Work, Illness and Speaking Out

I had a rather sad conversation online yesterday in a peer support chat room. The guy I was talking to asked the room whether it’s best to be honest with his GP about the state of his mental health. From what I gathered he has been struggling a long time without any help; I asked him if he had a diagnosis and he replied ‘nothing official, just a fucked up psyche.’

His main concerns seemed to be being locked away and losing his job – two things I can truly identify with; when I first started seeking help I tended to play-down things in fear of the psych ward and lost a job over my mental health when it was at its direst point. But the truth is that most health systems – or at least those that are run by the state – actively seek to provide support to keep people out of hospital, and as for workplaces, in most cases the person is protected by anti-discrimination laws.

A quick Google suggests a figure of around £350 a day to treat someone in hospital on the NHS whilst intervention outside of the psychiatric wards costs far less (although I couldn’t find any concrete figures). There is also the consideration that internment in a mental health unit causes considerable stress to the client; the wards are far from peaceful, recuperative places. In most areas here in the UK there are specialist teams for acute care outside of the clinical setting; Home Treatment Teams (HTT) are able to visit clients in their homes to help with medication and provide someone to talk to; they also have 24 hour phone services so even in the middle of the night a nurse will be on hand to discuss concerns.

There are also many care homes in the UK that usually support long-term residents in transitioning back into the ‘real world’ which have ICBs (intensive care beds) for shorter term stays. I’ve been in two of these homes and they proved to be incredibly therapeutic environments; space to recover, freedom to come and go and 24 hour support from trained staff. Whilst staying in the homes, clients are supported by their own psychiatrist and care co-ordinator so there is no variation in treatment plans or any stress of seeing staff that are unfamiliar to someone who is in a fragile state.

Hospital is a last resort here; there have been only two occasions when I’ve been threatened with a section and both were when my ability to keep myself safe went beyond the scope of what the earlier interventions could cope with. This is despite suicide attempts and self-harm; despite drinking to cope. There was a real push from the NHS staff I dealt with to keep me out of the psych wards until it was an 11th-hour situation; even then I remained out of the hospital thanks to redoubled efforts from the HTT and care homes.

The guy I was speaking to online was concerned about the security of his job if he wound up needing to take time off sick for his illness. This was in part due to the nature of his work; he had passed psych clearance tests in order to secure the role in the first place. With a little discussion I discovered that he was nervous that his employer would indirectly find ways to push him out of his job; despite my reassurance of discrimination law he remained convinced that he would not be able to stay employed if he sought help and treatment.

The fact is that most countries have solid disability discrimination laws; if the illness is significant and long term. Essentially – in relation to the workplace – they lay out a requirement to allow reasonable adjustments that ensure the employer facilitates the needs of their employee and also a requirement to treat their employees equally despite their disability. These laws are the backbone for activists to be able to speak out openly about their illnesses and go a long way towards true equality and the end of stigma.

I sincerely hope the online chatter is honest with his GP and gets the help he needs; he seemed desperate for someone to hear him and assist him in his recovery – unfortunately there is still such stigma surrounding mental illnesses that it remains difficult to speak up in confidence of not being judged for something we cannot change.

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Work, Illness and Speaking Out

My Mission Statement

I heard a wonderful quote today: “Never look down on somebody unless you’re helping them up” (Jesse Jackson). It got me thinking about what my goals in life are; what am I aiming for? When I am old and frail, what will I count amongst my greatest successes?

Smile: sums up the attitude I take to everyday life. I am inclined to see other people as customers-of-sorts (my old work did some psychometric testing once, and I came out as a “circle” – resilient, bouncy and no sharp edges!). It’s hard to get through a day where I don’t manage to make a human connection with someone; whether that’s online, in the office or simply a giggle with my husband when I get home. Smiles matter to me!

Praise: I promise to praise others achievements. I also promise to praise myself for reaching those standards. After all, as much as I’m my own worst enemy I equally can be my own best friend. When I see a disheartened friend, colleague or just a guy on the bus; I will praise, compliment or otherwise cajole a smile from their downturned face. Credit for our actions is vital!

Love: I’m lucky; I have a lot of love in my life. Between my husband, my family, my friends and my online community I have all bases covered. I will always appreciate the love that I receive; I will always aim to give out just as much!

Activity: No resting on my laurels. Work keeps me busy, but I admit to being less than passionate about inputting data and checking through records. I need to do something worthwhile with my life – the site, Twitter, the shop. I have a voice and I fully intend to use it. It is vital to my sense of wellbeing to be heard; I will not stop shouting and lending my words to a cause I am truly passionate about.

Punk: I will always have a rebellious streak – and it’s a good thing (no, really!) . To me, punk is an expression of being dissatisfied with the world as it is, and represents an intrinsic need to do something about it. I will be a punk today, in whatever way I am able!

I am always going to be me; I just want to ensure I’m the ‘best me I can be’.

My Mission Statement

OMG – Colleague X is a nice person!

It’s amazing what a heart to heart over a few drinks can do for a relationship.

I’ve written a bit about Colleague X and our differences. She is blunt, quick to judge and gives off a tough-gal exterior. By contrast, I am milder, don’t take criticism well and only get riled up when it’s the last option. At work, I think I’m seen as a bit of a door-mat, but that’s ok. I’ve developed my style in the workplace over the last almost-ten-years and I know I get results. In the time I’ve been working, I’ve only ever had one major row and that was with a supplier who had truly screwed me over. I like to think I’ve perfected the ‘nice guys don’t always finish last’ approach.

On Friday, our new line manager invited the whole department for drinks to welcome her to the company. Pretty quickly we all migrated out to the pub garden; warm night plus a lot of smokers plus alcohol. Somehow a group formed away from where we were sitting, and Colleague X and I found ourselves alone together with a silence between us.

Now, it’s important to know that I don’t make a secret of the fact I suffer mental health issues (hence this blog, hence Twitter, hence Facebook!). Pretty much anyone I’m on chatting-basis with in the office knows the rough outline of things; as does Colleague X – in her case it is because I ‘came out’ to the team as I felt it was unfair to leave them in the dark as to the reasons behind my changeable moods and mid-afternoon disappearances.

Colleague X and I tentatively began talking; we were both drinking ales and, like any passionate ale aficionado, we started comparing tasting notes. We decided the one I’d picked was the nicer one. We decided to head inside for a top up. What surprised me, though, was that once we’d got fresh pints, neither of us made a move towards re-joining the group. The ice was broken!

That night, we spent five hours in deep, meaningful conversation. We talked about our childhoods, our upbringing and our current struggles. In my quick-defensiveness, I’d totally missed out on the fact we have a lot in common at the moment. We discussed coping-strategies, I told her about the course of my mental health journey. She admitted she is afraid of pills-and-professionals, and I waxed lyrical about making the path as smooth as possible.

What we realised is that we need each other. Instead of being two solo artists competing for the top-dog spot, we actually complement each other. Colleague X is methodical, detail orientated; I am the kind of person who learns a process and then looks to improve it/speed it up (read: I find shortcuts!). We agreed that we can learn from each other. I need to improve my eye for detail, and she needs to improve her efficiency.

It feels really good to have cleared the air between us now. This morning we were collaborating and communicating. When giving me some criticism I appreciated the way she approached it; she took a softer approach than before. I really do feel we’ve turned a corner here, and together we can be truly awesome.

OMG – Colleague X is a nice person!

Back to work and a bit on personality disorders

I’m pleased to be able to report that as of 12:30 today I’m back in the saddle; catching up on nearly a week’s absence has kept me busy enough that I’ve not really had time to think about Tweeting or Pressing until now. My CPN was very encouraging that I should come back and get some routine in my schedule. Part of the issue of the last few days has been being caught between not-coping-with-work and not-coping-alone-at-home.

This morning’s appointment threw a curve-ball at me. We chatted a bit about what’s been going on and ways to mitigate dangerous situations and then she said the team thinks I have a personality disorder going on in the soup I like to call my mind. They are referring me to a specialist team, who will do an assessment, and then from there I am likely to be offered talk-therapy; this is fab news really, but the idea of having another label kind of freaks me out too. I know it shouldn’t, but whoever decided to call them personality disorders needs a good spanking – your personality is a key part of your identity and saying there’s something wrong with it is a bit like being nut-punched in the mind.

Of course, being me, I’ve now been reading up on the various types of personality disorder (there are ten of them). I have known people with Borderline Personality Disorder and know how difficult a condition it is to live with for them, but I have never really identified with this disorder.

Here’s a super-brief rundown of the ten types:

Cluster A:

  • Paranoid PD: irrational suspicion and mistrust of people
  • Schizoid PD: social detachment, apathy
  • Schizotypal PD: social interactions are uncomfortable, unusual or eccentric beliefs.

Cluster B:

  • Antisocial PD: lack of empathy, grandiosity and manipulative behaviour
  • Borderline PD: unstable relationships and self-harm is common
  • Histrionic PD: attention-seeking behaviour, excessive emotions
  • Narcissistic PD: grandiosity, need for admiration, lack of empathy.

Cluster C:

  • Avoidant PD: social inhibition and sensitivity to criticism
  • Dependent PD: psychological need to be cared for
  • Obsessive-compulsive PD: sticks to rules, perfectionism and control.

I am feeling a lot of anxiety towards Histrionic Personality Disorder; I know this is because I’ve been accused of attention-seeking in the past and I think I would feel like a fraud in every aspect of my life. It almost feels like that diagnosis would invalidate the last three years of ups and downs, and that makes me nervous.

All I can do is wait for the referral and see what comes of it. I am keen to access talk-therapy again as this was helpful the last time I did a course with a psychologist.

Back to work and a bit on personality disorders

So What’s Good About This Anyway?

There’s a lot of publicity surrounding mental health awareness, and the mission to bring the general public to a better understanding of mental illness grows stronger every day. The fact is that mental illness sucks, but it’s not all doom and gloom. Here’s a few things that make it a little better for me each day (unfortunately they are in no way a reward for the struggles we face).

Depression has taught me empathy.

I am highly creative when manic.

My productivity and output at work benefits from hypomania.

Understanding delusional beliefs gives me insight into my own psyche.

I have a passion to make the world a better place.

My supporters have shown me true love (parental, societal and romantic).

I can relate to my father in a real way by understanding what it means to be depressed.

Writing is my outlet and I’ve been getting better at it.

Therapy has given me great skills and taught me how to be kind to myself.

I learn a lot about anger and sadness through my ‘alter’ – I am able to observe her pain and talk to Her about it. (Still not comfortable calling Her an alter, but I guess it’s as good a word as any!)

I get to see the world as a vibrant and exciting place.

When depression lifts I get to feel pleasure in things in a meaningful way.

What are the benefits you see in your mental illness? I think it’s harder to see the ‘good’ in relentless depression than it is to see it in bipolar disorder. And I’ve not got personal experience of any personality disorder, so I’m definitely not qualified to comment there!

So What’s Good About This Anyway?

The Blips

We’ve come to call these little trip-ups ‘blips’. It’s our euphemism for ‘maybe it’s a little rough at the moment’.

Blip: an unexpected, minor, and typically temporary deviation from a general trend.

Yes, that’s the right word then.

This blip is coming up on two weeks old. In the grand scheme of my three years since initial melt-down, two weeks is nothing. Compared to the long months it took to get stable initially it’s no big deal. Right?

The problem with a blip is that it feels a lot like failure. During it, it very much feels like the health I’ve fought so hard to gain is gone for good. In the moment, when dysphoric and anxious, the term blip offers no solace.

My CPN has suggested that I panic when faced with a blip. Another euphemism here – we call it ‘having a wobble’. The issue lays in the way my mind catastrophizes a very simple thing. So your mood is elevated? You’re definitely going to end up back in crisis care!

There’s no real reason for me to believe that this minor episode won’t pass innocently by and I should probably have faith that I’ll normalise in a week or so. It doesn’t stop the worry, the anxiety, of being unwell again. It’s one of those things that always stays with you after the experience has ended. Mania = psychosis = crisis.

I’m not even sure this blip is bad enough to warrant calling the team. With my CPN on holiday this week, I don’t want to waste the psychiatrists time over what is potentially nothing. On the other hand, maybe the sertraline is kicking my mood up a notch. We’ve long been aware that 100mg is my therapeutic dose; but it also has a tendency to send me high.

The balancing act of staying well is tough. I’ve been getting better at it but it’s taken a lot of trial and error along the way. For now, I will continue to track my mood, watch for the red flags and hope this passes without incident. Fingers crossed.

The Blips