Sanity & The City, Part 3 - Relationships at Work
We asked a former patient to highlight their personal experience of mental health in the workplace as part of a new series of Priory blogs.
The post below is the third in a six-part series entitled ‘Sanity and the City’, and gives an honest and insightful look into their own experience of mental health at work:
Relationships at work are tough enough at the best of times. You’re squeezed into a building with hundreds of people you don’t really know and you’re expected to get along in the face of a series of increasingly inexplicable challenges. At least it seems that way to me.
I like to think I can get along with most people. When I’m well I have a dry sense of humour and a good sense of perspective on work, which I try and foster among those who work with me. I really enjoy the pastoral aspect of managing a team and developing people and their talents.
Socialising with work colleagues
But there is another side to it. I am very reluctant to attend social occasions outside of work hours, including the casual after work drinks or the enforced jollity of seasonal occasions. It’s not because I don’t like people, and I do make an effort but on the whole I’d rather not, thanks very much. I find the environment difficult together with heavy drinking colleagues. It’s over stimulating for me and I prefer one-to-one lunches to develop working relationships.
When my mood is low, I find it hard enough going into work at all, let alone making small talk in a pub playing awful music at an unpleasant volume. I know going to work is good for me. I know socialising is good for me. But I can’t find the energy, let alone the desire, to do both. If I am feeling on the verge of a dip, I stop drinking completely and avoid most situations where it’s an option.
Of course, this has an impact on relationships. One member of my team told me he assumed I was an alcoholic, while others have just assumed I didn’t like them and was just being polite during work hours. Actually I really like the people I work with. My wife recently remarked that I am quite sociable now, but that I didn’t used to like people. I told her it was me I didn’t like, not them.
When I am unwell this distance can become a gulf, but if someone sees I am suffering and offers a hand, I know I can rely on this person too much. They help me through the day and are happy to do so. But after a while, I know it is really hard on them and it doesn’t help our relationship one bit. For someone like me, asking for help has always been difficult. So when I’m better, I feel embarrassed and ashamed of having relied on someone else for support. Especially a colleague.
Asking and accepting help is not a sign of weakness
I have battled with this. I know and accept it’s not a sign of weakness to ask for and accept help. In fact, I know it’s really, really important. Especially when you have contemplated harming yourself. But I know these relationships have suffered when I have recovered. It’s hard to go back to where you were with someone after something like that. Bizarrely, it’s almost like a drunken fling. Neither of you is really comfortable talking about it.
The other side of bipolar disorder is not particularly helpful either and it’s probably best to avoid out of work socialising then too. I can drink like a fish then and I don’t need to sleep much so I can be the life and soul of the party and then carry on that way at work the next day.
Self-monitoring is important
In the workplace, I speed up and pretty much everyone is working in slow motion in my eyes. This can cause friction as you can imagine. I can become very irritable and get angry over the strangest things when I am hypomanic. I know it’s happening too, but at the same time, it makes perfect sense. That’s one of things that bothers me most. I can’t really trust my brain. That’s why close self-monitoring is so important all the time.
People just want to avoid you when you are like this and with good reason. It’s hard because I have seen it make life difficult for other people. I can switch off empathy at times like that and I hate it. This does lead to paranoia and I close myself off from all work relationships completely. I make myself emotionally unavailable. That’s when the balance is tipping from high to low and the descent begins.
On the plus side, when I am well, I think I am good fun to be around. Now I’m stable and more established in my recovery I am better at spotting the signs of distress in others and offering support. I work in an industry where heavy drinking seems to be the norm, so I can help people work through the consequences. I can handle difficult people and adjust when I need to.
Just don’t ask me out for a drink.
Tip of the month
This month I was quite run down. I take a steroid for low blood pressure and when I am ill I need to take more to compensate for the fact that my body won’t produce enough on its own. Unfortunately, this tipped me dangerously close to hypomania. I was turbo-charged, couldn’t sit still and quipped my way through the day, often inappropriately. When I got home, I realised I wasn’t feeling right. I felt hyper-caffeinated. I know this feeling well from taking high steroid doses in the past. I texted my boss to apologise and explain. I also made my team aware that I was out of sorts.
Being self-aware and monitoring my moods closely is important, but if I don’t take action it’s not really any good. So I stopped alcohol and caffeine, reduced unnecessary stimuli to calm myself down and used meditation and mindfulness to get back on an even keel. I was also aware that I had lowered my medication (under medical supervision) two months ago and had been feeling the consequences. I put it back up to where it had been. All of this got me back on track. In the past I wouldn’t have noticed or felt able to do anything about it. There are lots of apps to monitor mood now. They really help. The more feedback you can get from yourself and others, the better.
Expert advice on coping at work
Coping with highs and lows in bipolar disorder is never easy. The mood fluctuations not only have a significant impact on the person going through these phases but also on the family, friends and colleagues trying to support the person they care about.
The key starting point in recovery tools for bipolar disorder is lifestyle management with a view to reduce stress, promote good sleep, eat a balanced diet, take regular light exercise and generally live a healthy routine without excessive alcohol or drugs. Mood monitoring and awareness of when things are going wrong is the next appropriate step.
Access to an individual toolbox of techniques and having an agreed written plan to help cope with these difficult periods may help reduce the uncertainty of what to do when a person becomes aware that their mood is shifting. These are likely to be things that a person knows work best for them. It is helpful that all those close to the person including family, friends and professionals are aware of any early signs that all is not well and know what works best for the person in this situation.
Relationships with colleagues fall into a different area where mutual expectations in these situations are often uncomfortable. Though the majority of us care about people we work with and would like to be supportive, many are unsure how to do so. Simply being there to listen, making the person feel that you care about their wellbeing and helping them to utilise skills in their toolbox if they have shared those, is generally all that is needed.
It is not uncommon for a person to be left with feelings of guilt when they come out of a mood phase and have a period of reflection on the impact it had on them and those around them. The thoughts, emotions and behaviour of a person when going through a high or low phase are not representative of their usual personality and individual identity. Social interaction and support networks are a key part of the recovery process and it is important for these to be developed and maintained.
The temptation for isolation following the episode based on guilt alone needs to be overcome but it does not mean losing your assertive self and continuing with aspects of social life which are not helpful. If people around, including colleagues, know and understand what it is like for a person going through bipolar episodes, they are more likely to be supportive in the process. Sometimes it is little things that make a huge difference in the end.