And I am aching to get there, straining towards the moment I close the door to my hospital room on a world I am the wrong shape for right now.
How did I get here this time?
Fourteen days ago I had a regular appointment with my psychiatrist. Just a Bipolar 1 Disorder monthly maintenance appointment. I was completely asymptomatic.
Thirteen days ago I left for our beach holiday and forgot to pack my swim wear. Subtle. I mean that could happen to anyone. Right? But by the following morning I was symptomatic alright. My short term memory and concentration were dissolving like sugar cubes in boiling water.
A buzzing pressure behind my eyes radiated up my forehead. I knew from bitter experience, if I did nothing, soon that buzzing could make me second guess what was real or not.
That was symptomatic enough to page my psychiatrist on a Saturday morning. It’s only the second time I’ve paged him out of hours in 14 years. He called back in under three minutes.
Over the last nearly two weeks, the first of which I stayed at the beach, he telephone consulted with me every second day, adjusting medications, a little more of this, a little more often of that. I slipped from my bed gratefully into the ocean, timing the most sedating medications for times when I’d be in bed not the ocean. I seemed a little better, maybe? But then not.
Back home we continued every second day phone consults, adjustments. This is by far not the sickest I have ever been (although psychosis and catatonic depression requiring ECT to reverse, do set a very low bar)
So why would I want to go into hospital, rather than continue treatment at home?
The surface of my brain feels as though it is covered in papercuts and being surrounded by people and noise is like having lemon juice dribbled over the cuts.
Trying to hold in the irritability of being around people and noise (including my close family) is like being intensely nauseous with someone threatening to punish you if you vomit.
One of the parameters I use to assess how close I am to needing to go into hospital is ‘the sandwich test’. Think about the amount of concentration and short term memory it takes to make a sandwich – nothing fancy, just two slices of bread, some butter and one topping. For most healthy, able bodied, able brained adults, this is not a challenging task.
Right now – I can still make a sandwich, but it’s a challenge. I am making a decision, based on past experiences, not to wait with hospitalisation until challenge becomes an impossibility.
As for the seasonal timing – Christmas and New Years celebrations? I am veteran enough in the management of this illness to know it has no knowledge of nor respect for holidays and anniversaries. I could list my tenth and fifteenth wedding anniversaries as times spent in hospital, a longed for trip to Paris cancelled because of recent hospitalisation, and that would be the beginning of a list so long I’ve forgotten most of it. These times are just human constructs. If it swallows them I don’t dwell on them.
Instead I celebrate the unscathed special occasions extra hard, to make up for the times there is nothing.
The final reason for going into hospital now, is because I can access this level of care. I am fortunate to have the option of going into a private psychiatric hospital when I am sick. The standard of hospital care I will receive will be excellent. It will far exceed anything the public psychiatric hospital system has to offer.
I loathe getting sick enough to need hospital support. But perhaps even more than this I loathe the hypocrisy of someone with my privilege not utilising that support because of some misguided stigmatising ideas about what it means to be a patient in a psychiatric hospital.
I am profoundly grateful I can afford care in a good private psychiatric hospital. And part of my own recovery, once I’ve stabilised medically, is to remember there are many people living with this illness, and other severe mental illnesses, who are learning to live with them with far less support and privilege than I have. When my recovery feels hard I focus on this:
If I access the supports I am fortunate to have, I am more likely to be around for long enough to help raise awareness of the inequality between our private and public mental health hospital systems, and work towards our public mental health hospital system actually supporting some of our most vulnerable when they need it most.
If you are new to Thought Food and would like to know a little bit about who I am when I am well, you may like to check out:
Long before Covid-19 arrived, vets and vet nurses were quiet, hard workers who didn’t complain about less than ideal working conditions. And, possibly unbeknownst to most of the pet owning public, for many veterinary staff, challenging working conditions were the norm.
Since this crisis hit, these essential workers are not getting much opportunity or airtime to communicate the difficulties they currently face at work.
The advent of the Covid-19 pandemic has put the challenges of veterinary work on steroids.
I know a bit about what it takes to work in this industry.
I fell in love with veterinary work at fifteen, when I started volunteering at a local vet clinic. I wiped down tables, cleaned cages, and held animals. Then I started work as a casual junior vet nurse on Saturday mornings.
I committed the second half of my teenage years to the tunnel visioned hard work it took to get into veterinary science at university.
I worked as a small animal vet for twenty years, in many different practices in Australia and the UK. Working conditions ranged from excellent to atrocious.
Thanks to my experiences, I know this:
Vets don’t talk about their work stresses outside their own tightly knit vet circles. Some of us don’t even confide our struggles to our colleagues. We talk about our cases in detail for hours, but many of us still cringe at opening up about the state of our mental health.
Our clients get our kindness, our compassion our sympathy our skills our knowledge, our communication skills. But they never see our vulnerability. They don’t understand how high our risk of burn out (borne of caring too much and being overworked and undervalued) is.
They don’t see that when we walk through the door of the clinic our rostered working hours become irrelevant because we give ourselves over completely to everyone else who walks through that door after us.
Our clients don’t feel our pain when we lose yet another amazing member of our profession to its sky-high suicide rates.
I am currently taking a break from veterinary work while I concentrate on writing and mental health advocacy work. But I have many vet friends who are out there working and hurting.
I have spent the last couple of weeks collecting descriptions of work life from some of my (currently working) veterinary friends and contacts, because I believe that for the veterinary profession to survive this pandemic with its collective mental health relatively intact, the pet owning public needs to know about the difficulties its workers face at this time.
Here are some of the (summarised, paraphrased, and quoted) insights these vets generously shared with me:
On Covid-19 Regulations:
Some aspects of veterinary work make social distancing between staff impossible. For example, it is not feasible for a nurse giving a wriggly, excited puppy a cuddle and a vet looking in its ears with an otoscope, to be 1.5 metres apart.
Some of the protocols necessary to minimise the risk of Covid-19 transmission, such as contactless consultations (where the owner waits outside the clinic in their car, the pet is transported inside by a nurse in PPE, the vet examines the pet and then phones the owner to discuss further diagnostics or treatment), severely hamper efficiency and slow everything down.
Vets are used to working as efficiently as possible:
‘Normally I would type the history while the owner is in the consult and do an exam in between taking notes. Now I can only do one of these things at a time.’
Contactless consultations also limit a vet’s ability to read their client’s body language during the consultation, which can interfere with effective communication between vet and client.
Pets can be more anxious when separated from their owners. This may mean it takes longer to perform a physical exam, or it may be impossible to do as thoroughly as the vet would like.
Covid-19 level cleaning recommended between consults is more labour intensive and takes longer than usual.
Downsizing or closure of a practice due to further restrictions or a Covid-19 infection will have negative effects on the practice’s financial stability very quickly.
‘The nature of small to medium sized veterinary practices even in normal times is to run with incredible efficiency, but still on very low margins. They cannot sustain even mild to moderate downturns. They will not survive and jobs will be lost long before the drop of 30% revenue occurs required to be eligible for the Job Keeper Payment.’
Locum vets are particularly vulnerable to job loss now. As practices work to minimise the risk of a Covid-19 infection in their permanent staff, many locum vets are having their shifts cancelled, and are facing the financial difficulties and mental health challenges that come with job loss.
Vets are also more aware than ever of the financial constraints facing many of their clients.
‘It is super sad when you see a client who wants to do everything for their pet, but they have lost their job and can’t afford it. It breaks my heart. I am doing a surgery at a 25% discount tomorrow. The client didn’t ask for it, but I feel so sad for them.’
‘I feel even more conscious of the usual dilemma we have in vet practice of having to mix financial discussions with emotive ones as most people are understandably a lot more stretched financially right now. But veterinary practices are also under a lot more financial stress and if our invoices are not paid, there won’t be a vet for clients to take their animal to.’
And now more than ever vets are at risk of being on the receiving end of their clients’ financial frustrations.
‘I’ve already been abused in the car park once this week and I am preparing myself for a lot more of that to come as the stress is almost palpable in the air.’
On Mental Health
Vets often hold themselves to a very high standard. Under sub optimal working conditions that pressure will increase stress levels further.
‘Veterinary practice is already an emotionally draining vocation with highs and lows every day. Our staff feel responsible for their patients and care for our clients. And it goes against the grain to just drop our standards of care because of what’s going on. So, we are not going to start cutting corners.’
Many clinics have split their staff into two or more teams to reduce the chance of the whole clinic having to close if one staff member contracts Covid-19. This means vets and nurses may be working under short staffed conditions and even longer hours than usual:
‘The phones are ringing constantly. We hang up and pick up the next one. I am answering dozens of phone calls daily as a vet, as well as being my own anaesthetist, recovery nurse, and doing the usual vet things. And right now none of us have regular access to our stress relieving hobbies.’
Splitting staff into teams at work usually also means no contact between teams outside of work.
‘There were genuinely tears after the last ‘normal’ shift as people realised they may not see some of their friends for weeks, months even.’
Before Covid-19 brought added work stressors with it, vets were already at a high risk for mental ill health. This knowledge weighs heavily on many of us:
‘I’m concerned that abuse of controlled substances will increase and don’t even want to think about the suicide issue the veterinary industry already faces.’
Vets appreciate the many clients who are doing the things that make their work less stressful, such as practicing social distancing, being patient when things take longer than normal, and assessing what might constitute an essential phone call.
For example, now is not the time to phone your vet clinic for a lengthy discussion about which breed of cat you should get.
‘If the public can show extra understanding towards vets and vet nurses that will only be a good thing. We are not the only profession under strain but the pressures we are under are very real. Everything is taking longer so people need to be patient.’
‘We place a lot of blind faith in the honesty of strangers at the moment…I feel angry when I hear of my colleagues having got to the end of a consult only to have a client mention that they just came back from a cruise a week ago.’
‘Thankfully 99% of our clients are understanding and adhering to protocols without complaint, but I don’t think they quite understand how hard everything is for us right now.’
‘The shortage of equipment is tricky – no hand sanitiser, limited paper towels and gloves. It makes it hard to follow the guidelines to use hand sanitiser between every patient. Some human medications we use are in short supply, which will be hard to explain to clients when their pet’s medication needs to be stopped suddenly.’
‘We have also been asked to supply a list of things we can donate if needed – such as ventilators, propofol, midazolam, and surgical gowns and gloves.’
What is getting us through?
Now more than ever, humour, teamwork and appreciative clients balance out the challenges of veterinary work.
‘On the positive side of things, I work with a group of amazing humans and the way we all have each other’s backs has definitely shone even more so in recent times.’
‘On the upside we have always been good at the ‘make do and mend’ mentality. Also, we were born for this – we just need to pretend every person is a parvo puppy!’
(Parvovirus is a highly infectious, potentially fatal viral infection, most common in puppies, and requires full isolation nursing.)
‘Our team are amazing and have chosen to pull together with a plan to fight and minimise risks to client and staff safety, mitigate risk to the business and work toward sustainability.’
‘We have had wonderful support from our clients and community who have commended us for our initiatives during this pandemic to ensure both human and animal welfare,’
To conclude I will reach for words one of my close vet friends passed on to me. Even though upper management of veterinary practices, can be notoriously out of touch with the needs of its veterinary workers, this directive from the upper management of my friend’s practice encapsulates perfectly what I would want all vets working through this pandemic to hold close to each day, and what I would want all veterinary clients to be aware of and respect:
‘Throughout our career, veterinarians have always put our patients first, then our clients, then ourselves. In this pandemic, we must put our safety and the safety of our nurses and support staff first.’
Just over a year ago I unclenched and allowed myself to fall. I’d been peering over the ledge of a complete break from veterinary work for a couple of years, eyes scrunched shut against the change. The reality of not being able to do everything at once and do it well, a splinter in my thumb – impossible to ignore.
If you are a man or know any men – please read on.
I recently accepted a SANE Peer Ambassador Speaking engagement for a small all-male audience in a male dominated industry (ages 30-50). To be clear, when this opportunity first arose a couple of months ago I applauded the company for their focus on male mental health and then sat back, certain they would find their ideal candidate in a male Peer Ambassador with a background in the trades to take this on.
Fast forward to a couple of weeks ago: No one had applied. It was re-advertised. This time with a note that the presenter did not need to be male. They just wanted someone willing to take this project on.
I gave it a lot of thought. On the surface, the only thing I have in common with this audience is my age. But I am also fast developing an interest in men’s mental health. Over the last couple of years I have supported several men from different areas in my life during episodes of mental illness.
Another strong motivator to learn more about this area, is being the mother of a son. I appreciate his future mental health is not all under my control, but I want to do what I can to secure him the most mentally healthy future I can.
So, I signed up for this engagement because I believe having me speak to this group has got to be better than having no one speak. Having no one, sends the message that men don’t experience mental illness. So wrong. Or it sends the message that if they do, then we shouldn’t be talking about it. Also, so wrong.
I am pretty confident I can do it, with the base knowledge I’ve got now, but I believe it could be so much better if I had the voices of some men to include in this presentation.
So if you are a man or can direct a man to this post who has some lived experience of mental illness and is well enough to offer some insights (or even if you are a man who hasn’t lived with mental illness but has some thoughts), either message me (on facebook or instagram) or email me email@example.com
I’d love to have a casual chat or exchange some emails if preferred. Any information I am given will be used anonymously unless you specifically tell me you would like to be named and/or identified.
I have mentioned in other posts, I am a huge fan of stretching myself outside my comfort zone. I am definitely doing that with this engagement. I gently encourage you to stretch yourself too and get in touch with me. You could make a real difference to other men’s lives by donating your voice.
Have you ever had a moment when your answer to a question determined whether your life imploded?
It came five days into parenthood. I was lying on the floor in my maternity hospital room crying because I was trying to outrun a jaguar chasing me towards a cliff. Things were starting to go very wrong in my brain.
In the following months, when my mind warped and writhed in the grip of psychosis and later catatonic depression, and when what started out as postnatal psychosis turned out to be a first episode of bipolar 1 disorder, I could not imagine things being worse.
Thought about homelessness, after I witnessed displaced people with cardboard placards to explain their belongings smudging the busy and important streets of Sydney in the first days of the new year. My emotional barometer flicked between pity, sadness, relief, and settled on horror because this could still be me one day. The Right To A Home
Went to work. After twenty years the neural pathways for running a consultation competently and compassionately, for reading who I am in a room with, and being a shock absorber for their anxieties and concerns, are so well-worn they are almost automatic. Contrary to popular belief (and this photo), we spend much less time playing with puppies and kittens, than we do using our communication skills to explain, empathise, and advise our way to the best outcome for our patients via their owners.
Felt it come for me. In February, over two days. My sanity stepped into quicksand. Mania swallowed me. I called into work sick. I said goodbye to my family. I went into hospital. Battened down my hatches and prepared for the usual long stay. Only to be pleasantly surprised. Four weeks in hospital. That’s short for me.
Lost my job. I do every time I get sick.
Opened new neural pathways by setting up a website, which enabled me to write and publish this blog. My technological ineptitude is boundless, so the existence of Thought Food is a minor miracle.
Supported three men. All stepping through the sticky tar of depression at some point this year. All blindsided by the ferocious nature of this beast. All strong, kind, intelligent, undeserving.
Exercised most days. Ate green vegetable omelets for breakfast some days and Nutella on toast with mug loads of coffee on others. #NotFitspo
Welcomed Clarence, our baby Stimsons python into the family. He is the lowest maintenance pet I have encountered. Gentle, inquisitive, and only needs to be fed every seven to ten days.
Continued to receive rejection after rejection of the manuscript for my memoir from publishers via one of the best literary agents in the country. Each one stings. Each one frustrates. According to publishers’ feedback the quality of the writing is great, but it’s not commercial enough. In other words: No one wants to read about psychosis if you haven’t killed someone in the throes of it or at the very least been picked up wandering the streets nude and ranting.
Began considering self-publishing the manuscript for my memoir.
Climbed back into some weekend work.
Heard my mother’s voice tell me my father had nearly died after a massive heart attack. Seeing him on day two after triple bypass surgery, comatose, tubes and wires snaking in and out of him, and the comforting blips and beeps and numbers flashing on familiar screens was easier than seeing him on day four, awake, in agony with each movement. He survived. My Father’s Heart Broke
Applied for, was accepted into, and completed the SANE Peer Ambassador training program. The glow of being in a room with others who went through hell, survived, and are now well enough to use that experience for good, still warms me. And I finally feel I’m not advocating on my own anymore. The Chosen Ones
Gathered friends for dinners and lunches to enable my love of cooking, baking, great food and wine, and conversation…so much conversation.
Became familiar with the inside of an ambulance courtesy of seven night time trips to hospital in ten days. My son developed partial seizures lasting up to ninety minutes each. Relief flooded me when his MRI scan was clear (of brain tumours) and he was diagnosed with benign rolandic epilepsy (infinitely more manageable). Lessons For A Control Freak
Clung to small wins amongst the manuscript rejections. Three posts published on Mamamia, one on SANE, and a submission for Dr Mark Cross’s book on anxiety accepted.
Narrowly avoided a second hospital admission in October. I pounced on the onset of a depressive episode with an emergency psychiatrist appointment, a medication adjustment and slashed away all commitments except exercise for several weeks. Razor Blades In Mud: Laziness Or Depression?
Became a spokes person for the Australian Genetics of Bipolar Disorder Study, and suggested edits to make the language in the main study survey more consistent and less stigmatising. Most of my edits were approved and included less than twenty-four hours before the study launched. A clip of some of my participation and how to participate in the study can be found here:
Attended my first ever non-veterinary conference: ‘Empowering online advocates’ and came away feeling much more hopeful than the trip to Sydney in January had left me. #HealtheVoicesAU
Discovered the joy of camping, absolutely enabled and enhanced by beautiful friends who supplied (and set up) most of the gear.
Resigned from veterinary work. Ostensibly to stop straddling several worlds and free up more time and energy for writing, mental health advocacy, and my children. That is all true. But I am also bone crushingly tired of the cycle. Work, get sick, lose employment because the nature of my illness means I can’t give a date when I’ll be well enough to return, and I can be sick for months. Then I clamber my way back into a demanding profession you can only inhabit when you are functioning at 100% of your capability. I expend time, energy, and money to do enough CPD (continuing professional development) to keep my registration up to date…only to lose it all again the next time I get sick. The plan is two years off. Then see where I’m at.
Received a handwritten Christmas card and instant scratchie from my pharmacist… one of my six medications alone costs $30/week. Treatment
Reminded you to end the year saying no when your gut tells you to, and being kind to yourself when you feel like doing the opposite.
I have never paid much attention to Kanye West. From the snippets of entertainment news that have trickled into my consciousness, he has at various times reminded me of a lost little boy, a toddler throwing a tantrum or red paint on a white rug, to get attention. My sympathy went out to him when it sounded as though he’d suffered a psychotic break under the media’s scrutiny. I have never listened to his music or worn any of his designs. By many accounts he is a talented artist. But humble he is not.
So, why would I risk being caught in a room with Kim Kardashian and not enough in common with her to even cover pleasantries, in order to step into Yeezy’s Yeezys for a day?
I don’t dwell on what might have happened had I been sent home on day five after my daughter was born. But whenever the news throws up sensational stories reporting murder, infanticide, or suicide, and there is even a slim possibility the perpetrator might have been psychotic – then I think about it. Because that could have been me.