Tuesday, October 10, 2017

The Elephant in the Office

Today is World Mental Health Day.  This year’s theme is mental health in the workplace.

While most of us would probably agree that work shouldn’t be the focus of our lives, the reality is we spend most of our waking time at work. It’s no surprise then that the workplace can have a significant impact on our overall well-being.

A recent study by the World Health Organization (WHO) estimates that “depression and anxiety disorders cost the global economy US$ 1 trillion each year in lost productivity.” *

The WHO also states that “Employers and managers who put in place workplace initiatives to promote mental health and to support employees who have mental disorders see gains not only in the health of their employees but also in their productivity at work.”

There’s no doubt that with each year that passes, we’re breaking down the stigma that surrounds mental illness, bit by bit. 

In Canada, campaigns and advocacy by groups like SickNotWeak, Bell’s Let’s Talk initiative and the Partners for Mental Health “Not Myself Today” campaign  — as well as stories shared by high-profile people such as Michael Landsberg (sports journalist), Clara Hughes (Olympian athlete) and Howie Mandel (comedian/actor) — are helping to promote mental health, raise awareness about mental illness and spread the message that there is no more shame in having a mental illness than a physical one. * *

Over the past few years, I’ve seen an uptake in mental wellness initiatives being introduced into workplaces. 

For example, the Mental Health Commission of Canada created The National Standard of Canada for Psychological Health and Safety in the Workplace. It’s been incorporated into Canada’s federal public sector and other organizations across the country. Other workplaces have also incorporated their own wellness strategies.

This is notable progress, to be celebrated.

But there is still room to improve.

I’ve been open in my workplace about my challenges with depression, and more recently with bipolar II.  I’m happy to report that people have been very receptive, accepting, sympathetic …

But I still see discrepancies in how people who are off work for physical vs mental health reasons are treated. 

When someone is off work for appendicitis, cancer treatment, broken leg, an operation, a card is circulated in the office, offering best wishes and get well messages. If they are off for an extended amount of time, the social committee or someone in the office will organize a gift of flowers or basket of goodies to send to the person for a “pick me up” while they are recovering.

Yet when someone is off on stress leave, or for a non-disclosed reason (which most people assume is a mental health issue) or for a disclosed mental health issue, there’s rarely a card, gift basket, phone calls or social media messages offering get well wishes. 

Too often, there’s silence.

Too often, time off for mental health reasons becomes the elephant in the office.

More and more is being done to address mental health at the organizational level. I’m happy to see this and look forward to seeing this kind of work expand further.  

But I’ll know that breaking down stigma in the workplace has truly made strides when I see a card circulating (or receive one myself) for needing time off for mental health reasons.

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* Source: http://www.who.int/mental_health/world-mental-health-day/2017/en/

** Author note: I hope one day soon there won’t be “mental” vs “physical” descriptors when discussing illness. That we won’t, for example, call depression a mental health issue and diabetes a physical health issue. That they will both simply be health issues or illnesses, period.

Wednesday, October 04, 2017

The Waiting Is the Hardest Part

It’s been a while since I last wrote a blog post. It’s been a tough spring and summer.

A very busy year at work, combined with adjusting to a diagnosis of bipolar II — and all the medication trials and errors, and the side effects that come with each tweak and change — wore me down: physically, mentally and cognitively.

Brain fog made sorting through my thoughts and articulating them difficult, to say the least. Exhaustion didn’t help. The longer I went without writing (even journalling), the more daunting the prospect became.

I was frustrated: frustrated with what I saw as slow, excruciatingly slow, progress. I waited to write when I felt better, when I had something more positive, more hopeful, to share. I waited and waited.

As these thoughts bounced around in my mind again today, a snippet of a song popped into my head: “the waiting is the hardest part.” It’s from a song by Tom Petty — a singer/songwriter/musician who passed away earlier this week.

I saw him in concert in July. I’d wanted to see him perform live for close to three decades. When the tickets went on sale a few months before, I grabbed them, even though I knew I might not be in a good place yet by then.

Music, especially live performances, is part of my mental health toolbox. When in the midst of depression or burnout, it can be hard to muster the enthusiasm and energy to open the box, let alone use the tools in it. But when I do, it almost always helps to lift me up — for a little while at least.

Tom’s performance that night certainly did. His songs (often routed in journeys, both uplifting and poignant), his passion for doing something he loved, the excitement in the crowd … was infectious. I felt that lift for days.

When I learn of a concert coming up, I buy tickets right away, even knowing that when the hour comes to attend, I may very well not want to go. But having the tickets, and not wanting to let the person I’m going with down, makes me drag myself there even if all I want to do is cocoon. It’s always worth it.

Sometimes, though, it takes a while to work. I attended another concert in August (Guns N’ Roses). I’d seen them before, in their heyday. This time it was the nostalgia factor that drew me. But, as the hour approached, I began to dread the outing. It had been an especially hard day in a difficult week. The thought of being in a crowd, putting on the happy face, making conversation, seemed overwhelming. But I went. I didn’t want to bail on my friend, even though she’d have understood.

As the concert started, I waited for that good feeling to emerge. Three songs in, I still felt numb, still disconnected. Then, the thoughts started: Has even this tool become useless? Will I always feel like this?

I looked around at the fans, caught up in the music, the smiles on their faces, their joy in being there. I wanted to feel that so desperately. So I pulled out another tool: fake it until you make it.

I pasted on a smile, swayed and tapped my feet to the music. I closed my eyes at times, to focus on the sound. Slowly, I started to feel it: the lift. I felt my chest open up, felt the music vibrating there, and the tingle on my skin as I watched and listened in awe to an amazing guitar solo. My smile was real. I was glad to be there — and nothing else mattered in that moment. 

I’ve seen five amazing concerts this summer (add Bob Dylan, Margo Price and Rodriguez to the list). I’m learning to pull out those memories — the feeling of being in that moment when everything settles into place and I recognize myself again — when I need a lift. 

It's no cure, but it helps.

It reminds me that the darkness does lift.

And, when it does, revel in that moment (whether it lasts for hours or weeks or years). Feel it with every fibre of your being.

To borrow a phrase from Jenny Lawson (aka The Bloggess), in those moments don’t just be happy, be “furiously happy”. 

Then keep that feeling, that memory, in your toolbox to remind yourself that you will feel that way again. 

Tuesday, April 11, 2017

How Much Do You Value Your Health?

Have you ever done a value exercise? 

I did one not long ago, in a professional development workshop. We started with three columns filling a page with values: words like creativity, stability, family, integrity, happiness …  

We were instructed to pick the 10 that mattered to us most.  But they all matter! How do I choose only 10?  After serious contemplation, and more than a little angst and second-guessing, I had my list of 10.

But we weren’t done.  The instructor told us to choose from our 10 most important values the three that really mattered most.

After a few minutes (this is all we were given) of soul searching, I narrowed down my list to three. As I waited for others in the room to finish up, I reviewed my three again. Yes, these mattered most. This step was, oddly, easier for me than choosing the original 10. 

Then, the other shoe dropped: from the three, we were told to choose the ONE value that mattered most to each of us.

What would you chose, today?

From my three, I chose health.  Easily. Without hesitation.

But I can tell you, with absolute certainty, that a few years ago health wouldn’t have even made my top 10.  And I don’t think I’m alone.  I think good health is something we all take for granted, until it’s threatened, or gone.

In my four decades of living on this planet, I’ve experienced my share of physical health issues: some incidental (broken fingers, fractured nose, mild concussions — all from an adventurous and active childhood), some minor in the grand scheme of things but recurring enough to be disruptive (chronic sinusitis, migraines, GERD, asthma), some constant and painful (scoliosis, degenerative discs, bulging discs, arthritis).

But none of these ever made me value my health. Not really. Not when it came to choosing what matters most to me. I could control these health issues, to some degree. I could understand why they happened, why they caused discomfort or pain, why they interrupted my life. I had test results, x-rays, CT scans, MRI results. I had remedies that helped me live with them.  

It wasn’t until mental illness overtook me, wore me down, without reason or cause or anything I could understand, and led me to take time off work, that I truly valued the importance of good health.

Poor health impacts everything:  your relationships, your sense of self, your ability to do your job, your finances.  

My physical ailments vandalized my life.  Depression robbed me of everything. I couldn’t feel enough, empathize enough, care enough to be a good family member, friend or colleague; I couldn’t think fast enough, juggle enough, show up enough to be good at my job anymore; I lost interest in all my former hobbies and passions that used to energize and refuel me; I didn’t care to eat well or exercise; I felt my physical pain more acutely than ever; I was off work without pay and couldn’t care less about my finances.

When I took that values exercise I had been back at work for a few months, after time off because of depression. I was coping okay: not great, but making progress, day by day. But then along came this values exercise and it knocked me on my ass. It made one thing very clear to me that I’d never given proper attention to before: my health, good or bad, impacts all areas of my life and, by extension, everyone and everything my life touches. 

And — I can’t emphasize this enough — good health includes good mental health. In fact, I don’t understand why we differentiate between physical and mental health/illness. The last time I checked, the brain is an organ of the body. I’d even go so far as to say a pretty important one, as far as body parts go.

Thanks to this values exercise, I developed a new appreciation of just how much my health is worth to me.  Recently, I received a new diagnosis of Bipolar II. This diagnosis reaffirmed for me the value I place on my health. It has made me more determined than ever that I will do everything I can to be as healthy as I can be while living with the conditions I have – for me, and for everyone and everything I value in my life.    

Tuesday, February 21, 2017

Talking About Mental Illness, Unashamedly

I was diagnosed with depression in July 2012, after I guess what could be described as “a little bit of a breakdown” (sorry Paul Simon, for borrowing from one of your songs).  

It wasn’t a sudden thing, but the culmination of years, decades really, of relentless hammering at my resilience, my self-confidence, my joy. 

I resorted to half-truths to explain to family and friends why I wasn’t at work at first: I was using up some of the comp time I’d acquired from all the overtime I’d worked in the previous months.  True, as far as having the comp time from working overtime; false as for why I was taking time off.  

I’d been off work for months before I told my closest friends that I was still off work, and why. I knew they would support me. But every time I talked to them and was about to “admit” what was going on with me, I’d feel … shame. 

Look at that word: admit.  That right there speaks to the stigma I not only applied to my diagnosis, but that I expected to receive from others. 

It took time for me to accept my diagnosis. And during that time, I found a tribe of mental health bloggers to follow, and authors who, through their books, shared their stories. I began to feel less alone. Their stories were my lifeline. I looked up to them. I saw the value in speaking out. 

By the time I returned to work four months later, I was becoming more comfortable with being honest about my ongoing battle with depression with anyone who asked me about my time off work. But I still hesitated to volunteer anything. 

Over the following months and years, I began, incrementally, to proactively share my story with co-workers, extended family, acquaintances — whenever it lent itself to the conversation. 

And something unexpected began to transpire: each time I volunteered my story, I felt stronger. 

I felt a little more confident because — instead of waiting for people to find out, or guess, and then wonder what they would assume or how they might react — I was putting it out there, unashamedly. I was setting the tone. I was controlling the story.  Because, finally, I didn’t feel shame. 

A few weeks ago, I met with a psychiatrist because I, and my new family doctor, had begun to suspect I may have been misdiagnosed all those years ago. His diagnosis confirmed my suspicions: I have bipolar II and social anxiety disorder. 

That night, I changed the description of my mental illness in my blog from depression to bipolar. The next day, I joined in helping to make Sarah Fader’s #ThisIsWhatAnxietyFeelsLike hashtag trend on Twitter.  I’ve been telling my friends and family as I talk to them. This time, I am not ashamed. 

This is why we need to tweet, blog and share our mental illness stories, unashamedly: so that the people coming after us won’t ever feel ashamed for having a mental illness. 

Because there is NO SHAME in mental illness. 

Monday, February 13, 2017

Fly No More

Last week I was diagnosed with Bipolar II, after years of being treated for depression.  It’s not uncommon for people to get this diagnosis years later. It makes sense, when you think about it. 

When it comes to diagnosing mental illness, doctors, whether GPs or psychiatrists, are largely reliant on what they see and hear from us.  It’s not like there’s a blood test, or an MRI, that can confirm depression or bipolar.

And who goes around complaining about feeling full of optimism and self-confidence?

Or having bursts of creativity and productivity that don’t even need sleep to fuel them?  Hell, those bursts laugh at sleep. 

Or feeling unusually social and uninhibited; senses alive, with an extreme connection to music, texture, light?  

Being on fire – the multi-tasking queen getting stuff done. Brilliant ideas and exquisite plans flying through my brain at the speed of light, so fast I can hardly capture them all. Thank god for sticky notes. (That is, until a few days or week later, when I look around at all the notes fluttering from my desk, monitor, notebooks, and, with a little more clarity, peel them off, crumple them up and wish I’d bought stock in 3M.)

No, we most often seek help when we have fallen so far down the rabbit hole we can hardly get back out on our own. When our brains are too dull and bogged down to process information. When we feel empty, numb and exhausted.  When we don’t care about anything.  When we are teetering on edge of the void of depression – that’s usually when we go to our doctors. That’s when they see us.  And when they ask how we’ve been feeling, it’s the depression that’s top of mind, so that's what we tell them about.

So it’s not hard to fathom that after years of being treated for depression, but not responding, a person can find out they’ve been misdiagnosed. Especially when it comes to Bipolar II, in which depression is often the more noticeable state and the highs (known as hypomania), while disruptive, are not as destructive as the mania that accompanies Bipolar I.

Of course, there’s no guarantee that this is the right diagnosis either (cylcothymia is another option).  However, given my history, both my psychiatrist and I feel quite confident we’ve got it right. But only time – and treatment – will tell.

As for treatment, he’s added Lamotrigine (mood stabilizer) to the Cymbalta (antidepressant) I am already taking.  And he’s prescribed routine – for sleep, eating habits, exercise, chores and hobbies – as essential.  Routines are stabilizing.

Sounds reasonable. Except I’ve spent my life eschewing, as much as possible, routines.  Schedules and plans make me itchy.  I’ve lived a lifetime of eating when I feel hungry, sleeping when I need it, creating when I feel moved to do so. I hate making plans, I avoid committing, because who knows how I’ll feel, what I’ll feel like doing, at any given time.  

"Fly by the seat of her pants Cheryl" has some adjusting to do. 

Saturday, February 11, 2017

And Then Things Change

It’s only been a few weeks since I “came out” on social media as a person living with depression.  I had long thought of writing a blog about my journey but, throughout much of the past few years, I simply didn’t have the brain power after the end of a day or week at work to do so. 

I still didn’t, really, last month when I finally came out. But it was Bell Let’s Talk Day, and I decided to stop waiting for when I felt rested, or clear-headed, or articulate enough and just do it.  Reading the influx of posts from others dealing with mental health issues gave me the push I needed to finally just do it and not wait for the right time.

I’m glad I did. I’ve had so many people approach me since then – from my personal and professional worlds – to comment on my post.  It has opened up doors of communication; renewed old friendships; introduced new ones. 
And just as I was becoming a bit used to being a face of depression, things changed. 

I had an appointment on Friday with a psychiatrist for an assessment.  Previous diagnosis and treatment had been at the hands of multiple GPs and psychologists; this was my first time meeting with a psychiatrist. After one and a half hours of questions, seemingly random to me, he delivered his diagnosis: bipolar II. 

I can’t say I’m surprised. I’d begun to suspect as much over the past year or two, as my depression treatment lifted me up enough to be more and more functional, to read and learn more about mental illness, to better assess my being, to better track my moods and symptoms …   The more I tracked, the more a pattern began to emerge.  Once the depression became a bit more manageable, I began to see the other monsters lurking in the shadows.

The result of my assessment wasn’t what I wanted. But it isn’t surprising to me, and it does explain a lot, about my past and present.  And while I look ahead with some trepidation, I also look ahead. I see a route to follow, a diagnosis that makes sense, a treatment plan to follow.  I know it won’t be easy, but now that I’ve started talking about it, I also have a tribe to share this journey with. 

And that helps.   

Wednesday, February 01, 2017

The mask of depression

I think that, at different points in our lives, we all wear masks — whether it’s, for example, pretending to be brave when facing fear, or putting on a smile when we are sad, or faking indifference when upset. 

I don’t know how often the average person dons a mask, but I now realize that, going through most of my life with (until recently undiagnosed) depression, I’ve worn masks for as long as I can remember … long before I even knew I had depression.

On the bus on the way home after a day at high-school, gazing blindly out the window, wondering “what is the point?”, “why am I alive?”, “why bother?” only to have, seconds later, a school-mate I didn’t even know all that well ask me, “why don’t you talk more, smile more? You’re a completely different person when you do.”  So I’d beam a mega-watt smile, flash my dimples, join the conversation, laugh at jokes, make jokes, earn some laughs, and be life of the bus party … all the while wondering if I was even remotely pulling it off. Then I’d get off the bus and sigh with relief that the acting was over. I wasn’t made to be an actor.

Years later, in university, different people, different venue, same feeling.  And in the workplace … and at family gatherings… At some of these occasions, I’d look around, see people I loved having fun with, and wonder why I couldn’t feel, well, anything, and then try to mimic them — and hope to hell I was passing for normal.  

Of course, there were a lot of real moments too during these times — what I now think of as true moments. I’m fortunate that I can remember (and have probably forgotten) an abundance of times when my laughs were straight from my belly without thought, the jokes as impromptu and genuine as the sun, the love I expressed coming straight from my heart.  But, when depression clouded reality, I wore a mask — a mask designed to hold over until real feeling returned.

Why the mask?

For most of my life, I donned a mask because I didn’t know (or admit?) that I had depression. So, uncertain, I mimicked people around me.  In recent years, dealing with depression, I’ve put on the mask because how do you tell people on any given day – your co-workers, your friends, your family – what you are really feeling when you can’t even quite understand or express it yourself?  It’s just easier to answer “fine” and paste on a smile.

I don’t think there is anything wrong with wearing the depression mask. Sometimes it just isn’t the time or place to reveal your true face.  Sometimes the mask is a very helpful aid to get through the day. The important thing is to recognize when and why we are putting on our masks.  And to show off our real faces, let them shine, whenever we can.  

That’s what I’m working on. 

Wednesday, January 25, 2017

I'm finally starting to talk about it

I’ve been sharing mental health posts and articles on Facebook for a few years now, and then on Twitter. I’ve commented on blogs about depression.  And I’ve told some of the people closest to me and my bosses at work.  But I never come right out and said it, publicly, to my world: I have depression.

In fact, I’ve had depression for most of my life. But it got really bad a few years ago. So bad that I couldn’t live in denial any longer.  So bad, that one evening I found myself in my car, waiting at a red light, shaking, overwhelmed, tears rolling down my face and yet I didn’t know why. I didn’t feel sad. Nothing had happened to me that day, week, month, year. I had a good life – family, friends, interests, job I loved, a home. As I searched for what I felt, if it wasn’t sadness, I came to the realization that I felt nothing. I didn’t care, about anything. I was blank. A shaking, crying mess of blankness sitting at a red light. The next day  I finally went to a doctor, finally got a diagnosis, finally started treatment …

I was off work twice for long periods of time because of the cognitive fog — I couldn’t think, couldn’t read, could hardly speak, couldn’t make a decision about the simplest of things.  As a strategic communications advisor in a very busy workplace, I’m sure you can see how this would hamper my ability to do my job.

I was also off work because I couldn’t feel. I couldn’t feel anything. There was no flight or fight response. None. I just didn’t care. I didn’t care if I lived or died. There was no hunger, no thirst, no joy.  I had no interest in what used to be my passions: reading, writing, art, being outdoors, cooking, building, creating, gardening, renovating. I didn’t care if I got out of bed, or showered, or picked up after myself. There was just emptiness.

I was also off work because of the physical effects. I was shaky – my hands shook, my voice shook, my balance was off.  I was tired – beyond tired. I’ve never felt such exhaustion. Headaches became standard and migraines became more frequent and more intense. And ached all over – my bones, my joints, my muscles.

With treatment and time, I gradually I got better.  Enough that I could at least fake it until I make it. I went back to work. I rejoined the land of the living. But I still struggle. I still wouldn’t say I’ve made it.  There are definitely days that I fake it. Depression isn’t gone, but I’m learning to live — with it and despite it.

Over the past four and half years, I’ve been through many medication switch ups, trying to find a combination that worked and for which the side effects didn’t outweigh the benefits. I’ve tried different types of therapy. I’ve built an impressive arsenal of natural treatments too, after much experimentation – healthy diet, physical activity, meditation, sleep regimen, symptom trackers, blue lights, playlists, journaling... . I won’t lie, it’s been hard.

But finally admitting, to myself and then to others, that I have a mental illness has probably been the hardest. There is stigma attached to mental illness. I know this, because it took falling hard and deep for me to realize that I myself had attached stigma to mental illness.  That’s why it took me 25 years to admit to myself that I had depression – that it wasn’t just something I should be able to ignore, pull up my boots and get over it.

Mental illness is as real of an illness as any other.  It affects the brain, it affects the body. And sometimes that in itself makes me wonder, why is it held separate from physical illness? Why do we still differentiate between the two?

Thankfully the stigma is starting to lift – and that is in very large part because people with mental illness started to talk about it.  So, on #BellLetsTalk Day 2017, I’m starting to talk about it too.