Sitting on the fence – working with mental illness (Day 4 of my Mental Health Awareness Week blog posts)

My first degree and my post grad are aligned to my previous career as an HR manager. I worked really hard to get to where I was in my career when the thief that is mental illness crept up and stole it all. It’s been written about in previous posts but long story short is that after serious postnatal depression which left me five months in hospital I was made redundant and at this point realised I was utterly employable. Stigma meant as soon as any prospective employer realised I had spent half of the previous year in a psychiatric hospital they would noticeably put their head to one side and tell me they’d be in touch. They never called.

Whilst still grieving for my career I decided to open a bridal boutique (in hindsight maybe my judgement was impaired 😉) but when I had a relapse we couldn’t afford staff to cover me to I lost the business too.

By this stage I was grieving a list of things mental illness has stolen from me and it now had a career, a business, a couple of ‘friends’ so it was a bit of a if you can’t beat them join them sort of thought that led me to apply for my nursing degree.

Despite having lost so much to stigma I was still determined to keep fighting it so was very honest at university when they asked why I had applied. They thanked me for sharing, they embraced my honesty. These people were my tribe.

The three years at uni were hard, financially, academically, emotionally. I only had one short ish relapse though, a short episode of mania which led to me missing an entire placement, ironically since I am a CPN now it was the community placement!

Fast forward past graduation and started working as a staff nurse on an acute ward, I loved it and the team didn’t just tolerate my quirks and ultimately my mental illness they celebrated it. They accepted me for just who I am and will likely never know how much they all healed me and helped me ‘get over’ my previous losses to stigma. Nightshift though, that impacted my mental health hugely so it was time to move on after a year and a half to a life on the road as a CPN.

About a year into my role as a CPN I had a major relapse and fell into a deep depression (see previous post) which not only kept me off work but led to me having 22 ECT. When I came back to work my confidence was knocked, I was afforded the amazing opportunity to go and work on a non clinical secondment which meant I had time to build myself back up to clinical in a timely way.

When I returned to clinical a few months later I felt nerves that I hadn’t experienced before. I tried to cover them with humour but driving into the car park took a ridiculous effort some days. I began to worry that my colleagues, many of whom I class as dear friends, associated my competence with my illness and therefore thought I ought not to be there.

I could hear myself saying “yes go on I will take someone else on” and offering to go above and beyond as a way of proving myself but this just added to my workload and therefore stress levels, despite applying many of the psychological approaches I use with service users I was still trying to prove myself.

I have never really needed validation from anyone as I felt confident in what I was doing and the work I was producing in addition to, as a Christian, knowing that validation is not needed because it comes only through Him. Yet those first few months back at work I craved it like a child being super good to attract praise. I needed to know I was doing ok and I needed to know other people thought I was doing ok, hiding this anxiety was exhausting.

I am blessed to work with some amazing people, friends as well as colleagues who again like those on the ward embrace the person I am. They have told me when they were worried about my wellbeing, in the office it’s an open dialogue. In varying degrees most mental health staff have personal experience of mental illness whether as an individual or as a support to someone else… Let’s face it no one comes into this job for the salary do they?!?!

My confidence was just beginning to improve when as luck would have it it didn’t stop improving and mania tapped me on the shoulder. This episode could be described in many ways, discreet is not a word I would use at all.

I was mortified to realise just how public this had been, how work friends had both expressed their concerns amongst themselves and to me. I had sent emails I wouldn’t usually send full of ideas and bought items I hadn’t even realised I needed. I had been speaking quickly and at times speaking nonsensical utterings. Nonsensical to everyone except me.

I can’t hide my diagnosis anymore even if I wanted to. I wear it daily, I wear it as a layer of fat from the excess weight gained from medication and I wear it in the rosy cheeks memories of that time.

And this is where I am stuck. My confidence as a nurse has never been so low. I don’t know where I fit any more. I worry that the trust I work for has invested heavily in peer support which is brilliant and works so well as a concept so “why would they want a nurse with the unpredictable diagnosis of bipolar affective disorder?”

My logical brain knows that this is not right but my emotional brain takes over at times. I’m certainly not poster girl for recovery given the relapses I have had. Who am I and how do I find my place again?

I am nauseous with fear when my lovely managers make offers such as a reduced caseload all because I worry that this sort of gesture will ‘prove’ I am incompetent.

When I returned to work I dressed for a funeral, so concerned that if I wore colour colleagues would assume this was a symptom of further relapse. Only now weeks later am I starting to wear colour again. I try not to laugh excessively in case people think mania or to display any negative emotion in case people think I’m depressed.

I find myself wondering what to do; do I stay with my lovely team where they know all about my illness but where I run an inner monologue of self depreciation or do I move to a new team where they have no knowledge of my illness and hope to feel more confident but where I don’t have my ‘tribe’ looking out for me?

Lived experience is the ‘in thing’ though isn’t it? On that basis maybe my illness is an asset to my nursing or maybe I will sit on the fence and watch. I will watch and try to fit where I got best whilst praying for me to be able to separate my competence and my illness.

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