Depression had been part of my life for many years, but I believed I had learned to manage it well.
I was not alone. I knew that a fifth of adults in the UK experience depression and anxiety at some time. Indeed, many of my colleagues experienced those feelings, even if not expressed in those exact words.
However, I found myself ill-prepared for the experience when I became a client of the mental health services. I had been getting medication from my doctor for depression but it didn’t seem to be working very well and my mood was getting lower, so they referred me to the community psychiatric team.
I thought no more about it but noticed how much harder it was to be doing things, both at home and work, and to deal with my responsibilities.
Being in frontline social work meant that I had to keep my wits about me and not get distracted, but the feelings of depression made this difficult. The depressive thoughts would be intrusive and distracting.
‘It was harder to make decisions’
Alongside depression came anxiety; it was harder to make decisions, so I was pleased that many casework decisions were ones I could share with my manager or colleagues. Nonetheless, this was a period when I was plagued with much self-doubt about my skills and abilities and I needed more support than normal.
It was hard to keep things in perspective and remember everything, so I became dependant on my mobile phone in order to help me keep lists of things to do and deadlines. I became over focussed on my work and getting things done, adding to my stress levels but was ever fearful that someone would find out I was feeling depressed and it would be seen as a failing.
The social work profession still seems to stigmatise mental health problems in its staff, despite all the talk of offering support. I did not want to go off sick and so it was a difficult balancing act trying to keep going. At times it seemed overwhelming.
After three months I got an appointment with the mental health services and saw a community psychiatric nurse who did an initial assessment and referred me to a psychiatrist.
The psychiatrist picked up on my low mood and assessed it well, I thought. We talked about new medication and he recommended one which would be monitored by regular visits by community psychiatric nurses (CPNs).
Suddenly, I found myself in the dependent role of client, having to see the CPNs on a regular basis.
I had to juggle my working week to fit around their appointment times, which was made all the more difficult as they could only tell me the day of the visit but not the time, only a vague indication of morning or afternoon. So I had to be home for blocks of time to make sure I was in; I did much home working and had to juggle visits to clients, so often worked late to catch up.
I also became an expert on the side-effects of the new antidepressants that I was taking, and found it easy to slip into thinking that every twinge, ache or pain was due to the new drug. I longed for this phase to end, for it took some time before the drugs became effective. Those were long weeks indeed.
Depression affected my family life, too, for while my wife was very understanding, it was difficult to explain my low moods to our young children and to say the CPN was someone who came to make me feel better. They understood illness as being like a cold, which you recovered from, so I explained it in terms of “feeling sad”.
It was hard to relax and play with them, but that was something I had to force myself to do. I was able to afford private counselling and had supportive friends, which helped as I found that the focus of the CPNs was mainly about how I was responding to the medication.
It felt like they had a tick box of things that had to be covered in each visit and since it wasn’t the same person who visited each time, it was hard to form a lasting relationship. After six weeks the visits ended and after that I had to go back to my doctor for medication. It seemed that I had had my ration of service.
The hardest part
Having been a client of the mental health services helped me understand the experiences of my clients who suffer depression and anxiety and who couldn’t afford private therapy.
The hardest part was avoiding identifying with them, but rather to keep the focus on the care of their children. Part of me longed to say I was aware of their suffering but rather found myself like the CPNs were with me: professional and objective.
Even so, the human being in me wanted to reach out and help relieve their suffering so they and their family would benefit. I had to remember while the similarities helped me to understand them, it was the differences that made me able to help.
One client had waited a long time to be assessed by the mental health services and queried how desperate you had to be to get a service. I could have helped them answer that but it was best just to empathise. I told them that I’d try to get their case prioritised knowing that I could not make it happen, but hoped my gesture was of some help.
Being a client of the mental health service was a curious experience. Being dependant on a service was hard to adjust to. It showed me that we all have our vulnerable side and sometimes need extra help, like our clients, and that line can be easily crossed. None of us are fireproof.