Tag: mental health

  • Sleep is not for the weak

    Sleep is not for the weak

    I am usually quite hesitant to talk about the issue of sleep because it feels hypocritical coming from me. I struggle with sleep, and I have for a long time. It therefore feels ironic to speak to anyone about the benefits of sleep and how to get good sleep when I would benefit from this advice the most.

    Or perhaps this is precisely why I am well placed to do so. Having lived on the other side, I understand how unsustainable poor sleep habits are, and the heavy consequences borne by those for whom quality sleep is a luxury rather than a given.

    My struggles with sleep allegedly started in infancy. My mother claims that I would reserve whatever sleep I had for the day, then rise proudly and piercingly loud at night, much to the anguish of those tasked with babysitting me after a long day of being adults. She concluded that I would grow up to ply some nocturnal trade.

    I have always found it easier to stay up late to work, study, or think, and then sleep in the wee hours of the morning, starting my day in mid-morning. When visitors came to my mother’s house, I would often be asleep, and the conclusion was that I must be very lazy, especially being a boy. What do you mean by sleeping during the day?

    At school, I struggled with early mornings from primary school all the way through university. Missing many morning classes meant compensating with long hours of self-study, covering what others had already been taught. When I eventually began working on a vocation that required night shifts (prophetic, in hindsight), I excelled at working through the night but frequently clashed with my daytime supervisors.

    The struggle to do what came naturally to me was constantly at odds with how the world around me was ordered. Often, I had to adapt. Adaptation inevitably meant shorter hours of sleep, dependence on an alarm clock, and persistent daytime fatigue.

    This is a familiar story for many of us. Call it different versions of the same book.

    Many are driving with the handbrake on.

    Irritable. Fatigue. Headaches. Difficulty concentrating. Less productive, or entirely unproductive.

    And you know this is true. Morning coffee is not optional; it is a ritual. Alarm clocks so loud that they could be heard on the moon, yet they are snoozed in unison. People steal winks early in the morning, when they should be most fresh and energized from a good night’s rest. In offices, classrooms, and public transport, you see it everywhere. Wake up early to go to work. Sleep on the way to work. Sleep at work. Sleep on the way home from work.

    If you are so tired that you fall asleep at every available opportunity, is it possible that this is your most cognitively alert and productive self?

    I would never have begun to take the issue of sleep seriously had two things not happened.

    The first was that I began working with mental health patients. In these five years, I can state with certainty that poor sleep, or the lack of it, has been the single most common symptom I have encountered. Sleep is a massive problem, and when it is bad, it is profoundly distressing. This made me curious about sleep and what it truly is.

    Then the second thing happened: I read Why We Sleep by Matthew Walker. It is a deeply insightful book, and if you didn’t think sleep was a big deal, it turns out there is an entire branch of medicine dedicated to it: sleep medicine.

    With my curiosity piqued, my own challenges with sleep came into sharper focus. I needed to help myself, but I also realized that this was not a problem unique to me. Many others were battling it too, knowingly and unknowingly. Some were fighting to stay awake in environments that demanded alertness. Others were desperately searching for elusive sleep. Still others believed they could survive on three hours a night and that their bodies would simply adapt and move on.

    Sleep is a biological urge. The longest time on record without sleep is 18 days, 21 hours, and 40 minutes. The Guinness World Records no longer recognizes attempts to break this record because of the serious health concerns associated with both acute and chronic sleep deprivation.

    All animals sleep. Even those in extremely dangerous environments, surrounded by predators, find ways to sleep while flying, while swimming, or even by resting one hemisphere of the brain at a time. Nobody escapes sleep. Nobody should.

    Learning about sleep continues to be a deeply fascinating journey, and hopefully one I can convince you to join me on. Learn a few crucial things. Sleep better. Sleep longer. Get more life out of your days.

    Sleep is not for the weak.

  • Why I am writing

    Why I am writing

    Mental health is a world that few truly understand. It is also a world in which I have been privileged to work for the last four years. In this time, I have trained and worked at the largest mental health institution in East and Central Africa – the Mathari National Teaching and Referral Hospital, with a bed capacity of 700 patients and an outpatient department that runs 24/7 year-round. This institution was officially opened in 1901.

    I have also had the opportunity to work in a smaller setting in a different part of Kenya. Over these years, I have attended to thousands of patients, both those suffering from diagnosed mental illness and those experiencing poor mental health.

    During this time, I have been well-positioned to observe and experience the attitudes towards mental health as held by the community, other health workers, and the patients themselves. I gain these insights through experiences with patient relatives, discussions with colleagues, and interactions with people who discover that I work in mental health.

    For many, mental health work sparks curiosity: they ask what mental illness is like, what it is like working with mentally ill people, whether I can tell if they themselves are mentally ill, whether I can “read their minds,” how they can improve their mental health, and most commonly, why I chose this field. These insights give a glimpse into the perception of mental health.

    I chose to join this discipline because of my academic interest in psychology and human behavior, because I recognized a desperate need for mental health services and personnel, and because there was an opportunity to pursue the discipline while helping those who needed support. I believed I could join others “holding hands in service” and offer something, even if I was no superhero.

    Having already trained in biological sciences and practiced general health for several years, I might have assumed I knew a lot about mental health. I couldn’t have been more wrong.

    I would describe working in mental health as a cliff dive into the ocean of real life. There can be no gentle entrance, because mental health work immediately thrusts you into experiences alternate and sometimes alien to those we frequently experience in our daily lives.

    Every day is different. Each experience is uniquely intense.

    The emotional weight from the story of a divorce, then one who is bereaved, then one who has suffered trauma of war. Sometimes they are the first three encounters before tea.

    The ambiguity of hearing voices, from nowhere and no one in particular. Troublesome voices, sometimes dangerous voices that no one else can hear and that refuse to be silenced.

    The internal conflict of empathizing with a tragic story while having to maintain professional boundaries (distance) and authority.

    The unpredictability of a session that begins lighthearted but erupts into violence almost without warning.

    Perspective, perhaps, has been the deepest lesson. If you have lived a shielded, carefully curated life, mental health work suddenly disrobes you, demanding comfort with the unknown, unseen, and unexpected. The word “normal” becomes the most abnormal concept, and anything becomes expected—or at least accepted.

    These experiences made me realize how much we do not know, how many people do not know, and how much we all need to learn. Conversations around mental health, illness, trauma, and recovery are gaining momentum, but stigma remains significant. Subtle discrimination, mingled with deep love and compassion, is often what I witness from families of those living with mental illness. Poor access to affordable, sustainable care continues to be the greatest challenge.

    Working in mental health is a journey that continually reveals, just as it confuses, draws excitement and despair in equal measure, humbles unapologetically, and teaches an effortless fusion of science with art.

    It is this journey that I will try to share. I hope to help those who wish to understand, those who may wish to participate and make a difference, and those who simply wish to know. We in the discipline have a responsibility to strengthen the human connection in mental health, advocate more fiercely, show the hidden face of mental health within medicine, fight for better access to quality care, and influence communities to support each other.

    So here I am. Trying.