I never considered my mental health as part of the decision to have a baby, because when I first fell pregnant within a month of trying, I had never experienced mental illness.
The pregnancy was uneventful.
Then I went into a thirty-three hour labour on two hours sleep. This severe sleep deprivation and the swirling hormone levels woke a slumbering monster, a genetic predisposition, which ensured that by the time my baby was one week old, psychosis had wrenched me away from reality. I found myself in the Special Care Unit of a private psychiatric hospital trying to explain my way out of my delusions, while my husband and mother cared for my daughter at home.
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.’
The Covid pandemic feels as though it has equalised our collective mental health. Or if not equalised, then it has certainly ‘flattened’ the mental health curve.
Most people who live with a mental illness have at some point experienced unpleasant times with no fixed end point, over which they have little control. And now the rest of the world is being forced to experience this too.
I imagine everyone’s mental experience of this pandemic differs based on their mental health history (among other factors). But it’s fair to say that right now most, if not all, of us are experiencing some form of mental discomfort.
On the surface, those who live with mental illness appear to be most vulnerable to this. But, this demographic may not be as at risk as we think.
As someone who lives with a severe mental illness but is currently relatively asymptomatic, I feel surprisingly resilient…for now.
Having previously lived through the rock-solid horror of psychosis, the inevitable Covid anxiety that flits through my brain now feels relatively easy to manage. I have an arsenal of finely honed tools to combat it. All that Cognitive Behavioural Therapy, the Acceptance and Commitment Therapy, and individual sessions with my psychologist are coming in handy.
I am also familiar with having my freedom restricted at times. When I am on fifteen-minute observations in hospital, I can’t go outside. At my sickest I have been too unwell for visitors. It doesn’t mean I like it, but I have at least previously encountered similar conditions to the ones I am living with now.
But what about everyone else?
Many people had been living with mild to moderate undiagnosed or poorly managed anxiety and/or depression for several months or years before Covid hit. I am particularly concerned for this group.
They don’t have solid medical and social support systems in place yet. The all-encompassing Covid generated stress is the perfect trigger for worsening symptoms. And accessing good mental health care quickly and efficiently may become even harder than it usually is.
Depression and anxiety symptoms can make the sufferer feel isolated even if they are closely surrounded by loved ones. Social distancing – so essential to manage virus transmission – will exacerbate symptoms of mental ill health in this group.
Then there are the people who have never lived with mental ill health.
They may never have experienced racing thoughts, heart palpitations, chest pain, irritability, distractibility, gastrointestinal signs such as nausea, vomiting and diarrhoea due to anxiety, a low mood, insomnia, incessant worry, or any other mental and physical symptoms that can arise due to stress and/or mental ill health.
These people may not know why they are experiencing symptoms or have the psychological skills to put them in perspective. So, they will suffer more than they need to.
But there is good news in the quagmire of black headlines we are sucked into daily.
We can use our own mental health histories to help ourselves and others in this crisis.
If you live with mental illness and are currently symptomatic, your sole focus must be to do what you can to get well. I know from my experience I am of no help to anyone if I am symptomatic. It’s a cliché but one that applies here:
‘Put your own oxygen mask on before you help anyone else with theirs’.
Firstly, contact the medical professionals you would usually consult when you are symptomatic – whether that’s your psychiatrist, psychologist, GP, community health workers, or psychiatric hospital.
Limit your exposure to the news to once a day – if that. If you have family or friends who can reliably update you on the essential news only, do that. Immersing yourself in the details, is of no practical value, and it can make you feel worse.
Use the same tools you would usually use to distract yourself when you are living through an episode of illness. Eat regularly and well. Don’t consume alcohol or recreational drugs. And move your body in some way, even if it’s small, every single day.
If you live with mental illness and are currently asymptomatic be vigilant but not obsessed. Just because this time is stressful, doesn’t mean developing an episode of illness is inevitable.
Your oxygen mask will consist of continuing to take medication (if you take it), keeping your regular appointments with your psychologist, psychiatrist or GP where possible, eating regularly and well, exercising most days, avoiding or minimising alcohol consumption, and practising whatever psychological skills (for example Cognitive Behavioural Therapy) that you have learnt over the course of your illness.
Be aware of any news developments that have practical ramifications for you, but don’t marinate in the news. Once you have done all this and whatever else you need to stay well – consider this:
You can offer support to those who are struggling mentally, those who have never experienced symptoms of mental ill health. Reassurance that their symptoms are survivable with the right care, could mean a lot to someone who is new to these issues.
That said – only do this if you have the mental energy to spare – otherwise just look after yourself.
To those who sense they may have been living with anxiety or depression for a while and it is worsening: All the suggestions with regards to eating well and exercise apply. Don’t self-medicate with alcohol or other recreational drugs. It will make things worse. Getting the right help is also crucial.
I am acutely aware that accessing good mental health care is a challenge in this country even when we are not mid crisis, but some excellent online resources to start with are: Lifeline, Beyond Blue, and SANE (Links at the bottom of this post)
To all the people who have never lived with mental illness: Distraction, exercise, eating well, and maintaining social connections via technology are a good start. Don’t self medicate with alcohol or recreational drugs. If you are still experiencing symptoms related to anxiety or depression (as listed above) then the online resources at the bottom of this post may be useful, or make an appointment with your GP as a starting point.
And one more thing…
Once you have done what you need to help yourself – take stock of how this situation is making you feel. And then imagine feeling like this for much longer periods of time than this pandemic will last.
Imagine feeling like this but the pandemic didn’t exist and people around you made you feel as though your symptoms weren’t real.
Then translate your feelings into compassion. And when you feel like yourself again (and you will), extend some sympathy and support to those whose mental illness lasts a lifetime.
And to everyone: We can use our individual experiences of mental health and ill health to support each other through this strange new world and into a kinder future.
So look at who you are sharing your living space with at the moment and consider starting a conversation about where on the spectrum of mental health and illness you and your housemates or family sit. Then think about how you could help each other psychologically.
My own household is one of extremes (regarding the adults). I live with severe mental illness, currently asymptomatic. My husband has never experienced mental illness.
So, when he expressed frustration a couple of days ago about his attention span feeling like that of a gold fish, I said:
‘Yes, I know it sucks feeling like that. But it will be ok.’
And I gave him a hug – something which I believe (at the time of writing) is still acceptable and safe to do in a household in which no one is symptomatic or has returned a positive Covid test.
This post is based only on my own experience and anecdotal evidence.
For professional mental health advice please contact your psychiatrist, GP, or for more mental health and ill health information check out the following links, all three of which are currently set up to deal with questions about Covid related mental health issues:
I am in hospital, compromised by my standard symptoms that precede a manic or depressive episode. Looking more manic at this point though. The three symptoms are: lack of concentration, loss of short term memory, and pathological irritability.
If you have never been ravaged by them, then listing these symptoms can make it sound as though I am just a bit ditzy and cranky.
It’s going to take it out of me but let me see if I can paint a more accurate portrait of this beast. I am not yet so sick that it has silenced me.
The memory loss and lack of concentration leave my brain moth eaten. Holding onto thoughts long enough to articulate them takes a lot of effort. It is like using tweezers to try and catch tiny fish darting around in a big aquarium.
And the irritability? Surely as a rational, compassionate human being I should not feel so permanently unreasonable. I always insert the word ‘pathological’ in front of this symptom to try and describe just how out of control the stream of swear words is that run through my head when I am surrounded by people within ten metres of my personal space.
I say ‘pathological’ to describe the feeling of having hundreds of mosquito bites, my hands tied, and someone running a feather over the bites while they make fun of me. Sometimes it feels more like I’ve been sandpapered and then doused in lemon juice.
It is excruciating.
I will eventually get better. I always do. I know in time I will have the reserves to write properly again, and I will eventually go home and continue to rehabilitate. But for now, any spare energy is going towards doing what I need to do to get well, and if anything is left over it is going towards giving some moral support to my husband and children. So there may be some time between posts.
I always hope it won’t be too long but have been here often enough to know that it will take the time it takes and focusing on it won’t speed my recovery.
Most would agree that even just seeing the billowing smoke, the hellish glow, buckled tin roofs, smouldering ash, the ghostly silhouettes of dead animals lining the roads into obliterated small towns, even when viewed from the safe parts of the country and the globe, even when the horror is confined to a steady scroll behind a screen, is overwhelming. The helplessness bruises our emotions. We can be forgiven for making a donation, posting something derogatory about our inept prime minister and then switching off our screens for a bit.
For the fire fighters, the people in masks in boats under those bloodied skies there can be no thought other than surviving one hour or minute to the next. The same goes for the emergency services, the army personnel, those with loved ones in the danger zones, those who have lost loved ones.
But what about the rest of us. Yes, we can donate to the Red Cross or Celeste Barber or any of the other funds set up to try and help deal with this unprecedented crisis. We can go shopping and buy things on a list that are needed by the emergency services.
I liken comparing myself to others to a landscape of skin. In some areas that skin is as thick as a crocodile’s. Very little penetrates it. Take social media. I came to it old enough to have a solid sense of myself. My self-esteem and body image didn’t grow up in the glare of Instagram. FOMO generated by someone else’s curated holiday/body/green smoothie/adorable family snaps is foreign to me.
Other tracts of skin are a little thinner but still not easily breached, a bit like a callused heel. My career path and choices have held few twinges of comparison. Maybe in the early years of my veterinary career I did some comparing. But that was part of the trek of working out what sort of vet I wanted to be.
Writing and advocacy work have only evolved in the last few years, and I view other people’s work in these areas as something to either aspire to or steer away from. Yes, it’s comparison, but a cool, dispassionate kind.
Then there are the areas of soft skin, vulnerable, but hidden away too deeply to be strip searched by comparisons. My relationship with my husband fits here, I couldn’t compare us to anyone else, because what we have is as unique as a fingerprint.
Then there’s skin ripped open at unnatural angles.
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.