MHM Magazine

24 | MENTAL HEALTH MATTERS | 2025 | Issue 4 MHM difference: • Normalise seeking help: Stigma remains one of the biggest barriers. Doctors fear being judged or penalised for admitting to mental health challenges. • Introduce regular mental health screenings for interns, just like routine physical check-ups. • Provide safe spaces — peer support groups, mentorship programmes, and confidential counselling services within hospitals. • Target both old and new substances in education campaigns. It’s not enough to talk about alcohol and tobacco anymore; we need to openly address vaping, shisha, and other emerging trends. Tips For Doctors Warning Signs to Watch For Substance Use Red Flags • Escalating Patterns: Increasing frequency, higher doses, or using substances earlier in the day to “cope”. • Tolerance and withdrawal: Needing more to feel the same effect, or experiencing irritability, tremors, or sleep disturbance when not using. • Workplace impact: Reduced concentration during ward rounds, missed shifts, or reliance on stimulants to stay alert. • Neglected responsibilities: Skipping CMEs, paperwork delays, or difficulty meeting academic deadlines. • Risk-taking behaviour: Driving after alcohol, unprotected sex, or borrowing medications from colleagues. • Social withdrawal: Avoiding friends, colleagues or family, in order to use substances in isolation. • Psychological cues: Rationalising substance use as “deserved” after long shifts, or minimising the problem (“everyone does it”). Depression Red Flags • Mood changes: Persistent sadness, irritability, loss of humour or enthusiasm. • Loss of pleasure: No longer enjoying hobbies, professional achievements, or social gatherings. • Cognitive symptoms: Poor concentration on patient notes, difficulty with clinical decision- making, forgetfulness. • Somatic complaints: Headaches, unexplained aches, fatigue, or GI symptoms that have no clear organic cause. • Behavioural clues: Arriving late, looking dishevelled, or neglecting personal appearance. • Sleep & appetite changes: Difficulty falling asleep, early morning awakening, overeating or loss of appetite. • Hopeless thoughts: “What’s the point?” or “I can’t keep going like this.” • Suicidality: Expressed wishes of escape, giving away possessions, or passive thoughts of not wanting to wake up. Reminder: Doctors may normalise or conceal these signs — peer observation and supportive check-ins are crucial. Healthy Alternatives for Stress Relief & Mindfulness Mindfulness and Relaxation • Micro-mindfulness: two to five minutes of breathing before ward rounds or after difficult cases. • Grounding exercises: Naming five things you can see/hear/ feel in moments of overwhelm. • Guided practices: Use apps or free YouTube videos for guided meditations. • Mindful transitions: Taking a few minutes before leaving work to “close the day”, preventing spillover into home life. • Gratitude journaling: Writing down 3 things that went well each day or shift. Physical Well-being • Movement as medicine: Even 10 minutes of walking between shifts improves mood and focus. • Exercise/Yoga: To help clear your mind • Sleep hygiene: Set a wind-down routine, avoid caffeine in the evenings, and use blackout curtains or eye masks for off- shift sleep. • Balanced nutrition: Meal- prepping simple, healthy snacks to avoid reliance on hospital junk food or vending machines. • Hydration ritual: Carrying a refillable water bottle and linking drinking water to routine tasks (e.g., charting vitals). Social & Emotional Health • Peer support: Join or start small peer groups where colleagues can share struggles safely. • Mentorship: Seeking guidance from senior colleagues who normalize vulnerability. • Boundaries: Learning to say “no” to non-essential requests when already stretched. • Professional help: Accessing EAP, confidential counselling, or psychiatric support early. • Creative Outlets: Engaging in art, music, gardening, or writing to decompress outside of medicine. • Spiritual Practices: Prayer, meditation, or community worship for those who find strength in spirituality. Quick Stress Reset Tools • Box Breathing: Inhale for four counts, hold four, exhale four, hold four, Repeat three times. • Nature micro-breaks: spend five minutes outdoors — sunshine, fresh air, trees. Resilience in medicine is not just about pushing harder — it’s about pausing, noticing the warning signs, and choosing healthier ways to cope. Final Thoughts The face of substance use is changing, and the incidence of depression is on the rise, and with it, the risks faced by our youngest doctors. As colleagues, educators, and policymakers, we must act early — not just to protect these doctors but also to safeguard the patients who rely on them. Because when the doctors aren’t well, the whole system suffers. References available on request. MHM | 2025 | Volume 12 | Issue 4 | Emerging Drug Trends and the Hidden Mental Health Struggles of Young Doctors In Kenya H