Friday, 13 April 2018

Mental health and making things better in the university

I've been posting a lot on twitter recently, and this thread of tweets is bang on the topic of Depressed Academics, so am posting it here unedited.

Thursday, 1 March 2018

Having a breakdown as an early career researcher: it's not always doom and gloom.

This is a guest post by Irene Sutcliffe to celebrate University Mental Health Day.  We have a standing invitation for guest posts - see here - and they can be under your real name, pseudonymous, or anonymous.  Irene is not the writer's real name, so it is not the actor


Academic Twitter is aflame with tales of mental health in academia, whether it be students, early career researchers or tenured academics. A prominent theme that has emerged is that academic institutions are woefully unequipped to deal with mental health issues. While I have no doubt that many of my colleagues - and their students - at universities across the UK have not received the best support possible from their institutions, my story is more positive.

I’m a postdoctoral researcher on a project at a leading UK university. It’s a digital humanities project, and I’m part of a small team.  I don’t live in the town where my institution is: I work from home but that’s OK – all I need is my laptop and the internet. We’re all integral to the project: if one of us cannot work, it affects us all. Moreover, what we do is so niche and highly skilled that employing someone to cover a role is impossible. We have deadlines, we have responsibilities (I wish I could tell you more but my status as an ECR means I don’t want to provide clues as to who I am). Essentially, someone going off sick for a long time is potentially catastrophic for the entire venture.

I finished my PhD in 2014 and started my role straightaway. I have a history of anxiety and depression, and have been on medication for over 20 years. At my induction meeting, I told my boss about my medical history, but said that as I’d just managed to do my PhD with only a couple of ‘blips’ I didn’t anticipate any huge issues. They were glad I’d told them: the admin department were informed that I had a disability but I declined an Occupational Health meeting.

I won’t go into the reasons for my breakdown: that’s another story. It wasn’t about my job, or even academia, more about my attitude to myself and events beyond my control. By December 2015 I was really struggling, and in January 2016 I had a complete breakdown: I dashed straight back to my parents in A Very Rural Part Of The UK and spent three months there, mainly in bed. During this time I was diagnosed with severe depression and obsessive-compulsive disorder (OCD, in case you didn’t know, is really vile and totally misunderstood. See https://iocdf.org/about-ocd).

The minute I fled, I told my boss I was ill. Realising how serious it was, they only asked that I a) obtain sick notes and b) check in with them once a week. I had three months’ full pay, which was a relief (my institution has a good sick pay package). After a while, I asked if I could do some work while off sick, to give me something to do. My boss and Departmental Administrator agreed, and so I gradually built up work until I was doing half my usual amount per day. I found the courage, from somewhere, to leave my parents’ place in April. By this point, I was on half-pay for three months. At the end of July I went back full-time, partly because that was when Statutory Sick Pay kicked in.

Mentally, I continued to struggle throughout the rest of 2016: I was on the waiting list for specialist treatment for OCD, but the list was long. I was also weaning off a strong dose of diazepam from September to November – far too quickly, in hindsight. By December 2016 things got so bad that I was voluntarily admitted to an acute psychiatric ward. The whole time I was in touch with my boss, who was very understanding. I was discharged after a few days, but readmitted over Christmas for two weeks.

I was moved over to a different medication after the second admission which didn’t agree with me and in mid-January 2017 I was readmitted to the unit. Once again my boss was great, only requesting that I obtain sick notes. Two weeks later an incident led to me being placed under Section 3 of the Mental Health Act (effectively, detention for up to six months). Telling work about this was terrifying, especially considering how unwell I was and how much the project would suffer. But the only vibe I got was ‘My colleague and friend is unwell and suffering. I just want them to be OK’.

I spent two months on the ward and was discharged in late March. I saw a brilliant doctor in Occupational Health in April who agreed I could go back to work, and I started on a phased return in May. Since our project’s funding was being renewed for a final year at the end of June, my department offered a flexible contract from that point if I wanted it. I ultimately declined, but it was great to have the option. My boss asked that I check in with them via email each Friday, but didn’t hassle or pressurise me at all. By mid-June I was back to full-time hours. I saw the Occupational Health doctor again in August and they were really amazed at my progress, and said I could always contact them.

Life is stable now, due the right medication, amazing therapy and the passage of time. I have plans for the future, and my boss is more than happy to sponsor me for a postdoc. I worry that my history of having over 200 days off sick over a year and a half is going to damage my prospects, but there’s not much I can do about that.

So: if you have mental health problems and are starting a new role, be upfront from the outset. As my boss knew that I had issues, it made things easier when things went south. Find out what your options are with Occupational Health – institutions should have decent provision. If necessary, send your line manager information about your condition (with something as misunderstood as OCD, this was helpful). Most importantly, be kind to yourself. As a wise psychiatrist once said to me, ‘You can’t be an amazing academic if you’re dead’.


Friday, 16 February 2018

Call for Participants: Mental Health at the Joint Mathematics Meetings

I have been talking for the past couple of Joint Mathematics Meetings to people in AMS and MAA about the need for more of a support structure, and how to get there.

This year, I talked to Chris Goff (leader of the Spectra LGBT support network) and Helen Grundman (AMS Director of Education and Diversity) about wanting us to do more, and they suggested to start with a panel discussion on the next Joint Mathematics Meetings.

I would like to ask if you my reader or you my community member would
1. be planning on going to the Joint Mathematics Meetings, and
2. be interested (or persuadable) to participate in a panel discussion / conversation about life and issues with living and working with mental health problems in mathematics.

I would like for our focus to be more on how to handle mental health on the teacher/professor/staff side, rather than on the student side — though I expect that both will naturally come up in the discussion.

Please get in touch with me if you find this even slightly interesting — michiexile@gmail.com is a good email address — and show this post to anyone else who might have an interest either in listening or participating.

Monday, 27 November 2017

The unreasonable effectiveness of tabasco shots

A few years back a therapist of mine came with a suggestion that sounds weird: to break out of the more debilitating anxiety attacks — drink a spoonful of tabasco.
She had been using this with self-harm patients, as a way to get the release that comes with cutting, without actually causing yourself harm.

Since then, I have been drinking tabasco whenever my mood crashes out too hard to handle. And it is effective.

Surprisingly effective.

Bizarrely effective.

Exemplia gratia: yesterday, after a full but very pleasant day, a bunch of things conspired against me. A panhandler intimidated me. Then various things kept my edge high, and eventually S brought up a high priority family task and suggested I do it today. I teach all day today, and don't have much in the way of slack, and ended up working up a real panic about how to fit this additional thing in, and about whether delaying until Tuesday would work.

All in all, as I went to brush my teeth, I went from quiet, sad, upset, on the verge of crashing to sitting on the bathroom floor, rocking and crying quietly. Once I finished brushing, I asked S (I had to try twice for her to hear me, each time taking a real effort to get any sound out at all) to fetch me some tabasco.

To really, really show how effective it was, let me paint the scene before and after in even more detail:

Before: I'm sitting on the bathroom floor. Rocking back and forth. Crying. Not able to get any words out. Standing up is completely out of the question. I panic, hard, when S tries to ask me which of our hot sauces I want. It's an effort to even reach up and accept the spoon S has filled with hot sauce.

After: I have barely even swallowed the spoonful of tabasco when my crying stops, a wry smile slowly creeps in. I stand right up, step over to the sink and rinse out my toothbrush, then go to bed.

It doesn't even take a second, but swallowing a spoonful of tabasco will stop — dead in its tracks — my ongoing paralyzing anxiety attacks, return me back to a reasonably good humor and quite capable of taking care of myself and functioning in my surroundings. I have yet to find anything, at all, that is quite as effective at managing my moods: the one obstacle I face is to remember that this is in my toolbox when I need it.

Tuesday, 21 November 2017

Suspended in Air

This is another guest post by Dorothy Donald.

Imipramine
I was twelve years old. Dr B said she didn’t like to prescribe antidepressants for someone so young, but I was such a classic case that she felt she had to. My mother kept my meds in a high cupboard so that I couldn’t… you know. I didn’t get better.
Fluoxetine
I was a teenager. It made me feel like I was looking at the world from the bottom of a swimming pool. I did things without deciding to do them. I had never harmed myself before…
Citalopram
Early 20s. I just didn’t think it was helping. I thought I was just getting worse. I wanted to know if there was an alternative. Dr R wrote ‘patient refused to continue treatment’ on my medical notes and dismissed me from his office.
Sertraline
I didn’t want another SSRI. I remember citing some meta-analysis or another on the success rate of SSRIs. I remember saying that I’d tried them before. I remember saying I was not in the least convinced that they would do me any good. Dr S gently asked if maybe doing something that might work was preferable to doing nothing. What did I have to lose, from where I was?
I agreed to give the damn pills a try. I agreed to stick out the first few weeks of dizziness, nausea, acid reflux, and general big weird feelings. I even agreed to up my dosage last summer when I had ‘a bit of a wobble’. Since then I’ve been different.
I still get low mood, but it kicks around for a day or so, rather than weeks or months.
I still have times when I struggle to get out of bed, but the thought process goes “oh, I need more sleep” rather than “I am useless”.
I still think about offing myself, but it’s a thought that drifts into my head and then just drifts right out again, rather than some abominable earworm.
I’m not happy all the time – that would be odd. I get grumpy, furious, sad, excited, tired, TIRED, lost in the flow state, bored, amused, content… all the stuff.
I just looked through my diary for 2017. It shows a bereavement, a house move, a couple of other fairly serious upheavals, and only one thing that felt like a depressive episode. Which seems to have lasted only three or four weeks. I think this is pretty good going, considering.
It would be premature to conclude anything about the efficacy of these tablets (my memory is not infallible and I’m not good enough a girl to keep a really comprehensive diary). It would be unwise to draw comparisons with the other drugs (oh, the confounding variables!).

18 months and counting.