Stress and mental health - one man's story
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.
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: SWalter@eef.org.uk
My thanks go to Isobel Allen, Editor of the UK's Health and Safety at Work magazine which first published this article.
Steve Walter has now published a book entitled "Fast Train Approaching..." - for details and purchase see www.makingconnectionsmatter.org