Working in an outpatients’ mental health service in the NHS I was well-placed to recognise the signs and symptoms of a mental health problem. I have seen most ends of the spectrum from working in a secure men’s forensic unit, treating people experiencing psychosis in a clinic and in their homes, to treating outpatients with mild to moderate depression and anxiety. Yet none of this prepared me for my own mental health crisis that crept up on me suddenly and unexpectedly last year.
I have experienced anxiety in my life on many occasions before. I developed a fear of panicking and losing control going on the tube and was starting to avoid taking tubes and trains and places I felt I could not escape from easily. Later on I realised this was panic and agoraphobia and since I was considering dropping out of my Masters degree because it involved travelling long routes by tube, I knew I had to get some help. I had a course of CBT privately using graded exposure therapy which I had to get on board with and be committed to, and was incredibly effective for me. My CBT therapist was a real lifeline for me and we had an effective rapport which really helped.
I have since moved out of London and abroad. In September last year I started a number of new part-time teaching roles (not in mental health) in my relatively new European city. I was really worried about my ability to speak the language and to be able to communicate if there was a problem. In fact, I had pretty much spent my entire summer holiday dreading, worrying and catastrophising about all the things that could go wrong, and didn’t really tell anyone exactly how I was feeling.
I started in one of my jobs and it seemed to be going just fine the first week. I did experience a lot of worry after each class and before the next one. I was really concerned about how other people would perceive and judge me, particularly as I was not yet fluent in the language and could not understand 100%. I continued to be anxious about how other people thought I was doing my job for the next few days and had consistently negative thoughts that would not go away which were concerning as they seemed to upset me more and more. I remember that on the last day of that first week, I had been introduced to my new colleague, a really lovely lady who seemed really helpful. She was really experienced and obviously had a lot of knowledge and I started to feel inadequate in that moment. That was the moment everything spiralled out of control.
I went home and over the weekend I experienced constant racing thoughts of things going wrong and worst case scenarios. My husband and I were watching TV in the evening and I just could not focus on anything as my mind was racing so much. What surprised me the most was how physically I felt the anxiety this time and how different it was to any anxiety I had before this. I felt hot and cold every few minutes, had the sweats and could not sleep for days. I could not seem to regulate my emotions and rationalise them. I retreated to bed to warm up and calm down and called my mum for moral support. I lost my appetite and could physically not put anything in my mouth apart from forcing some sugar down me.
This pattern continued the closer it came to Monday. I found it really hard to get out of bed – I was heavy, anxious and tired due to lack of sleep. It was hard to sit up straight and I forced myself to have breakfast. I have never felt before the way I felt that day. I was inconsolably crying, paralysed with terror, and curled up on the sofa. I called in sick to work and spent the best part of the entire day on the phone to my parents who flew out the next day to be with me. All of this was entirely alien to my husband. He knew I worked in mental health but I guess I never realised that he totally didn’t understand what I did and what mental health looks like. He had no idea what was going on with me and had to learn how to support me.
I am really lucky to have found a supportive and really competent GP when it comes to managing mental health. I wanted to be put on a course of medication as I know that medication is a key part of the treatment equation and the SSRIs I am on have helped tremendously. My GP also gave me a temporary course of benzodiazepine very closely monitored by her to help me with the initial stage of going to work, coping with the anxiety and helping me sleep initially.
All in all, this was a really acute depressive/anxious episode and I did go back to work the following week with a LOT of positive self-talk, support from husband and family, and a chill pill. My recovery was gradual and I guess I realised that we are all vulnerable at one time or another. My parents have both experienced anxiety and depression over their lives and I know that having a depressive episode makes it more likely that we will experience further episodes.
Recovery means making your mind your priority and this is what I’ve tried to do. I have regular follow-ups with the GP every few weeks as I’m still taking medication. I am concerned about how coming off the medication might affect me but I have a good relationship with my doctor and trust that she will manage that process with me in the next few months. When I’m feeling anxious and restless I know I need to up my exercise to channel my adrenaline elsewhere. I try to facetime friends and family more often and say what I’m feeling more. My friends have been so supportive and didn’t judge or change their behaviour towards me when I told them- I found it really hard to tell them though. Having a good night’s sleep helps too- going to bed and waking up at regular times. I have also found Acceptance and Commitment Therapy (ACT) self- help reading to be extremely helpful too and highly recommend “The Happiness Trap” by Russ Harris- a refreshingly easy way of managing difficult emotions and learning to live with them.
The biggest piece of advice I can give anyone who is struggling with negative thoughts, depression, anxiety, stress, is to tell the people closest to you what helps you. Sometimes it’s the fact that our family’s, partners, friends don’t know what helps or what to say which causes more stress or potential conflict. Tell them what you would like them to do or say to you when you are feeling a certain way. I told my husband that every time I start to feel anxious, inadequate and catastrophising about my work, to remind me of how much enjoyment I have had at work and the positive things I say when I get home from work.
I don’t believe that a cardiologist should have experienced a heart attack to make them more capable of treating a patient effectively, but as a Mental Health Professional, I do have that bit more compassion and understanding of the vulnerability that we all have, no matter which chair you are sitting in.
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