August 2017 / Non-fiction & mental health / 7 mins (1800 words)
Imagine you’re in your car by yourself on a busy motorway. Just one of the tens of thousands of cars on that motorway.
You can guess what you’re up to better than me. Maybe you’re driving carefully or maybe you’re not. Maybe you’re flicking between radio stations or songs on your phone. Maybe you’re imagining what you really wanted to say in that argument or you’re thinking about something that happened last week or will happen next week. Maybe you’re cursing the weather or the traffic. Maybe you’re crying. Maybe you’re singing. Whatever you’re doing, it’s what you do when you’re on your journey alone in your car.
As you drive, a car cuts past you on the fast lane. For a moment you see the driver’s tense face, his white knuckles gripping the wheel and then – whoosh – he’s gone.
He’s late. He changes lanes impatiently. He’s driving as fast as he legally can, already thinking of what he needs to say and do in his upcoming home visit. He’s not watching the road as closely as he should.
It’s Thursday afternoon. As he drives he remembers things that he needs to do later or tomorrow or soon. He takes his eyes off the road to scribble them onto a makeshift to do list on the back of a petrol station receipt. He takes phone calls on his hands free kit. He’s busy.
He’s a child protection social worker which means he deals with children who have been abused and neglected. He is allocated to 30+ vulnerable children, some still at home, some in foster care, some in residential care, some homeless. It’s more work than he can ever get done, even with his eight years experience in the job. In fact it’s twice as much as he should really be allocated, but that’s just how it works in his social work team.
He’s in his mid-thirties, but feels years old. He’s tired. He didn’t sleep well last night. Kept thinking about how much he has to do. Kept thinking about the things that might go wrong for the children that he works with. He doesn’t want to let them down. This keeps him awake most of all. He hasn’t slept well for months. He used to be able to take everything in his stride. Lately he’s finding this harder and harder to do.
Suddenly, an intense feeling of dread and fear fills him. No particular thought caused it. Nothing happened on the road. The feeling hits him so hard that he can’t keep driving. He pulls over to the side of the motorway. Puts on his emergency lights. Sits in the car. Something’s wrong, but he doesn’t understand what. His hands shake. His heart beats fast beneath a terrible overwhelming sense of doom. He waits and hopes for it to pass.
It does pass. It only takes a few minutes as the cars flash past him for the dread to ebb away. He doesn’t understand what just happened. He hopes it’s a one off, but doesn’t fully believe that. A few weeks earlier he did a home visit to a difficult family with a colleague. He’s done visits like that hundreds of times, but that time he’d felt the same dread and terror as today. He’d struggled to walk up the driveway to the front door of the house. There was no one home. The feeling subsided, but his colleague had noticed. Asked him if he was alright. He lied. Said he was fine.
On the side of the motorway, he phones the foster family. Says that he’s sick and cancels the meeting and then cancels the meeting after it. He starts the engine, waits for an opening in the traffic then pulls out onto the motorway and drives home carefully. When he gets to his apartment, his housemate is out. He sits down at the kitchen table and cries. Cries inconsolably.
On Friday he goes straight into his boss’s room at the side of his open plan office. She’s looking through a case file and doesn’t look up, but she’s cheerful. It’s Friday after all. ‘How are you?’
His voice shakes and his lip quivers. ‘Not good.’
By the time she looks up, he’s started crying. He can’t stop himself. She closes the blinds on the office then moves her chair over to sit at his side. She waits for him to calm a little then she asks him what’s upsetting him. As he explains she tells him she knew deep down something was wrong.
Together they identify his paperwork backlog as one of the biggest stressors. He’s prioritises the urgent needs of the children he works with, but this means that he has months, and years in some cases, of casenotes to type up onto the computer system. Each day he gets further and further behind and any attempts he has to made to catch up always fail due to crises on cases.Now his boss takes charge. She has managed him for 7 years and he respects and trusts her. She tells him that he won’t be doing any work on his cases all next week and that he’s to cancel all scheduled meetings. She’ll cover anything arising on his cases for him. From Monday to Friday all he’ll do is type up casenotes. They agree to schedule other paperwork days or weeks in the near future until he gets back on top of it all. He leaves the office hopeful for the first time in a long time.
Day 3 & 4
On Saturday and Sunday he sleeps well enough, stays optimistic. There’s a plan in place. That’s it. He’s going to get over this. He’s taken home some of the case notes that he has to write up, but he’s shattered and doesn’t do them. Besides he knows he has a week to get through them.
Days 5 to 8
On Monday he starts working on his paperwork, but by the end of the day he’s a little worried. He has caught up on less than he expected and he’s finding it hard to focus. As the week progresses the magnitude of the task becomes disabling.
On Friday his worry has turned to panic. He has barely made any progress. Getting nowhere. He knows that on the coming Monday he’s going back to work with clients and the thought of everything he needs to do feels overwhelming. That night he’s feeling flat, but goes out to a gig with a friend. It helps him focus a little and calm down.
On Saturday morning he wakes up in hell. Utterly overwhelmed with dread and worry. When he does get out of bed, he can barely lift his head and look up. His housemate is a friend who has known him since childhood. He takes him out to the park with hurls and a sliotar to cheer him up. They regularly do this, but today he misses every pass. Just trudges to pick the ball up without looking up.
He abruptly stops playing and sits down on a bench. His friend joins him and asks if he’s ok. He starts crying. He can barely talk. His friend can’t calm him and realises that this is a crisis.
His friend drives him to his family home where his parents try to steady him, but can’t. He can’t sit still. Can’t calm his mind. The GP is phoned. He paces endlessly back and forth in the garden talking to the GP on the phone. Nothing the GP says helps to calm him. He feels that everything is going to go wrong. Can’t hold thoughts together to work out what is going to happen. Can’t keep his body still. Catastrophic thinking taking over. And a terrifying fear that this won’t ever stop.
That Saturday night, this man – who plays sports, plays music, has a large social circle, is always active and busy with an enthusiastic passion for life, and has devoted eight years to helping vulnerable children – has to be sedated by his GP and collapses into sleep on the couch in his parents’ sitting room. It’s more than just a breakdown really. It’s a crash.
Six years later
I meet with this man, a friend from my own years as a social worker, in a quiet corner of a hotel foyer. Over cups of tea, he speaks with me for more than two hours telling me the story of his breakdown and recovery. I am deeply grateful to him for letting me tell his story here.
He tells me that the Monday after he was sedated he still went back into work. He thought he could work through his issues. He soon found he couldn’t. With his boss’s support, he spent 6 months being office based and not doing front line work with children. Tried everything to sort himself out, every type of therapy and treatment he could find, but there was no simple solution to fix things.
All in all it took him two years to get his mental health largely back under control. He found the help he needed in his, now trusted, psychiatrist. He is still on medication and may well be for some time. But he’s ok with that. He feels he only fully recovered his mental health when he left child protection. He now works in a different, less chaotic and over-worked area of social work. He’s says that he feels ten years younger now and enthusiastic about life.
He’s back on the road again.
Why am I am telling his story here? Well, in some senses, this is the story of the failure of the child protection social work system in Ireland to protect and support its employees. This failure ultimately leads to the greater failure of the system to protect the children in the system who rely on their social workers to cope with the immense upheavals in their lives.
But in a general sense, this is a story for all of us. It shows us that not all mental health issues can be resolved by positive thinking or meditation or the day to day tools we use to get by (and have been discussed in my previous blog posts). Sometimes mental illness tears a life apart and it takes courage and perseverance to recover. And, despite all these efforts, some people never recover.
So as we all race along on the busy motorways of our lives, each trapped in our own worlds, we need to learn to take care of ourselves, because if we don’t then the next breakdown might be our own.