John Taylor, IFoA President, shares his story about the importance of mental health awareness.
“I’m the great and powerful Wizard of Oz,” says the wizard just as the curtain is drawn back to expose a very different truth. I’ve never considered myself the great and powerful president, but I am drawing back the curtain to reveal my truth.
Poor mental health has affected me for much of my adult life. Until now, I’ve only told a small number of close friends and family.
The current pandemic crisis means that talking about mental health has rarely been so important, but a sense of stigma can make that difficult. By being more open now, I’m hoping to follow others who have shared their own stories and helped to diminish that stigma. It’s not that my story is so extraordinary that it will single-handedly shatter the stigma. Nor will it become a celebrated case study in The Annual Review of Psychology. It’s actually pretty ordinary and, I suspect, all too common. I hope the ordinariness enables more people to connect it.
Struggling with mental health is difficult. Often, there’s a potent cocktail: a situation that’s triggering the stress; psychological scars that may be re-opening; an excessive emotional response. Managing these can be hard even when you’re seeing clearly but, in the midst of it, the sufferer’s perspective is rarely reliable.
All of that sounds hard enough, doesn’t it? Well, let’s add a further ingredient to the cocktail: the stigma. The sufferer now believes their state of mind is shameful, that they shouldn’t reveal it to anyone, that it’s a guilty, dirty secret to be guarded at all costs. And, so, someone very much in need of help won’t ask for it.
I’m now revealing secrets, some that I had once considered shameful. But as I type away, this feels like a very private act and I’m questioning how open to be, how much to share and in what detail? I could simply say that I’ve suffered and leave it at that. I could follow others who have “let it all hang out”. Indeed, some have let so much hang out that not only was I convinced that there was no more to hang out, but I couldn’t quite believe it had all fitted in the first place. I guess that was part of the problem; it couldn’t actually be contained.
Well, I’m going to let a lot hang out, enough to make a small dent in the stigma, enough to allow some to connect with the details. But I’m going to keep some things private, though, partly out of respect for others in the story, partly because the stigma still has some power over me.
Looking back, I realise my mental health story goes back several decades. Some of what I considered “dark moods” whilst at university was almost certainly mild depression. I’d occasionally have spells of feeling down and alone where I’d avoid social contact. Most often, these moods came without any obvious cause; Churchill’s “black dog” would just wander across my path. I was fortunate not to have serious symptoms, such as self-harm or substance addiction, but it meant I had no obvious way of knowing I should seek help.
Sometimes, there was just a desire to stay in bed for the day, or to skip a party. Despite these temptations, I had a sense that this could be a slippery slope to far more serious despair. So, avoidance became part of the game: I’d channel that anxiety into what felt like an enormous effort to keep going. But it seemed a precarious existence: if I couldn’t keep going, that chasm of despair was ready to pull me in.
As a young adult, I tried to make sense of this experience, inventing some “stories” for myself. Most frequently, I’d tell myself that everyone suffers like this and we each need to “get on with it”. I’d sometimes tell myself that, because I hadn’t suffered any unusual hardship or trauma in my life, I wasn’t allowed to feel down.
These interpretations didn’t encourage me to seek help. The likelihood that I was being self-indulgent, or in some other way “bad”, meant that shame became part of the mix.
When I started work, my career went well in conventional terms. I was passing professional exams and getting promoted. But there was also periodic despair. The stark contrast between the bright career and dark moods made the self-examination even more eviscerating. There was nothing in my environment that would account for these moods; the explanation must lie within. I came to suspect there was something really wrong with me. Even though I didn’t know what this was, I had a sense that it would be too painful to confront. So, I’d keep myself occupied through work, socialising and sport as a way to avoid that confrontation.
What I couldn’t disregard was an unhealthy sleep pattern. At that stage in my life, I was often waking in the middle of the night with a feeling of panic. I still remember the experience of waking as akin to swimming up from the depths, racing to the surface for fear of drowning. I’d lie awake with my heart pounding, unable to get back to sleep. When morning came, I would force myself out of bed despite the fatigue. Adrenalin would see me through the day. I was often exhausted by the evening, so sleep came easily. However, I’d wake early again and the cycle would repeat.
It was this that made me realise that I needed professional help. Years of depression and anxiety had built to what seemed like a pivotal moment, where I’d finally seek professional help. So, I was somewhat bewildered when I emerged with a prescription for anti-depressants after only a few minutes in front of a GP. It was that easy.
There followed several years taking medication. I struggle to recall whether my mental health improved during those years. I have heard some say that medication improved their mood, others that it made them feel numb and yet others that it made them feel worse. I’m not sure I experienced any discernible change in mood or sleep pattern but I think I took some comfort from the fact that I was taking some action.
Periodically, I would try some form of therapy, from cognitive behavioural therapy (CBT) to psychotherapy. This seemed to help on occasion, and it certainly helped me begin to explore those negative feelings that I’d previously been so keen to avoid. I realised that what often kept me awake was known as “catastrophising”. This is when you start with one bad event and then imagine a series of worst-case consequences.
For instance, I might start by worrying about a bad meeting at work. From there, I’d fear that this would lead to the sack. That sacking could mean I’d never work again. Ultimately, I’d be unable to pay the mortgage and I’d be homeless. And all this would happen from one bad meeting! As I write this down, it makes me laugh and cringe at the same time. It seems absurd. Yet, all those years ago, staring at the ceiling in the middle of the night, such scenarios seemed alarmingly plausible.
One of the most helpful pieces of advice I’ve come across about managing anxiety is to avoid confusing the possible with the probable. In this case, losing my job was a possibility but certainly not a probability. As an actuary, I make professional judgements about probability all the time, but I was struggling to apply the same objectivity in my personal life.
As I worked with a therapist on my catastrophising, I began to realise that a lack of self-esteem was a fundamental contributor. It was a belief in my own inadequacy that made these catastrophes seem plausible. This new awareness of what my mind was doing to itself helped me get some perspective and tempered the catastrophising.
Having poor self-esteem is not much fun. But it often comes with a compensation: a powerful desire to prove yourself. It drove me on to climb the career ladder, in the hope that each successive rung would deliver that elusive proof that I was ok. And each step did provide a temporary balm, but it was never long before the return of the gnawing insecurity.
Things carried on like this for a few years until I met my wife to be. Whilst the excitement and joy of having this person in my life improved my mood significantly and made me more optimistic, it created a new stress for me. Could I invite this person into my life without sharing my shameful mental health secret? But what if the revelation causes her to reconsider our relationship when she saw the real me?
After some soul-searching, I decided that I had a responsibility to tell her what she was taking on. With a great deal of trepidation, I braced myself to tell the first real person about my sordid secret, half-expecting that could be the end of our relationship. But no. Although surprised, she was immediately supportive and keen to understand more. Rather than pushing us apart, this discussion actually brought us closer.
We got married and, within a year, we had a child. Despite our new-born daughter hardly helping my sleep pattern, my mood improved significantly. The simple joys of first smiles, steps and words were irresistible. I also felt I had a responsibility to my daughter and was invested in the future. This was a turning point for me.
(I know that starting a family can make things worse for some people, not least those affected by post-natal depression. So, I’m not claiming this will make your life better. Indeed, I’m not trying to advocate any particular course of action. I’m just sharing my story, what worked for me and what didn’t. Each of us is unique and we have to find our own way through.)
This improvement was not a miraculous, instant cure. The same troubling thoughts and self-doubt were still there, just not as acute. The improvement seemed enough for me to stop taking medication. And so, just as quickly as I had started, I stopped taking the pills. Stopping quickly was A mistake. Within a small number of days, physical and mental withdrawal symptoms meant I had to resume the medication. Under doctor’s guidance a second time, I made a more gradual attempt at weaning myself off. After several months, I had done it! I was triumphant at being off the medication and in pretty good mental health.
It seemed plain sailing for a while until a relatively small challenge at work triggered a lot of the old feelings. I didn’t want to start medicating again after my hard-won efforts to stop. So, I decided to engage with counselling in a more committed manner.
Counselling is most effective when there’s a good relationship between client and counsellor. That means it can take several attempts to find a counsellor who’s effective for you. Thanks to a referral, I was lucky enough this time to find a wonderful counsellor whom I felt understood me. She practices a form of psychotherapy that involves exploring the origins of feelings, with a view to better understanding and adapting to them. I quickly felt better because someone understood my issues, and I was addressing them. That got me through that initial crisis.
All of this took place over ten years ago. Since then, I’ve maintained a regular relationship with the same counsellor. I don’t consider myself to have significant mental health issues nowadays but the understanding I continue to gain about myself feels very valuable. Importantly, it helps me better understand the goals that matter to me; they’re no longer about proving myself to others.
Counselling has also helped with low self-esteem and catastrophising. I generally think I’m “ok” these days and not on the brink of disaster. Like everyone, I still have my moments. Those might be caused by an objectively difficult circumstance or, alternatively, when some old perspectives are triggered. A combination of counselling and taking regular exercise helps to keep things manageable. I even talk to other people too!
My hand was forced that first time by the prospect of marriage. The second time, serendipity played a part. I went with a close friend to see a play, where two performers re-enacted their own mental health story. After a standing ovation, they exhorted the audience to talk more about mental health issues. Doing so with my friend afterwards, I felt increasingly uncomfortable in not acknowledging my own issues. How could I discuss the play’s central message of opening up about mental health with one of my best friends and not open up even just a little bit? So, I confessed! To having taken medication, to seeing a counsellor. And, again, nothing terrible happened.
Ever since that second experience of disclosing, I’ve not had to wait for marriage or a play to talk about mental health. I’ve been increasingly open with my close circle of friends.
Most have been surprised by my revelation, trying to reconcile it with what they see as a “calm and collected”, “self-assured” demeanour. I realised I’d been pretty successful in suppressing that inner anxiety. But the consequence of that suppression strategy was all those issues I mentioned previously. Counselling has given me a better strategy, where I face up to the anxiety, try to understand it and change the way I think about it. Thanks to all that effort, I even feel “calm and collected” on the inside, some of the time at least!
So, after long years of secrecy, my experience of talking has been universally positive, for me and for others. So much so, that I’m now doing something that would have horrified me previously, sharing this experience with a much wider audience.
For those suffering, I hope this gives you comfort that many others suffer. If you have yet to talk about your own suffering or seek help, please think about doing so – my own experience of opening up has been exclusively positive despite my fears to the contrary.
If you are lucky enough not to be a sufferer (at the moment), be aware that 25% of people experience a mental health problem in a typical year, and 2020 is far from typical. There are many sufferers around you, even some you wouldn’t expect.
I’m going to leave the last word to another wizard, a literary one. At these very trying times for mental health, we could do worse than be guided by Kurt Vonnegut’s summation of the meaning of life: “We’re here to help each other get through this thing, whatever it is.”