Recovery Diaries In Depth
Welcome to Recovery Diaries In Depth; a mental health podcast that creates a warm, empathic, and engaging space for discussions around mental health, empowerment, and change. Executive Director and podcast host Gabe Nathan brings a unique combination of lived experience with mental health challenges, years of independent mental health and suicide awareness advocacy, and an understanding of the inpatient psychiatric millieu as a former staff member at a psychiatric hospital. This extensive background helps him navigate complex and nuanced conversations with a diverse array of guests, all of whom are vulnerable and engaged; doing their utmost to eradicate mental health stigma through advocacy, storytelling, and open conversation.
Guests who have previously contributed a mental health personal essay read their essays aloud during the podcast and then chat with Gabe about what has changed in their lives since their essays were published on the site. By engaging in deep discussions with people living with mental health challenges like bipolar disorder, trauma histories, addiction issues, schizophrenia, anxiety, depression, obsessive compulsive or eating disorders, Recovery Diaries in Depth further carries out Recovery Diaries' mission to #buststigma by showing people that they are not alone, instead of just telling them. This mental health podcast features guests from all over the world and, while their own personal experiences are unique, the human experience is what unites, inspires, and connects. Subscribe, like, share, and enjoy!
Recovery Diaries In Depth is supported in full by the van Ameringen Foundation.
Recovery Diaries In Depth
A Doctor in Rwanda's Life with Anxiety | RDID; 117
Florence Mukangenzi is a doctor in Rwanda who lives with mental health challenges, including anxiety. In 2017, back when she was a medical student, she wrote a beautiful essay for our site called "Playing Hide and Seek with a Demon: My Struggle with Anxiety." In 2019, she flew across oceans to join other women from around the world for a unique women's writers retreat in Cape May, New Jersey, where her bond with the staff and contributors at Recovery Diaries flourished. She returned to Rwanda empowered and inspired.
However, COVID soon hit and Florence's life and studies were upended; her mental health struggles continued and she remained committed to finishing her medical education so that she could become the general practitioner she is today, helping others in need in her own community; people living with immense struggles, with the perpetual scars from war-torn genocide, people who sometimes struggle with unhelpful and unhealthy views of mental illness.
In her interview with Recovery Diaries in Depth host Gabe Nathan, Flo talks about what is different about living with anxiety, particularly as a doctor, in Rwanda, but what is also similar to anybody else's experience living with mental health challenges anywhere else in the world. She also shares about ketamine treatment she has tried, which is so hard to access in her country. Flo is honest, charming, witty, and passionate about her career, her recovery, and her advocacy, and it shows in the thoughtful responses she gives to Gabe's questions.
We are delighted to share Flo with you, to introduce you to this inspiring human being, and to share her message of hope and strength.
Are you ready to discover more stories of mental health, empowerment and change? Check us out for more essays, films, and more podcast episodes featuring diverse voices from around the world.
Conversations like the ones on this podcast can sometimes be hard, but they're always necessary. If you or someone you know is struggling, please consider visiting www.wannatalkaboutit.com. If you or someone you know is considering suicide, please call, text, or chat 988.
Hello, this is Recovery Diaries In-Depth. I'm your host, gabe Nathan. Thanks so much for joining us. We're very happy to have you here. We are so pleased to be welcoming to Recovery Diaries In-Depth Florence Mukengenzi. She is a doctor living in Rwanda, in the heart of Africa. She enjoys blogging at secretswillkillyouwordpresscom. She also enjoys quality prayer time and long conversations. There's an essay by Florence called Playing Hide and Seek with a Demon my Struggle with Anxiety on our website, as well as a short documentary film we made about Florence and she was visiting the US in 2019 for a women's writer's retreat.
Gabe Nathan:Each week, we'll bring you a Recovery Diaries contributor folks who have shared their mental health journey with us through essay or video format. We want to see where they are on their mental health journey. Since initially being published on our website, our goal is to continue supporting our diverse community by having conversations here on our podcast to follow up and see what has shifted, what has changed and what new things have emerged. We're so happy to have you along for this journey. We want to remind you to follow our show for new and back episodes at recoverydiariesorg. There, like the podcast, you'll find stories of mental health, empowerment and change. You can also sign up for our mailing list there so you never miss a new podcast episode, essay or film, and you can find this podcast pretty much anywhere you get your podcasts.
Gabe Nathan:We appreciate your comments and feedback about our show. It helps us improve, make changes and grow and, of course, make sure to like, share and subscribe, and subscribe. Florence, thank you so much for being here on Recovery Diaries in Depth. It is an incredible joy to see you here.
Florence Mukangenzi:Oh, thank you so much. I'm excited to be here. I'm just really excited.
Gabe Nathan:So can you just tell the people listening talk about the last time we saw each other in person, Because I actually don't have the joy and the privilege of seeing a lot of the Recovery Diaries, contributors, especially from people who live in Rwanda, where you do, from people who live in Rwanda, where you do. Most of the time, I'm communicating with authors via email and we're editing essays back and forth and essays published and that's it. But I had the opportunity to spend some time with you six years ago. Can you just talk about that?
Florence Mukangenzi:Yeah, so the last time we saw each other was in 2019, right before the pandemic at the OC87 women's retreat, you know, exciting and overwhelming, to say the least, because you know, just there's me making all this, this trip all the way from East Africa to the US and, you know, attending this retreat, and it was all like a dream. And also from just receiving that email of you inviting me to the US, and me being like, oh, is this real? And for it to like, really happen, yeah, so just a very I don't know dreamlike time.
Gabe Nathan:And it was for me too, and I just want to say that from you know, getting to know you when your essay was first published, which was a couple of years before the Women's Writers Retreat first published, which was a couple years before the Women's Writers Retreat, and then the Writers Retreat happening in 2019.
Gabe Nathan:And now here we are in 2025, getting to talk on this podcast about how extraordinary life is and about how I feel like this kind of thing. This is going to sound like I'm kind of tooting our own horn or Recovery Diaries' own horn, but I feel like other publications. They get an essay and they publish it and then they move on to the next one and it's just about producing content and just getting essays out there, getting writing out there, and here it's relationships. It doesn't happen with everyone, it doesn't happen with every single contributor, and I understand and acknowledge that. But when I look at you and I see the thread of the human relationship, from essay to the retreat to now to just maintaining this connection, it's extraordinary and I just you never know what can happen when you write an essay and send it to a publication. Um, it's, it's sometimes it's just way more than getting published.
Florence Mukangenzi:Uh, yeah, so I don't know to me, um, you know, just like you say that I thought I was, you know, going to publish it and then you know, was going to be over and and, and you said I thought I was going to publish it and then it was going to be over and all stuff, and that happened. But then after that, two years after that, you get in touch with me again and you're like, okay, we're doing this retreat, would you want to come? And then that happened. And now you know, six years after that, we're doing this podcast and I think one of the things I feel that's meant is that the things I feel that cement is that um, so there is this story of you tell your story about you know mental health and you know things you've learned and your journey and the.
Florence Mukangenzi:There is, um, I don't know if I would say like humanity that comes with you know, following up, sort of like following up to the story instead of assuming that you know this person, just you know. Then you know brought up in the sunset and then you know, lived happily ever after and stuff, and to keep in touch with writers and hearing from them. You know, wondering what happened to that story, you know, is what makes the experience really unique and really valuable in such a way that I feel the people at OC87 are really kind of like recognizing all these contributors as this person with a story and really putting value into that.
Gabe Nathan:It means a lot to me that you think that and believe that, because it's like the guiding light of what we do. I think it's one of the reasons why I hate the word content. It makes me want to puke when I hear someone say about a piece of writing, about a personal essay by someone who has lived experience with mental health what's your content for the week? Fuck, that it's not content. This isn't like we're not posting memes or just like meaningless shit. These are people, these are human beings, who are putting themselves out there in this incredibly vulnerable way, naked, really standing naked before the world and saying this is who I am and this is my story, or a part of my story and my journey. And it's been really hard. And I think you all of our contributors open themselves up to ridicule by mean, nasty people, criticism people who doubt them, people who fault them, people who say, well, such and such happened because you're weak or it's your fault or you weren't whatever enough to overcome what you're dealing with. And we'll get to thoughts about mental health in Rwanda and maybe some stigmatizing ideas that people have about mental health, but it's we feel so strongly here about people and that that's. That's what we're doing here is sharing human beings with others and the thing that you said about checking in.
Gabe Nathan:So you know, I used to work at a psychiatric hospital and I think that one of the most valuable things that you can do, like post-discharge, you know patients, they're hospitalized for five days or seven days or nine days or whatever it is, and they're discharged. You check in with them, you send a postcard, you pick up the phone and call hey, how are you doing? Hey, I know it's been three weeks since you were last in the hospital. What's been happening? Because more often than not it ain't just riding off into the sunset and la la, la and everything's great, right.
Gabe Nathan:Life is like this and it's so important to be there for people when it's going down right. And if you never check in with them, you never know and the other people think, well, they don't care about me. You know, we just had this transactional relationship. I was in the hospital and now I'm not, so they're not thinking about me, or I wrote the essay and it was published, and then it's, they're onto the next one, and that's not right. We want to be with you guys as much as we can, and that's the whole point of doing this podcast is we wanted a vehicle to bring people back so we can check in with them and know what's been going on. So what's been going on, flo, what's?
Florence Mukangenzi:been going on since 2019?
Gabe Nathan:Spill it, spill the tea.
Florence Mukangenzi:So what's been going on? Where does one start? So in 2019, I was in medical school. I don't even remember what year I was in.
Gabe Nathan:Like second.
Florence Mukangenzi:Yeah, like a second year. And then there were issues with my school, and then there was the and my, you know, graduation was delayed by years, so I ended up going back to medical school and in 2023, I graduated.
Gabe Nathan:Cheers doctor.
Florence Mukangenzi:Yeah, cheers to that. It's very surreal and yeah, sometimes you know I have a hard time calling myself a doctor because I'm like what you mean me.
Gabe Nathan:Well, you better get used to it.
Florence Mukangenzi:Yeah, like you mean me. Who can, you know, make a decision about what shoes to wear in the morning? Now I have to make a decision about people's lives. Yeah, so that happened. And then I did a year of medical internship, which I was working in a hospital for a year, and then, in July of last year, I decided to take a break and so I've been on that break. It's going to be almost no.
Florence Mukangenzi:Yeah, in three months it will be a year of me not working and me, yeah, just hanging out, and a lot of you know things led to that, to that.
Florence Mukangenzi:But another thing that was significant that happened is that shortly before that, I started a ketamine treatment which my therapist, who is an American woman who has been living in Rwanda for several years, started this clinic, which was in the making for several years. She would, you know, we would talk about it, and it sounded like it was never going to happen and she had to, like, jump through several hoops and then she successfully started this ketamine clinic here and it's in May. It will have been operating for a whole year. So that's, you know, an experience all of its own. Yeah, so those are, I think, the most significant things that have happened in my life since then, in my life since then and now, like I've taken this year to kind of like calm down, you know, reevaluate my life, figure out what I want to do, if I want to go to residency, if I want to do a master's in this or that.
Gabe Nathan:Yeah, that's where I've been at. That's. That is a lot, um, and I have so many questions, but I think the first question that I have is about the ketamine treatment. Um, do you find it helpful? Can you talk a little bit about it, and were you anxious about trying it at first, and how have you been feeling?
Florence Mukangenzi:Um, so for me it it couldn't um come like this. The clinic couldn't start fast enough. Um, because it's very funny, where I started with medication, where I started being very reluctant about trying different medications and stuff and getting to the point of being like, if something is going to help, I'm willing to try anything. It's going to help, I'm willing to try anything. And so through the years I went through this history of really trying almost everything that was available at the market here in Rwanda and also getting to a point where I was also even like getting medication that wasn't available and rather like getting medication shipped from like Europe or the US things, and I would have some work, you know, imperfectly some work, and then stop working after a while. I would have some that would not work right away.
Florence Mukangenzi:And so I had this experience of, you know, continuing to be very depressed and even when I felt like anxiety was controlled, it was this thing of, like you know, just working on two things Sometimes anxiety is controlled, but then depression is there, or sometimes depression is better, but then I'm very, very anxious. And so we tried all these things and my therapist had experience with had clients who had good results with ketamine and she would talk to me about it and stuff, and because she was someone who I've worked with for several years, who knew me very well and who knew also the history of how I would change medication, go back to weight, try something new, how my body would react to that, and so I was very anxious to try. I was very eager. I was like, if this is something that could help me, even if it was, you know, for a while, like I'm very willing to try. So I think I was probably like at the first infusion I was a bit anxious, but, um, effusion, I was a bit anxious, but leading up to it I was very, um, just excited to being like this is something that could help me significantly. Um and um I'm trying to remember if you asked me, uh, also about if you know, like, if it works, if it has helped me, um, and so it's it's been a year and I think going into it, um, I was like this is not like antidepressant, this is going to fix me, like right away.
Florence Mukangenzi:And you know, boy was I wrong, because it ended up being a journey being a journey, and I got more help when I, when I kind of like changed my mind and like committed to it, willingness to continue to take care of myself, you know, every day, and to work on things, work on things. And so it is, you know, very dramatic change that I wanted after like at least the first six infusions. It wasn't like that, but along the journey, because it's been almost a year now is when I see how things have changed in my life. Also with working with my therapist, where sometimes we sort of just go through things and just realize how that I have made leaps in terms of you know how my brain works, how it perceives things.
Gabe Nathan:Yeah, I love that you made the point about how we want this thing, whether it's a ketamine infusion or whether there's so much more to maintaining your mental health and recovery than just taking a thing right, putting some kind of substance in your body.
Gabe Nathan:It's work. It's always so much work that you have to do in therapy out of therapy, dealing with cognitive distortions, dealing with perceptions of well, other people are thinking this about me, or I'm thinking this about me, or I'm bad, or I'm a lazy piece of shit, or I'm bad or I'm a lazy piece of shit or I'm. Whatever the narrative is in our minds. It's so much work to constantly be challenging that and to be committing to being better or committing to challenging those thoughts or committing to changing behaviors that are no longer helpful or no longer serving you. It's a lot, and so my question is how do you? How are you doing all of that, or trying to do all of that, while, like taking care of patients, um, taking care of other human beings? How, how do you? How were you keeping that train on the track of also taking care of flow at the same time?
Florence Mukangenzi:time. Yeah, so I started like I was always, you know, taking some sort of antidepressant and even before I graduated, I and especially during the last years of medical school a lot of it is just really hospital work, and so I was always taking some sort of you know, antidepressant stuff to help my mental health so that I can, you know, show up as you know as best as I can, you know, show up as you know as best as I can. And one of the ways that I was able to like to take care of myself, and also how affirming it is to do great things, to see myself helping people, there's this thing that happened in the hospital where you may see a patient at first and they're like really sick, and then maybe you go home on the weekend and you're not the one on the weekend shift, and then you come back on Monday and you can recognize them because they've just so healed so much. Their face has changed, everything has changed. You're like, okay, like is this the same person you know, especially in kids?
Florence Mukangenzi:I've seen that, especially in kids, where you know person just really changes and it's just really affirming that, really affirming that something like that happens and that you can see yourself doing that and that you can see yourself doing that.
Florence Mukangenzi:And it challenges this belief that mental health issues put you on, of really convincing you that you're useless you that you're useless, that you're yeah, you're useless, you don't have that much strength physically or otherwise and I felt like it was. You know, it was like I was helping myself and, at the same time, the work I was doing was also helping me by affirming me, by reminding me that I can do hard things, that I'm helping. Sometimes they're just dealing with depression or anxiety in their own way, especially in a community like ours, where they're not even doing what I was doing for myself, like you know, taking medication and I don't know. I feel like I've spoken in circus about this, but I feel like there was a really big affirming part of my work, affirming part of my work that it was like I was taking care of myself, but also my job was sort of, you know, taking care of me, and that's a really extraordinary gift.
Gabe Nathan:And I think there are healthcare providers, particularly during COVID, who you know their mental health took such a hard hit and you know they were being run ragged and saying, you know God, I'm running around helping everyone else but my tank is completely empty. Extraordinary is that, through the work that you were doing, your tank was getting filled by the work that you were doing. You know, from seeing those changes happening in patients and seeing people who you could identify with, who were going through similar things that you're going through, and it's it's just um, it's really moving to hear. And you know, I know you don't need to hear it from anyone else, but I'll tell you anyway, you can do hard things, uh, and you are strong and, um, resilient and very, very brave, um, very brave, and I, you know, I just know it in my heart.
Gabe Nathan:You mentioned flow in a community like this. You were talking about people living with mental health challenges. Can you talk about what it's like to live with mental health challenges in a community like this, in a small area in Rwanda? What is it like? What are some of the prevailing views? That question is have you noticed a change, even if it's very?
Florence Mukangenzi:small in how people view people living with mental illness. Yeah, so I would say I would have to compare from when I wrote my essay in 2023 and now. So I would say there's probably been a change, you know, however small. But coming back to the first part of the question, but coming back to the first part of the question, how you know, in a crazy, or you're going to be a volatile person, or you're going to be a violent person, or you're going to be someone who cannot, you know, take care of themselves or be valuable in any kind of way, because of the culture that is really deeply ingrained in people. That is very hard to change. But also as new generations of people come up millennials, gen Z, people who are consuming the internet more, seeing how, maybe, people from other countries express themselves, and also even the efforts of really the Ministry of Health here and other people in position to drive that change, to really educate people, to really put things out there, to really try to, you know, drive it home. Like mental health is this? Mental health is not this Having issues that's not stop you from being a contributing member of society, trying to break stigma and stuff like that. Break stigma and stuff like that. And yeah, so I would say that there is some change. It's harder to drive that change in older generations. Younger people are more likely to be willing to see this issue differently and to learn more.
Florence Mukangenzi:And another factor to that that sort of makes the situation of Rwanda unique is our history of the genocide, the 1994-20 genocide. That is something that you know, just there is no way to deny. You know mental health issues when it comes to stuff like that To you know survivors, children of survivors and all of the other issues that are related to genocide genocide because of the way heinous genocide is and how it's been. I was born during the genocide, so it's been 31 years since I was born, it's been 31 years since the genocide happened and it feels as fresh as ever. It's just that one thing where you know from the outside, you may, you know, think about genocide and even other genocides that has happened in. You know other countries and think of them, as you know it's been these many years and stuff.
Florence Mukangenzi:But there is, you know, the trauma from the people experiencing who experienced it, their children, and you know it's something that just really gets ingrained in people. But then there is that was one part where I would say the community would understand that you know some people had PTSD or depression or you know stuff from that. But then what about mental health issues from other aspects of life, from losing a child, from being overwhelmed at work, from losing an important relationship or struggling with extreme poverty and stuff? And so I think there is a part that they understand. There's a part that is easier to understand because you're like this is something horrible that happened to people and we can understand that.
Florence Mukangenzi:But at the same time, you know we don't understand why you're having all these crises because your boyfriend broke up with you, right, right? Or because of you know this and that, or because of you know this and that. So that is where most of the efforts are being put on to just really try to understand. You know what depression is, what you know anxiety is bipolar, all these things, and also really seeing them as diseases and not seeing them as personal failures from people who are not as resilient where they're like in this situation we can understand it, but in this situation it's not valid. Yeah, so I think that is what I can say about that.
Gabe Nathan:And it's fascinating to hear you talk about that. It's fascinating to hear you talk about that and it reminds me of how people can have empathy for something that they can see like a physical illness or, oh, you got your leg amputated. I can see that. I can see that you have one leg and I can feel something because it's so in my face. It's so obvious. The way that you were talking about genocide.
Gabe Nathan:It's like, well, of course, we can understand trauma and PTSD related to that, but it can be so easy to then minimize other things, which are all still valid, and but there is I guess there is that tendency to negate or say, well, yeah, but it's not this.
Gabe Nathan:But that's the thing about mental health is, it's not the suffering Olympics, and one person's experience doesn't negate another person's experience. It's, it's all valid, um, so thank you for pointing that out, and I think this is a good time actually to to get into the way back machine and go to your essay, um, which, uh, was published a number of years ago on the site and it's how you first came to us, and just full disclosure. This was written a long time ago, I think you were 23,. You said yeah, and now you're 31. And some thoughts and opinions and feelings may have changed, and we're going to talk about that when you're finished reading it. But it is such a beautiful essay and an essay is a snapshot in time, and so we're going to go back to that time playing hide and seek with a demon, my struggle with anxiety. Take it away, flo, when you're ready.
Florence Mukangenzi:Yeah take it away, flo, when you're ready? Yeah, so do you want me to like read the whole thing, and then you will like stop me or just read, and you can just read the whole thing, and then we're gonna talk about it a little bit yeah.
Florence Mukangenzi:So playing hide and seek with a demon, my struggle with anxiety. I don't know when it started. I was not. It was not as though I suddenly woke up with a raging heartbeat and butterflies in my stomach, wishing I could run away for myself. It came in tiny beats of worry. I felt confused by this set of emotions, but I thought it would go away. Of course, the feelings did not end and I knew I wasn't supposed to feel this way. I wanted to understand where the feelings were coming from, but I didn't. I couldn't bring myself to investigate them. Thus I experienced many years of wrestling with an unknown demon anxiety.
Florence Mukangenzi:Sometimes during dinner with the family, a simple thought crossing my mind would send my heart on a crazy ride. This was before my anxiety started to have direct triggers. Eventually, I recognized that my anxiety was attached to specific situations like socializing. My energy was consumed. By trying to stop my anxiety, I'd hold my breath and give myself a pep talk inside my mind you are worried about something that no one else is worried about. Worrying isn't going to help you. You will be just fine. Breathe, say a prayer and it will go away.
Florence Mukangenzi:I thought I could fix my problems by just snapping out of these modes of thinking. In reality, this just made the attacks worse. I couldn't sleep. I thought it was insomnia. Doctors asked me what I thought about while lying awake at night and I said nothing. Truthfully, I was worried for my life, but I could not put these fears to words. I lay awake thinking that one day I would not be able to wake up and face the day. I lay awake thinking about how strange it was that I couldn't sleep while everyone else could. I thought I am failing. I don't have what it takes to be here on earth, but I couldn't speak these thoughts aloud to the doctors. My anxiety made it so that I could not even close my eyes and rest. I tossed and turned and wished to see the morning come, so the scary sounds of the night would be replaced by people. Social situations made me anxious, yes, but when I could get myself to go to class or chat with a neighbor, it was such a relief to exist for a little while in a world that had more characters other than me and where I wasn't alone with my demons.
Florence Mukangenzi:My whole life became worry. My whole life became worry. I felt scared to talk to people, scared to go to church, scared to go to parties, scared of visitors showing up at the house, things that used to bring me solace. I didn't want to be part of any aspect of my life. It all felt so unsafe. I anticipated worst-case scenarios embarrassing myself at a party, falling in front of everyone.
Florence Mukangenzi:In the morning on a Sunday, I would tell myself that I would go to church. In the evening, I said to myself that I would go, no matter what, and as the clock neared 4 pm, I was consumed by thoughts that there was something out there, even though I couldn't admit. And then, just when I thought it couldn't get worse, I started medical school and my anxiety progressed to new heights. I remember my alarm going off around 4 pm. I had said it to wake up and study for my test. When it went off, I felt as though I had been paralyzed in my bed. My anxiety told me I could never pass my test. I couldn't even bring myself to study because my anxiety told me I would fail, no matter what. My fears became so foreign that I believed them as concrete facts.
Florence Mukangenzi:These days were long and full of paths to accomplish. I was so tired, yet when I tried to sleep, my heart would beat like a drum that wanted to rip my chest in two, beat like a drum that wanted to rip my chest in two. Worry brought more worry and I was getting scared of my emotional state. I was a stranger in my body. I had no coping methods. I couldn't talk to anyone about what happened. When I told the doctor that it felt as though my heart was racing, he did a test but found that nothing was wrong. He told me to go home and relax. I couldn't bring myself to confide in anyone. I was afraid of being judged. I was afraid no one would be able to understand what I was going through. It all felt too complicated and impossible to explain to anyone else. I was convinced there was no way that I could be helped.
Florence Mukangenzi:When I finally let go, I learned to listen to another voice, other than the voice of my anxiety. This was the voice of a friend. I had reached out to her online and, though I didn't know it at the time, she happened to be a therapist. I confided in her and, surprisingly, she didn't tell me to get over it. She told me that it wasn't my fault, that I didn't deserve to feel this way. She said there was a way to make things get better. I kept talking with her and tried to do some of the things she suggested, like being kinder to myself, exercising and writing. Her ideas helped me some, but she urged me to find a therapist in Rwanda to talk to Mental health. Resources are very limited in my country. After a long search, I found a therapist with whom I felt comfortable.
Florence Mukangenzi:In Rwanda we don't talk about mental health. It's taboo. Our culture condemns those who dare to feel or say or to say what they feel. When I started going to the hospital to meet with my therapist, I was certain that if I run into anyone I knew they would think I had lost my mind, that I had become the illness and that there was no me. After that. I couldn't tell anyone that I was speaking with someone to help fix my mind. Being a person with mental illness is incredibly shameful in my community. It isn't recognized as a health issue and doesn't get the same acknowledgement that a disease like malaria receives, no matter how debilitating mental illness can be. Our traditions and culture teach strength and resilience, and mental illness is seen as a contradiction to this, a flaw or defect, as a contradiction to this, a flaw or defect, something shameful to be hidden. Mental illness is a reality the African culture repeatedly rejects. Thus, going to meet with my therapist was incredibly difficult. However, I recognized I had to find help or I may lose my life completely. Something inside of me chose life, no matter what it would take. Where that strength came from, I didn't know.
Florence Mukangenzi:My first days of therapy were more traumatic than healing. I knew that my therapist was there to help me and wasn't going to judge me, but in talking with her I felt like there was a spotlight on my shame and the mess my life was. Therapy made me visit ugly places I had checked out of and intentionally disconnected from. I was terrified to replace sins of an abusive childhood and serotoxic relationships. It took a few sessions for me to feel as though I was healing instead of moving towards self-destruction. I was reminded that it wasn't my fault that I felt the way that I did and that I was strong to choose to fight. And that I was strong to choose to fight.
Florence Mukangenzi:My therapist approached therapy from a cognitive behavior therapy point of view, something I had never heard of before. This meant that I had to be aware of my thoughts and write them in a notebook. My therapist explained that anxiety was always a result of thoughts. The thoughts acted as triggers. The consequences were fear. I was beginning to train my brain to be aware of this. I would challenge myself to look at the thoughts from a different perspective and decide if they were rational or not. It helps to take a rational mode and not let my anxiety dictate the way I process things.
Florence Mukangenzi:Entrusting someone with my past, with my shame and anxiety, with the childhood traumas I had suppressed, was something I longed for but never expected to receive. My therapist helped me to find this. The idea of medication was something I wanted to avoid. I thought it was going to change me that I may lose track of myself. Through much convincing, my therapist started to work with the neuropsychiatric hospital to choose the right course of medication for me. I was warned that it would take about six weeks for me to adjust to my medication and it would get worse before it got better. And it did get worse, so much worse. It was a complete nightmare. It was a complete nightmare. For six weeks I could hardly function. I would jump at any sound. I dreaded the night. I dreaded the nighttime with the fear that people would bring into my house, rob and rape me. I was frozen in fear and helpless. I wanted to die. I had to fight through the worst of my anxiety to get to the other side. My friend whose idea it was for me to start treatment was my main support system. My therapist also listened to my concerns. She talked to the hospital about adjusting my doses until my body was ready. They both promised over and over, when I wanted to give up, that it was going to get better. And then, after rain came sunshine. My body got used to my FSRI medication and suddenly life felt like life again.
Florence Mukangenzi:A few weeks into the medication, helping to bring me strength, I signed up for a youth conference and once it wasn't difficult for me to get out of bed and attend something, I was able to show up, be myself and participate. I talked to a lot of strangers and reconnected with parts of myself. I thought I had forever lost to anxiety. I didn't have to question my speech a thousand times before saying something. It felt incredibly easy to be myself. I became confident. I looked forward to each day when I woke up, ready to take risks and be myself. I reconnected with the me that I knew was deep inside. I could hardly believe I was still there inside. I could hardly believe I was still there. It's been two years after that high and that moment of extreme positivity. The medication I was taking that had been working so well for me became unavailable in my country and I tried alternatives, experiencing many highs and lows of other medications, dealing with side effects and resistance, and trying to handle the cost of medication and therapy. Eventually I exhausted the alternatives which were available for me and tried the healing process without medication.
Florence Mukangenzi:About medication While I am not living the high and the beautiful sunshine of when my body got used to my old medication, I am far from the girl I used to be. Yes, I still have days when I am overwhelmed and frozen in fear. Sometimes I feel again that a stranger is living inside of me. But I also have days when I talk to my fears and I listen. Just last week I was trying to get my head around the fact that the hectic part of my semester is approaching.
Florence Mukangenzi:My anxiety hit as I was packing to go. I felt so far out of touch with my studies. Anxiety yelled that I wasn't like the others, that I was sick and weak and sleep deprived. I firmly said to myself. I have done this for four years now and I can do this. I am sick, but I've got this, and all you ever tell me is lies. I no longer let anxiety stop me from living the experiences of this life. I take chances and I dream. I know I am never going to go back to where I used to live. There is no easy or instant fix for mental illnesses, including anxiety. Healing is a journey and a choice one makes every day. Sometimes you're going to try a million different things before something works for you. Sometimes something is going to help you. At first try. The most important thing is don't give up. Reach out. You cannot make it on your own own, and letting yourself be helped is not shameful. It is strength, a powerful way to fight.
Gabe Nathan:Oh, and that's the end wow, that is the end, and what a powerful, affirming, hopeful end. Um flo. Thank you so much for writing that and for sharing that with our community and for starting this long relationship with this piece. This is how it all began. What is it like for you to go back to this after so many years?
Florence Mukangenzi:It's beautiful and shocking in a way, because I'm reading it and I'm relating to it and then I'm also in awe of that voice, knowing what I know now and knowing you know what would happen in my life for the years to follow. And you know, one of the things that hit me was you know how I was talking about medication and how hard it was to access.
Florence Mukangenzi:And that was before COVID, because in 2019, covid started and none of the medications that I was taking none of it is manufactured in even Africa, to begin with, and you know flights from Europe or you know from all the places where the medications that I was taking was being manufactured. Everything was disrupted and for several months during COVID, I went without. I just couldn't find my medication anywhere. And you know, which is something that I know, that people, even to this day, even post-COVID, struggle with. There's like a limited list of medications here, and then there is a limited list of medication that your insurance will pay for, and then there was a list of limited. Maybe the medication is available, but it is just so much money.
Florence Mukangenzi:I remember how I used to feel. At some point. I felt very, very guilty about the price of my antidepressant. I was like, how do I buy medication with this amount of money? And at that time, a friend was helping me to pay for that. But then I was like there is somebody who is making this amount a month to take care of a family of five in my country, and there was a part of me that felt really like I don't deserve this. I don't deserve to be spending this much money on medication and stuff and I had to learn to believe that it was worth it and it wasn't easy.
Florence Mukangenzi:So recognizing that and also, I don't know, just it made me, you know, nostalgic of, you know, that person. You know, like I was young, I had gone through stuff, but it was also full of hope. But I'm also excited about the hope that I have, especially towards the end, that comes with having answers, comes with having answers To this day. I'm sure that there are probably people who are having symptoms of anxiety and going to the doctor, even in like your GP's vocabulary, like they just they don't even consider it. And I, just, like, I, have hope. I have hope for my community, for my country, because I have just learned a lot of things since that essay about myself and about mental health and about hope, but I also sort of you know, miss that young person.
Gabe Nathan:Yeah, she's still there, flo. She's still in there and I mean, you're 31, girl, you are still that young person. I'll tell you as someone who has a number of years on you I won't say how many, but she's still in there. And I just want to say that you know, earlier we were talking about perspectives, about mental health in Rwanda, and you were talking about younger people Gen Z and millennials coming along with new ideas, different ideas, better ideas, more openness. You're part of that change. I hope you understand that and know that and believe that Through the essay that you've written, through the film PS let's not forget about that. You made a film while you were in Cape Cod, while you were in Cape.
Gabe Nathan:May at the Whiff's Writers Retreat, this podcast, your work, your advocacy, your voice that's part of what's moving the needle. When someone Googles depression, anxiety, rwanda, your essay is coming up, um, and you are helping people through your perspectives and through your recovery, um and your story. So I hope that you understand that and appreciate that and believe that, because I do, and I see it and I know it, and you just deserve so much credit. I think there are so many people going through what you're going through who don't step forward in a public way, and that's okay, like that's their choice. But you made a different choice and I'm very grateful for that.
Florence Mukangenzi:Thank you. Thank you very much. I think the me who wrote that essay was scared but also brave, was scared but also brave Because I would think that I probably wouldn't have as much fear talking about that today as I did then, even if I still chose to write this essay. And I also don't have as much fear at the thought of, you know, someone Googling me and you know they see that One of the important things is you know just, you know just like we're talking about. You know this generation, um, some of the ways in which I found, um, you know resources was just to Google people to. You know, try to find resources, and there are more centers now in the country.
Florence Mukangenzi:And another aspect that is probably specific to me is that, like, I work in health care and you know so, I'm a doctor, and somehow there are people who are holding me in high regard and then me coming out and being like you know, I'm struggling with this and this. You know, I still wonder if I don't know, I don't know if I have the answer to that. There are people just having a fear of being like, if somebody goes this, are they going to think that I'm not fit for my job because of this. Which, to me, is what's harmful, is lots of people who will never go to anywhere near a psychiatric hospital or a therapist's office because they're a minister or because they're head of a certain hospital or because they're in the parliament. You know stuff like that, and that's not what's shameful. You know what's shameful is maybe, well, not shameful, but having a problem is not shameful, and taking care of them is not shameful. It's brave, it's a responsible thing and it's something that people should take pride in.
Gabe Nathan:Absolutely.
Gabe Nathan:And I would want a doctor who is having issues and does something about it, who is having issues and does something about it, not someone who's struggling with something and denying it and pushing it aside and pushing it down and repressing it and coming to work, all you know, messed up because they're not getting help. I want a world where our professionals, our teachers, our law enforcement, our, our physicians, our nurses are our law enforcement. Our physicians, our nurses are struggling with real life things and are doing something about it and not just pretending oh, I don't have anything, I'm perfect, look at me, I'm robot doctor and nothing bothers me. Bullshit, it's absolute bullshit. So I want a world where people are honest about what they're going through and getting help.
Gabe Nathan:I would much rather that, and that's the example that you're setting, and if there are people out there who are too narrow-minded or ignorant or stupid to understand that. To put it in another way, let's say you had raging diabetes, but you weren't controlling your blood sugar, you weren't taking insulin, you were denying that you had diabetes, but you have it, but well, I'm just not going to do anything about it. It's absurd. So why would we want people who operate the same way about their mental health. We all have mental health issues, so just deal with them. That's the example I would want said, and that's the example I think you're showing to other people.
Florence Mukangenzi:Yes, and at some point understand, you know, maneuvering through a community like mine. For example, my psychiatrist had an office at a neuropsychiatric hospital, but there were people who would reach out to her and be like I am someone who is important, maybe I'm the CEO of something or this and that, and I want to look for help, but I will not set foot into a psychiatric hospital and she would see them at her home and she would see them at her home and she is also careful about where she leaves. She wants it to be as discreet as possible, which I believe the right privacy and also the journey of you know where people are at, because some people will, you know, take a little while to not be as ashamed or understand. Yeah, but also I think people are making these decisions because it has happened before where, if somebody knows you're going to a psychiatric hospital for I don't know whatever, then your boss is going to conclude that you can't do your job, conclude that you can't do your job, or you know people are going to whisper, or people are going to tell your fiance that you're crazy and it's not responsible to marry into that family.
Florence Mukangenzi:Even if it's not you, they'll be like um, that person's dad was hospitalized at the. That person's dad was hospitalized at the mental hospital at some point. You know stuff like that. So there's still a lot of work and I just really have a lot of hope for my country. I really hope that things can continue to move in a positive direction and that conversations keep happening until people are really radically changed.
Gabe Nathan:Conversations like this one, and thank you so much for joining me and for having this, and I'm going to end this with your words you cannot make it on your own, and letting yourself be helped is not shameful. It is strength, a powerful way to fight. Flo, thank you so much for being with me on Recovery Diaries In Depth.
Florence Mukangenzi:You're welcome. I don't know like I'm very, very thankful for this conversation and for getting to speak with you again and for really just you know thinking about these things and also talking about these things from a perspective of you know, someone from a country like Rwanda and also other countries in sub-Saharan Africa where the culture is pretty much the same. So thank you very much for having me and for continuing this relationship with the writers. I was very, very excited to be part of this.
Gabe Nathan:It's a joy. I'm wishing you all the best, thank you.
Florence Mukangenzi:You're welcome.
Gabe Nathan:Thank you again for joining us in conversation today. It's beautiful to see the progression of our contributors. We are so grateful to Dr Florence Mukengenzi from Rwanda for spending some time with us here on Recovery Diaries In-Depth. You can find her essay Playing Hide and Seek with a Demon my Struggle with Anxiety on our website, and you can also find a short documentary film we made about Florence's struggle with her mental illness in Rwanda on our YouTube channel. Before we leave you, we want to remind you to check out our website, recoverydiariesorg. There, like this podcast, you'll find additional stories, videos and content about mental health, empowerment and change. We look forward to continuing to grow our community. Thank you so much for being a part of it. We wouldn't be here without you. Be sure to join our mailing list so you never miss a podcast episode, essay or film. I'm Gabe Nathan. Until next time, take good care.
