Mental Illness in the Workplace

It’s exhausting to care so deeply for others, to give so much of yourself day in and day out, and to constantly put yourself into the shoes of the suffering so that you can truly empathize with their experience.  This is what I do as an occupational therapist.  I work with children and their families who are experiencing new and often life-changing injuries or illnesses.  My basic role is to help teach the child and family how to function in their everyday life with a new disability.  For example, I may help the child gain back skills to be able to take a shower and get dressed, teach the child’s caregiver how to safely assist them on and off the toilet, and teach adaptive strategies or technology to be able to participate in enjoyable play or leisure activities.  But for me, this only scrapes the surface of what an occupational therapist in a rehabilitation setting brings to their patients.  In order to teach parents/caregivers new skills, I need to gauge how ready they are to learn.  In the moment I was planning to teach a mother how to safely lift her child, she may have just gotten off the phone with the insurance company that is threatening significant financial burden; she may be grieving the loss of her husband who died in the car accident that resulted in her child’s brain injury; she may be worrying about how her other children are coping at home with much less “mom” time available to them; she may be worrying about an upcoming medical procedure her child will undergo that the doctor just reviewed with her.  No matter how I am feeling that day, I am searching for a constant state of empathy, to put myself in the shoes of my patient and his/her family in order to provide the best care possible.  I feel this is a critical part of my job, even though you may not read it in the bulleted list of job responsibilities for an occupational therapist.  I truly believe that if I am not able to effectively give this much of myself to the people I serve—compassionate care, unwavering emotional support, creative problem-solving, and determined advocacy, then I am not providing the care that these children and families deserve.  And on top of this, I want to bring a light to the child’s day anytime I can.  If this means I have to muster literally every ounce of energy I can to bring my charisma and silliness to a 10 out of 10 in order to get a laugh or a smile, I do it.

Sometimes I walk through my front door after work, and I can feel myself crumble into pieces.  I have nothing left to give.  I am physically and emotionally exhausted.  Caring deeply for others when you are struggling to care for yourself is still something I am trying to figure out.  Depression leaves me apathetic, exhausted, unmotivated, and uninterested.  Yet I get to work and I dig as deep as I can to access empathy and energetic enthusiasm for one patient after another after another.  Then I get home and the cup is even emptier than before.  I may eat something that’s quick but unhealthy for dinner, or skip it altogether.  I may skip exercising.  I may make little to no meaningful conversation with my husband.  I may snap at the dog more than I would like to.  I may fall asleep on the couch watching television, then end up going to bed before 8PM.  I may wake up the next day feeling even more exhausted and hopeless.  I may think to myself, how am I going to get through another day? I didn’t know the cup could be this empty.

Whether or not you struggle with your own mental illness, you have likely felt this to an extent with your work—especially if you work in a service field of some sort.  Healthcare workers are feeling this burnout more than ever amidst a global pandemic, yet continue to tirelessly show up for their patients.  While my day-to-day job in healthcare is not greatly affected by COVID-19, the added stress of the world as an overlay onto my mental illness is creating burnout like I’ve never experienced before.  I will readily admit that I do not have the answers.  All I have are the things I’ve learned along the way, while working in a caregiving profession through intense depression and anxiety episodes, sometimes lasting months at a time.  Here are some things that have helped me maintain as much work and life satisfaction as I can while managing my own mental health struggles; or things I am still grappling with that may spark a topic of reflection for you.

You are not perfect.  You cannot be a perfect employee.

I can’t speak to this without first admitting with full transparency that I struggle with this fact the most.  While I rationally understand that I cannot be at 100% every single day, I struggle to accept that from myself.  Because I am serving children and families during often traumatic times in their lives, it feels like a disservice to them if I am not operating at 100%, always.  This has caused me to historically call off work if depression or anxiety are symptomatic enough that I cannot get close to that 100%.  Here are some things I do to combat the belief that I need to be perfect, or near-perfect to effectively do my job.

• When I have done something less-than perfect at work, I talk about it.  I have learned that if I don’t talk to a trusted colleague about it, I will ruminate on the situation, and the shame will build.  If I feel I have made a mistake, I am working on acknowledging and apologizing.
• I continue to be mindful of my current thoughts and emotions, so that I can combat the thought-trap “I must be perfect.”  If I can catch myself walking toward the thought trap, I can avoid falling in.  I may simply tell myself No one is perfect, I am not and cannot be perfect and that is okay,  or I am doing my best and that’s all I can do.
• My ability to do my job is not black and white, not all or nothing.  If I am not feeling as energetic and enthusiastic with my patients as I’d like to be, this does not mean I am a terrible occupational therapist.  If I make a mistake at work, it does not mean I am failing at my job.  I am trying to keep dialectical thinking at the forefront by considering that even though I want to be a better OT tomorrow, I am still doing a good job today.

It is okay to make yourself a priority.

I used to feel intense guilt if I took a day off just to have a day off; or if I couldn’t work due to intense onset of depression or anxiety symptoms.  I am happy to say that this guilt is fading, as I have learned to recognize and prioritize my needs.  What I have realized is that time off of work is important for me to recharge.  I do two things to support my own mental health needs in balance with job attendance.  

• If I know there is a long stretch of time without a holiday or planned vacation time, I request a day off; or if I am starting to struggle, I look ahead to see if there is a day I can request off soon.  I do not take for granted that I work for a company that values provision of paid time off work, and that may not be everyone’s work situation.
• I make sure to keep an intermittent leave available by keeping up with necessary documentation to maintain an open FMLA status.  This ensures job security if I need to call off of work due to incapacity from my mental illness.

Give your co-workers grace. Give your managers grace. Give yourself grace.

We can hold each other accountable for our job responsibilities, while also giving each other and ourselves grace in the workplace. By accepting the idea that I am not perfect, I am also accepting that my colleagues are not perfect.

I hope this post has allowed you to reflect on the balance in your own life. Whether you are serving diners in a restaurant, serving employees as a manager, serving patients in a hospital, serving customers in a retail store, serving students as a teacher, serving communities as a government-worker or advocate, we must acknowledge that serving others is always hard, especially now. Take care of yourself so that you can take care of others. And if you have any tips to share, please use the comments below. Keep fighting, friends ❤