I am the Chief Psychologist in an NHS healthcare Trust and, with colleagues, I started and now co-chair the trust’s Staff Mental Health Network that we’ve called ‘1 in 4’.
More importantly, I am a person. I am a person who has experienced anxiety and depression since a young age.
Throughout my 38-year NHS career I have heard pejorative statements aimed at colleagues with mental health difficulties. These have included “They’re bonkers!”, “He’s a nutter”, “She’s so odd” (accompanied by a raised eyebrow or cruel laugh). Whilst I realise that we need to let off steam and people might not mean to cause harm, these words are offensive. These people are our colleagues, and these people are, well, people, who deserve as much respect and kindness as everyone else.
In May 2023 I was talking to my colleague, co-chair and friend, Ben Collins about the network and its main aim which is to reduce workplace stigma about mental health. I thought about how I feel at work when I’m anxious or depressed. I went home and wrote about this. I didn’t think about it much but sent it to Ben who thought it was very powerful. I wasn’t sure it would interest people because, to me it was just a description of me, but Ben’s reaction kept going through my head. I sent it to my partner; he had tears in his eyes when he read it and yet I was sure I’d explained all this to him over the last 4 years. I began to think that maybe what I thought was obvious, actually wasn’t.
A few weeks later the network ran a campaign week to highlight stigma in the workplace. Ben and I secured a 15-minute slot in the trust’s Leadership Briefing to talk about the campaign and network. Ben’s the creative half of the duo and wanted the 15 minutes to be different from most presentations in the Briefing. He suggested I read out my ‘blog.’ I laughed, saying it would put an end to any credibility that I had in the organisation. Telling the 100 or more leaders on the Briefing that the Chief Psychologist experiences depression and anxiety filled me with horror and anxiety. Whilst I realised that some would be kind, I had no idea what others’ responses would be; they might be the people who use “bonkers,” “nutter” or “odd,” I just didn’t know. Over time the horror and anxiety were replaced by a sense that if I didn’t read my blog, I was a fraud in my position of Chief Psychologist and co-chair of the network; I wasn’t modelling what I believe in - that no one should be ashamed of experiencing mental health problems. So, I agreed. Whilst Ben began to talk on MS Teams to over 100 leaders, I could feel the apprehension rise. Ben handed over to me and I began reading. I explained the sensations that I experience when anxious or depressed; I spoke of all the self-deprecating statements that loop in my head; I said how some colleagues are kind and others are like vultures. I finished by saying that I’m not deficient, damaged, or less than.
As I was reading, I couldn’t hear a thing. It wasn’t that I’d gone into a protective state; it was because everyone had stopped what they were doing and were listening in silence. You could hear a pin drop. I couldn’t tell if they were listening in horror (“What on earth is she doing??!”) or if they were interested. The 5 minutes felt longer. I stopped, looked up, and I saw MS Teams heart emoji’s floating up the screen. I heard the words “brave”, “amazing”’ “vulnerability”, “thank you” and realised that many were not judging me. I felt such relief and then pride; I had let over 100 senior people in on my ‘secret’ and the response that I could hear was positive and warm.
The Briefing stopped and Ben and I looked at each other in amazement. My line manager came into the room and checked if I was OK; a senior nurse came in a gave me a hug; a colleague called us on Teams and thanked me because what I had said made her understand some of what her daughter was feeling and that she could now talk differently to her. An hour later, I saw 41 comments in the Teams chat, all were positive. Phrases included “Thank you, very moving”, “That meant a lot to me”, “I understand that!”, ”Meant a lot to me personally”, “Beautiful, honest words”, ”Thank you for reading aloud what clearly resonates with many of us”, “ Being able to share vulnerability is a strength in leadership”, “I have learnt a lot listening to you”. I was struck by their honesty. Their names were in black and white, and they were being open about their struggles.
That afternoon I felt different. It was as though I was no longer hiding, no longer worried. I had revealed all of me and things were still okay. The comments kept coming over the next few weeks (and still are); people stopped me to thank me, and people were having conversations about it.
Rather than feeling judged and ‘less than’, I feel that I have contributed to giving colleagues who experience mental health issues a voice and have shown that we are not strange beings who should be avoided; we are just like everyone else. I’m not saying that the response will be so positive in all organisations, but I do believe that, in general, the response might be more positive than we’d predict and will begin to reduce the stigma of mental health difficulties in the workplace.
If writing this can help a few people talk openly at work about their own mental health and begin to normalise the fact that 1 in 4 of us experience mental health problems in our lives, then I’m glad I have.
What follows is Clare's narrative that she read out on the day:
Depression and anxiety have come in and out of my life for many years. For me they co-occur, as they do for many people. I’ve given up trying to explain how depression feels and how anxiety feels; I experience them as one thing, one overwhelming thing that stifles me; makes me feel ashamed; makes me believe that people are judging me.
Sometimes I know the trigger and sometimes I don’t. However, every time it happens it creeps up on me over a few days and then I suddenly become aware of it. It’s one of the worst experiences I have and it’s one that oppresses me. I constantly compare myself with others; feel stupid; incompetent; stuck and ineffective. It locks me in an opaque bubble, making me feel distanced from everyone around me, and sound is strangely muffled. I look out at them talking and laughing, with no way to connect.
It makes me smile when people say that I can come across as calm and confident. Yes, that’s how I feel when I’m not depressed, but when I am, these are the last things I feel. I don’t feel calm, I feel overwhelmed and paralysed with anxiety; I don’t feel confident, I lose my self-belief. When I’m anxious I hear that critical voice at the back of my head telling me “I’m not good enough”, telling me that people will think I’m stupid if I speak out loud, shaming me l when I forget my words or lack eloquence.
Never ever underestimate how awful depression is. It’s horrendous and its effects are enormous. Never think that it’s similar to feeling sad or fed up because I don’t think there are any similarities. I can honestly say that depression/anxiety are the things that have had the worst effect on my life.
Many people are great when they find out there are times when I feel like this. Others are like vultures, ready to swoop and attack when I’m vulnerable. Vulnerability is a brave thing but when it’s in the presence of cruel people, it’s another horrible experience. Thankfully, these people are in the minority. I know that some people are like this because of their own psychological difficulties, and I try to remain mindful of this. Others just seem cruel because they either haven't experienced anxiety or depression and/or are fearful of talking or thinking about it. Maybe they don’t know what to say?
When I’m anxious/depressed, I don’t want to hide behind a smile, pretending. I want someone to say kindly “You don’t seem yourself; how are you doing?” and when I reply with the inevitable “Oh, I’m OK” and change the conversation, I want them to change it back and say “You don’t seem ok. Fancy a chat and coffee?”.
Forget hierarchies and power. When it comes to depression/anxiety those things don’t come into play. If anyone, no matter how junior or senior they are in the organisation said these things to me, I’d be so grateful. Please don’t allow your fear of “I don’t know what to say,” or “I can't help” stop you from talking to me. A kind face and a listening ear is what I need. I don’t expect you to cure me; I don’t expect you to spend hours with me; I don’t expect you to solve my problems. What I need is kindness.
I sometimes think that if I could change anything it would be to live a life without depression. And then I reflect on how this experience enables me to be more empathic with patients and colleagues, and I’m grateful for that. I’m not deficient, damaged, or less than; I experience depression, just like many others. I have made the best relationships at work with colleagues who are kind, authentic and who can be vulnerable. I value these relationships. These are the people with whom I go on to do good work. So, you see there are far reaching benefits to kindness: colleagues feel supported, and they do good work which surely benefits our patients.
If you only take one thing away with you after listening to this, I’d like it to be this: Re-read the section in blue italics again and substitute ‘I’ with ‘colleagues’ and ‘me’ with ‘them’ and I’d like us all to remember and act on those words.
We thank Clare for allowing us to share her story and you for reading Clare's brave and tender narrative; there is much in it as learning for all people in the systems that we work in. Clare is one of many mental mental health professionals who experiences mental health difficulties, mental health difficulties being common in our society, and no less so for people who hold a professional role in one part of their lives. It would take much on a structural, societal level to free us all up from this kind of pain. We can often be subject to oppressions, marginalisations and stigma, and the difficulty of society, and the mental health scene, in holding a whole and integrated view of humanity in mind. Until then, it is not that we may struggle with our mental health that matters, it is how we and the systems around us communicate together about our needs and gifts in equal measure.
If you are interested in writing for us about your experience of being a mental health professional and having mental health difficulties get in touch on our contact page. If you want even more inspiration, then go and have a look at the Inside Outsider art exhibition we put on in Edinburgh as part of the Scottish Mental Health Festival, funded by Thrive Arts. If you are interested in our individual or PeerSpace mentoring, have a look at our mentoring page and get in touch. If you are a Trust or mental health system, we'd love to help, see our consultancy page for more.
And in general, thanks for sticking with us, it has meant a lot over the past 7 years from when Natalie managed to get up from her recovery bed :)