Monday, April 11, 2016

Bark: The Invisible Monster

Apologies in advance if this post is rather incoherent. Even I don't exactly know where it's going to go at this point. In fact, all I really hope to achieve with this is to record (with at least some degree of accuracy) the maelstrom of thoughts churning through my brain at the moment, in the (perhaps vain) hope that it might provide some insight for the reader as to what it's like to experience what I'm going through at the moment.

Towards the end of November last year, I experienced an uncomfortable, yet familiar, realisation: I was clinically depressed. It hit me when I was delivering the assemblies in my school for Movember. For the uninitiated, Movember is a men's health charity that focusses on prostate and testicular cancer, and in the last year or two, it has raised awareness on the health risks of inactivity and mental health issues. I first got involved with Movember to honour the memory of a dear friend and one of the most inspiration people I have ever known - Caroline - who died of breast cancer in her mid-30s. Little did I know that my involvement with this charity would (eventually) provide me with the insight that has undoubtedly prevented me from descending into an unrecoverable spiral of depression.

Picture the scene: I'm stood in front of nearly 400 students and staff (I don't even recall which year group or House it was), passionately explaining why it's so important that men don't ignore warning signs about their own health, and what the warning signs are for the various cancers and common mental disorders in men. And while I'm talking, I realise that I'm on the verge of a panic attack - that I'm stressed and sweating buckets and all I want to do is GET OUT of that room. I realise that I'm the person I'm talking about who's not acting on very obvious indications that not all is well, chez Iain's brain...

So, after this epiphany, what do I do? Ignore it completely, of course... my job's far too important for me to be sick or take any time off. So on I plod, hoping it will go away, but it doesn't.

Denial has its uses, but never when it comes to health issues. I've suffered from depression before, but never like this. I'm dimly aware that something is badly wrong, as it feels like I'm a spectator to my own life, I'm so detatched from reality and the feedback from my own senses. This is a version of me that I'm not happy about being: a zombie version of myself that shambles from one day to the next, uninterested in anything, unable to cope with the rigours of modern day-to-day life, but similarly unable to ask for help - not because of the fear of losing face; but because I don't want to inconvenience anyone else because I can't fulfil my professional responsibilities.

I've become a spectator, or passenger, in my own life. I'm watching events taking place from the back of my own head, not feeling like I can influence anything. My days (weeks?) pass before my eyes in a stupefying fog, incoherent and hazy. It's life by tele-operation - remote, distant, lacking form and sensation. The only thing that tells me that I'm actually alive is the pressure of what feels like a small rhino sitting on my chest - anxiety building and building up to an inevitable breaking point. Even waking up in the morning becomes a chore. The things I used to enjoy - the small pleasures in life: a good meal, a kiss from your partner, watching TV, playing a game, or reading a book - they all become joyless and meaningless.

You're nearly 40 years old. You're a teacher - a responsible adult. You should be able to deal with this. You have an obligation to your students and your colleagues. You can't be sick - why should some poor Cover Supervisor have to pick up your Set 5s? Suck it up, for pity's sake... says the unhelpful voice in the back of my mind. It's one of the charming things about depression - yet one of the reasons I don't have any qualms about posting this publically. There's nothing anyone can say to me that I haven't already said to myself, only worse. You become your own troll - the nightmare heckler from Hell. You're being melodramatic. Pathetically self-indulgent. If there was anything really wrong with you, you'd be in hospital already. It's not like you've had your legs blown off by an IED or been paralysed by a car crash. For fuck's sake, Iain, just get a fucking grip, you worthless waste of carbon, you waste of life, you waste of oxygen... If you really feel that bad, find a nice tall bridge or building and get it over with. After all, you have all these dreams about jumping off tall places. Why not make it a reality? Dreams should come true, right? Find somewhere high enough and you won't have time to feel it when you hit the ground. 

This is one of the things that's so insidious about being mentally ill. It's invisible. From the outside, because we feel the need to keep up appearances of "being normal", we become our own worst critics and enemies - we feel like we're somehow putting it on, or malingering, or that we're not "properly ill", because it's not as obvious as a broken leg, say. So we blunder on, trying to act "normal", but instead repeating mistakes and modes of thinking that only reinforce our psychosis - and here we need to be careful about terminology, because as soon as a word with "psycho-" in it is mentioned, most people imagine Anthony Perkins cross-dressing as his mother, wielding a 30cm kitchen knife in a frenzy of murderous violence... not an entirely helpful image for wider understanding of mental health issues. A psychosis is an impairment of cognition where thoughts and emotions become separated from reality - for example, an impression that someone asking you questions is because they want to kidnap and murder you, rather than because they simply like you and would like to know you better and become friends.

So I ploughed on at work, "being normal" for another few weeks until I essentially had a meltdown and needed to be sent home after having a nightmare commute to work and a near panic attack in front of my tutor group. There's a world of difference between getting flustered (which is what most people would describe as having a moment of panic) and a panic attack. They are not a pleasant experience. A panic (or anxiety) attack is when the brain enters a state of hyper-arousal and produces an excess of fight-or-flight chemicals. Again, here we need to be careful about terminology - this isn't the kind of arousal that you get when you see your partner waiting for you on the bed naked, covered in maple syrup and giving you a come-hither look. No, this is the kind of arousal you get from being trapped in a locked iron cage with three hungry Bengal tigers... This is "if I don't get out of here I am going to die or I'm going to need to kill someone" arousal. Primal fear and anxiety, soaked in litres of adrenalin. Something that's okay for once in a lifetime stress situations (such as being trapped in a locked iron cage with three hungry Bengal tigers), but not great if you're experiencing it all day, every day for weeks and months on end. I was strung out, mentally and physically exhausted - not sleeping or eating properly - and essentially unable to function as a regular human being. Finally, in mid-December last year, I saw my GP and sought help - subsequently starting medication and therapy. In many ways, this was a little victory. It only took me a few months to recognise and acknowledge my depression, whereas the last time I had an episode like this, it took over a year for me to recognise and act upon it. And it's only in retrospect, after having researched my symptoms and having done a few months of CBT with a therapist that I've realised that this isn't a new phenomenon in my life. I've been through bouts of depression in my teens and early 20s that lasted months (maybe longer) without me even recognising them or seeking help. I've gone through periods of depression my entire life, and will undoutbedly continue to do so, since this isn't a disease you can "cure" with antibiotics. In many ways it would be easier if I'd had both legs taken off below the knee in a car accident. Get some prosthetics, go through the physical therapy to learn how to walk again, and lead a relatively normal life. Unfortunately, because it's my brain that's ill, I'm stuck with it - they haven't invented prosthetic brains as yet (more's the pity!). You need to retrain your brain how to think in ways that aren't likely to promote stress, depression and anxiety, that promote positive rather than negative thinking, and that's no easy thing to do, because thinking patterns and habits can be more addictive than drugs.

I think it might be worse for me because I'm a scientist. I have a degree in Physics with Space Science & Technology. I am not stupid. You can accuse me of many things, but stupidity is not one of them that will stick. You don't get morons with Physics degrees. But physicists and scientists are supposed to be rational, logical. And mental disorders are anything but. I suffer from Generalised Anxiety Disorder and Social Anxiety Disorder. These are, at heart, wildly irrational mental disorders.   

Leave your logic at the door, pilgrims, you won't be needing any of that in here...

I've never been comfortable in crowds or surrounded by people I don't know (as you might expect, I'm great fun at parties, lurking in a dark corner in the garden, hoping everyone will just stay away from me while I try and stave off an anxiety attack without the benefit of self-medicating with alcohol to dull my mental torment, as I'll inevitably be driving home), which might strike you as a little bit odd, considering in my profession I'm surrounded by 1800 people (the majority of which I don't know) for eight hours a day. What can I say? Contradiction is part of my nature. I am vast and empty and contain multitudes. You could call it a quantum superposition of cognitive dissonance: my own particular brand of aversion therapy. Face your fucking fears, dammit. Come on in. The water's lovely and the sharks are very friendly...

I'm not going to go into an analysis of my Generalised Anxiety Disorder because I believe in preserving a little mystery and also because it's arguably the lesser of my two problems (mentally speaking) at the moment. Social Anxiety Disorder is driven by the fear and anxiety of being judged or found inadequate by the people around you - also not a good thing for a teacher, given the invasive paranoia (which, in the teaching profession, we call being a "reflective practitioner" - that is, your best is never good enough) that permeates the profession from top to bottom like an inoperable cancer. At this point I'm not even really interested in where it came from (though given certain factors in my childhood, I've got a very good idea), because I'm not looking for someone or something to blame for me being like this. I might not be happy about it (and believe me, there are days where I absolutely hate myself for feeling like this, to the point where I can't even get out of bed because I can't face the idea of being this hollow, soulless version of me for another day), but I do have to accept that this is who, how and what I am right now so that I'm able to do something about it and heal. The CBT helps, but the problem in my job is being able to find or make the time to practice it, because it's quite time consuming if you want to do it properly (and there's honestly no point in trying to do it half-arsed) - and time is a premium commodity in the teaching profession. You never have enough of it. If there is anyone still out there who thinks teachers roll in at 9am and piss off home at 3.30pm, you really have no idea. I've been working 6-day 50-70 hour weeks for the last 6 years. And I could add at least another 10-20 hours per week to that and still not get everything done. And the government wonders why it has a teacher recruitment crisis... You're constantly under pressure from all directions, from students, parents, colleagues, senior management, Ofsted, politicians, being asked to achieve the impossible in terms of attaining unrealistic target grades with kids who can't string a sentence together in Year 11 because they're so weak, having their attainment linked to your pay (when you have no control over the classes you teach and no control over their expected grades), while simultaneously having to be a surrogate parent and role model for children who have been invariably been raised by TVs, games consoles and iPads, rather than their families... It's unreal. I worked for IBM as an IT Specialist for over 9 years - one of the biggest IT Services multinationals out there - and the scrutiny and work pressure you're put under as a teacher makes the workplace accountability you get in the private sector look trivial. The teaching profession is currently haemorraging staff at an unsustainable rate - simply because the changes being pushed through are ill-considered and ill-defined and will lead to an increased workload for an already overworked, underpaid and underappreciated workforce. In two years' time, expect the GCSE results to tank. Likewise with next year's A2 results. Pushing through simultaneous changes in both Key Stage 4 and Key Stage 5 was absolute madness. Even the exam boards and the course content providers can't keep up, since they're trying to do about four years' worth of work in less than two years. Another great job by the Conservative government, pushing through "reforms" that take the education system backwards by at least 30 years. All for the sake of making changes to look like they're improving things, whilst marginalising the voice of teaching professionals and parents - the very people on the front line who have the best view of how the changes are affecting outcomes for children. But hey, what the fuck do we know? We're not "expert" consultants on business-oriented Think Tanks who want to asset-strip and privatise education provision, or politicians who might have spent perhaps as much as an hour a month in an actual school...

Anyway, I digress... Today was my first day back at school following the Easter holidays and it started badly, without ever really improving. And it was a really petty, trivial trigger, but these are the things that set you off when you're in this kind of fugue state of irrational, disproportionate thinking. Part of my schtick as a teacher is that I like to accessorise. I have a full set of geeky ties, cufflinks and tie pins - and I didn't know where my tie pins were because they'd been "tidied" by my other half, and she hadn't told me that a) they'd been "tided" or b) where they'd been tided to. In the great scheme of things, it's not really a massive thing. But it was an unnecessary and avoidable stress I really didn't need. And I have to admit my own culpability here. Had I been more aware of the little details in my office, I would have seen that my tie pins weren't in their usual place sitting on top of the base of my desk lamp. But you don't notice that kind of thing when you're depressed - you expect things to be where you left them and flip out when they aren't (sorry, sweetie). So not the best start to the day, then. It also didn't help that the weather was awful on the drive in to work (fortunately redeemed by the power of Fleetwood Mac - you have to love Lindsey Buckingham, he really commits to his songs) nor that when I finally arrived, the IT team had rolled out an update that rendered all of the school's laptops unusable without a trip to the network centre for a LAN refresh, since the update had killed the ability of our laptops to log in to the wireless network. Not exactly an auspicious start to the term. One that wasn't helped by my first lesson being derailed by the site cleaning team having rearranged all the desks in my classroom and then I had to spend half the session chasing pieces of kit for my first lesson's practical since it hadn't been put back in the proper place following the lab being cleaned over the Easter holiday. It also didn't help that half of my Year 12s couldn't read a simple circuit diagram and assemble a series circuit that shouldn't trouble Year 7, so I spent the rest of the day trying to fend off an anxiety attack and sweating like a pig on a bonfire due to the side-effects of my medication, making me feel disgustingly unclean and even more like a zombie barely interested in the passing of the day.

And all the while, that unhelpful voice was still there, Trolly McTrollface, doing his trolly thing.

Really, Iain? You've just been on holiday for two weeks. You have no right to be depressed. What the fuck is wrong with you?

Thanks for that, brain. That's really helpful. Fortunately, I've been reading Ruby Wax's new book, A Mindfulness Guide for the Frazzled. Everyone needs to buy and read this book, if only for Chapter 4. As well as the frighteningly reassuring account of one of Ruby's depressive episodes in Chapter 4 (it's nice to know it's not just like that for you), she also goes into the science of how brain chemistry affects your responses to stressful stimuli, and also how we're evolved to think negatively and be constantly on guard for danger - how our bodies shut down systems to keep us on alert and reactive when we sense fear and anxiety around the corner. The first things to go are your appetite and libido. If your body and mind are convinced that there's a mortal threat around the corner (such as a hungry Bengal tiger, or perhaps an axe murderer), they become unnecessary luxuries (though sadly not a nice side effect if you want to maintain a healthy relationship with your partner). Another side effect of long-term stress is increased cortisol levels, which suppress the immune system and make you prone to picking up every bug you're exposed to - something which has happened to me regularly since the end of September last year, given that I'm surrounded by 1800 students and staff (or as I affectionately refer to them, disease vectors) every day - an unhealthy mind can literally lead to an unhealthy body - but as Ruby would say, mental illness is the same thing as physical illness - it's an illness in the brain, which after all, is just another organ system in the body, just like your heart, lungs, liver or kidneys.

The worst thing was, I knew it was coming. In the last three or four days of the holiday I'd spent a good 12 hours a day or more back in "The Pit", trying and failing to find mental equilibrium and calm before the new term. Saturday was a tipping point, when Fleur and I went to see our friends Ali and Candace for lunch at a pub in Frensham and halfway through, about thirty or forty people (mostly young families) descended on the pub in a massive group, packing the restaurant half of the pub that we were in. My Social Anxiety Disorder kicked in big style as I felt hemmed in on all sides and I had to suppress a fight-or-flight impulse for the rest of the time we were in the pub - which is not an easy thing when your senses are on overload and you've got forty people around you jabbering away at full volume and all your instincts are screaming at you GET OUT! GET THE FUCK OUT OF HERE! (so, yeah - I'm great at social occasions. I do cheap rates for bar mitzvahs and childrens' parties... very cheap...)

I almost feel back where I started in December, despite the medication. But at least I now know that I can't keep on going like this and have accepted that something has to change. I still feel that I need to fulfil my responsibilities to my classes taking exams this year, and to do that I need another month. Then I will take a view as to whether I need to see my GP again to get signed off - because in retrospect (oh, that wonderful 20:20 vision of hindsight), I definitely went back to work too early and picked up my full timetable too soon (that damned sense of pride in not wanting to let other people do your job). But I have made a long term decision. I can't stay in teaching and be healthy. They're mutually exclusive propositions regarding the amount of time and effort and the demands that doing a good job in this profession places on you. And if I can't do a good job, there's no point staying in teaching anyway. It's not a good deal for myself nor the students - you can't do this job unless you're totally 100% committed, and my illness means that's no longer a commitment I feel that I'm able to give.

So a new challenge presents itself: find a new career before the end of July. Easy, right?
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