up About Mental Health. I'll Start.

Thoughts around mental health awareness, and the importance of finding ways to communicate.

Oct 14, 2023

It was World Mental Health Day last Tuesday, October 10th. I shared this message on Notes that day, which felt meaningful. Mental health has been a relevant topic in my life, so I want to commemorate it, and also honour the mental health journeys lived by so many through space and time.

It’s Saturday, and I’ve been thinking all week on what to share to make this a valuable, yet not technical, post.

I realised I feel like doing a brain dump instead. Let’s start by defining brain dump so that we are all on the same page, shall we?

According to the Merriam-Webster Dictionary, a brain dump is:

‘the act or an instance of comprehensively and uncritically expressing and recording one's thoughts and ideas (as on a particular topic).’

There’s also The Free Dictionary which defines it as:

‘1. The act of writing down all of one's current thoughts or necessary tasks, as to help one become more organized, and 2. The act of communicating a large amount of information all at once or in a short span.’

So, as for today’s post, we will understand brain dump as the act of expressing one’s thoughts all at once or in a short span, for the sake of mental health.

Brain dumps are like writing a personal journal. They are good for you and for your brain. When you journal you write freely, without fears or expectations. It’s your deepest feelings without filters. Probably one of the most liberating ways to write, and the most healing too. I practice it all the time, and I always introduce my patients to the art and benefits of journaling, which they find interesting every time.

I felt inspired to do a brain dump myself thanks to this post by

Alex Dobrenko`

(sorry

Mike Sowden

!), and also this post by

Jess Pan

. Both posts being beautifully deep and messy, making me really care. So, to honour World Mental Health Day, I’m ready to share a special and personal brain dump here today. I hope you feel inspired too.

First things first. I want to express a massive thank you! We are now a family of 56 feel-gooders in here. 56!

I’ve done teaching and public speaking (which I love doing btw), but if I think of a room filled with 56 faces, I feel mind blown. Do I really own the pleasure to have 56 of you in front of the screens choosing to read my words? This is a whole new level of writing for me, you know?

I used to write a health column back in 2015-2016. It was a project I proposed to the largest digital newspaper in my country. I was excited about my big vision, and even more excited when they said yes. It was my first time writing for a large audience of strangers in a public newspaper, and to my surprise, their feedback was so positive and heartwarming! It was a big thing for me and I loved every second of it.

Before that time, I had written on blogs mostly, either mine or as a guest on other blogs. My blog has been the longest project ever. My baby. It has grown and transformed so much through the years. However, I never really felt like I knew my readers, except for a few.

I’ve also written for different publications, sometimes on travel, sometimes on health - my two biggest things. I’ve written for inflight magazines, for newspapers, for travel search engines like Skyscanner, for specific brands on health, on wellness, on tourism, both in English and Spanish, you name it. It’s all been a great experience, however, none of those ever felt as intimidating and exciting as this Substack! So yes, 56 is a good lot and I want to thank every single one of you for being here. What an amazing online place to be.

I landed on Substack thanks to the influence of incredible people like

Mike Sowden

And I’ve been inspired by other equally great people like

and

and

and

and

and

and

and

and

and

and

and

and

and

. Each one of them teaching me things through their words, their kindness, their art, their joy, their humour, their curiosity, their vulnerability. Honestly, it’s so moving and inspiring.

I feel this sense of community and belonging here on Substack like I never felt in any of my previous writing endeavours. It’s quickly growing on me. And you know what? This is damn good for mental health.

The thing with mental health is that we all know it, we all have it, and we all suffer from it.

We all struggle with imbalances through life - the anxiety, the panic, the depression, the burnout, the sadness, the heaviness, the mental fog. And then we come out of it, learning how to ride the waves. Not easy, but certainly a part of life.

Fun facts: Did you know that many emotional imbalances originate mostly in the brain, but also in other organs of the body? Like the thyroid, a tiny gland in the throat area, controlling the speed in which many of your body’s processes work. Or the pancreas, an organ in your abdomen in charge of processing your blood sugar levels. All organs in the body have specific functions, but they all certainly interconnect when it comes to hormones and emotional balance. I like to think of hormones as the ocean, and emotions as the surfers riding the waves. It really takes a lot of effort, both mentally and physically, for our brains to keep us steady through the waves. Kudos to the amazing human body!

I’m no stranger to mental health issues. I’ve had my own share like everyone else.

Not just as a doctor helping my patients, which I feel honoured every time I have an opportunity to do so. But also as a patient myself - sometimes even doing the doctor thing when we try to diagnose ourselves. Bad! (Don’t do that at home, aka., don’t Google your symptoms at 3:00 am. Yes, you, I see you!)

Through my own mental health struggles, I’ve been lucky to have a huge, loving support system, starting with family and friends, followed many a times by amazing therapists who helped me untangle that skein of wool that our thoughts and emotions are.

The funny thing about mental health is that when you’re in the thick of it, you’re barely aware you’re struggling with it. It’s sneaky like that! But then a loved one, or a even stranger, may see something and kindly ask if you’re okay. It’s difficult at first, but we eventually come to see our own cloud on top of our heads. And that’s when we realise we might need some help, because paddling on our own for too long it’s terribly exhausting.

I believe that the first step to seeking mental health is acknowledging that something might be going on, and then, opening up to someone we trust. This might be the most difficult step of all, because feelings! Sharing them is a hard task. The brain makes us believe we are weak by doing so, when in fact, it is a sign of incredible strength. It takes huge vulnerability and self-awareness to open up about something that is troubling us.

I remember in my last year of med school, somewhere between July and August 2006, I had one of the most important realisations of my career: I didn’t want to become a heart surgeon after all.

The problem with this was that I didn’t want to be anything else. But being in hospitals day in and day out, with full night shifts every two or three days, running on little sleep and lots of fear, was the most depressed I had ever been. So I was determined to avoid such lifestyle at all costs. But how could I even admit that out loud? I choose my career after all. I wanted it. What would I tell my parents? What about their efforts to put me through uni? What about my relatives, classmates, strangers? I worried about everyone’s opinion…except my own, because I didn’t think I had one.

I still had five months ahead of me before finishing and getting my degree. I cried every day for five months. Desperate, exhausted, scared and confused, not knowing what to do, how to carry on, fearful to make mistakes, unsure of everything I was feeling. Maybe I was just exhausted, I thought to myself. But the crying wouldn’t stop. Neither did the work days and the night shifts. I learned a lot through it all, and some good days seemed to balance things out. But in the larger scheme? It wasn’t fun. I was only 24 years old, about to graduate as a Doctor, and completely fried and clueless about life.

After all this, at least I knew what I didn’t want: to work in hospitals for the rest of my life. This became my rule for personal mental health.

It would take me over a decade to understand and overcome this feeling. I had convinced myself I wasn’t good enough of a doctor, because you know, society’s pointless and meaningless scales of comparison.

After so long, I understood several things:

I had been suffering from strong burnout and PTSD (Post Traumatic Stress Disorder) for longer than I knew.
Depression doesn’t feel like what the books taught me. It’s utterly surreal and abstract. Honestly, every time I’ve gone through deep lows, it took me a while (or someone else’s kind observation) to recognise it.
There was no support or open-talk possibilities back then to help students or healthcare professionals to deal with the stress of medical life. It just wasn’t a thing. And this was not even that long ago, you’d think.
Talking about your feelings was considered a waste of time or a sign of weakness in every case scenario, whether personally or professionally. And when you’ve been insecure to the core, the last thing you want is to jeopardise whatever little sense of security you have left.
Medicine as a career is NOT easy. And it should be a huge source of pride and sense of accomplishment for having done it - feelings I couldn’t see or embrace for years.
Mental health matters more than anything we ever knew. In fact, I’m convinced: health begins in the mind.

How far we’ve come!

After all these years of trying to better understand and improve myself, I’ve also come to some conclusions that I want to live by (and you can too):

Healing is important. And it’s difficult to do it on your own. In fact, we shouldn’t go through healing alone. But what does healing means? It means realising that your life experiences, whether you remember them or not, have shaped the way you think, feel or make decisions. Understanding the roots of who you are is key, and we all need to start integrating this.
Nowadays, everyone talks about trauma, myself included. It’s important. But sometimes we can normalise the word trauma just like we have normalised being stressed. So I think we should be careful when using this word. However, I also think we can all agree that, as humans, we are all influenced by everything we have lived through. Then we can also agree that 1) no one is perfect, 2) that we all have issues we need to heal from, and 3) that a lot of it isn’t always negative. Yes, healing is a gift. I’m the first one to acknowledge how hard at work I’ve been in this department myself for years. I really wish everyone can heal and overcome the things that have hurt them.
Choosing a different path for yourself is more than okay. In fact, it’s necessary. Can you imagine embracing that palpitating nudge in your heart without worrying about the negative voices in your head? Maybe this is something that comes with age, maybe not. But whatever the case, how wonderful if we could nurture this confidence at any point in life. Utopic? Maybe. But I choose to believe.
Understanding that you are allowed to be your own person, with opinions, views, feelings and thoughts of your own, took me a long while - but I’ve arrived. At least to the start of this maturity journey which is already amazing and liberating. And you can too.
Talking about your feelings should feel natural and safe. If it doesn’t feel like this, then you’re in the wrong place. In order to grow, you need to feel safe and protected. You need to trust before you can open up. It’s only natural, and everyone deserves the safety of a nurturing connection to help them start healing.

It takes work, yes. We are masterpieces in constant work. We never stop healing, but it becomes easier and easier through time. We learn to live better, happier, calmer and wiser. And what’s life if not a journey to learn about being human, with all its perks and wonders.

I’m sitting in my bedroom as I type this, with beautiful Scotland outside the window, winking me and reminding me of how life has changed for me in the last three months, let alone in the last six or twelve months. It’s been yet another of my most transformative years. And among the most beautiful ones.

Writing like this, in brain-dumping mode, helps me process, make sense of it all and join the dots of life.

Ah…Life.

Ten years ago, I went through divorce. I remember going to therapy on my own in the two years prior, because I was convinced I was the one who needed fixing. Eventually, the inevitable happened. I continued therapy for a few more months despite feeling calm about my decision, just to examine myself in the process. What happened next was the most amazing year of writing when I journaled through it all, reaching the unbelievable number of 200.000 words written in a few months. (Just so you can have an idea: 200.000 words is the equivalent of 400 pages single-spaced or 800 pages double-spaced.) Writing that much changed me. So yes, I will always support brain dumps for the sake of self-awareness and mental health.

Later on at age 36, I stepped without knowing, into yet another deep period of depression and burnout. It happened while attempting to build a medical online business, which eventually failed, or so I thought. It didn’t really fail, it simply didn’t work like I had envisioned. Eventually, money wasn’t enough to sustain me. Again: the failure, who to talk to, oh the stigmas, I chose this, no one forced me, I’m dumb, what will people think, I am the failure, I should listen to everyone else, what’s happening to me, I wanna disappear, no one gets me, so why even try, no one cares, let me just sleep and cry.

Mental health issues don’t care about age.

When I was 14 years old, I handed my parents a letter (more like I slipped a letter under their bedroom door) sharing what was probably a massive teen brain dump (oh dear!) with some hints of me wanting to be gone from this world. I remember feeling it all and writing that letter, and I also remember not really considering suicide. Ideas went through my mind, but never so strong to consider any actions. It takes something else to get there, and I’m glad I never did. What I did was imagine endless scenarios - like being in a bad accident, making me dependent, or wanting to be badly sick on the verge of dying, so that I could be surrounded by family. Now I know they were all coping mechanisms to find relief from the pain inside.

At age five, my parents divorced. It wasn’t traumatic at all (or so I thought). There was no yelling, no screaming, no fighting. Nothing. I don’t remember much though. All I knew was that we were suddenly going to “take care of my grandma’s house while she travelled.” Except we never went back home. That’s how I remember it. And so life went by, convinced that parental divorce did not affect me one single bit. Well, the things you discover when you go through therapy! Bless.

Life may be what happens to us at any age, influencing our personalities and our ways of thinking. But life is also what we make out of it, with our growth, our awareness and our conscious decision-making.

Since I’ve reached 40, I have found myself feeling calmer, stronger and clear on how I don’t want societal norms or my old fears dictate the way I live. I have so much to do, to give, to learn, to feel and to enjoy yet!

I’ll soon be making big moves again. I’m going back to my home country after 13 years in Spain, the most amazing third of my life. It even turned out that love knocked on my door again in the process! Life, eh?

And you know what? I’m loving this phase. Because why not? Because some years have been hell-ish, and now it’s feeling heavenly, and I’m determined to enjoy the heck out of it. Life is so uncertain. Sometimes we are riding the wave, and sometimes we are being stirred by the wave. Life is messy. And overwhelming. But also beautiful.

Life is a mental health journey.

No matter in which stage of life you are, you can choose whatever you want, and do whatever you need for yourself. Because you matter. Your voice matters. Your life matters. Your emotions matter. Your feelings and thoughts matter. Your dreams matter. Your rants and overwhelmingness matter. Your respectful opinions matter. Everything matters without distinction.

Because deep down, we are all the same

At the end of any day, what we all want is to love and feel loved. To feel heard, accepted and seen. Why does society insist on making us believe that we are different? Yes, cultures, languages and beliefs are there, but the deep human desire to be loved and to belong knows no boundaries.

When we feel safe and like we belong, we start understanding ourselves and others better. We can heal. And when we heal, we can love more. And when we love more, we come to peace with ourselves and the world around us. We learn that community can be a beautiful thing.

We also come to understand that it’s okay to draw healthy boundaries into relationships and the world in general. By setting them, we become kind, hopeful and unstoppable.

And I think this is a magical place to be in.

A place where we can create, inspire, and enjoy.

A place where we can stop surviving and start thriving.

What a journey. I would normally write this kind of stuff in the privacy of my journals at home. But life has also shown me that when you heal enough, you can embrace yourself and help others on the way.

So thanks for joining me on my brain dump! Maybe you could practice some brain dumping too. I promise you it will make your inner world, and consequently the entire world around you, a much better place.

And because it’s World Mental Health Day, I want to bring this specially important reminder to you.

If you struggle with mental health, please know that:

1) You’re not alone
2) You can always ask for help
3) People will come out of their way to help and support you
4) You can do this

Reach out to your most trusted person, your local mental health community or your nearest healthcare establishment. No one should ever go through those rough mental health patches on their own.

And if you know someone who might be struggling, please reach out, be kind, offer some help in the best way you can. Your efforts could mean the world (and life) to them.

With all my healed love and support!
Dr. Mariana