STP Support | Navigating the STP with ADHD

Bioinformatics Trainee – Suzy

Mental illness affects all of us in some way, whether through personal experience or the experience of a loved one. Hopefully we all know by now that mental illness can affect anyone, and I like to think that in the past few years society has moved towards unravelling the shame and stigma that is attached to it. Don’t get me wrong though, we still have a long way to go.

I’ve just started my second year of the STP on the Bioinformatics specialism and I’ve spent most of my life since I was a teenager with some degree of depression and anxiety. 

I struggled my way through a BSc and then a PhD, both of which were hard in different ways. I enjoyed the structure of an undergraduate degree, but I hated lectures. That person in the row behind you, bouncing their leg so violently it shakes the whole section of desks? Yeah that was probably me. I made fantastic notes for about the first ten minutes of every lecture I attended, but none beyond that as I quickly became distracted. During my PhD I would knit through seminars as I found this was the only way I could maintain focus on the presentations.

It turns out that these aren’t just personality traits of mine, I have ADHD. Which (contrary to popular belief) isn’t just a disorder for ‘naughty little boys who can’t sit still’.

Not everyone with ADHD experiences hyperactivity. ADHD also doesn’t tend to magically disappear in adulthood, and has a conniving way of presenting itself as other mental health issues (hello anxiety). It’s a disorder that comes with a vast array of symptoms and challenges, many more than people may expect.

I’ve recounted my experiences over the first year of the STP below, and I’ve also roped in Alice to help, a first year on the Respiratory & Sleep Science specialism, who also has ADHD. As a trainee in a patient-facing role, her experiences are very different to mine!

My STP Experience as a Bioinformatician

The past year on the STP has flown by incredibly quickly. As a bioinformatician, my job is pretty much 100% desk-based. I spend a lot of my time staring at a computer screen, willing my code to run. On the whole I thoroughly enjoy what I do, the work is important and it engages my brain in a way that keeps it stimulated and interested. I do find it quite stressful at times, as there always seems to be too many things to do and never quite enough time – talking to my friends on the STP is one of the most reassuring things to do when I’m feeling like this, they’re probably stressed as well!

Having ADHD (and anxiety alongside it) has made the past year tough, and there’s things that are an ongoing struggle for me. For example, my questionable time management skills (I have a serious love/hate relationship with deadlines), inability to plan my way out of a paper bag, and a strong dislike of paperwork (looking at you, competencies). I’ve developed strategies to deal with these things (see the tips at the end of the post), and along with some help from medication, I’m generally happy with the progress I’ve made over the last 18 months.

The pandemic wasn’t exactly what anyone expected for 2020, and I’ve been working from home for nearly a year now. It’s been an uphill battle getting used to the new routine (or lack of). My brain loves external structure, and while it wasn’t so fond of the 6:30am alarm that came with office life, I did enjoy leaving the house everyday and seeing people.

I’ve learnt how to work from home now. I have my own quiet little space, and I get to wear comfy clothes everyday (the real win here). But it was challenging at first feeling isolated from my department. At the time, my main support was the other people in my cohort. We had regular catch-up sessions where we could have a chat or discuss issues we were having with training.

Respiratory & Sleep Sciences trainee – Alice

I too have struggled since my early teens with anxiety and depression. University was a real struggle and I considered dropping out nearly every day because of my mental health. But somehow I dragged myself over the finish line and completed my degree last May. Having an interview offer for the STP was a huge motivator for me and is probably what gave me the motivation I needed to keep going and not give up.

I couldn’t understand why I hated uni so much as I loved the social side and was interested in my degree subject (Sports and Exercise Science). However, lectures just did not suit me at all. I was either sat fidgeting in my seat, doing things like spinning my head/ponytail round in circles (without being fully aware I was even doing it…), or I was head down on the desk fast asleep, completely dead to the world. There was no in between, it was one extreme or the other.

Given how much I ‘hated’ uni I wasn’t sure if I was slightly crazy to be embarking on further education via the STP. However, there were two major factors that made it different this time around:

1.     The STP (for my specialism) is all about hands on learning, rather than being sat and talked at for hours on end

2.     I was diagnosed with ADHD in May 2020 (better late than never…) and suddenly my life made sense. Nearly all the difficulties I had experienced throughout school/uni were attributable to ADHD and were not simply character flaws like I’d always believed! And there were things that could help make my life easier!

My STP experience

Unlike Suzy, my role is mainly patient facing and involves a lot of interaction with patients, explaining to them how to perform tests and providing encouragement to ensure they give their maximum effort. Building a good rapport with patients and putting them at ease is essential to getting the best results out of them. I love talking to people so this is an aspect of the job I really enjoy, as well as the fact I can move around and flail my arms about with no judgement (it’s an essential part of encouraging the patients…). It’s things like this, along with the varied nature of the job, that make me think the STP might just be the perfect thing for an ADHD brain like mine. I feel a genuine sense of excitement as I go into work, not knowing what’s in store for the day ahead. I usually arrive home from work and collapse on my bed, often exhausted, but content. My brain is in a sort of ‘food coma’ but the ‘food’ is the excitement and stimulation of the day it’s had. So satisfied and content but it may have possibly slightly overindulged and now needs some time to rest and digest.

At times I feel like different parts of my brain are in total disagreement with one another, just trying to make things as difficult as possible for me. The anxious part of my brain definitely had (and still does have) worries about the lack of ‘structure’ and the high levels of uncertainty with what will happen with my training, due to the chaos of COVID, and the wheres, whens, whos and hows of it all, but the ADHD side of my brain is kinda loving the excitement of it all and the surges of dopamine and adrenaline it brings. For example, one week I started off in cardiology, then the next day was sent home by 9.30 am and told that my cardiology training was being temporarily suspended, due to a possible COVID-19 outbreak amongst staff. However after lots of chaos, confusion and COVID swabs (negative) I was allowed back to work in the respiratory department. Whilst the anxious part of my brain was slightly freaking out about whether I would be able to keep training and fearing I would be getting behind, the ADHD part was actually enjoying the excitement and chaos of it all. Basically half my brain craves structure, whilst the other half favours spontaneity, and this conflict can make things difficult at times… (I think this must be what people mean when they say they are in two minds about something!)

My mental health has definitely been a rollercoaster throughout these first few months of the STP, I think largely exacerbated by the current Covid situation. There’s been so many ‘highs’ with the excitement of being in the hospital, getting to see and do loads of new interesting things and I feel like I am constantly learning and my brain is finally getting the stimulation it needs! But there have also been some extreme ‘lows’,  like having to isolate (twice!) in December meaning I only spent 5 days at work the whole month…

This was not an enjoyable experience at all and my mental health deteriorated massively as a result! I reached a very low point during the first isolation period so I was absolutely distraught when I found out I would be isolating again after only a week back at work. However there were some important changes that made the second isolation slightly less unbearable than the first. The main thing was being more honest and open with my training officer about how I was feeling. As she rightly pointed out to me, people can’t help you if they don’t know that you’re struggling. I’m glad I was more open as she was so kind and supportive, making an extra effort to make sure I was okay in isolation, regularly checking in on me and listening to me complain about how bored I was(!!). Little things like this really can make such a difference and I was so grateful (although I’m sure she was probably sick of me by the end of it!!)

Tips from us: 

1. Reach out for support if you’re struggling with your mental health and tell other people – e.g. training officers, friends, family, your GP, Occupational Health, University (for example, from the disability support service). If no one knows you’re struggling, no one can help!!
2. Connect with other STP trainees in any way you can. They understand what you’re going through, are great for bouncing ideas off of and generally make you feel far less isolated. Unfortunately the trainees that started the STP in 2020 haven’t had the luxury of meeting fellow trainees in person at uni, social media (Alice met a lot of trainees through Instagram!) and WhatsApp are great for getting to know trainees!
3. Find a way to organise and keep track of what you need to do/have done. The liberal use of lists is always a good thing! Here are some options to try:
   • iPad: You’ll get one from your university. Great for having on hand to make notes throughout the day. The apps GoodNotes and OneNote are fantastic for notetaking and keeping track of competencies.
   • Get a planner: This can be a good old fashioned paper one, or a digital one
   • Calendars: Not just for appointments! Use them to structure your day if you often find yourself at a loose end or getting off task.
   • Trello/Notion/Jira: More formal methods of organising your projects, tasks and time. All of these are very visual tools. You might want to try a couple of these options before sticking to one, what works for one person might not for another!
4. Exercise. This is an essential thing to help keep you sane! Moving your body and getting some fresh air can have massive benefits for your mental health. It doesn’t need to be anything too strenuous, you can simply put on some music or a podcast and go for a short walk

Authors: Suzy (Bioinformatics) and Alice Bonham-Carter (Sleep & Respiratory Sciences)