May 19, 2025 • 72 mins
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.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Gabe Nathan (00:01):
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 youhere.
We are so pleased to bewelcoming to Recovery Diaries
In-Depth Florence Mukengenzi.
She is a doctor living inRwanda, in the heart of Africa.
She enjoys blogging atsecretswillkillyouwordpresscom.
(00:24):
She also enjoys quality prayertime and long conversations.
There's an essay by Florencecalled Playing Hide and Seek
with a Demon my Struggle withAnxiety on our website, as well
as a short documentary film wemade about Florence and she was
visiting the US in 2019 for awomen's writer's retreat.
Each week, we'll bring you aRecovery Diaries contributor
(00:46):
folks who have shared theirmental health journey with us
through essay or video format.
We want to see where they areon their mental health journey.
Since initially being publishedon our website, our goal is to
continue supporting our diversecommunity by having
conversations here on ourpodcast to follow up and see
what has shifted, what haschanged and what new things have
(01:06):
emerged.
We're so happy to have youalong for this journey.
We want to remind you to followour show for new and back
episodes at recoverydiariesorg.
There, like the podcast, you'llfind stories of mental health,
empowerment and change.
You can also sign up for ourmailing list there so you never
miss a new podcast episode,essay or film, and you can find
(01:27):
this podcast pretty muchanywhere you get your podcasts.
We appreciate your comments andfeedback about our show.
It helps us improve, makechanges and grow and, of course,
make sure to like, share andsubscribe, and subscribe.
(01:51):
Florence, thank you so much forbeing here on Recovery Diaries
in Depth.
It is an incredible joy to seeyou here.
Florence Mukangenzi (01:55):
Oh, thank you so much.
I'm excited to be here.
I'm just really excited.
Gabe Nathan (02:03):
So can you just tell the people listening talk
about the last time we saw eachother in person, Because I
actually don't have the joy andthe privilege of seeing a lot of
the Recovery Diaries,contributors, especially from
people who live in Rwanda, whereyou do, from people who live in
(02:26):
Rwanda, where you do.
Most of the time, I'mcommunicating with authors via
email and we're editing essaysback and forth and essays
published and that's it.
But I had the opportunity tospend some time with you six
years ago.
Can you just talk about that?
Florence Mukangenzi (02:39):
Yeah, so the last time we saw each other
was in 2019, right before thepandemic at the OC87 women's
retreat, you know, exciting andoverwhelming, to say the least,
(03:12):
because you know, just there'sme making all this, this trip
all the way from East Africa tothe US and, you know, attending
this retreat, and it was alllike a dream.
And also from just receivingthat email of you inviting me to
the US, and me being like, oh,is this real?
(03:36):
And for it to like, reallyhappen, yeah, so just a very I
don't know dreamlike time.
Gabe Nathan (03:51):
And it was for me too, and I just want to say that
from you know, getting to knowyou when your essay was first
published, which was a couple ofyears 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.
And now here we are in 2025,getting to talk on this podcast
(04:16):
about how extraordinary life isand about how I feel like this
kind of thing.
This is going to sound like I'mkind of tooting our own horn or
Recovery Diaries' own horn, butI feel like other publications.
(04:39):
They get an essay and theypublish it and then they move on
to the next one and it's justabout 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 Iunderstand and acknowledge that.
(05:01):
But when I look at you and Isee the thread of the human
relationship, from essay to theretreat to now to just
maintaining this connection,it's extraordinary and I just
you never know what can happenwhen you write an essay and send
(05:25):
it to a publication.
Um, it's, it's sometimes it'sjust way more than getting
published.
Florence Mukangenzi (05:34):
Uh, yeah, so I don't know to me, um, you
know, just like you say that Ithought 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 wasgoing to publish it and then it
was going to be over and allstuff, and that happened.
But then after that, two yearsafter that, you get in touch
(05:58):
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 yearsafter that, we're doing this
podcast and I think one of thethings I feel that's meant is
(06:23):
that the things I feel thatcement is that um, so there is
this story of you tell yourstory about you know mental
health and you know thingsyou've learned and your journey
and the.
There is, um, I don't know if Iwould say like humanity that
(06:44):
comes with you know, followingup, sort of like following up to
the story instead of assumingthat you know this person, just
you know.
Then you know brought up in thesunset and then you know, lived
happily ever after and stuff,and to keep in touch with
writers and hearing from them.
(07:08):
You know, wondering whathappened to that story, you know
, is what makes the experiencereally unique and really
valuable in such a way that Ifeel the people at OC87 are
(07:34):
really kind of like recognizingall these contributors as this
person with a story and reallyputting value into that.
Gabe Nathan (07:49):
It means a lot to me that you think that and
believe that, because it's likethe guiding light of what we do.
I think it's one of the reasonswhy I hate the word content.
It makes me want to puke when Ihear someone say about a piece
of writing, about a personalessay by someone who has lived
(08:11):
experience with mental healthwhat's your content for the week
?
Fuck, that it's not content.
This isn't like we're notposting memes or just like
meaningless shit.
These are people, these arehuman beings, who are putting
themselves out there in thisincredibly vulnerable way, naked
(08:33):
, really standing naked beforethe world and saying this is who
I am and this is my story, or apart of my story and my journey
.
And it's been really hard.
And I think you all of ourcontributors open themselves up
to ridicule by mean, nastypeople, criticism people who
(09:00):
doubt them, people who faultthem, people who say, well, such
and such happened becauseyou're weak or it's your fault
or you weren't whatever enoughto overcome what you're dealing
with.
And we'll get to thoughts aboutmental health in Rwanda and
maybe some stigmatizing ideasthat people have about mental
(09:22):
health, but it's we feel sostrongly here about people and
that that's.
That's what we're doing here issharing human beings with
others and the thing that yousaid about checking in.
(09:45):
So you know, I used to work at apsychiatric hospital and I
think that one of the mostvaluable things that you can do,
like post-discharge, you knowpatients, they're hospitalized
for five days or seven days ornine days or whatever it is, and
they're discharged.
You check in with them, yousend a postcard, you pick up the
(10:07):
phone and call hey, how are youdoing?
Hey, I know it's been threeweeks since you were last in the
hospital.
What's been happening?
Because more often than not itain't just riding off into the
sunset and la la, la andeverything's great, right.
Life is like this and it's soimportant to be there for people
(10:28):
when it's going down right.
And if you never check in withthem, you never know and the
other people think, well, theydon't care about me.
You know, we just had thistransactional relationship.
I was in the hospital and nowI'm not, so they're not thinking
about me, or I wrote the essayand it was published, and then
(10:50):
it's, they're onto the next one,and that's not right.
We want to be with you guys asmuch as we can, and that's the
whole point of doing thispodcast is we wanted a vehicle
to bring people back so we cancheck in with them and know
what's been going on.
So what's been going on, flo,what's?
Florence Mukangenzi (11:11):
been going on since 2019?
Gabe Nathan (11:13):
Spill it, spill the tea.
Florence Mukangenzi (11:17):
So what's been going on?
Where does one start?
So in 2019, I was in medicalschool.
I don't even remember what yearI was in.
Gabe Nathan (11:30):
Like second.
Florence Mukangenzi (11:32):
Yeah, like a second year.
And then there were issues withmy school, and then there was
the and my, you know, graduationwas delayed by years, so I
ended up going back to medicalschool and in 2023, I graduated.
Gabe Nathan (11:59):
Cheers doctor.
Florence Mukangenzi (12:01):
Yeah, cheers to that.
It's very surreal and yeah,sometimes you know I have a hard
time calling myself a doctorbecause I'm like what you mean
me.
Gabe Nathan (12:16):
Well, you better get used to it.
Florence Mukangenzi (12:19):
Yeah, like you mean me.
Who can, you know, make adecision about what shoes to
wear in the morning?
Now I have to make a decisionabout people's lives.
Yeah, so that happened.
And then I did a year ofmedical internship, which I was
(12:41):
working in a hospital for a year, and then, in July of last year
, I decided to take a break andso I've been on that break.
It's going to be almost no.
(13:02):
Yeah, in three months it will bea year of me not working and me
, yeah, just hanging out, and alot of you know things led to
that, to that.
(13:24):
But another thing that wassignificant that happened is
that shortly before that, Istarted a ketamine treatment
(13:44):
which my therapist, who is anAmerican woman who has been
living in Rwanda for severalyears, started this clinic,
which was in the making forseveral years.
She would, you know, we wouldtalk about it, and it sounded
(14:07):
like it was never going tohappen and she had to, like,
jump through several hoops andthen she successfully started
this ketamine clinic here andit's in May.
It will have been operating fora whole year.
So that's, you know, anexperience all of its own.
(14:31):
Yeah, so those are, I think,the most significant things that
have happened in my life sincethen, in my life since then and
now, like I've taken this yearto kind of like calm down, you
know, reevaluate my life, figureout what I want to do, if I
(14:54):
want to go to residency, if Iwant to do a master's in this or
that.
Gabe Nathan (15:05):
Yeah, that's where I've been at.
That's.
That is a lot, um, and I haveso many questions, but I think
the first question that I haveis about the ketamine treatment.
Um, do you find it helpful?
Can you talk a little bit aboutit, and were you anxious about
trying it at first, and how haveyou been feeling?
Florence Mukangenzi (15:26):
Um, so for me it it couldn't um come like
this.
The clinic couldn't start fastenough.
Um, because it's very funny,where I started with medication,
(15:47):
where I started being veryreluctant about trying different
medications and stuff andgetting to the point of being
like, if something is going tohelp, I'm willing to try
anything.
It's going to help, I'm willingto try anything.
(16:09):
And so through the years I wentthrough this history of really
trying almost everything thatwas available at the market here
in Rwanda and also getting to apoint where I was also even
like getting medication thatwasn't available and rather like
getting medication shipped fromlike Europe or the US things,
(16:52):
and I would have some work, youknow, imperfectly some work, and
then stop working after a while.
I would have some that wouldnot work right away.
And so I had this experience of,you know, continuing to be very
depressed and even when I feltlike anxiety was controlled, it
(17:14):
was this thing of, like you know, just working on two things
Sometimes anxiety is controlled,but then depression is there,
or sometimes depression isbetter, but then I'm very, very
anxious.
(17:34):
And so we tried all thesethings and my therapist had
experience with had clients whohad good results with ketamine
and she would talk to me aboutit and stuff, and because she
(17:56):
was someone who I've worked withfor several years, who knew me
very well and who knew also thehistory of how I would change
medication, go back to weight,try something new, how my body
would react to that, and so Iwas very anxious to try.
I was very eager.
(18:18):
I was like, if this issomething that could help me,
even if it was, you know, for awhile, like I'm very willing to
try.
So I think I was probably likeat the first infusion I was a
(18:42):
bit anxious, but, um, effusion,I was a bit anxious, but leading
up to it I was very, um, justexcited to being like this is
something that could help mesignificantly.
Um and um I'm trying toremember if you asked me, uh,
(19:04):
also about if you know, like, ifit works, if it has helped me,
um, and so it's it's been a yearand I think going into it, um,
I was like this is not likeantidepressant, this is going to
(19:25):
fix me, like right away.
And you know, boy was I wrong,because it ended up being a
journey being a journey, and Igot more help when I, when I
(20:05):
kind of like changed my mind andlike committed to it,
willingness to continue to takecare of myself, you know, every
day, and to work on things, workon things.
And so it is, you know, verydramatic change that I wanted
(20:34):
after like at least the firstsix infusions.
It wasn't like that, but alongthe journey, because it's been
almost a year now is when I seehow things have changed in my
(20:57):
life.
Also with working with mytherapist, where sometimes we
sort of just go through thingsand just realize how that I have
made leaps in terms of you knowhow my brain works, how it
(21:21):
perceives things.
Gabe Nathan (21:24):
Yeah, I love that you made the point about how we
want this thing, whether it's aketamine infusion or whether
(21:46):
there's so much more tomaintaining your mental health
and recovery than just taking athing right, putting some kind
of substance in your body.
It's work.
It's always so much work thatyou have to do in therapy out of
(22:10):
therapy, dealing with cognitivedistortions, dealing with
perceptions of well, otherpeople are thinking this about
me, or I'm thinking this aboutme, or I'm bad, or I'm a lazy
piece of shit, or I'm bad or I'ma lazy piece of shit or I'm.
Whatever the narrative is inour minds.
It's so much work to constantlybe challenging that and to be
(22:35):
committing to being better orcommitting to challenging those
thoughts or committing tochanging behaviors that are no
longer helpful or no longerserving you.
It's a lot, and so my questionis how do you?
(22:57):
How are you doing all of that,or trying to do all of that,
while, like taking care ofpatients, um, taking care of
other human beings?
How, how do you?
How were you keeping that trainon the track of also taking
care of flow at the same time?
Florence Mukangenzi (23:32):
time.
Yeah, so I started like I wasalways, you know, taking some
sort of antidepressant and evenbefore I graduated, I and
especially during the last yearsof medical school a lot of it
is just really hospital work,and so I was always taking some
sort of you know, antidepressantstuff to help my mental health
(23:57):
so that I can, you know, show upas you know as best as I can,
you know, show up as you know asbest as I can.
And one of the ways that I wasable to like to take care of
(24:55):
myself, and also how affirmingit is to do great things, to see
myself helping people, there'sthis thing that happened in the
hospital where you may see apatient at first and they're
like really sick, and then maybeyou go home on the weekend and
(25:22):
you're not the one on theweekend shift, and then you come
back on Monday and you canrecognize them because they've
just so healed so much.
Their face has changed,everything has changed.
You're like, okay, like is thisthe same person you know,
especially in kids?
(25:42):
I've seen that, especially inkids, where you know person just
really changes and it's justreally affirming that, really
affirming that something likethat happens and that you can
see yourself doing that and thatyou can see yourself doing that
(26:06):
.
And it challenges this beliefthat mental health issues put
you on, of really convincing youthat you're useless you that
(26:31):
you're useless, that you're yeah, you're useless, you don't have
that much strength physicallyor otherwise and I felt like it
was.
You know, it was like I washelping myself and, at the same
time, the work I was doing wasalso helping me by affirming me,
by reminding me that I can dohard things, that I'm helping.
(27:01):
Sometimes they're just dealingwith depression or anxiety in
their own way, especially in acommunity like ours, where
they're not even doing what Iwas doing for myself, like you
(27:23):
know, taking medication and Idon't know.
I feel like I've spoken incircus about this, but I feel
like there was a really bigaffirming part of my work,
(27:46):
affirming part of my work thatit was like I was taking care of
myself, but also my job wassort of, you know, taking care
of me, and that's a reallyextraordinary gift.
Gabe Nathan (27:52):
And I think there are healthcare providers,
particularly during COVID, whoyou know their mental health
took such a hard hit and youknow they were being run ragged
and saying, you know God, I'mrunning around helping everyone
else but my tank is completelyempty.
(28:14):
Extraordinary is that, throughthe work that you were doing,
your tank was getting filled bythe work that you were doing.
You know, from seeing thosechanges happening in patients
and seeing people who you couldidentify with, who were going
(28:38):
through similar things thatyou're going through, and it's
it's just um, it's really movingto hear.
And you know, I know you don'tneed to hear it from anyone else
, but I'll tell you anyway, youcan do hard things, uh, and you
are strong and, um, resilientand very, very brave, um, very
(29:13):
brave, and I, you know, I justknow it in my heart.
You mentioned flow in acommunity like this.
You were talking about peopleliving with mental health
challenges.
Can you talk about what it'slike to live with mental health
challenges in a community likethis, in a small area in Rwanda?
What is it like?
What are some of the prevailingviews?
(29:36):
That question is have younoticed a change, even if it's
very?
Florence Mukangenzi (29:49):
small in how people view people living
with mental illness.
Yeah, so I would say I wouldhave to compare from when I
wrote my essay in 2023 and now.
So I would say there's probablybeen a change, you know,
(30:14):
however small.
But coming back to the firstpart of the question, but coming
(30:38):
back to the first part of thequestion, how you know, in a
crazy, or you're going to be avolatile person, or you're going
to be a violent person, oryou're going to be someone who
cannot, you know, take care ofthemselves or be valuable in any
(31:00):
kind of way, because of theculture that is really deeply
ingrained in people.
That is very hard to change.
But also as new generations ofpeople come up millennials, gen
(31:24):
Z, people who are consuming theinternet more, seeing how, maybe
, people from other countriesexpress themselves, and also
even the efforts of really theMinistry of Health here and
(31:47):
other people in position todrive that change, to really
educate people, to really putthings out there, to really try
to, you know, drive it home.
Like mental health is this?
Mental health is not thisHaving issues that's not stop
(32:12):
you from being a contributingmember of society, trying to
break stigma and stuff like that.
Break stigma and stuff likethat.
And yeah, so I would say thatthere is some change.
It's harder to drive thatchange in older generations.
(32:38):
Younger people are more likelyto be willing to see this issue
differently and to learn more.
And another factor to that thatsort of makes the situation of
(32:58):
Rwanda unique is our history ofthe genocide, the 1994-20
genocide.
That is something that you know, just there is no way to deny.
(33:21):
You know mental health issueswhen it comes to stuff like that
To you know survivors, childrenof survivors and all of the
other issues that are related togenocide genocide because of
(33:42):
the way heinous genocide is andhow it's been.
I was born during the genocide,so it's been 31 years since I
was born, it's been 31 yearssince the genocide happened and
(34:07):
it feels as fresh as ever.
It's just that one thing whereyou know from the outside, you
may, you know, think aboutgenocide and even other
genocides that has happened in.
You know other countries andthink of them, as you know it's
(34:29):
been these many years and stuff.
But there is, you know, thetrauma from the people
experiencing who experienced it,their children, and you know
it's something that just reallygets ingrained in people.
But then there is that was onepart where I would say the
(34:50):
community would understand thatyou know some people had PTSD or
depression or you know stufffrom that.
But then what about mentalhealth issues from other aspects
of life, from losing a child,from being overwhelmed at work,
(35:19):
from losing an importantrelationship or struggling with
extreme poverty and stuff?
And so I think there is a partthat they understand.
There's a part that is easierto understand because you're
(35:40):
like this is something horriblethat happened to people and we
can understand that.
But at the same time, you knowwe don't understand why you're
having all these crises becauseyour boyfriend broke up with you
, right, right?
Or because of you know this andthat, or because of you know
(36:04):
this and that.
So that is where most of theefforts are being put on to just
really try to understand.
(36:25):
You know what depression is,what you know anxiety is bipolar
, all these things, and alsoreally seeing them as diseases
and not seeing them as personalfailures from people who are not
as resilient where they're likein this situation we can
understand it, but in thissituation it's not valid.
(36:46):
Yeah, so I think that is what Ican say about that.
Gabe Nathan (36:57):
And it's fascinating to hear you talk
about that.
It's fascinating to hear youtalk about that and it reminds
me of how people can haveempathy for something that they
can see like a physical illnessor, oh, you got your leg
amputated.
I can see that.
I can see that you have one legand I can feel something
(37:20):
because it's so in my face.
It's so obvious.
The way that you were talkingabout genocide.
It's like, well, of course, wecan understand trauma and PTSD
related to that, but it can beso easy to then minimize other
things, which are all stillvalid, and but there is I guess
(37:45):
there is that tendency to negateor say, well, yeah, but it's
not this.
But that's the thing aboutmental health is, it's not the
suffering Olympics, and oneperson's experience doesn't
negate another person'sexperience.
It's, it's all valid, um, sothank you for pointing that out,
and I think this is a good timeactually to to get into the way
(38:09):
back machine and go to youressay, um, which, uh, was
published a number of years agoon the site and it's how you
first came to us, and just fulldisclosure.
This was written a long timeago, I think you were 23,.
You said yeah, and now you're31.
(38:31):
And some thoughts and opinionsand feelings may have changed,
and we're going to talk aboutthat when you're finished
reading it.
But it is such a beautifulessay and an essay is a snapshot
in time, and so we're going togo back to that time playing
hide and seek with a demon, mystruggle with anxiety.
(38:53):
Take it away, flo, when you'reready.
Florence Mukangenzi (38:54):
Yeah take it away, flo, when you're ready?
Yeah, so do you want me to likeread the whole thing, and then
you will like stop me or justread, and you can just read the
whole thing, and then we'regonna talk about it a little bit
yeah.
So playing hide and seek with ademon, my struggle with anxiety.
(39:14):
I don't know when it started.
I was not.
It was not as though I suddenlywoke 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 ofemotions, but I thought it would
(39:37):
go away.
Of course, the feelings did notend and I knew I wasn't
supposed to feel this way.
I wanted to understand wherethe feelings were coming from,
but I didn't.
I couldn't bring myself toinvestigate them.
Thus I experienced many yearsof wrestling with an unknown
(39:59):
demon anxiety.
Sometimes during dinner with thefamily, a simple thought
crossing my mind would send myheart on a crazy ride.
This was before my anxietystarted to have direct triggers.
Eventually, I recognized thatmy anxiety was attached to
(40:20):
specific situations likesocializing.
My energy was consumed.
By trying to stop my anxiety,I'd hold my breath and give
myself a pep talk inside my mindyou are worried about something
that no one else is worriedabout.
Worrying isn't going to helpyou.
You will be just fine.
(40:42):
Breathe, say a prayer and itwill go away.
I thought I could fix myproblems by just snapping out of
these modes of thinking.
In reality, this just made theattacks worse.
I couldn't sleep.
I thought it was insomnia.
Doctors asked me what I thoughtabout while lying awake at
(41:05):
night and I said nothing.
Truthfully, I was worried formy life, but I could not put
these fears to words.
I lay awake thinking that oneday I would not be able to wake
up and face the day.
I lay awake thinking about howstrange it was that I couldn't
sleep while everyone else could.
(41:27):
I thought I am failing.
I don't have what it takes tobe here on earth, but I couldn't
speak these thoughts aloud tothe doctors.
My anxiety made it so that Icould not even close my eyes and
rest.
I tossed and turned and wishedto see the morning come, so the
(41:49):
scary sounds of the night wouldbe replaced by people.
Social situations made meanxious, yes, but when I could
get myself to go to class orchat with a neighbor, it was
such a relief to exist for alittle while in a world that had
more characters other than meand where I wasn't alone with my
(42:11):
demons.
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 ofvisitors showing up at the house
, things that used to bring mesolace.
I didn't want to be part of anyaspect of my life.
It all felt so unsafe.
(42:32):
I anticipated worst-casescenarios embarrassing myself at
a party, falling in front ofeveryone.
In the morning on a Sunday, Iwould tell myself that I would
go to church.
In the evening, I said tomyself that I would go, no
matter what, and as the clockneared 4 pm, I was consumed by
(42:56):
thoughts that there wassomething out there, even though
I couldn't admit.
And then, just when I thoughtit couldn't get worse, I started
medical school and my anxietyprogressed to new heights.
I remember my alarm going offaround 4 pm.
I had said it to wake up andstudy for my test.
(43:18):
When it went off, I felt asthough I had been paralyzed in
my bed.
My anxiety told me I couldnever pass my test.
I couldn't even bring myself tostudy because my anxiety told
me I would fail, no matter what.
My fears became so foreign thatI believed them as concrete
(43:41):
facts.
These days were long and full ofpaths to accomplish.
I was so tired, yet when Itried to sleep, my heart would
beat like a drum that wanted torip my chest in two, beat like a
(44:01):
drum that wanted to rip mychest in two.
Worry brought more worry and Iwas getting scared of my
emotional state.
I was a stranger in my body.
I had no coping methods.
I couldn't talk to anyone aboutwhat happened.
When I told the doctor that itfelt as though my heart was
racing, he did a test but foundthat nothing was wrong.
He told me to go home and relax.
(44:23):
I couldn't bring myself toconfide in anyone.
I was afraid of being judged.
I was afraid no one would beable to understand what I was
going through.
It all felt too complicated andimpossible to explain to anyone
else.
I was convinced there was noway that I could be helped.
(44:48):
When I finally let go, I learnedto listen to another voice,
other than the voice of myanxiety.
This was the voice of a friend.
I had reached out to her onlineand, though I didn't know it at
the time, she happened to be atherapist.
I confided in her and,surprisingly, she didn't tell me
(45:08):
to get over it.
She told me that it wasn't myfault, that I didn't deserve to
feel this way.
She said there was a way tomake things get better.
I kept talking with her andtried to do some of the things
she suggested, like being kinderto myself, exercising and
(45:32):
writing.
Her ideas helped me some, butshe urged me to find a therapist
in Rwanda to talk to Mentalhealth.
Resources are very limited inmy country.
After a long search, I found atherapist with whom I felt
comfortable.
In Rwanda we don't talk aboutmental health.
(45:54):
It's taboo.
Our culture condemns those whodare to feel or say or to say
what they feel.
When I started going to thehospital to meet with my
therapist, I was certain that ifI run into anyone I knew they
would think I had lost my mind,that I had become the illness
(46:14):
and that there was no me.
After that.
I couldn't tell anyone that Iwas speaking with someone to
help fix my mind.
Being a person with mentalillness is incredibly shameful
in my community.
It isn't recognized as a healthissue and doesn't get the same
(46:37):
acknowledgement that a diseaselike malaria receives, no matter
how debilitating mental illnesscan be.
Our traditions and cultureteach strength and resilience,
and mental illness is seen as acontradiction to this, a flaw or
defect, as a contradiction tothis, a flaw or defect,
(47:03):
something shameful to be hidden.
Mental illness is a reality theAfrican culture repeatedly
rejects.
Thus, going to meet with mytherapist was incredibly
difficult.
However, I recognized I had tofind help or I may lose my life
completely.
Something inside of me choselife, no matter what it would
(47:23):
take.
Where that strength came from,I didn't know.
My first days of therapy weremore traumatic than healing.
I knew that my therapist wasthere to help me and wasn't
going to judge me, but intalking with her I felt like
there was a spotlight on myshame and the mess my life was.
(47:45):
Therapy made me visit uglyplaces I had checked out of and
intentionally disconnected from.
I was terrified to replace sinsof an abusive childhood and
serotoxic relationships.
It took a few sessions for meto feel as though I was healing
instead of moving towardsself-destruction.
(48:07):
I was reminded that it wasn'tmy fault that I felt the way
that I did and that I was strongto choose to fight.
And that I was strong to chooseto fight.
My therapist approached therapyfrom a cognitive behavior
therapy point of view, somethingI had never heard of before.
This meant that I had to beaware of my thoughts and write
(48:30):
them in a notebook.
My therapist explained thatanxiety was always a result of
thoughts.
The thoughts acted as triggers.
The consequences were fear.
I was beginning to train mybrain to be aware of this.
I would challenge myself tolook at the thoughts from a
(48:51):
different perspective and decideif they were rational or not.
It helps to take a rationalmode and not let my anxiety
dictate the way I process things.
Entrusting someone with my past,with my shame and anxiety, with
the childhood traumas I hadsuppressed, was something I
(49:14):
longed for but never expected toreceive.
My therapist helped me to findthis.
The idea of medication wassomething I wanted to avoid.
I thought it was going tochange me that I may lose track
(49:35):
of myself.
Through much convincing, mytherapist started to work with
the neuropsychiatric hospital tochoose the right course of
medication for me.
I was warned that it would takeabout six weeks for me to
adjust to my medication and itwould get worse before it got
better.
And it did get worse, so muchworse.
It was a complete nightmare.
(49:56):
It was a complete nightmare.
For six weeks I could hardlyfunction.
I would jump at any sound.
I dreaded the night.
I dreaded the nighttime withthe fear that people would bring
into my house, rob and rape me.
I was frozen in fear andhelpless.
I wanted to die.
(50:16):
I had to fight through theworst of my anxiety to get to
the other side.
My friend whose idea it was forme to start treatment was my
main support system.
My therapist also listened tomy concerns.
She talked to the hospitalabout adjusting my doses until
(50:38):
my body was ready.
They both promised over andover, when I wanted to give up,
that it was going to get better.
And then, after rain camesunshine.
My body got used to my FSRImedication and suddenly life
felt like life again.
(51:01):
A few weeks into the medication,helping to bring me strength, I
signed up for a youthconference and once it wasn't
difficult for me to get out ofbed and attend something, I was
able to show up, be myself andparticipate.
I talked to a lot of strangersand reconnected with parts of
(51:31):
myself.
I thought I had forever lost toanxiety.
I didn't have to question myspeech a thousand times before
saying something.
It felt incredibly easy to bemyself.
I became confident.
I looked forward to each daywhen I woke up, ready to take
risks and be myself.
I reconnected with the me thatI knew was deep inside.
(51:53):
I could hardly believe I wasstill there inside.
I could hardly believe I wasstill there.
It's been two years after thathigh and that moment of extreme
positivity.
The medication I was takingthat had been working so well
for me became unavailable in mycountry and I tried alternatives
(52:14):
, experiencing many highs andlows of other medications,
dealing with side effects andresistance, and trying to handle
the cost of medication andtherapy.
Eventually I exhausted thealternatives which were
available for me and tried thehealing process without
medication.
(52:40):
About medication While I am notliving the high and the
beautiful sunshine of when mybody got used to my old
medication, I am far from thegirl I used to be.
Yes, I still have days when Iam overwhelmed and frozen in
fear.
Sometimes I feel again that astranger is living inside of me.
But I also have days when Italk to my fears and I listen.
Just last week I was trying toget my head around the fact that
(53:07):
the hectic part of my semesteris approaching.
My anxiety hit as I was packingto go.
I felt so far out of touch withmy studies.
Anxiety yelled that I wasn'tlike the others, that I was sick
and weak and sleep deprived.
I firmly said to myself.
(53:28):
I have done this for four yearsnow 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 mefrom living the experiences of
this life.
I take chances and I dream.
I know I am never going to goback to where I used to live.
(53:49):
There is no easy or instant fixfor mental illnesses, including
anxiety.
Healing is a journey and achoice one makes every day.
Sometimes you're going to try amillion different things before
something works for you.
Sometimes something is going tohelp you.
At first try.
(54:09):
The most important thing isdon't give up.
Reach out.
You cannot make it on your ownown, and letting yourself be
helped is not shameful.
It is strength, a powerful wayto fight.
Gabe Nathan (54:26):
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 writingthat and for sharing that with
our community and for startingthis long relationship with this
(54:47):
piece.
This is how it all began.
What is it like for you to goback to this after so many years
?
Florence Mukangenzi (55:00):
It's beautiful and shocking in a way,
because I'm reading it and I'mrelating to it and then I'm also
in awe of that voice, knowingwhat I know now and knowing you
(55:20):
know what would happen in mylife for the years to follow.
And you know, one of the thingsthat hit me was you know how I
was talking about medication andhow hard it was to access.
(55:45):
And that was before COVID,because in 2019, covid started
and none of the medications thatI was taking none of it is
manufactured in even Africa, tobegin with, and you know flights
(56:07):
from Europe or you know fromall the places where the
medications that I was takingwas being manufactured.
Everything was disrupted andfor several months during COVID,
I went without.
I just couldn't find mymedication anywhere.
(56:28):
And you know, which issomething that I know, that
people, even to this day, evenpost-COVID, struggle with.
There's like a limited list ofmedications here, and then there
(56:50):
is a limited list of medicationthat your insurance will pay
for, and then there was a listof limited.
Maybe the medication isavailable, but it is just so
much money.
I remember how I used to feel.
(57:11):
At some point.
I felt very, very guilty aboutthe price of my antidepressant.
I was like, how do I buymedication with this amount of
money?
And at that time, a friend washelping me to pay for that.
But then I was like there issomebody who is making this
(57:38):
amount a month to take care of afamily of five in my country,
and there was a part of me thatfelt really like I don't deserve
this.
I don't deserve to be spendingthis much money on medication
(57:59):
and stuff and I had to learn tobelieve that it was worth it and
it wasn't easy.
So recognizing that and also, Idon't know, just it made me, you
(58:25):
know, nostalgic of, you know,that person.
You know, like I was young, Ihad gone through stuff, but it
was also full of hope.
But I'm also excited about thehope that I have, especially
(58:50):
towards the end, that comes withhaving answers, comes with
having answers To this day.
I'm sure that there areprobably people who are having
(59:13):
symptoms of anxiety and going tothe doctor, even in like your
GP's vocabulary, like they justthey don't even consider it.
And I, just, like, I, have hope.
(59:35):
I have hope for my community,for my country, because I have
just learned a lot of thingssince that essay about myself
and about mental health andabout hope, but I also sort of
(01:00:03):
you know, miss that young person.
Gabe Nathan (01:00:06):
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 whohas a number of years on you I
won't say how many, but she'sstill in there.
And I just want to say that youknow, earlier we were talking
(01:00:30):
about perspectives, about mentalhealth in Rwanda, and you were
talking about younger people GenZ and millennials coming along
with new ideas, different ideas,better ideas, more openness.
You're part of that change.
I hope you understand that andknow that and believe that
(01:00:53):
Through the essay that you'vewritten, through the film PS
let's not forget about that.
You made a film while you werein Cape Cod, while you were in
Cape.
May at the Whiff's WritersRetreat, this podcast, your work
, your advocacy, your voicethat's part of what's moving the
(01:01:14):
needle.
When someone Googles depression, anxiety, rwanda, your essay is
coming up, um, and you arehelping people through your
perspectives and through yourrecovery, um and your story.
So I hope that you understandthat and appreciate that and
(01:01:37):
believe that, because I do, andI see it and I know it, and you
just deserve so much credit.
I think there are so manypeople going through what you're
going through who don't stepforward in a public way, and
(01:01:57):
that's okay, like that's theirchoice.
But you made a different choiceand I'm very grateful for that.
Florence Mukangenzi (01:02:04):
Thank you.
Thank you very much.
I think the me who wrote thatessay was scared but also brave,
was scared but also braveBecause I would think that I
(01:02:27):
probably wouldn't have as muchfear talking about that today as
I did then, even if I stillchose to write this essay.
And I also don't have as muchfear at the thought of, you know
, someone Googling me and youknow they see that One of the
(01:02:55):
important things is you knowjust, you know just like we're
talking about.
You know this generation, um,some of the ways in which I
found, um, you know resourceswas just to Google people to.
You know, try to find resources, and there are more centers now
(01:03:18):
in the country.
And another aspect that isprobably specific to me is that,
like, I work in health care andyou know so, I'm a doctor, and
(01:03:39):
somehow there are people who areholding me in high regard and
then me coming out and beinglike you know, I'm struggling
with this and this.
You know, I still wonder if Idon't know, I don't know if I
(01:04:01):
have the answer to that.
There are people just having afear of being like, if somebody
goes this, are they going tothink that I'm not fit for my
(01:04:24):
job because of this.
Which, to me, is what's harmful, is lots of people who will
never go to anywhere near apsychiatric hospital or a
(01:04:45):
therapist's office becausethey're a minister or because
they're head of a certainhospital or because they're in
the parliament.
You know stuff like that, andthat's not what's shameful.
You know what's shameful ismaybe, well, not shameful, but
(01:05:13):
having a problem is not shameful, and taking care of them is not
shameful.
It's brave, it's a responsiblething and it's something that
people should take pride in.
Gabe Nathan (01:05:31):
Absolutely.
And I would want a doctor who ishaving issues and does
something about it, who ishaving issues and does something
about it, not someone who'sstruggling with something and
denying it and pushing it asideand 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 ourprofessionals, our teachers, our
(01:05:56):
law enforcement, our, ourphysicians, our nurses are our
law enforcement.
Our physicians, our nurses arestruggling with real life things
and are doing something aboutit and not just pretending oh, I
don't have anything, I'mperfect, look at me, I'm robot
doctor and nothing bothers me.
Bullshit, it's absolutebullshit.
(01:06:18):
So I want a world where peopleare honest about what they're
going through and getting help.
I would much rather that, andthat's the example that you're
setting, and if there are peopleout there who are too
narrow-minded or ignorant orstupid to understand that.
To put it in another way, let'ssay you had raging diabetes,
(01:06:42):
but you weren't controlling yourblood sugar, you weren't taking
insulin, you were denying thatyou had diabetes, but you have
it, but well, I'm just not goingto do anything about it.
It's absurd.
So why would we want people whooperate the same way about
their mental health.
We all have mental healthissues, so just deal with them.
(01:07:03):
That's the example I would wantsaid, and that's the example I
think you're showing to otherpeople.
Florence Mukangenzi (01:07:13):
Yes, and at some point understand, you know
, maneuvering through acommunity like mine.
For example, my psychiatristhad an office at a
neuropsychiatric hospital, butthere were people who would
(01:07:37):
reach out to her and be like Iam someone who is important,
maybe I'm the CEO of somethingor this and that, and I want to
look for help, but I will notset foot into a psychiatric
hospital and she would see themat her home and she would see
(01:08:01):
them at her home and she is alsocareful about where she leaves.
She wants it to be as discreetas possible, which I believe the
right privacy and also thejourney of you know where people
are at, because some peoplewill, you know, take a little
(01:08:25):
while to not be as ashamed orunderstand.
Yeah, but also I think peopleare making these decisions
because it has happened beforewhere, if somebody knows you're
(01:08:45):
going to a psychiatric hospitalfor I don't know whatever, then
your boss is going to concludethat you can't do your job,
conclude that you can't do yourjob, or you know people are
going to whisper, or people aregoing to tell your fiance that
(01:09:07):
you're crazy and it's notresponsible to marry into that
family.
Even if it's not you, they'll belike um, that person's dad was
hospitalized at the.
That person's dad washospitalized at the mental
hospital at some point.
You know stuff like that.
So there's still a lot of workand I just really have a lot of
(01:09:43):
hope for my country.
I really hope that things cancontinue to move in a positive
direction and that conversationskeep happening until people are
really radically changed.
Gabe Nathan (01:09:51):
Conversations like this one, and thank you so much
for joining me and for havingthis, and I'm going to end this
with your words you cannot makeit on your own, and letting
yourself be helped is notshameful.
It is strength, a powerful wayto fight.
Flo, thank you so much forbeing with me on Recovery
Diaries In Depth.
Florence Mukangenzi (01:10:13):
You're welcome.
I don't know like I'm very,very thankful for this
conversation and for getting tospeak with you again and for
really just you know thinkingabout these things and also
(01:10:34):
talking about these things froma perspective of you know,
someone from a country likeRwanda and also other countries
in sub-Saharan Africa where theculture is pretty much the same.
So thank you very much forhaving me and for continuing
(01:10:57):
this relationship with thewriters.
I was very, very excited to bepart of this.
Gabe Nathan (01:11:06):
It's a joy.
I'm wishing you all the best,thank you.
Florence Mukangenzi (01:11:11):
You're welcome.
Gabe Nathan (01:11:16):
Thank you again for joining us in conversation
today.
It's beautiful to see theprogression of our contributors.
We are so grateful to DrFlorence Mukengenzi from Rwanda
for spending some time with ushere on Recovery Diaries
In-Depth.
You can find her essay PlayingHide and Seek with a Demon my
Struggle with Anxiety on ourwebsite, and you can also find a
(01:11:37):
short documentary film we madeabout Florence's struggle with
her mental illness in Rwanda onour YouTube channel.
Before we leave you, we want toremind you to check out our
website, recoverydiariesorg.
There, like this podcast,you'll find additional stories,
videos and content about mentalhealth, empowerment and change.
(01:12:00):
We look forward to continuingto grow our community.
Thank you so much for being apart of it.
We wouldn't be here without you.
Be sure to join our mailinglist so you never miss a podcast
episode, essay or film.
I'm Gabe Nathan.
Until next time, take good care.
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 youhere.
We are so pleased to bewelcoming to Recovery Diaries
In-Depth Florence Mukengenzi.
She is a doctor living inRwanda, in the heart of Africa.
She enjoys blogging atsecretswillkillyouwordpresscom.
(00:24):
She also enjoys quality prayertime and long conversations.
There's an essay by Florencecalled Playing Hide and Seek
with a Demon my Struggle withAnxiety on our website, as well
as a short documentary film wemade about Florence and she was
visiting the US in 2019 for awomen's writer's retreat.
Each week, we'll bring you aRecovery Diaries contributor
(00:46):
folks who have shared theirmental health journey with us
through essay or video format.
We want to see where they areon their mental health journey.
Since initially being publishedon our website, our goal is to
continue supporting our diversecommunity by having
conversations here on ourpodcast to follow up and see
what has shifted, what haschanged and what new things have
(01:06):
emerged.
We're so happy to have youalong for this journey.
We want to remind you to followour show for new and back
episodes at recoverydiariesorg.
There, like the podcast, you'llfind stories of mental health,
empowerment and change.
You can also sign up for ourmailing list there so you never
miss a new podcast episode,essay or film, and you can find
(01:27):
this podcast pretty muchanywhere you get your podcasts.
We appreciate your comments andfeedback about our show.
It helps us improve, makechanges and grow and, of course,
make sure to like, share andsubscribe, and subscribe.
(01:51):
Florence, thank you so much forbeing here on Recovery Diaries
in Depth.
It is an incredible joy to seeyou here.
Florence Mukangenzi (01:55):
Oh, thank you so much.
I'm excited to be here.
I'm just really excited.
Gabe Nathan (02:03):
So can you just tell the people listening talk
about the last time we saw eachother in person, Because I
actually don't have the joy andthe privilege of seeing a lot of
the Recovery Diaries,contributors, especially from
people who live in Rwanda, whereyou do, from people who live in
(02:26):
Rwanda, where you do.
Most of the time, I'mcommunicating with authors via
email and we're editing essaysback and forth and essays
published and that's it.
But I had the opportunity tospend some time with you six
years ago.
Can you just talk about that?
Florence Mukangenzi (02:39):
Yeah, so the last time we saw each other
was in 2019, right before thepandemic at the OC87 women's
retreat, you know, exciting andoverwhelming, to say the least,
(03:12):
because you know, just there'sme making all this, this trip
all the way from East Africa tothe US and, you know, attending
this retreat, and it was alllike a dream.
And also from just receivingthat email of you inviting me to
the US, and me being like, oh,is this real?
(03:36):
And for it to like, reallyhappen, yeah, so just a very I
don't know dreamlike time.
Gabe Nathan (03:51):
And it was for me too, and I just want to say that
from you know, getting to knowyou when your essay was first
published, which was a couple ofyears 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.
And now here we are in 2025,getting to talk on this podcast
(04:16):
about how extraordinary life isand about how I feel like this
kind of thing.
This is going to sound like I'mkind of tooting our own horn or
Recovery Diaries' own horn, butI feel like other publications.
(04:39):
They get an essay and theypublish it and then they move on
to the next one and it's justabout 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 Iunderstand and acknowledge that.
(05:01):
But when I look at you and Isee the thread of the human
relationship, from essay to theretreat to now to just
maintaining this connection,it's extraordinary and I just
you never know what can happenwhen you write an essay and send
(05:25):
it to a publication.
Um, it's, it's sometimes it'sjust way more than getting
published.
Florence Mukangenzi (05:34):
Uh, yeah, so I don't know to me, um, you
know, just like you say that Ithought 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 wasgoing to publish it and then it
was going to be over and allstuff, and that happened.
But then after that, two yearsafter that, you get in touch
(05:58):
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 yearsafter that, we're doing this
podcast and I think one of thethings I feel that's meant is
(06:23):
that the things I feel thatcement is that um, so there is
this story of you tell yourstory about you know mental
health and you know thingsyou've learned and your journey
and the.
There is, um, I don't know if Iwould say like humanity that
(06:44):
comes with you know, followingup, sort of like following up to
the story instead of assumingthat you know this person, just
you know.
Then you know brought up in thesunset and then you know, lived
happily ever after and stuff,and to keep in touch with
writers and hearing from them.
(07:08):
You know, wondering whathappened to that story, you know
, is what makes the experiencereally unique and really
valuable in such a way that Ifeel the people at OC87 are
(07:34):
really kind of like recognizingall these contributors as this
person with a story and reallyputting value into that.
Gabe Nathan (07:49):
It means a lot to me that you think that and
believe that, because it's likethe guiding light of what we do.
I think it's one of the reasonswhy I hate the word content.
It makes me want to puke when Ihear someone say about a piece
of writing, about a personalessay by someone who has lived
(08:11):
experience with mental healthwhat's your content for the week
?
Fuck, that it's not content.
This isn't like we're notposting memes or just like
meaningless shit.
These are people, these arehuman beings, who are putting
themselves out there in thisincredibly vulnerable way, naked
(08:33):
, really standing naked beforethe world and saying this is who
I am and this is my story, or apart of my story and my journey
.
And it's been really hard.
And I think you all of ourcontributors open themselves up
to ridicule by mean, nastypeople, criticism people who
(09:00):
doubt them, people who faultthem, people who say, well, such
and such happened becauseyou're weak or it's your fault
or you weren't whatever enoughto overcome what you're dealing
with.
And we'll get to thoughts aboutmental health in Rwanda and
maybe some stigmatizing ideasthat people have about mental
(09:22):
health, but it's we feel sostrongly here about people and
that that's.
That's what we're doing here issharing human beings with
others and the thing that yousaid about checking in.
(09:45):
So you know, I used to work at apsychiatric hospital and I
think that one of the mostvaluable things that you can do,
like post-discharge, you knowpatients, they're hospitalized
for five days or seven days ornine days or whatever it is, and
they're discharged.
You check in with them, yousend a postcard, you pick up the
(10:07):
phone and call hey, how are youdoing?
Hey, I know it's been threeweeks since you were last in the
hospital.
What's been happening?
Because more often than not itain't just riding off into the
sunset and la la, la andeverything's great, right.
Life is like this and it's soimportant to be there for people
(10:28):
when it's going down right.
And if you never check in withthem, you never know and the
other people think, well, theydon't care about me.
You know, we just had thistransactional relationship.
I was in the hospital and nowI'm not, so they're not thinking
about me, or I wrote the essayand it was published, and then
(10:50):
it's, they're onto the next one,and that's not right.
We want to be with you guys asmuch as we can, and that's the
whole point of doing thispodcast is we wanted a vehicle
to bring people back so we cancheck in with them and know
what's been going on.
So what's been going on, flo,what's?
Florence Mukangenzi (11:11):
been going on since 2019?
Gabe Nathan (11:13):
Spill it, spill the tea.
Florence Mukangenzi (11:17):
So what's been going on?
Where does one start?
So in 2019, I was in medicalschool.
I don't even remember what yearI was in.
Gabe Nathan (11:30):
Like second.
Florence Mukangenzi (11:32):
Yeah, like a second year.
And then there were issues withmy school, and then there was
the and my, you know, graduationwas delayed by years, so I
ended up going back to medicalschool and in 2023, I graduated.
Gabe Nathan (11:59):
Cheers doctor.
Florence Mukangenzi (12:01):
Yeah, cheers to that.
It's very surreal and yeah,sometimes you know I have a hard
time calling myself a doctorbecause I'm like what you mean
me.
Gabe Nathan (12:16):
Well, you better get used to it.
Florence Mukangenzi (12:19):
Yeah, like you mean me.
Who can, you know, make adecision about what shoes to
wear in the morning?
Now I have to make a decisionabout people's lives.
Yeah, so that happened.
And then I did a year ofmedical internship, which I was
(12:41):
working in a hospital for a year, and then, in July of last year
, I decided to take a break andso I've been on that break.
It's going to be almost no.
(13:02):
Yeah, in three months it will bea year of me not working and me
, yeah, just hanging out, and alot of you know things led to
that, to that.
(13:24):
But another thing that wassignificant that happened is
that shortly before that, Istarted a ketamine treatment
(13:44):
which my therapist, who is anAmerican woman who has been
living in Rwanda for severalyears, started this clinic,
which was in the making forseveral years.
She would, you know, we wouldtalk about it, and it sounded
(14:07):
like it was never going tohappen and she had to, like,
jump through several hoops andthen she successfully started
this ketamine clinic here andit's in May.
It will have been operating fora whole year.
So that's, you know, anexperience all of its own.
(14:31):
Yeah, so those are, I think,the most significant things that
have happened in my life sincethen, in my life since then and
now, like I've taken this yearto kind of like calm down, you
know, reevaluate my life, figureout what I want to do, if I
(14:54):
want to go to residency, if Iwant to do a master's in this or
that.
Gabe Nathan (15:05):
Yeah, that's where I've been at.
That's.
That is a lot, um, and I haveso many questions, but I think
the first question that I haveis about the ketamine treatment.
Um, do you find it helpful?
Can you talk a little bit aboutit, and were you anxious about
trying it at first, and how haveyou been feeling?
Florence Mukangenzi (15:26):
Um, so for me it it couldn't um come like
this.
The clinic couldn't start fastenough.
Um, because it's very funny,where I started with medication,
(15:47):
where I started being veryreluctant about trying different
medications and stuff andgetting to the point of being
like, if something is going tohelp, I'm willing to try
anything.
It's going to help, I'm willingto try anything.
(16:09):
And so through the years I wentthrough this history of really
trying almost everything thatwas available at the market here
in Rwanda and also getting to apoint where I was also even
like getting medication thatwasn't available and rather like
getting medication shipped fromlike Europe or the US things,
(16:52):
and I would have some work, youknow, imperfectly some work, and
then stop working after a while.
I would have some that wouldnot work right away.
And so I had this experience of,you know, continuing to be very
depressed and even when I feltlike anxiety was controlled, it
(17:14):
was this thing of, like you know, just working on two things
Sometimes anxiety is controlled,but then depression is there,
or sometimes depression isbetter, but then I'm very, very
anxious.
(17:34):
And so we tried all thesethings and my therapist had
experience with had clients whohad good results with ketamine
and she would talk to me aboutit and stuff, and because she
(17:56):
was someone who I've worked withfor several years, who knew me
very well and who knew also thehistory of how I would change
medication, go back to weight,try something new, how my body
would react to that, and so Iwas very anxious to try.
I was very eager.
(18:18):
I was like, if this issomething that could help me,
even if it was, you know, for awhile, like I'm very willing to
try.
So I think I was probably likeat the first infusion I was a
(18:42):
bit anxious, but, um, effusion,I was a bit anxious, but leading
up to it I was very, um, justexcited to being like this is
something that could help mesignificantly.
Um and um I'm trying toremember if you asked me, uh,
(19:04):
also about if you know, like, ifit works, if it has helped me,
um, and so it's it's been a yearand I think going into it, um,
I was like this is not likeantidepressant, this is going to
(19:25):
fix me, like right away.
And you know, boy was I wrong,because it ended up being a
journey being a journey, and Igot more help when I, when I
(20:05):
kind of like changed my mind andlike committed to it,
willingness to continue to takecare of myself, you know, every
day, and to work on things, workon things.
And so it is, you know, verydramatic change that I wanted
(20:34):
after like at least the firstsix infusions.
It wasn't like that, but alongthe journey, because it's been
almost a year now is when I seehow things have changed in my
(20:57):
life.
Also with working with mytherapist, where sometimes we
sort of just go through thingsand just realize how that I have
made leaps in terms of you knowhow my brain works, how it
(21:21):
perceives things.
Gabe Nathan (21:24):
Yeah, I love that you made the point about how we
want this thing, whether it's aketamine infusion or whether
(21:46):
there's so much more tomaintaining your mental health
and recovery than just taking athing right, putting some kind
of substance in your body.
It's work.
It's always so much work thatyou have to do in therapy out of
(22:10):
therapy, dealing with cognitivedistortions, dealing with
perceptions of well, otherpeople are thinking this about
me, or I'm thinking this aboutme, or I'm bad, or I'm a lazy
piece of shit, or I'm bad or I'ma lazy piece of shit or I'm.
Whatever the narrative is inour minds.
It's so much work to constantlybe challenging that and to be
(22:35):
committing to being better orcommitting to challenging those
thoughts or committing tochanging behaviors that are no
longer helpful or no longerserving you.
It's a lot, and so my questionis how do you?
(22:57):
How are you doing all of that,or trying to do all of that,
while, like taking care ofpatients, um, taking care of
other human beings?
How, how do you?
How were you keeping that trainon the track of also taking
care of flow at the same time?
Florence Mukangenzi (23:32):
time.
Yeah, so I started like I wasalways, you know, taking some
sort of antidepressant and evenbefore I graduated, I and
especially during the last yearsof medical school a lot of it
is just really hospital work,and so I was always taking some
sort of you know, antidepressantstuff to help my mental health
(23:57):
so that I can, you know, show upas you know as best as I can,
you know, show up as you know asbest as I can.
And one of the ways that I wasable to like to take care of
(24:55):
myself, and also how affirmingit is to do great things, to see
myself helping people, there'sthis thing that happened in the
hospital where you may see apatient at first and they're
like really sick, and then maybeyou go home on the weekend and
(25:22):
you're not the one on theweekend shift, and then you come
back on Monday and you canrecognize them because they've
just so healed so much.
Their face has changed,everything has changed.
You're like, okay, like is thisthe same person you know,
especially in kids?
(25:42):
I've seen that, especially inkids, where you know person just
really changes and it's justreally affirming that, really
affirming that something likethat happens and that you can
see yourself doing that and thatyou can see yourself doing that
(26:06):
.
And it challenges this beliefthat mental health issues put
you on, of really convincing youthat you're useless you that
(26:31):
you're useless, that you're yeah, you're useless, you don't have
that much strength physicallyor otherwise and I felt like it
was.
You know, it was like I washelping myself and, at the same
time, the work I was doing wasalso helping me by affirming me,
by reminding me that I can dohard things, that I'm helping.
(27:01):
Sometimes they're just dealingwith depression or anxiety in
their own way, especially in acommunity like ours, where
they're not even doing what Iwas doing for myself, like you
(27:23):
know, taking medication and Idon't know.
I feel like I've spoken incircus about this, but I feel
like there was a really bigaffirming part of my work,
(27:46):
affirming part of my work thatit was like I was taking care of
myself, but also my job wassort of, you know, taking care
of me, and that's a reallyextraordinary gift.
Gabe Nathan (27:52):
And I think there are healthcare providers,
particularly during COVID, whoyou know their mental health
took such a hard hit and youknow they were being run ragged
and saying, you know God, I'mrunning around helping everyone
else but my tank is completelyempty.
(28:14):
Extraordinary is that, throughthe work that you were doing,
your tank was getting filled bythe work that you were doing.
You know, from seeing thosechanges happening in patients
and seeing people who you couldidentify with, who were going
(28:38):
through similar things thatyou're going through, and it's
it's just um, it's really movingto hear.
And you know, I know you don'tneed to hear it from anyone else
, but I'll tell you anyway, youcan do hard things, uh, and you
are strong and, um, resilientand very, very brave, um, very
(29:13):
brave, and I, you know, I justknow it in my heart.
You mentioned flow in acommunity like this.
You were talking about peopleliving with mental health
challenges.
Can you talk about what it'slike to live with mental health
challenges in a community likethis, in a small area in Rwanda?
What is it like?
What are some of the prevailingviews?
(29:36):
That question is have younoticed a change, even if it's
very?
Florence Mukangenzi (29:49):
small in how people view people living
with mental illness.
Yeah, so I would say I wouldhave to compare from when I
wrote my essay in 2023 and now.
So I would say there's probablybeen a change, you know,
(30:14):
however small.
But coming back to the firstpart of the question, but coming
(30:38):
back to the first part of thequestion, how you know, in a
crazy, or you're going to be avolatile person, or you're going
to be a violent person, oryou're going to be someone who
cannot, you know, take care ofthemselves or be valuable in any
(31:00):
kind of way, because of theculture that is really deeply
ingrained in people.
That is very hard to change.
But also as new generations ofpeople come up millennials, gen
(31:24):
Z, people who are consuming theinternet more, seeing how, maybe
, people from other countriesexpress themselves, and also
even the efforts of really theMinistry of Health here and
(31:47):
other people in position todrive that change, to really
educate people, to really putthings out there, to really try
to, you know, drive it home.
Like mental health is this?
Mental health is not thisHaving issues that's not stop
(32:12):
you from being a contributingmember of society, trying to
break stigma and stuff like that.
Break stigma and stuff likethat.
And yeah, so I would say thatthere is some change.
It's harder to drive thatchange in older generations.
(32:38):
Younger people are more likelyto be willing to see this issue
differently and to learn more.
And another factor to that thatsort of makes the situation of
(32:58):
Rwanda unique is our history ofthe genocide, the 1994-20
genocide.
That is something that you know, just there is no way to deny.
(33:21):
You know mental health issueswhen it comes to stuff like that
To you know survivors, childrenof survivors and all of the
other issues that are related togenocide genocide because of
(33:42):
the way heinous genocide is andhow it's been.
I was born during the genocide,so it's been 31 years since I
was born, it's been 31 yearssince the genocide happened and
(34:07):
it feels as fresh as ever.
It's just that one thing whereyou know from the outside, you
may, you know, think aboutgenocide and even other
genocides that has happened in.
You know other countries andthink of them, as you know it's
(34:29):
been these many years and stuff.
But there is, you know, thetrauma from the people
experiencing who experienced it,their children, and you know
it's something that just reallygets ingrained in people.
But then there is that was onepart where I would say the
(34:50):
community would understand thatyou know some people had PTSD or
depression or you know stufffrom that.
But then what about mentalhealth issues from other aspects
of life, from losing a child,from being overwhelmed at work,
(35:19):
from losing an importantrelationship or struggling with
extreme poverty and stuff?
And so I think there is a partthat they understand.
There's a part that is easierto understand because you're
(35:40):
like this is something horriblethat happened to people and we
can understand that.
But at the same time, you knowwe don't understand why you're
having all these crises becauseyour boyfriend broke up with you
, right, right?
Or because of you know this andthat, or because of you know
(36:04):
this and that.
So that is where most of theefforts are being put on to just
really try to understand.
(36:25):
You know what depression is,what you know anxiety is bipolar
, all these things, and alsoreally seeing them as diseases
and not seeing them as personalfailures from people who are not
as resilient where they're likein this situation we can
understand it, but in thissituation it's not valid.
(36:46):
Yeah, so I think that is what Ican say about that.
Gabe Nathan (36:57):
And it's fascinating to hear you talk
about that.
It's fascinating to hear youtalk about that and it reminds
me of how people can haveempathy for something that they
can see like a physical illnessor, oh, you got your leg
amputated.
I can see that.
I can see that you have one legand I can feel something
(37:20):
because it's so in my face.
It's so obvious.
The way that you were talkingabout genocide.
It's like, well, of course, wecan understand trauma and PTSD
related to that, but it can beso easy to then minimize other
things, which are all stillvalid, and but there is I guess
(37:45):
there is that tendency to negateor say, well, yeah, but it's
not this.
But that's the thing aboutmental health is, it's not the
suffering Olympics, and oneperson's experience doesn't
negate another person'sexperience.
It's, it's all valid, um, sothank you for pointing that out,
and I think this is a good timeactually to to get into the way
(38:09):
back machine and go to youressay, um, which, uh, was
published a number of years agoon the site and it's how you
first came to us, and just fulldisclosure.
This was written a long timeago, I think you were 23,.
You said yeah, and now you're31.
(38:31):
And some thoughts and opinionsand feelings may have changed,
and we're going to talk aboutthat when you're finished
reading it.
But it is such a beautifulessay and an essay is a snapshot
in time, and so we're going togo back to that time playing
hide and seek with a demon, mystruggle with anxiety.
(38:53):
Take it away, flo, when you'reready.
Florence Mukangenzi (38:54):
Yeah take it away, flo, when you're ready?
Yeah, so do you want me to likeread the whole thing, and then
you will like stop me or justread, and you can just read the
whole thing, and then we'regonna talk about it a little bit
yeah.
So playing hide and seek with ademon, my struggle with anxiety.
(39:14):
I don't know when it started.
I was not.
It was not as though I suddenlywoke 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 ofemotions, but I thought it would
(39:37):
go away.
Of course, the feelings did notend and I knew I wasn't
supposed to feel this way.
I wanted to understand wherethe feelings were coming from,
but I didn't.
I couldn't bring myself toinvestigate them.
Thus I experienced many yearsof wrestling with an unknown
(39:59):
demon anxiety.
Sometimes during dinner with thefamily, a simple thought
crossing my mind would send myheart on a crazy ride.
This was before my anxietystarted to have direct triggers.
Eventually, I recognized thatmy anxiety was attached to
(40:20):
specific situations likesocializing.
My energy was consumed.
By trying to stop my anxiety,I'd hold my breath and give
myself a pep talk inside my mindyou are worried about something
that no one else is worriedabout.
Worrying isn't going to helpyou.
You will be just fine.
(40:42):
Breathe, say a prayer and itwill go away.
I thought I could fix myproblems by just snapping out of
these modes of thinking.
In reality, this just made theattacks worse.
I couldn't sleep.
I thought it was insomnia.
Doctors asked me what I thoughtabout while lying awake at
(41:05):
night and I said nothing.
Truthfully, I was worried formy life, but I could not put
these fears to words.
I lay awake thinking that oneday I would not be able to wake
up and face the day.
I lay awake thinking about howstrange it was that I couldn't
sleep while everyone else could.
(41:27):
I thought I am failing.
I don't have what it takes tobe here on earth, but I couldn't
speak these thoughts aloud tothe doctors.
My anxiety made it so that Icould not even close my eyes and
rest.
I tossed and turned and wishedto see the morning come, so the
(41:49):
scary sounds of the night wouldbe replaced by people.
Social situations made meanxious, yes, but when I could
get myself to go to class orchat with a neighbor, it was
such a relief to exist for alittle while in a world that had
more characters other than meand where I wasn't alone with my
(42:11):
demons.
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 ofvisitors showing up at the house
, things that used to bring mesolace.
I didn't want to be part of anyaspect of my life.
It all felt so unsafe.
(42:32):
I anticipated worst-casescenarios embarrassing myself at
a party, falling in front ofeveryone.
In the morning on a Sunday, Iwould tell myself that I would
go to church.
In the evening, I said tomyself that I would go, no
matter what, and as the clockneared 4 pm, I was consumed by
(42:56):
thoughts that there wassomething out there, even though
I couldn't admit.
And then, just when I thoughtit couldn't get worse, I started
medical school and my anxietyprogressed to new heights.
I remember my alarm going offaround 4 pm.
I had said it to wake up andstudy for my test.
(43:18):
When it went off, I felt asthough I had been paralyzed in
my bed.
My anxiety told me I couldnever pass my test.
I couldn't even bring myself tostudy because my anxiety told
me I would fail, no matter what.
My fears became so foreign thatI believed them as concrete
(43:41):
facts.
These days were long and full ofpaths to accomplish.
I was so tired, yet when Itried to sleep, my heart would
beat like a drum that wanted torip my chest in two, beat like a
(44:01):
drum that wanted to rip mychest in two.
Worry brought more worry and Iwas getting scared of my
emotional state.
I was a stranger in my body.
I had no coping methods.
I couldn't talk to anyone aboutwhat happened.
When I told the doctor that itfelt as though my heart was
racing, he did a test but foundthat nothing was wrong.
He told me to go home and relax.
(44:23):
I couldn't bring myself toconfide in anyone.
I was afraid of being judged.
I was afraid no one would beable to understand what I was
going through.
It all felt too complicated andimpossible to explain to anyone
else.
I was convinced there was noway that I could be helped.
(44:48):
When I finally let go, I learnedto listen to another voice,
other than the voice of myanxiety.
This was the voice of a friend.
I had reached out to her onlineand, though I didn't know it at
the time, she happened to be atherapist.
I confided in her and,surprisingly, she didn't tell me
(45:08):
to get over it.
She told me that it wasn't myfault, that I didn't deserve to
feel this way.
She said there was a way tomake things get better.
I kept talking with her andtried to do some of the things
she suggested, like being kinderto myself, exercising and
(45:32):
writing.
Her ideas helped me some, butshe urged me to find a therapist
in Rwanda to talk to Mentalhealth.
Resources are very limited inmy country.
After a long search, I found atherapist with whom I felt
comfortable.
In Rwanda we don't talk aboutmental health.
(45:54):
It's taboo.
Our culture condemns those whodare to feel or say or to say
what they feel.
When I started going to thehospital to meet with my
therapist, I was certain that ifI run into anyone I knew they
would think I had lost my mind,that I had become the illness
(46:14):
and that there was no me.
After that.
I couldn't tell anyone that Iwas speaking with someone to
help fix my mind.
Being a person with mentalillness is incredibly shameful
in my community.
It isn't recognized as a healthissue and doesn't get the same
(46:37):
acknowledgement that a diseaselike malaria receives, no matter
how debilitating mental illnesscan be.
Our traditions and cultureteach strength and resilience,
and mental illness is seen as acontradiction to this, a flaw or
defect, as a contradiction tothis, a flaw or defect,
(47:03):
something shameful to be hidden.
Mental illness is a reality theAfrican culture repeatedly
rejects.
Thus, going to meet with mytherapist was incredibly
difficult.
However, I recognized I had tofind help or I may lose my life
completely.
Something inside of me choselife, no matter what it would
(47:23):
take.
Where that strength came from,I didn't know.
My first days of therapy weremore traumatic than healing.
I knew that my therapist wasthere to help me and wasn't
going to judge me, but intalking with her I felt like
there was a spotlight on myshame and the mess my life was.
(47:45):
Therapy made me visit uglyplaces I had checked out of and
intentionally disconnected from.
I was terrified to replace sinsof an abusive childhood and
serotoxic relationships.
It took a few sessions for meto feel as though I was healing
instead of moving towardsself-destruction.
(48:07):
I was reminded that it wasn'tmy fault that I felt the way
that I did and that I was strongto choose to fight.
And that I was strong to chooseto fight.
My therapist approached therapyfrom a cognitive behavior
therapy point of view, somethingI had never heard of before.
This meant that I had to beaware of my thoughts and write
(48:30):
them in a notebook.
My therapist explained thatanxiety was always a result of
thoughts.
The thoughts acted as triggers.
The consequences were fear.
I was beginning to train mybrain to be aware of this.
I would challenge myself tolook at the thoughts from a
(48:51):
different perspective and decideif they were rational or not.
It helps to take a rationalmode and not let my anxiety
dictate the way I process things.
Entrusting someone with my past,with my shame and anxiety, with
the childhood traumas I hadsuppressed, was something I
(49:14):
longed for but never expected toreceive.
My therapist helped me to findthis.
The idea of medication wassomething I wanted to avoid.
I thought it was going tochange me that I may lose track
(49:35):
of myself.
Through much convincing, mytherapist started to work with
the neuropsychiatric hospital tochoose the right course of
medication for me.
I was warned that it would takeabout six weeks for me to
adjust to my medication and itwould get worse before it got
better.
And it did get worse, so muchworse.
It was a complete nightmare.
(49:56):
It was a complete nightmare.
For six weeks I could hardlyfunction.
I would jump at any sound.
I dreaded the night.
I dreaded the nighttime withthe fear that people would bring
into my house, rob and rape me.
I was frozen in fear andhelpless.
I wanted to die.
(50:16):
I had to fight through theworst of my anxiety to get to
the other side.
My friend whose idea it was forme to start treatment was my
main support system.
My therapist also listened tomy concerns.
She talked to the hospitalabout adjusting my doses until
(50:38):
my body was ready.
They both promised over andover, when I wanted to give up,
that it was going to get better.
And then, after rain camesunshine.
My body got used to my FSRImedication and suddenly life
felt like life again.
(51:01):
A few weeks into the medication,helping to bring me strength, I
signed up for a youthconference and once it wasn't
difficult for me to get out ofbed and attend something, I was
able to show up, be myself andparticipate.
I talked to a lot of strangersand reconnected with parts of
(51:31):
myself.
I thought I had forever lost toanxiety.
I didn't have to question myspeech a thousand times before
saying something.
It felt incredibly easy to bemyself.
I became confident.
I looked forward to each daywhen I woke up, ready to take
risks and be myself.
I reconnected with the me thatI knew was deep inside.
(51:53):
I could hardly believe I wasstill there inside.
I could hardly believe I wasstill there.
It's been two years after thathigh and that moment of extreme
positivity.
The medication I was takingthat had been working so well
for me became unavailable in mycountry and I tried alternatives
(52:14):
, experiencing many highs andlows of other medications,
dealing with side effects andresistance, and trying to handle
the cost of medication andtherapy.
Eventually I exhausted thealternatives which were
available for me and tried thehealing process without
medication.
(52:40):
About medication While I am notliving the high and the
beautiful sunshine of when mybody got used to my old
medication, I am far from thegirl I used to be.
Yes, I still have days when Iam overwhelmed and frozen in
fear.
Sometimes I feel again that astranger is living inside of me.
But I also have days when Italk to my fears and I listen.
Just last week I was trying toget my head around the fact that
(53:07):
the hectic part of my semesteris approaching.
My anxiety hit as I was packingto go.
I felt so far out of touch withmy studies.
Anxiety yelled that I wasn'tlike the others, that I was sick
and weak and sleep deprived.
I firmly said to myself.
(53:28):
I have done this for four yearsnow 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 mefrom living the experiences of
this life.
I take chances and I dream.
I know I am never going to goback to where I used to live.
(53:49):
There is no easy or instant fixfor mental illnesses, including
anxiety.
Healing is a journey and achoice one makes every day.
Sometimes you're going to try amillion different things before
something works for you.
Sometimes something is going tohelp you.
At first try.
(54:09):
The most important thing isdon't give up.
Reach out.
You cannot make it on your ownown, and letting yourself be
helped is not shameful.
It is strength, a powerful wayto fight.
Gabe Nathan (54:26):
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 writingthat and for sharing that with
our community and for startingthis long relationship with this
(54:47):
piece.
This is how it all began.
What is it like for you to goback to this after so many years
?
Florence Mukangenzi (55:00):
It's beautiful and shocking in a way,
because I'm reading it and I'mrelating to it and then I'm also
in awe of that voice, knowingwhat I know now and knowing you
(55:20):
know what would happen in mylife for the years to follow.
And you know, one of the thingsthat hit me was you know how I
was talking about medication andhow hard it was to access.
(55:45):
And that was before COVID,because in 2019, covid started
and none of the medications thatI was taking none of it is
manufactured in even Africa, tobegin with, and you know flights
(56:07):
from Europe or you know fromall the places where the
medications that I was takingwas being manufactured.
Everything was disrupted andfor several months during COVID,
I went without.
I just couldn't find mymedication anywhere.
(56:28):
And you know, which issomething that I know, that
people, even to this day, evenpost-COVID, struggle with.
There's like a limited list ofmedications here, and then there
(56:50):
is a limited list of medicationthat your insurance will pay
for, and then there was a listof limited.
Maybe the medication isavailable, but it is just so
much money.
I remember how I used to feel.
(57:11):
At some point.
I felt very, very guilty aboutthe price of my antidepressant.
I was like, how do I buymedication with this amount of
money?
And at that time, a friend washelping me to pay for that.
But then I was like there issomebody who is making this
(57:38):
amount a month to take care of afamily of five in my country,
and there was a part of me thatfelt really like I don't deserve
this.
I don't deserve to be spendingthis much money on medication
(57:59):
and stuff and I had to learn tobelieve that it was worth it and
it wasn't easy.
So recognizing that and also, Idon't know, just it made me, you
(58:25):
know, nostalgic of, you know,that person.
You know, like I was young, Ihad gone through stuff, but it
was also full of hope.
But I'm also excited about thehope that I have, especially
(58:50):
towards the end, that comes withhaving answers, comes with
having answers To this day.
I'm sure that there areprobably people who are having
(59:13):
symptoms of anxiety and going tothe doctor, even in like your
GP's vocabulary, like they justthey don't even consider it.
And I, just, like, I, have hope.
(59:35):
I have hope for my community,for my country, because I have
just learned a lot of thingssince that essay about myself
and about mental health andabout hope, but I also sort of
(01:00:03):
you know, miss that young person.
Gabe Nathan (01:00:06):
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 whohas a number of years on you I
won't say how many, but she'sstill in there.
And I just want to say that youknow, earlier we were talking
(01:00:30):
about perspectives, about mentalhealth in Rwanda, and you were
talking about younger people GenZ and millennials coming along
with new ideas, different ideas,better ideas, more openness.
You're part of that change.
I hope you understand that andknow that and believe that
(01:00:53):
Through the essay that you'vewritten, through the film PS
let's not forget about that.
You made a film while you werein Cape Cod, while you were in
Cape.
May at the Whiff's WritersRetreat, this podcast, your work
, your advocacy, your voicethat's part of what's moving the
(01:01:14):
needle.
When someone Googles depression, anxiety, rwanda, your essay is
coming up, um, and you arehelping people through your
perspectives and through yourrecovery, um and your story.
So I hope that you understandthat and appreciate that and
(01:01:37):
believe that, because I do, andI see it and I know it, and you
just deserve so much credit.
I think there are so manypeople going through what you're
going through who don't stepforward in a public way, and
(01:01:57):
that's okay, like that's theirchoice.
But you made a different choiceand I'm very grateful for that.
Florence Mukangenzi (01:02:04):
Thank you.
Thank you very much.
I think the me who wrote thatessay was scared but also brave,
was scared but also braveBecause I would think that I
(01:02:27):
probably wouldn't have as muchfear talking about that today as
I did then, even if I stillchose to write this essay.
And I also don't have as muchfear at the thought of, you know
, someone Googling me and youknow they see that One of the
(01:02:55):
important things is you knowjust, you know just like we're
talking about.
You know this generation, um,some of the ways in which I
found, um, you know resourceswas just to Google people to.
You know, try to find resources, and there are more centers now
(01:03:18):
in the country.
And another aspect that isprobably specific to me is that,
like, I work in health care andyou know so, I'm a doctor, and
(01:03:39):
somehow there are people who areholding me in high regard and
then me coming out and beinglike you know, I'm struggling
with this and this.
You know, I still wonder if Idon't know, I don't know if I
(01:04:01):
have the answer to that.
There are people just having afear of being like, if somebody
goes this, are they going tothink that I'm not fit for my
(01:04:24):
job because of this.
Which, to me, is what's harmful, is lots of people who will
never go to anywhere near apsychiatric hospital or a
(01:04:45):
therapist's office becausethey're a minister or because
they're head of a certainhospital or because they're in
the parliament.
You know stuff like that, andthat's not what's shameful.
You know what's shameful ismaybe, well, not shameful, but
(01:05:13):
having a problem is not shameful, and taking care of them is not
shameful.
It's brave, it's a responsiblething and it's something that
people should take pride in.
Gabe Nathan (01:05:31):
Absolutely.
And I would want a doctor who ishaving issues and does
something about it, who ishaving issues and does something
about it, not someone who'sstruggling with something and
denying it and pushing it asideand 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 ourprofessionals, our teachers, our
(01:05:56):
law enforcement, our, ourphysicians, our nurses are our
law enforcement.
Our physicians, our nurses arestruggling with real life things
and are doing something aboutit and not just pretending oh, I
don't have anything, I'mperfect, look at me, I'm robot
doctor and nothing bothers me.
Bullshit, it's absolutebullshit.
(01:06:18):
So I want a world where peopleare honest about what they're
going through and getting help.
I would much rather that, andthat's the example that you're
setting, and if there are peopleout there who are too
narrow-minded or ignorant orstupid to understand that.
To put it in another way, let'ssay you had raging diabetes,
(01:06:42):
but you weren't controlling yourblood sugar, you weren't taking
insulin, you were denying thatyou had diabetes, but you have
it, but well, I'm just not goingto do anything about it.
It's absurd.
So why would we want people whooperate the same way about
their mental health.
We all have mental healthissues, so just deal with them.
(01:07:03):
That's the example I would wantsaid, and that's the example I
think you're showing to otherpeople.
Florence Mukangenzi (01:07:13):
Yes, and at some point understand, you know
, maneuvering through acommunity like mine.
For example, my psychiatristhad an office at a
neuropsychiatric hospital, butthere were people who would
(01:07:37):
reach out to her and be like Iam someone who is important,
maybe I'm the CEO of somethingor this and that, and I want to
look for help, but I will notset foot into a psychiatric
hospital and she would see themat her home and she would see
(01:08:01):
them at her home and she is alsocareful about where she leaves.
She wants it to be as discreetas possible, which I believe the
right privacy and also thejourney of you know where people
are at, because some peoplewill, you know, take a little
(01:08:25):
while to not be as ashamed orunderstand.
Yeah, but also I think peopleare making these decisions
because it has happened beforewhere, if somebody knows you're
(01:08:45):
going to a psychiatric hospitalfor I don't know whatever, then
your boss is going to concludethat you can't do your job,
conclude that you can't do yourjob, or you know people are
going to whisper, or people aregoing to tell your fiance that
(01:09:07):
you're crazy and it's notresponsible to marry into that
family.
Even if it's not you, they'll belike um, that person's dad was
hospitalized at the.
That person's dad washospitalized at the mental
hospital at some point.
You know stuff like that.
So there's still a lot of workand I just really have a lot of
(01:09:43):
hope for my country.
I really hope that things cancontinue to move in a positive
direction and that conversationskeep happening until people are
really radically changed.
Gabe Nathan (01:09:51):
Conversations like this one, and thank you so much
for joining me and for havingthis, and I'm going to end this
with your words you cannot makeit on your own, and letting
yourself be helped is notshameful.
It is strength, a powerful wayto fight.
Flo, thank you so much forbeing with me on Recovery
Diaries In Depth.
Florence Mukangenzi (01:10:13):
You're welcome.
I don't know like I'm very,very thankful for this
conversation and for getting tospeak with you again and for
really just you know thinkingabout these things and also
(01:10:34):
talking about these things froma perspective of you know,
someone from a country likeRwanda and also other countries
in sub-Saharan Africa where theculture is pretty much the same.
So thank you very much forhaving me and for continuing
(01:10:57):
this relationship with thewriters.
I was very, very excited to bepart of this.
Gabe Nathan (01:11:06):
It's a joy.
I'm wishing you all the best,thank you.
Florence Mukangenzi (01:11:11):
You're welcome.
Gabe Nathan (01:11:16):
Thank you again for joining us in conversation
today.
It's beautiful to see theprogression of our contributors.
We are so grateful to DrFlorence Mukengenzi from Rwanda
for spending some time with ushere on Recovery Diaries
In-Depth.
You can find her essay PlayingHide and Seek with a Demon my
Struggle with Anxiety on ourwebsite, and you can also find a
(01:11:37):
short documentary film we madeabout Florence's struggle with
her mental illness in Rwanda onour YouTube channel.
Before we leave you, we want toremind you to check out our
website, recoverydiariesorg.
There, like this podcast,you'll find additional stories,
videos and content about mentalhealth, empowerment and change.
(01:12:00):
We look forward to continuingto grow our community.
Thank you so much for being apart of it.
We wouldn't be here without you.
Be sure to join our mailinglist so you never miss a podcast
episode, essay or film.
I'm Gabe Nathan.
Until next time, take good care.
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