To say that it was strange to be a patient on a psych ward at a time when I worked as a nurse on a psych ward would be an understatement.
I was 27 when major depressive disorder first came knocking at my door. After an initial period of denial, I was able to tick off the diagnostic boxes in my head and recognize that yes, what I was experiencing was depression. I had the low mood, inability to enjoy anything, hopelessness, and poor sleep and appetite that tend to characterize depression. Being a nurse kind of got in my way, as I got hooked on the idea that because I took care of people with depression at work, I should be able to handle my own depression. That didn’t work out so well; I ended up attempting suicide and spent a couple of days in hospital on a medical unit. The last thing I wanted was to be admitted to psychiatry, especially since I was at the same hospital where I worked, so I (mis)used my insider knowledge to say exactly the right (wrong) things to the consulting psychiatrist to avoid getting diagnosed with depression and admitted to psych.
Not surprisingly, without treatment I just got sicker and sicker.
A couple of months later, I attempted suicide again. By that point I was far too ill to pretend anything and I was admitted to psych. I have no memories at all of my first 3 weeks in hospital, but I’m told the reason I got transferred to the psychiatric ICU was that I repeatedly tried to take my life while on a regular inpatient unit. In total, I spent two months in hospital and was still fairly unwell when I was discharged.
Eventually I did get well, though, and then it was time to go back to work.
I live in B.C., which has some very regressive, stigmatizing health professions legislation, which requires that hospitals notify the appropriate regulatory body any time a health professional is admitted specifically for mental illness. Before returning to work, there were a lot of hoops to jump through with the nursing regulator to get my license back, and there were conditions attached such as requiring me to see my psychiatrist regularly, take medications, and so on. These conditions had to be shared with my employer so if I had any hopes of keeping my gossipy manager in the dark, those were quickly put to rest.
Since privacy was not an option, I decided I might as well go to the other end of the spectrum and be radically open. The support that I got from my colleagues and friends was really helpful in coping with the stigmatized treatment I received from my manager, including watching over everything I did like a hawk and hauling me into meetings every day to tell me what she didn’t like about anything I did.
The first time I had a relapse of my depression, I got back on medications as soon as I noticed symptoms. However, I got very sick very quickly and ended up in hospital for another 2-month stay. Initially, everyone at work was very supportive. Then a year later I had a suicide attempt and everything changed. When my doctor eventually cleared me to return to work and I had all my ducks in a row, I was informed that I couldn’t go back yet. No one would tell me why, but I later learned that it was my manager putting up a fight against me returning. I had tried to kill myself, and that threw me solidly into the territory of the stereotypes of dangerousness and unpredictability that too often get attached to mental illness. Even when I did get back to work, I was clearly painted with a black mark. My other supervisor refused to talk to me or even make eye contact.
It’s disappointing and frustrating to see these kinds of attitudes within the field of mental health care.
When I moved from working in hospital to a community mental health team, I decided to start sharing certain bits of my story with carefully selected clients when there was a clear therapeutic objective I was aiming for. While self-disclosure is mostly frowned upon in health care, I quickly discovered that self-disclosure was an extremely powerful therapeutic tool.
The most memorable instance of self-disclosure was the one and only time I disclosed my history of suicidality to a patient. A breakup with her ex had triggered an episode of depression and a suicide attempt, and the ex was trying to use that as an excuse to keep their kids away from her. After she got out of hospital, she refused to talk about any ongoing suicidality as she was worried about losing access to her kids. I took a gamble that disclosing my own suicide attempts would get her talking, and it worked. It was like a key that opened the gates to her inner world. Our shared experience made me a safe person for her to open up to, and that put me in a far better position to assess her mental status and risk level.
The timing wasn’t great when I started grad school. I was six weeks into my online Master of Psychiatric Nursing program when I was hospitalized for the 3rd time. Luckily it was only a 3-week stay and my professors were pretty forgiving. I participated as much as I could using my smartphone while I was in hospital.
As it came time to decide on a thesis topic, I had an idea that was interesting, but not groundbreaking. I wrote up a proposal and sent it in to a professor who had experience with that type of research, and asked if he would be my thesis supervisor. He never got back to me, which turned out to be the best thing that could have happened.
While I was waiting to hear back, I stumbled across a research method called autoethnography. It’s rooted in sociology and uses the researcher’s subjective experiences to gain broader cultural insights. I knew immediately that this was it – a way to tell my story of being a nurse with a mental illness. I was excited, but unsure if I would get faculty support. As it turned out, I had no problems at all bringing together a thesis committee that got behind me 110%.
I was really proud of the thesis I put together but I was nervous when it came time to do my oral thesis defense. I had to stand up in front of my committee members, the Dean of the faculty and various faculty members, and talk about some of the most difficult times of my life. I was blown away by the positive reaction I got. Afterwards, the Dean congratulated me and encouraged me to pursue an academic career.
It was rather striking that academia was so much more accepting of my illness than the world of mental health care. I even had two papers based on my thesis work accepted for publication in academic nursing journals, which typically aren’t keen on the subjective style of autoethnography. Who would have thought that my story would be acceptable to journal editors and peer reviewers, while my presence in a mental health care workplace was considered so unpalatable?
Over the last few years, my illness has progressed to a point that I have continuous symptoms and I’m not able to work much. The pattern of unsupportive workplaces continues, and my illness leaves me with very little wiggle room when it comes to handling stress. The hit to my identity as a nurse, as well as my functional ability to hold down a full-time job, could have been devastating, but I found a new way to inject meaning and purpose into my life – through writing.
I knew nothing about blogging when I started in 2017. I don’t even remember how the idea popped into my head, but I was looking for a productive way to pass the time and blogging seemed worth a try. I discovered a whole community of people living with and talking about mental illness. Aside from the times I’d been hospitalized, this was my first chance to interact with a community of peers. I had no idea something like this existed.
Moving into online advocacy has given me a way to share my voice, story and professional knowledge in ways that I wouldn’t have imagined were possible in the early years of my illness. Seeing other bloggers self-publish books gave me the inspiration and confidence to forge ahead with my own. I’ve now self-published three books, all of which are written from the dual perspective of health professional and person living with mental illness. I’m taking the knowledge and skills from my education and professional experience and using them to raise awareness about mental illness and help others to better manage their mental health.
I don’t know what the future will hold in terms of my work as a nurse. What I do know, though, is that I can function far better on my laptop than I can in any workplace, and nothing is going to stop me from continuing to use my voice online to promote mental health awareness and challenge stigma. This is my way to thrive, and while I have that, I am unsinkable.