'This is how it feels like to me be mentally unwell'
Social worker Sally Redman* gives a powerfully honest account, describing her journey to recovery and how the support of employers is vital
Professional Social Work magazine - 5 October, 2020
I have always prided myself of being resilient, a problem solver and I admit I am guilty of having looked at people who were struggling with their mental health as a bit weak or somehow flawed.
So it came as quite a shock to me when I realised I was in the eye of the storm of an episode of very poor mental health. I have always been a bit of a worrier and looking back had symptoms of OCD and depression but was able to push through.
In February 2018 I was no longer able to function. I have felt low before and I have had worries that have kept me awake all night but I now know that this was not anxiety or depression. Poor mental health is very different to our normal and usual emotional responses to life’s ups and down.
So what does a mental health episode feel like? I guess for everyone it is different. For me it meant not being able to make the most simple of decisions. Not being able to participate in conversations. Not being able to find joy or comfort in anything. It feels like there is absolutely no point in continuing with life.
I became preoccupied with thoughts that bad things were going to happen to my dog, myself and my husband. I was preoccupied and obsessed with feelings that my dog was going to die and I would not be able to handle it. I remember sitting up all night with him staring at him waiting for him to stop breathing or show signs of some kind of deadly disease.
I was constantly plagued by feeling of panic and terror. The only way I can explain it is being chased by a shark but there was no shark to get away from. I was shaky, felt weak in my body and lost about 10kgs in weight because I had no appetite and suffered from terrible nausea.
Having worked as a social worker since 2002 as well as having a degree in psychology I guess I had a level of insight into mental health that many don’t have to draw on. I had been having some privately funded counselling, completed some one-to-one and group support through the NHS’s Improving Access to Psychological Therapies programme so felt I had exhausted all of the options.
The one thing I had not done was to be honest with my GP. I saw a triage nurse who advised I call in sick to work and have a couple of weeks to see if I picked up. She also booked me in to see the GP the following week.
Not being at work was the right thing to do but bought a new collection of problems. Having worked all my adult life I was stuck with no structure, no routine and little sense of purpose. My GP prescribed sertraline and signed me off work for a further two weeks.
I was eventually declared fit for work after having six weeks off in total. For me the sertraline was not a magic pill. It made my panic worse and I completely lost my appetite.
After some basic googling I discovered that there was a private mental health service in my home city. I emailed and explained that I would like some psychological support for anxiety and depression. They emailed back and booked me in with a psychologist in about ten days time from then.
The sessions were very expensive but I felt the need to feel well enough to get back to work meant it was worth the investment. For me one of the most frustrating parts of having poor mental health was the slowness of getting better. I still believed that I would find a quick solution and feel like myself again.
My first session with the psychologist involved going through my history and my symptoms. The psychologist explained that she had experienced periods of poor mental health herself and this really helped me feel relaxed. It also involved completing a week long diary of measuring my anxiety at hourly intervals and looking for triggers or worry themes.
The psychologist showed me a short cartoon clip called ‘the unwanted visitor’. It depicted a party with an uninvited guest which the host repeatedly tried to remove and as a result was not enjoying their party.
When the host accepted that the uninvited guest was not going anywhere, they were able to ignore them and enjoy the party. Anxiety was my uninvited guest and I knew I had to ignore it so I could get back to living my life.
Early on in my treatment the psychologist suggested my symptoms fitted with OCD. This came as quite a shock as I wrongly thought people with OCD were organised and tidy - two qualities that do not come easily to me!
The good news was that OCD is a relatively easy condition to treat as there is a very well tried and tested treatment pathway. It involves gradually exposing yourself to things that cause you anxiety and resisting the urge to carry out any kind of safety behaviour to reduce your anxiety or stop bad things happening.
For me this involved taking my dog out more and letting him get dirty and play with other dogs. It also involved starting to be a bit more sociable and experiencing the anxiety that accompanied that. I also joined a support group for people with OCD. This was very helpful and made me realise I was not alone.
Before I went back to work, the psychologist suggested that there are many things in my home and work life that I cannot control but there are also lots of things that I can. By focusing on the things that I cannot control I was actually increasing the risk of bad things happening because I was not focused on my day to day life and more likely to make mistakes. We agreed that I would give 100 per cent effort to the work that I can complete and the things I can change.
Returning to work was very hard. I made the decision to be open about the reason I had been off. I was surprised that colleagues were predominantly kind and understanding. One of the senior members of staff was particularly helpful saying that we should be able to be as open about mental health as we are about physical illness and that was the kind of culture that was being encouraged within the agency.
The ethos of my agency really helped my recovery. I was able to take time out for appointments and completed some resilience work run by occupational health. My management team continued to check in with me to see if I was okay and were supportive in getting me back to work full time. I can 100 per cent say that getting back to work was the most important milestone in my recovery.
Nearly two years later, I can say that my recovery was not easy and not linear. It was a series of ever-increasing victories over OCD, setbacks and times when I felt I was right back to square one again.
I think once you have had an episode of poor mental health you are never fully ‘well’ again and the after shocks are likely to last for years and years. The old cliché whatever doesn’t kill you makes you stronger has never been more accurate. I do feel stronger and this experience has given me immense insight into the lives of the service users I work with.
I am frustrated that the psychological support I received was only available for me because I was in a position to pay for it. More than anything this experience has taught me the importance of employers giving support to people who are experiencing periods of poor mental health. I hope that other people get the support that I did and we can all look forward to a future where support for mental health is as readily available as it is for those with poor physical health.
* The author’s name has been changed to protect their identity
This article is published by Professional Social work magazine which provides a platform for a range of perspectives across the social work sector. It does not necessarily reflect the views of the British Association of Social Workers.