Mental illness at work

The news that people with mental health problems suffer at work will not come as a surprise to anyone with those problems. In my experience it isn’t down to malice on any one’s part, but clearly something isn’t right if so much talent and money is wasted. Remember that people with mental health problems include some of the most creative people around.

One major problem at work is that mental illness …

“Mental health sees 300,000 people leave their jobs each year”

And I was one.

I should immediately qualify this statement by making clear that I was in no way forced to leave. I was one of the lucky ones: I just didn’t feel strong enough to do that job properly any more, and I had many other things I wanted to do instead. Like writing this blog, and producing the best book ever on consciousness. I was tired and worn out and lucky enough to have alternatives. But if I had been mentally stronger I might have carried on for longer.

The news that people with mental health problems suffer at work will not come as a surprise to anyone with those problems. In my experience it isn’t down to malice on any one’s part, but clearly something isn’t right if so much talent and money is wasted. Remember that people with mental health problems include some of the most creative people around.

One major problem at work is that mental illness is often not considered to be a “real” illness or disability. I know of many people with problems (including myself) who have never been asked what reasonable adjustments could be made to their work environment, and indeed whose requests for relatively minor changes have been met with something between pained resignation and aggressive exasperation. This aspect of things could be improved by better training of managers.

But the power of institutions and employers is limited: institutions and businesses are made up out of people. Generally instititions in the UK at least now have very good rules, and often there’s not much more they can do apart from making sure that they implement those rules, and to help change the attitudes of their employees.

It’s that final bit that’s difficult. How do you change centuries of stigma and ignorance? On the bright side things have changed for the better very quickly, but there is still a long way to go.

We can learn by looking at three areas where there have been enormous strides over the last fifty years: women’s rights, LGBT issues, and race. Again, I am not saying that everything is now perfect – clearly it isn’t, and there are still massive changes in attitudes to be made. They have all though made progress because those discriminated against have formed strong movements and taken direct action. We lunatics are hardly among the strongest people in society, but perhaps we have a duty to stand up and say we are ill, we are disabled, we need help at work. You wouldn’t treat someone with cancer or in a wheelchair this way, so don’t treat me like it.

I’ve lost track of how many mental health support groups and societies there are; there are too many. We need to unite, and we also need to mobilise. It’s difficult when you’re too depressed to move, and difficult when you’re worried everyone is going to mock you, but if you have the strength, it’s time to come out and be counted, and not let yourself be pushed around. Sing if you’re proud to be mad.

 

 

 

Student depression

University terms are starting all over the country. When I was an undergraduate, the Cambridge term started late, in early October, and our terms were only eight weeks long. That first one was seven weeks six days too long for me.

I have had several responses from students to my blog on dysthymia – low-level persistent depression, or what is now called persistent depressive disorder. The people who contacted me are just the tip of the iceberg. In your class of a hundred fellow students it could be that as many as nearly twenty of them are mentally ill, to some degree, right now. That’s a lot of sick people; imagine a class where twenty people were sneezing and coughing non-stop. Who are these people? Can you tell? Are you perhaps one of them? And a couple of lecturers are probably depressed right now, too.

What’s the leading cause of death for young people aged 20-35 in the UK? Those risky boys speeding round blind bends in their sporty cars? Drugs? Falling under a bus blind drunk? Being mugged and murdered? No, by some way, it’s suicide. Suicide is also the leading cause of death for men under 50. And most people kill themselves because they can’t take the hopelessness and pain of depression any longer. And if suicide doesn’t kill you, depression is associated with a host of disorders, such as heart disease, cancer,  and dementia, which might get you later.

Depression and anxiety are closely related, and usually go together. Epidemiological studies show that anxiety and mood disorders are remarkably common: it’s estimated that one in three people will suffer in their lifetime, and between one in six and one in ten are ill now. The reporting of mental illness has increased, but whether that’s because of better understanding of the disease, better diagnosis, reduced stigmatisation of the ill, increased pressure of contemporary life, or, most likely, all of these, is unclear.

When I was young (under twenty, say), I didn’t know what depression, anxiety, and obsessive-compulsive disorder were, although in retrospect I suffered from all of them. I was aware of something my relatives talked about in rather hushed tones called “a nervous breakdown”. I’m still not entirely sure what one of these was, but I think it was a sudden mental illness requiring some kind of treatment, and even incarceration in an “asylum”. Treatments were very limited back in the 70s; remember that chlorpromazine wasn’t released to the market until 1953, the first benzodiazepine, Librium, in 1960; and the first antidepressants in 1957 (iproniazid, a MAO inhibitor) and 1958 (imipramine, a tricyclic), although these drugs have many serious side-effects. The relatively more benign Prozac (fluoxetine) wasn’t available until 1987. I don’t think I knew about these drugs until I switched as a student from Natural Sciences Physical to Psychology. Indeed when I was a teenager, I thought of treatment as shock treatment; that’s about all there was.

Attitudes started to change when Prozac became widely available; perhaps that’s generally true – diseases only begin to lose their stigma when there is some hope. When I was young “cancer” was another dirty word, sometimes just called the “c word”. Don’t ask my younger self about swearing though; when I was ten, I thought the filthiest word in English was “pub” (where my father went Sunday lunchtime).

I was the first person in my family to go to university, and I had no idea what was involved, no idea really what a degree was (although I knew students “read” for it on University Challenge), no idea how to manage money (fortunately credit cards weren’t available then), no idea how to manage my time, no idea how to study independently, no idea how to live, no idea how to make use of what was available, no idea what a girl was, and no idea of how to cope when I was a raving loony without realising it. I was extraordinarily shy, which didn’t help. I wasn’t lazy; I tried my best, but I had no idea how to organise my time. I expected university to be like school, which of course it isn’t.

I stuck out the first year, mostly because I drift through things and staying was the easiest thing to do, and I was just clever enough to get by in spite of my deficits. The turning point was joining a society where I met other people. I still can’t say that I felt at home, and at the end of the first year I got a summer job where I did. I was earning good money, I had friends of sorts, I seemed to have some purpose, I felt like I was part of a community, and I wondered why go back to Cambridge. At that point I nearly gave up.

I don’t really know why I didn’t; it was easier to stay than not. And when I went back to Cambridge I discovered psychology, and things started to look up.

If I knew then what I know now I would have got professional help. I would have started with meta learning rather than learning. I would have been bolder about asking questions. Mostly I would have realised that I was ill, I wasn’t alone, and that I should talk to people.

Emptying the mind

It’s been a while since my last blog. Who would have thought that being self-employed would mean being so busy? I have been trying to focus on what’s important: my goals in taking early “retirement” from the full-time job have always been to increase my reading, thinking, and writing time.

But we live in a world of distraction. Distraction makes procrastination very easy. I even know of academics who have been encouraged by their “line managers” (what a repellent phrase) to “multi-task” their administration and research. I’m not sure at what level they’re supposed to multi-task – reading a paper while giving a lecture perhaps? – but we know that multi-tasking reduces efficiency: it just doesn’t work. Doing two things at once has a cost (which is why even speaking on the phone while driving increases the chance of an accident, let alone texting and driving). It also increases stress. And we know that doing important, creative work requires focus – you can’t carry out great research while students back their essays. I even have my doubts about one of those great sacrosanct beliefs in academic life that great teaching and research must go together: good teaching requires time, and research requires time, and you can’t be doing two things at once (see above).

I have tried to simplify my life, for peace of mind both for being mentally ill, and in order to be able to think more clearly. I have just been reading Timothy Ferriss’s excellent (if lengthy) Tools for Titans, and it is obvious that I am not alone in pursuing this strategy. Physical clutter is distracting – some of us even find it distressing. Mental clutter is just as bad, perhaps worse.

And how much mental clutter we all must have! How can you live in the moment when you are worrying about what you did wrong this morning and what you have to do this evening? How can you write well when your mind is on the telephone bill?

So here are some of the things that I’ve done to reduce mental clutter.

  1. Write down as much as possible. First I carried out a brain dump of everything I had to do, everything I was worried about, and everything on my mind. This task took a while, and I kept adding to the dump over a few days.
  2. Make structured lists. Over the years I have experimented with several types of list and time management systems. Now someone with an obsessional personality has to be careful of lists – they can easily take over and become an obsession and a distraction in themselves. I recently tried a complex system of email folders with tasks for doing today, tomorrow, the day after tomorrow, this week, waiting for, and so on … (I am familiar with Dave Allen’s Getting Things Done system and implement a simplified version of it. I have tried dedicated software but am aiming for a simple solution.)
  3. To do. Currently I am using Apple’s Reminders, with several types of list organised by location and time. I am trying to keep it simple. I have tried complicated systems and apps and remain to be convinced that a to do list can be bettered. The important thing is that nothing gets lost, and that I know everything will be dealt with by the deadline. I don’t want to have to think about peripheral things.
  4. Removing distractions. Social media distracts us and increases mental clutter. I can’t go as far as some and remove myself completely from Facebook and Twitter, and I don’t want to delete all my email accounts (and I don’t think it would be a good idea for future employment possibilities). But I don’t need to check my email every hour. Emails generate emails. I have reached the fabled “Inbox zero”, partly by moving things I can’t do now to an appropriate folder. (Actually as I write it is Inbox 1.) There are some emails I can’t do anything about just now, either because they refer to future events or because I need to do something to be able to answer them – they are moved to a “Waiting” folder. I do feel bad about several emails in my “Weather” folder that I plan to get round to when I have time. These are questions about or suggestions for or things to add to my British weather pages (http://www.trevorharley.com/trevorharley/weather_web_pages/britweather.htm). I do feel a bit bad that people have gone to the trouble of writing to me, and I always thank them, but it’s not my day job, and my time is very limited, so I can’t process them all at once. Recognising that we have limited time is a big part of the fight. WE CAN’T DO EVERYTHING. And that means MAKING CHOICES. (Apologies for shouting these statements.)
  5. Meditation. Everyone says meditation is good for clearing the mind and improving mental focus and clarity. I though with my monkey mind find the process very difficult, and probably as a result find the benefits – so far – limited. I will persevere though. I am using Andy Puddicombe’s Headspace site; I like the structure it provides and the implicit coercion. My jury is still out on meditation.
  6. Mindfulness. At all other times I am trying to be mindful of what I am doing now. If a distracting thought arises I try to push it away or if it is something I need to pay attention to add it to my list. It is easy though for obsessive people to get obsessed with clearing our minds, so we are for ever writing down minor thoughts. We all also occasionally at least need to plan what we’re going to do: living in the present doesn’t imply drifting.

Interestingly, as I was half way through writing this blog, the following landed in my inbox and caught my eye (I know, I know):

http://calnewport.com/blog/2016/12/18/on-digital-minimalism/

Finally, we should think about whether it’s even a good idea to strive for an empty mind. Life isn’t that simple. Things are always cropping up, and surprises are always happening. Rather than avoiding shit we must learn to respond to shit in the right way. The more I think about it, the more important I think this point is: we will never achieve a perfectly empty mind. It’s our responses we need to change.

Have a good Christmas and New Year everyone. It’s a difficult time of year for people with mental health problems – if nothing else it’s so dark in the northern northern hemisphere. So just hang on in there.

Taking the leap

Morning cirrus

Last week I took the plunge and decided to “retire” from my full-time job as an academic and go free-lance as a writer from 1 August.

Some call me brave, some lucky, and I worry I’m being stupid. I’ve been fortunate in life so far in being able to do the two things I wanted to do when I was young: be a professor and to write. After spending most of my time doing the first and only a little of the second, I now want to devote my life to writing, reading, and thinking. (And going to the gym building the perfect male body.) I realise I’m lucky to be able to pursue my dreams, but it is something I have been working towards; it’s just a bit earlier than I originally planned.
I’ve had twenty wonderful years at the University of Dundee. I love the place, and I’m proud of the Psychology group I managed and built up there. I love teaching, particularly those huge first-year lectures with an appreciative audience. But the times they are a-changing, and I’m starting to feel just a bit out of touch with academic life and the young of today. So it’s time for a change and a new challenge. Mainly I want to be free and I want to write. It remains to see what sort of living I can make.
I’ve never taken well to following orders – I remember I particularly hated PE at school not because I disliked sport or exercise, but because I hated the regimentation that went with it. And the cadet force at school was also most unpleasant: what was the point of shiny buckles and marching up and down just for the sake of it? In any job, however good, where you’re not the boss, you have to do what others tell you, to some extent at least – it’s hardly unreasonable if you’re getting paid, and particularly if you’re getting paid by the tax payer. But I have found that having to do things seems to make me anxious. My psychopathology again. So, non serviam.
I have several projects on the go that aren’t too far away from being completed. There’s the second edition of my beginner’s guide to the psychology of language, Talking the talk. I’m proud of that because I think it’s the best thing I’ve ever written. There’s a student guide to the philosophy of science and psychology on the way. And then there’s a book on consciousness. That should take me to the end of this year. And there’s my book on depression, anxiety, and me, for which my agent is currently trying to find an editor. Publishers and editors interested in the definitive book on the experience and science of depression, contact us (trevor.harley@mac.com).
And the effect of making the decision and signing the deal has been enormously beneficial to my mood and anxiety levels. I feel HAPPY (I do want to shout here) and my anxiety has virtually disappeared. So I’ve decided to reduce my medication.
So I am taking big steps to taking control of my life and trying to cure myself of depression and anxiety: in the last few months I’ve started working out with a personal trainer, and changed the job. And so far it seems to be working. But I know many battles lie ahead.

A brush with death

Just before Christmas I nearly died.
One Saturday I was feeling fine – rather stressed, but physically fine. Sunday morning I couldn’t urinate. Sunday evening I was in hospital. Monday evening my temperature was soaring, my pulse racing, my blood pressure falling through the floor, and I wasn’t breathing well. I was in a stae of severe sepsis – what my mother calls “blood poisoning”. Although I didn’t know it at the time, the stage I reached has a mortality rate of 50%. Fortunately I recovered; my infection responded to the antibiotics, and I had wonderful care at Ninewells Hospital in Dundee. Recovery was slow, and I still don’t feel completely well.
It turns out that there is nothing like nearly dying to focus the mind on what you should do while you’re living. We’re all going to die sometime; if I’m lucky I might have another 40 years or so, although how many of those will be quality years is unclear. What should I do in the next 20 – 30 years? What do I need to do now so that when in the future I am on my death bed I will be able to lie back satisfied and think “yes, that was a worthwhile life”?
It wasn’t just this near death experience that made me think about the meaning of life, although it has focussed my mind on it. I’ve always been a bit obsessed with how I should live my life, and how I should spend my time.
Someone once said something like “No one ever said on their death bed ’I wish I had spent more time at the office’.” (I think it was the American rabbi Harold Kushner.) I suppose though it depends what sort of office you’re talking about. Hillary Clinton might well end up saying “I wish I’d spent more time in the Oval Office”. It depends on your job in having an extremely good job: I am an academic, a Professor of Psychology.
For many years I even said “I don’t make any distinction between my work and my life”. My reasoning was that (most) academics are pretty much working all the time. You go on vacation (or “take annual leave” as it has now become) and you read a psychology book – are you now working on holiday? You think about a problem in the bath, answer a student email while sipping a glass of wine at midnight, you read a short article Christmas Day while waiting for the turkey to cook – you see the problem about defining work, holiday, and non-work.
Unfortunately some of fun, for me at least, has gone out of the job, caused by increasing bureaucracy and attempts to quantify academics’ time with the noble aim of ensuring that the public aren’t being ripped off. Of course the public should be able to sleep safe in the knowledge that university dons are earning their pay, but you, the public, can rest asure that there isn’t a widespread problem: we aren’t on holiday for half the year, because there’s always research to do, new teaching to prepare, PhD students to supervise, and administration to catch up on. A recent article suggests that many academics work considerably more than 50 hours a week. And now we have to account for our time, by filling in forms and keeping track of what we do. Mechanisms with names like TRAC determine how government money is allocated on the basis of these timesheets. Workload models proliferate, mostly giving us 1768 hours a year to account for – even though we might work more than 2500 hours! And they all suffer from the problems above: what exactly is an academic’s work?
For these sorts of reasons I no longer think that my work is my life. And certainly my job isn’t. The life of an academic has changed over the last 30 years, largely for the worse I think, and it is now full of countless meetings, evaluation, meetings, and forms to fill out. I don’t find that part of the job much fun (and I doubt if I am alone).
So now I do distinguish between my job and my life. It’s still a great job and better than most others. And there are still many parts of the job I love (writing and teaching enthusiastic students, for example). But after a brush with death I cannot find meaning in my job alone.
The mortgage has to be paid, but is it possible to do so while living a meaningful life? And where is this meaning to be found?