Just Take Five...and Five...and Five... :Can I Become an Executive with Mental Illness?

About a month ago, late August, early September, I don't exactly know when, I felt myself sinking towards rock bottom with my depression. Again. I came to my therapy session with my wonderful, patient, CBT therapist and couldn’t stop crying. For practically the whole session. A few things had come at me at once the day before, and the morning of that day, that winded me, and I fell straight down into deep depression. All we ended up doing during that session was trying to help me to stop crying, because I just couldn't. 

Rock bottom. Yeah, I liked this photo too. Ha.

I was kept at hospital that day, while my therapist, my therapist key worker, the doctor on shift, other therapists and a locum psychiatrist assessed my level of risk at various stages of the day. Were they prepared to let me go home? Would I harm myself, while I felt so completely that there was actually not much point of going home, of going anywhere in fact? During this limbo hospital time. Waiting in the purgatory of numbness and pain in equal measure, I shuffled along to my day patient groups but didn't talk. I wasn't just numb, I was mute. I am not someone who usually struggles to express what's going on, but all the words had drained out of me. I was dry, desolate, lifeless inside.

Dumbed by Depression

After speaking to several of the staff at hospital and confirming that - in fact - I would prefer to go home and promised that I wouldn't harm myself rather than be admitted to hospital again. (Which would have meant I'd have to deal with all the stresses that would have brought (pay caps from work because of my last year's absenteeism record, worries about bills, worries about whether friends would just give up on me because, clearly I was a lost cause)) I went home and to bed. I still felt numb. I took the doctor's advice and upped a couple of the over-the-counter things I take to help me to sleep / be sedated, although I was - frankly - fairly appalled that this was considered to be the only option - i.e. "Let's make you more of a sleep walker, less engaged with the world than they are; in fact let's put you to sleep so that you just pass through the days without engaging with anything at all." 

"Great," I thought. "More zombie like. What is the difference between this and being put into a coma? Really, why am I bothering? Is this what the next thirty years will look like? No thanks. No."

Stunned and Stunted by Sedatives

On Woman's Hour a couple of days ago, Jane Garvey helped radio 4 reach "peak radio 4" by making fresh pesto with Sally Clarke. At the end of the show, Jane remarked something like "It is absolutely lovely, it really does [taste as if it's just been made]..." and even Jane (apparently not a born chef?) thought she could manage this pesto: "even I could do that in probably not much longer [than five minutes]".

Sally Clarke

But that is not the point.

Think of all the things that 'only' take five minutes: getting out of bed? Well, that only takes 30 seconds if you shove away the duvet, kick your legs out and leap out. Have a shower? That takes 3 minutes if you're in Melbourne - or less, or maybe five if you're not exactly luxuriating in the bubbles. Getting dressed? 

5 minutes must be enough for that, if you don't count makeup and styling. Add another 5 for those, go ahead, be generous. Then 5 to pack up your lunch, grab your keys and leave the house. 5 + 5 + however many other five minutes to get to your car, the bus, the station, the taxi, the airport, and off to work, or wherever you're headed that day. 

How many fives is that? And that's just the start.

Woman's Hour... Is amazing

This week I heard on Woman's Hour (in a different episode) that fewer women are applying for senior positions. According to a study conducted by Harvard Business School, women associate power with conflict and don't want it. (And by conflict they mean conflicts - like family, for example. Board level executive versus CEO of mummy.) Some female leaders like Sheryl Sandberg tell us to 'lean in', that is, to move towards ambitious career opportunities and not say to ourselves, "I will not go for that position / that promotion because in a couple of years I might want to have children and..." But what about for mental health?

In my therapy session this week, I discussed with my therapist my current exploration of what I could do to make life better or easier. To make life liveable. You see, on that day above, when I was so low, my therapist didn't lie to me and tell me that everything would be completely better one day. In fact she said that I might always have to manage these feelings. That it might never get better. Never. Never ever. I might always have days when all I wanted to do was to not wake up the next day, when I felt that I had utterly failed (contrary to any rational proof) and that I was a ridiculous burden to everyone. And in any case, I wasn't having any fun. None. And so what was the point?

So, on that day, when I was wondering about whether I actually wanted to live at all, I went for my natural response to all situations: practicality. "What can I do to make my life better, if I'm going to have to get through the next thirty to fifty years (or, goodness knows, even longer) with this diabolical illness?"

I saw a locum psychiatrist as mine was away on (much deserved) holiday. (I say much deserved because, for goodness sake, even I can see that psychiatrists and all health professionals are people, and that they need time off, just like everyone else, so they can be productive.) He suggested I might like to see a life coach with an understanding of psychiatry so that I could explore options for changing my life and what I filled it with so that, on those terrible, awful days, I could at least look at the essentials and think: "Well, you're doing some good. You're helping someone, you're supporting people, you're trying to make people's lives better. And you're being creative. So, you see, Jessica, there is a point to your being here, even though you just want to close your eyes and never open them again."

However, seeing my therapist this week - after a month of getting used to new medication, and of making a couple of changes (and, for those of you who missed it, completely freaking out with massive anxiety at being named on the @BrummellMag (Brummell Magazine) list of 2015 inspirational women of diversity and then being shortlisted and having to attend a judging panel for the 2015 Women of the Future Award in the category for Community Spirits) I learned an alternative perspective. 

(Incidentally, this is the last year I qualify as a WOF @womenoffuture, #wof10yrs. Next year, I become a Woman of the Past. I'll be launching those awards very soon. Ha.)

My therapist said to me, "You have really changed. you're so much better than you were last year. You can't see it, but I can." And: "I'm not sure that you need to add more things to your life. your life is full of good things - your job, your blog and mental health work, your husband. You are already doing a lot!"

Finally, she said: "Your problem is not that what you're doing is bad; it's the feelings that are bad."

She is right. Those five minute activities described above, I can do about 150 of them, of those things that 'only take five minutes' in a relatively normal day, maybe 190x5 on a very full on day. I can do a lot, and I generally try to select meaningful things to do, because I know how hard it is for me to break through the numb wall of antidepressants and reach some kind of contentedness with life.

But on a bad day? I can still do 150 five minute things. I can maybe do more. But I don't want to do a single 1 of them. In fact my body and mind are fighting me against every. Single. One. Of those five minute activities. "Stop. Go back to bed. Close your eyes. Shut everyone out. Shut down."

So what does that mean for me? 

Am I one of those women referenced by the Harvard Business School? HBS studied 4000 men and women in total and "concluded that women are less likely to apply to rise up the corporate ladder because even though they feel they could get the job, they don't want to deal with the 'conflict' (my single quotation marks) that comes with corporate power." [Jenni Murray, Woman's Hour, 25th September 2015]. This means conflict against life goals / choices - trade offs and sacrifices that women would have to make at a higher level, rather than face interpersonal conflict on the job and at home as they juggled various enormous pieces of their life towards having a very successful career and a very enriched home life.

My FAVOURITES. Jenni Murray and Jane Garvey on Woman's Hour

The 30% club is about to change its focus towards board-ready women, that is, women ready for the executive. Clearly I have some way to go here as I'm at best a middle-senior manager at the moment. However, my firm KPMG co-published a study - Cracking the Code - which showed that it's really a lack of promotion rather than attrition which explains why women aren't making it to the top. Women are twice as likely to leave jobs on the way up because of the opportunity cost those higher level positions bring.

So am I one of those who are eschewing power because of the conflict associated with it? Not at the moment. At the moment I'm managing to do all those things above - I complete all those five minute activities. Like showering. Which, FYI, is not on the job descriptions of positions I've been looking at for over the last five years or so. Or so. 

But I don't know whether I can succeed or even survive in a job (anymore, or maybe not ever) where I consistently have to work 15+ hours in a working week day, every day. I know I have a smart mind, a willing heart, and a passionate drive to make a difference. I know I have the commitment to try to keep succeeding, to keep 'leaning in' and progressing. 

But working all hours is not - and never will be - good for my mental health (let alone my physical health). Can I still succeed in business on my own, balanced, healthier, terms where my five minute activities never reach the point where I've used up nearly every five minutes in that day, to the detriment of future health, the success of my ambitions, the satisfaction and transformative changes for the clients I work with, or the benefit of the mental health charities I am committed to supporting?

Do I have as much choice as I think I should have? Let's see...

The answer to these questions needs to be "Yes", but I really don't know if "yes" is the answer. My progress should be judged on outputs rather than the count of the five minutes I dedicate to my work. But one could argue that others with more stamina to put in more of those five minutes, just as productively, are going to overtake me in the career stakes (male or female) just based on their ability to go another five minutes. To do another thing when I had to stop to keep myself from becoming ill.

If I stay in business I imagine I will find out the answer to these questions. For now, I'll just try not to worry about them, which might cycle into anxiety or depression, and prevent me from doing those basic five minute activities.

So for now, I think I'll just go and buy a jar of pesto. Take care this weekend. x

R-E-S-P-E-C-T Let's Talk About Mental Health - Comfortably

I cannot believe it has only been five days since I wrote my manic Monday post. I am feeling distinctly odd after three consecutive nights of very little sleep at all, trouble even with getting to sleep, as well as my old favourite - trouble staying asleep - which is my biggest problem.

I expect attending the judging panel for @womenoffuture (Women of the Future awards) this morning did not induce additional drowsiness! I was so excited to have the opportunity to talk about mental health and the need to end the stigma around this widely experienced and more widely misunderstood category of illnesses. I also felt tremendously grateful to be in a position to speak about it: mental health for me is one of our most critical health issues in this country and globally.

It continues to become more and more apparent that mental illness does not discriminate. Speaking today to the judges I remarked upon this. There is not one group of people I can think of - whether we think about gender, age, ethnicity, sexual orientation, nationality, lifestyle, or life, in fact - where mental illness is not present. We may have 1 in 4 people with a mental illness in the UK, but that means that so very many more people are affected by their connections to those 1 in 4. Let's think of the mothers and fathers, the wives and husbands, the children, friends, work colleagues, medical professionals and strangers who are interacting every day with those 1 in 4. We are living in a world of tremendous pressure and challenge. I would be very surprised if many people at all were completely free of connection to someone with a mental illness (themselves or others).

The paradox is that while mental illness is everywhere, silence about it is also everywhere more often than not. We still do not talk about mental health comfortably. I try to, with my known background in this area serving as an "easy chair" to slide into for this discussion, but others who are speaking of their illnesses or struggles for the first time cannot gauge the reaction of others as there are so few precedents; cannot guarantee that when they take that huge step, that leap, risking so much, while so ill, to be honest about a part of them that is unwell and needs support, that they will get that support. They might not even receive acknowledgement, let alone respect and help.

The judges asked me what I would do if I won - what I thought needed to happen - to improve things. For me, it isn't about providing support mechanisms in the work place or better NHS care (although both of these things are absolutely critical and the latter is in dire need of help, with so many people excluded from care as they do not qualify for treatment based on basic statistics. For example, did you know that if you had an eating disorder and presented with a BMI of 17.1 (i.e. .9 points below the lowest 'healthy' weight for a height of about 5'5") that you would be turned away from A&E (the ER) and asked to return when your BMI had dropped further. You would not be deemed sick enough to receive care. "Please lose more weight." = "Please get sicker, and then maybe we can help you.") 

This is what I said needed to happen, and what my focus for the next three years will be: "We need to make it normal for people to talk about their mental health." 

Why did I say this? 

Imagine if you had a very unpleasant spot on your face. You can use concealer to hide it, sure, but at the end of the day, you're very aware of a throbbing, red, sore, mass on your face that you know you'd far rather would disappear, and you're pretty sure everyone has noticed. But if you tell people about it, you're more likely to get empathy and shared stories (and recommendations of nuclear strength Clearasil), as well as perhaps the odd puerile cry of "That's gross" than have people fall silent, look down, say "Oh," and nothing more. Say nothing. Walk away.

Imagine if you could walk into the office, and on the second (or third) round of 'How are you?'s (because we know that the first is a saying hello, and the second might be a reflex action from the first) that you could say, "I'm feeling quite anxious today, so I didn't sleep that well" or "I'm feeling quite unwell mentally. I think I need to take it a bit easy today to try to prevent things getting worse." The latter statement makes perfect sense to me: you're not feeling well, and you've got to work / go to school / attend your child's school play / go and run errands. Therefore you see how you can reduce your 'to-do' list for the day so that hopefully those sniffles or early symptoms don't turn into flu (or, worse, man flu. Hor.ror.). And so your sick feeling isn't exacerbated by excessive travel. 

Why is it, then, that we so rarely hear people say anything about their mental health? Why is 'presenteeism' (which is where people show up to work with a mental illness (or any other kind of illness) but pretend that they're fine when really they are not and probably shouldn't be at work) so prevalent in our world? Why do you so rarely hear people say that they are off sick "because of depression", rather than because of a cold, flu (man flu!), food poisoning, tonsilitis, etc? 

I think the answer is, because hardly anyone says that. Still.

People don't say "I'm feeling depressed today" / "I'm feeling manic today and can't concentrate" / "I need to sleep today because my anxiety kept me up all night". People don't say it, so people aren't used to hearing it spoken of. And so people assume they can't say it themselves. They assume it's not an acceptable statement to make, and not a "good enough" reason to be absent from work.

We do - desperately- need to help people get the support that they need, but if they can't talk about it in the first place the likely outcome is that they won't seek help. They won't feel it's important/ a valid illness. And before that, they will not feel they can even mention it. 

We know that men struggle more than women to even voice struggles with stress, anxiety, depression and so on. And not talking about this can be - literally - deadly. The number one cause of death among men aged 20-34 is suicide. And this could so often have been prevented by better comfort levels for saying: "I feel very anxious." "I need help." "I am not okay." 

Gender / other factors aside, the bottom line is that people really feel they cannot talk about their struggles with mental health (even with stress). They feel ashamed, weak, less than. Like they mean nothing. 

This is so wrong. We all matter and we all deserve respect, courtesy, kindness and care - for ourselves and others. If we could change this situation and make talking about our mental health as easy as discussing a nasty spot or, say, a broken arm, shingles, or flu, this would mean that our serious and debilitating illnesses would not be worsened by the massive shame we would associate with having them. I personally have berated myself, hated myself, shamed myself and been disgusted with myself for being ill with depression. Why? Why is my illness so shameful? 

It isn't.

If I had not been so ashamed I firmly believe I would never have become so ill. I know that because being honest with my team is the same as making me feel instantly lighter. I haven't had to pretend I'm fine when I'm not, which in the past twenty years at school, university, in my jobs to date, I have done, and which has made me feel more ill: not just sick, but sickened by myself, by my sickness.

So that is where I would start. With more conversations until mental health conversations are "normal". Until people feel they can say, "Today I'm depressed." "Today I'm anxious." "I need help please." "I need to take a day or two off." And I can't wait to get that conversation going again any chance I get, and definitely at the Women of the Future summit in October. In the meantime, let's talk about mental illness and mental health. We all have mental health. Let's make it easier to make time to talk about it. Please help by starting your own conversations.