Mental Health During PST (Pre-Service Training)

---Written on day 62 of PST-----

I wanted to take an opportunity to share more about my experience with mental health during Pre-Service Training (PST). I am sharing this because when I was searching for information, it was difficult to find much out there aside from the blanket Peace Corps messages about “living without the support of western-trained mental health providers.” If you are anything like me, this line tells you NOTHING useful for daily life. First things first…

“Hi, my name is Michelle and I struggle with depression.”

Good. Now that that’s out of the way, let’s talk real talk.

During the Peace Corps application process, I definitely felt that depression and mental health was fairly taboo in the Peace Corps. My reasons were as follows: (A) It was hard to find information about volunteers who have struggled with depression. (B) After disclosing that I have seen a counselor “at any point within the last three years,” I faced (what felt like) a bunch of extra hoops to jump through. Additional forms, counseling visits/evaluations, personal statements on my mental health status, triggers, coping mechanisms… ay bo! It was a process.

(I want to pause and take a deep breath with those of you who are living that frustration now. Breathe…)

Whoo! Even thinking about it now makes my blood pressure rise… BUT! I am so pleased/surprised to report that Peace Corps South Africa has many strategies for supporting volunteers in this country. Plus, they take a “we all need these things sometimes” approach to implementation. We have had sessions on resources, covered many coping strategies, discussed these personally with a member of the medical team, and will have multiple avenues of support (ranging from a peer support network to counseling visits) during a depressive period.

That said, PST definitely provides many potential “challenges” to one’s mental health. The first challenge is the schedule. Training days are very long and zap you of your energy. Your brain is tired from language and policy trainings; your emotions are wonky from safety and diversity sessions; your patience is tested each day…multiply that by 8 hours per day, 6 days per week. Aish!

It is also not surprising to find that the emotions, energy, and needs of 34 unique people are, well…different! One is up when the other is down; the same experience impacts both in different ways. This leads me to the second major challenge: coping with all of this stress when all of your PC friends are dealing with their own stuff… How do you reach out for a hand when we are all on our very own rollercoaster rides?

Add the typical culture shock, distance from loved ones, decreased control over personal schedule/use of time, and loss of some first world conveniences… It is the perfect environment to challenge one’s mental health!

So, for the benefit of other potential volunteers and for the sake of honesty, I would like to share a bit about my experience coping with depression during PST.

First, I will share a bit about my symptoms. Each person’s depression is unique. My depression comes and goes in waves. In the US, I may have anywhere from a few weeks to a year between depressive periods. My triggers are largely related to personal worth, competence, or inconveniencing/burdening others. During PST, I have experienced two minor depressive occurrences. The length of an occurrence is difficult to describe, because there are multiple stages/levels that are passed through. I will say that out of nearly 60 days, there have only been 4 that I have truly felt hindered by my symptoms.

During and immediately after an occurrence, I have found the following tools essential for moving forward:

• Patience with myself. I would like to say that I have handled these stressors with absolute grace…but, that would be a lie. I have been more than frustrated with other volunteers. I have been frustrated with myself. I have acted from that perspective of frustration…and I can make different choices tomorrow. At the end of the day, though, I am the only “me” I have. I am imperfect. I am emotive. And these are things that make me - “me.” I try to remember the components of the "Personal Bill of Rights" (there are several versions out there... they can be fairly cheesy, but good reminders. Google it...)
• Support from loved ones back home and fellow volunteers. I have been blessed with many beautiful relationships that uplift my spirit. The messages I have received from those back home remind me that they will be there for me, no matter where I travel. I have also found caring friendships in several other volunteers. They write me notes when I am sick, check-in when I am being quiet, and offer support in times of need. I need to remind myself to have the humility to reach out.
•  Journaling. This sounds so cliché, but it really does help to get it all out in writing. Seeing it all out on paper helps my triggers to feel more manageable, somehow. I can better identify ways to disrupt the internal dialogue that is unhealthy.
• Letting go. Ish happens. The thing about my depression is that it makes me believe in a false sense of “failure” (like “failure” as an identity). The truth is that, though I may stumble and discover imperfections, I have always overcome the obstacles of my life.  My lesson is to let go of my expectations of my life and, most importantly, of myself.  

Before joining the Peace Corps, I was definitely concerned about maintaining my mental health during service. What if my depression was triggered during service? What if I start to spiral?

For the benefit of others who share this fear, here is my message for you (and a reminder for myself):

• It is okay to struggle with issues of mental health or depression (I think that we all do-the only differences are the degree of impact and the level of honesty about it). It is okay to take the time and energy you need to get through, in whatever that looks like.
• You have already developed successful coping strategies throughout your life. These will likely be the same strategies you will use during your service.
• It helps to hone your self-awareness to identify depressive symptoms early. My strategy is to list 3 caring things (small or big) that I did for others and that were done for me each day. When I cannot think of 3 examples, then I know that my internal dialogue is getting skewed.
• Some volunteers believe that PST is the most difficult period of Peace Corps service. If you can get just through this, a significant part of the battle is over!
• If there does come a day when I truly believe that the best decision for my health would be to go back home, I know that the option is there. I will have been blessed by having lived in South Africa for a short while AND I will make the best decision for me to go home.

**Quick Note to Family and Friends: I am FINE. :-D My mental health is just as fine as it was in the States. It is common for the occurrences to become more frequent during states of great change. There is no need to worry any more than you did before.

If you would like to support me, just keep doing what you normally do. I’ve always loved that about you! Most importantly, don’t act all weird about this post in our next conversations. I do not currently feel any embarrassment about sharing these details. I hope that you don’t either.

Much love (Ngiyanithanda kakhulu),

M