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Focus
Stress and mental health - one man's story
February 2002
by Steve Walter
The UK Department of Health have recently launched a campaign 'mind
out for mental health', which seeks to stop the stigma and
discrimination surrounding mental health. Three in ten employees will
experience some kind of mental health problem in any one year. Employers
can make a massive contribution on mental health issues - and they have
a lot to gain. Mind Out for Mental Health is running an
employers' programme, 'Working Minds', in conjunction with
the Industrial Society, to support good practice on mental health issues
in the workplace. 'Working Minds' includes an 'ambassador
programme' of visiting speakers, and a practical 'toolkit' to help
companies improve their policy and practice on mental health. Steve
Walter has signed up as an 'Ambassador'. This is his story.
I write this brief, personal case study as a health and safety
practitioner, in the hope that it may be of interest to others.
Four years ago I had my first breakdown - two years ago my second.
I'm 41. Up until then my life had been relatively uneventful, more or
less ordinary. It had followed a familiar pattern: school, university,
further qualifications, kept fairly fit, healthy, hobbies, cycling,
drama, writing, got married had children, grandparents died. My life was
normal. At least as normal as life ever is.
The first time, it built up slowly, over a few months. Some of the
events leading up to the breakdown are interesting, and were significant
for me. But they wouldn't necessarily be significant to anyone else. A
couple stand out: discovering a cockroach in my mouth, while drinking
cappuccino, was not a good start! Having been an environmental health
officer, the shock, frustration and anger were doubly compounded. A few
months later, the second event: what most would regard as a 'minor
conflict' with a senior manager at work. However, I took the
disagreement (over a stress research project no less!) as a major,
personal insult and this blew the lid off everything for me.
It was May 1997, the day the IRA brought the country to a standstill
with bomb hoaxes, just before the election. From then on life began to
race wildly. I was on a high. Gradually, more people realised that there
was something wrong. At first, as far as I was concerned, I was having
one of the best times of my life and there seemed to be a profound
spiritual connection. I had so much creative energy, ideas would come
flooding in, racing through me at home and at work. Many great ideas,
and I wanted to do everything, all at once. I was experiencing mania. I
didn't realise it at the time but these ideas became more and more
bizarre, more removed from reality. Over the space of six to eight
weeks, I went from being increasingly surprised at ever more amazing
coincidences, to being overcome by what were delusions, for instance,
imagining coded messages in newspapers - MI6 were on my trail! During
the last few days before it happened, I really wasn't making sense.
Confused, at the doctors, I was recommended for psychiatric care and, on
being admitted, my world fell apart. I broke down completely: I had
experienced 'an acute psychotic episode'.
There were various further diagnoses: bipolar affective disorder
(manic depression) stress-related illness, schizo-affective disorder to
name but a few. The symptoms were mixed, unclear. I began to recover in
hospital during my first week, with medication. Medication! 'One Flew
Over the Cuckoo's Nest' had put me off 'medication' for life!! I was in
hospital for a month, and off work for three months altogether. Even a
brief visit by a very caring personnel officer had me in tears for no
reason. Everybody was very supportive, my employer, my manager and my
work colleagues. I've been the one worrying how people would take it,
what I would say. How could I explain something that I didn't
understand?
It was a gradual return to work, a well-managed process, and the job
was redesigned. It seemed a long time to get back up to strength. I
carried on taking tablets for a year. The second breakdown, in May 1999,
took everyone by surprise. I was to be lecturing a small class of
candidates for the day. From the moment I woke up things seemed
different, strange. I became afraid, out of all proportion to the usual
pre-presentation nerves. I entered another deluded world. Among other
things, I was lecturing members of the American CIA, we were in danger,
I was in fear of my life - anything could have been a bomb! Of course,
it seems stupid now. But then it was real. The journey home by train,
nearly two hundred miles, was weird, bizarre and frightening. I couldn't
get into hospital that night. I stayed with my parents. I was
hallucinating - I imagined torture, experienced the pain of being
dissected without anaesthetic. No dream. I wish my parents had never had
to hear my screams.
The day after, I was back in the same hospital. A few more days, more
tablets and I was sane again. I was keen to return to work, to get back
to normality as soon as possible. This time I was only out of work for a
month. Again I was phased back in gently: a few hours, a few days at a
time. First just visiting, to be there to meet colleagues, to talk, to
feel accepted.
Underlying all of this were tensions in my home life. There was much
left unresolved. It has taken me many months of therapy to realise what
I had tried to ignore and I've yet to find all the answers. Even now,
two years on, I sometimes feel as if I'm still going through a form of
rehabilitation.
Risk assessment
While I believe that employers need to carry out risk assessments in the
interests of mental health, this is still more of an art than a science.
It is only remotely possible that even a specialist, with considerable
time at their disposal, could have had any chance of identifying that I
was likely to breakdown the first time around. There were pressures of
course, from myself, from home, from work, but even I didn't really
appreciate them. Nevertheless, there need to be systems and procedures
in place at work, to minimise the risk of pressures creating stress, and
leading to ill health. Managers and employees have to know what
precautions can help. Fortunately, there are clear, practical steps that
can be taken.
Postscript - appendix
Having written this article, I found it almost refreshing - not that I
should wish to repeat it - to be rushed to hospital for emergency
removal of my appendix, a few weeks ago. Quite a contrast to experience
an illness (acute appendicitis) that is so distinct, so clearly defined,
so common and most of all so openly discussed. Everyone has an appendix
tale to tell, if not themselves or a relation, then a friend or
neighbour. And I was laughing with friends on the phone from a hospital
bed only hours after the operation.
And yet mental ill health is just as common, if not more so, (the
records show that as many as one in four of us suffer anxiety or
depression each year) but it is rarely discussed. I hope that this
article will at least make a small contribution towards further opening
the mental health debate. No stigma attached.
If you would like to discuss any of the issues raised feel free to
contact me at: stevew@eef-fed.org.uk
My thanks go to Isobel Allen, Editor of the UK's Health and Safety at
Work magazine which first published this article.
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