Employment with a mental illness

Does mental illness make someone a less competent worker? What’s precipitated this question is a comment I received on my previous post. It read:

“…if I had a family member recieving treatment from an OT, PT, any field, even teacher, and had a choice between someone with a history of mental illness and someone without, I would not hesitate to choose the person without. [...] I don’t want the people close to me receiving potentially less the the best. [….] I also think that anyone saying otherwise is not being fully honest with themselves…”

Everyone has different perspectives and it’s fair enough this particular commenter has been honest in sharing her viewpoint. Would I be willing to use the services of a professional who has a mental illness? Given their symptoms did not impact on how they performed the job, then yes I would. I see no reason why a person who has a mental illness can’t do as well as a person without. Especially as mental illness manifests in so many different ways. Whereas in one person it may affect their job to an extent where they cannot work, in another it may make a very insignificant impact on the job that they do. On placement I do everything that the other students do and my mental health issues do not influence the quality of my work. I have friends who are student health practitioners with mental health issues, including nurses, social work, psychology, medicine and I wouldn’t hesitate to use their services.

If someone was quite unwell though and it was impacting their work, that’s a different matter. If a person in the depths of a mental illness could not concentrate enough to provide me treatment, if their self care flew out the window, if their motivation decreased to a point where they weren’t completing their workload or turning up, then no, I wouldn’t use them. And as a health professional, one of the responsibilities that come with it is recognising when an illness, whether it be of a mental or physical nature, puts you and/or your client at risk. 

It comes as a sad reminder though that many people out in the big wide world may not be so understanding. This may include both employers or potential clients. They may say ‘no’ as soon as they hear the term ‘mental illness’. They may sack you after a period of being unwell. Just a couple of weeks ago, my uncle went back to work after one or two months as a patient in a psychiatric ward, only to find out he’s been fired. It’s a real shame that employment, especially as a health professional, is yet another barrier that may be faced by people with mental health issues, because of the prejudices that society hold. 

Jobless and Lazy

I don’t work. I did, many months ago before stopping. I am however a full time student for the seven or so months of the year that uni occurs. For me, that’s plenty enough to deal with. Compared to the people I know and have talked to though, it’s slack.

One of the drawbacks of appearing to cope as well as everyone else and keeping your struggles hidden is that you’re expected to function as well as everyone else too. Most of the people I know who are studying also have a part time job. As well as that, they also find time for extracurricular activities and socialising. How do they do that?!

I met up with a high school friend for lunch yesterday. I told her that I don’t do anything much during the break and answered “Not really,” when she asked me whether I was looking forward to returning to uni. “So lazy, WFH!” she jokingly teased me.

Prior to that, my OT supervisors at fieldwork asked me whether I had a job or not. I told them yes, I work in a pharmacy when in reality I ceased there early last year. I lied, embarrassed at how lazy I must seem if I told them the truth.

I feel like I should be doing more. Everybody else is. But then thinking about the amount of study I need to do, the amount of effort I need to put in to pass my units at uni already starts to send me into panic. And that’s without a job on the side or even much of a social life. Not to mention, both semesters last year left me playing catch up as a result of my two hospital admissions. Keeping a job at the same time would not have been manageable at all. Being able to pass uni is a big enough achievement for me. When I juxtapose that with what my friends are able to achieve though, it feels like nothing at all.

Visiting pharmacies

It seems as though more times than not, I will leave a pharmacy feeling a little irritated. It probably stems from my own self-consciousness in getting psychiatric medication dispensed. Having social anxiety, I fear being judged, and I can’t help worrying that the pharmacist or pharmacy assistant is judging me for taking an SSRI. Then there’s the fact that I was a pharmacy student and still work as a pharmacy assistant, so I get rather impatient when they treat me like an idiot.

My intention today, and every other day I attend a pharmacy, was to hand over my prescription, receive my box of medication, provide payment in return, and leave. Minimal conversation preferred. But no. The pharmacy was relatively quiet while I was being served, and thus the pharmacist decided he had time to ask some additional questions. “You been on these long?” he enquired. “Umm, not that long…a couple of months,” I said. “How are they going for you?” he proceeded to ask. “Umm. Okay,” I replied a little abruptly. I appreciate that he was just making some conversation, and he was a nice enough guy, if not a bit weird. But I also can’t help thinking, It’s none of your business! Just give me my pills without the unnecessary questions please!  Being asked how my medication is going is awkward at the best of times, asking while my mum was there accentuates the degree of awkwardness by ten. My mum and I never discuss my mental health issues, unless it’s to do with such practicalities as appointment times and fees.

Then there’s the assumption that I’m an idiot. Okay, there’s no way they’d know I’m a pharmacy assistant and an ex-pharmacy student, I’m aware of that. But I know the generic brand of sertraline you gave me is the equivalent of Zoloft. There is no need to add on with a pen to the printed dispensing label, Z-O-L-O-F-T.  It’s just frustrating to be treated in such a patronizing manner when I deal with generic medicines every day while I’m at work, packing at least eighty of those damn Webster-paks per eight hour work day.

Innocent & Naive, Yep That’s Me!

We are sitting in the lunch room at work, my Aunt, our workmate M and I. We’re conversing about workplace politics. According to my Aunt, because I try not to assume the worst in people, that makes me naive. M says,

It’s because she hasn’t experienced the shit in life yet.

I can’t quite grasp whether I feel more annoyed or amused. No appropriate response comes to mind. So I just laugh. Rather sarcastically, I might add.

I haven’t experienced shit? Really? I haven’t experienced shit?

Ahh, M, if only you knew.

It just keeps flying at me and never ceases to stop.

The Appointment with Psychiatrist No. 2

My mother drives along with me beside her in the passenger seat. We drive down a familiar road, it’s the one we used to get to my ex-psychologist’s office. I look out the window to the sparkling waters of the beach, nervous as I am, I am still able to appreciate its beauty. We drive further along, past the building in which G, my ex-psychologist, practices. In the ten months I have been out of therapy, we have not once had to pass it by. It is out of out way, a good twenty minute’s drive. It feels ridiculous that out of all days, today would be the one day, and out of all places, the route to the Specialist Center would require us to stumble upon this address. It brings back memories, and again, I wonder where I would be, had I continued on with her. Not on my way to my first appointment with a new psychiatrist, that’s for sure.  

It takes thirty minutes to arrive at the Specialist Center of a private hospital where I would meet my new psychiatrist. My mother drops me off and I walk in through the glass sliding doors. I notice the velvety red carpet, the soft, plush couches, the cafe in the corner, and I am reminded of a hotel lobby. The only indications of it being otherwise are the wheelchairs, the words on the doors and walls and the quietness that surrounds me. I read the directions on the letter from the secretary, I follow the signs and locate Room 6. I note Dr T’s name listed on a gold metal plaque, along with the name of three others, and I know I’m at the right one. A sip of water, a deep breath, and I push the door open. I am greeted by a receptionist in a small waiting room.

I announce to her I am here to see Dr T. ‘Ooh, you’re a bit late,’ she says. Am I? I glance at my watch. It’s 2:50pm. My appointment is scheduled at three, I was told to arrive ten minutes early to fill in the forms. ‘She might not see you today.’ My heart jumps to my throat. All this preparation, a two month wait, for…nothing? ‘You’re forty minutes late,’ she tells me. How could this be? I couldn’t possibly have mixed up the times, could I? ’But my appointment’s at three,’ I protested. She checks her appointment book again. ‘Oh sorry!’ she exclaims. She laughs, I put my hand on my chest, laugh too and breathe a sigh of relief. ‘I haven’t made you cry have I?’ Made me cry? No. It would’ve stressed me out, definitely, but not make me cry. I am made out of slightly tougher stuff than that. She hands me the forms, I fill them in. She asks for my referral letter. The thought of not surrendering it to her crosses my mind, but instead I hand it over without objection. Perhaps it is standard practice for the receptionist to be privy to your issues after all.

I take a seat in the waiting room, and I am struck by how small it is. I am the only one there, along with the receptionist. This is different to the P C Medical Suites, where I saw my last psychiatrist. Over there, there were at least two receptionists, a few psychiatrists and always more than one patient waiting to be seen.

A few minutes pass, a door is opened and I see a woman who I presume to be my psychiatrist. At this point, my nerves are at its peak. She walks out to the waiting rooms, does not glance at me, and I not at her. She has a brief conversation with her secretary about going to court. She goes to the small refrigerator at the back, pours herself a drink and walks back into her room. I continue to wait. The door is opened once more, and she calls me in. I take in a big comfortable couch, two smaller couches, and her computer desk behind this setting. I sit down and occupy the larger couch, she the smaller one.

She introduces herself and starts asking questions. She goes through my history and asks me about each of the points mentioned in my referral letter in turn.

She questions how I got a hold of the pills that I swallowed when I took an OD. I pause. I predict her opinion of me will be very much lowered once she hears the answer. I hesitate, and tell her that I took them from the pharmacy in which I work in. I am not disappointed. ‘That is highly illegal,’ she says patronisingly, and I want to cry in fear and shame. 

I am asked my diagnosis, from the mental health professionals I have consulted prior to this. I reply that I was told ‘depression’ by G and my ex-psychiatrist wanted to prescribe an SSRI for what he said were ‘bulimic behaviours.’

Dr T asks me why I am finding study hard. I reply that I am finding it hard to get motivated and to concentrate on my work. She inquires, ‘Have you ever thought that maybe it’s because you don’t have the ability to [do pharmacy]?’ I am taken aback, I want to cry, and I wonder what right she has to judge my ability to complete my course and become a pharmacist, within an hour of knowing me. I suspect it’s the whole ‘stealing pills from your workplace’ debacle. Never fails to turn medical professionals against you and question your ability to become a medical or allied health professional yourself. She says that a diagnosis will not help me in this area, regardless of the fact that I did not at all suggest I blame my academic failures on depression. I only said I was unmotivated and found it hard to concentrate.  She suggests I am depressed because I’m out of my depth in studying pharmacy, instead of the other way round, and in her words, ‘There is no point in flogging a dead horse.’

When I saw G, she told me I was capable of doing pharmacy. She told me it wasn’t because I was lacking in intelligence, it was because of my depression that I was struggling. She suggested deferring Uni, or doing part-time as opposed to full. She told me she would support me and write me the medical proof, had I chosen to follow on with her suggestion. Dr T suggests I withdraw from pharmacy and drop out altogether. Now I know who NOT to go to, should I ever need medical proof or help with an appeal against the Uni’s decision if they choose to terminate me from my course.

We talk about my eating issues. I tell her that I binge and purge, and have been doing so a few times a week, every week, for two years now. I tell her that I am unhappy with my current weight, as I have gained from my lowest weight two years ago. She asks what that would be. I tell her I got down to [tiga puluh lapan] kg but since then I have gained five kg and am currently at [empat puluh tiga] kg. She asks me whether it’s realistic to want to be that weight. I want to say yes, but instead I say nothing. She goes on to condemn being an anorexic pharmacist and for the third time that session, I hold back tears. She says something along the lines of not being able to be a pharmacist if you’re anorexic at the same time, and  I wonder why not. I’d agree wholeheartedly if I were training to become a dietician or an eating disorder specialist.  I fail to see the connection between pharmacy and an eating disorder however. I don’t recall reading the job requirement of being absent from mental illness in becoming a pharmacist. And there is no way of guaranteeing a registered pharmacist won’t develop an eating disorder or other mental illness later on in their life anyway.

Given the whole conversation we just had, I expected Dr T to maybe refer me to a psychologist or even better, do nothing at all and never see me again. I was surprised when she suggested trialling me on an SSRI. I came to the appointment ready to try what treatment was suggested to me, including medication. Ironically, it’s talking to Dr T that I’m questioning whether I really do need medication or not. Her rationale for medication confuses me even further. She doesn’t tell me they’re to help with depression. She doesn’t tell me they will hopefully reduce my need to binge and purge. Instead she tells me they are to reduce the anxiety I feel when I go to study so that I can focus. Considering she’s just told me I’m simply unhappy because I’m failing, and my lack of concentration is a reaction to the course being too difficult for me, it seems a bit of a contradiction.    

I have another appointment with her in one and a half weeks, on Wednesday 9th June. Between now and then, I’m meant to be making a decision about medication. I am still not sure, but as she took the liberty to point out to me, ‘You’re not sure about a lot of things,’ then proceeded to somehow relate that back to being an incompetent pharmacy student.

I’m not sure what to make of this appointment. Part of me wants to hate her. The other part thinks that maybe I only want to hate her because it’s easier than admitting that she’s right.  It’s what I’ve always suspected. I’m hiding behind the label of  Depression, using it as a pathetic excuse for failing academically, for pushing my friends away and rejecting their invitations to go out. I guess I don’t have depression after all, I just plain and simple suck at coping with life. And the cutting, the bingeing and purging, the overdosing, it’s all just an attempt to create the illusion of having a mental illness, so that I don’t have to deal with the fact that I’m just dealing with the very ordinary problem of finding my Uni course and education too difficult and feeling lost in life as a result. After my appointment today, I still come to the same conclusion I did with my last psychiatrist,  that I do not like psychiatrists very much at all. Despite my anxiety and nerves, I was still placing a fair amount of hope in this appointment and my new psychiatrist. Instead of leaving with hope, I am left feeling let down. Questioning whether I do in fact suffer from depression or any mental illness at all or whether I am just terrible at coping with what life throws at me and that’s as far as my issues go. She says that I seem to be a bit lost with my life. Right now I’m feeling all the more lost from attending this appointment.

I was given the business card of the clinical psychologist she is referring me to. I am meant to call to make an appointment. Dr T talks of psychotherapy and ‘not just CBT.’ For this, I am thankful. I’m placing my hope in this psychologist. Please don’t let this be a letdown too. Otherwise I would’ve lost all hope, and I really won’t know what to do.

Dinner With Workmates

A group of people from my workplace are organising to go out on Sunday night for dinner, to catch up with a workmate who has now left. I got asked whether I wanted to go or not. These past couple of months, with everything that’s been going on and my depression being worse than usual, I have avoided social situations and rejected invitations to go out. I thought it was time to break the cycle. So with some hesitation, I said yes.

I’m feeling a bit apprehensive about it. I’ve never been out with my workmates before. My Aunty will be there, as I work with her and she was the one who introduced me in, so it won’t be as intimidating as if I were to go by myself. I can convince myself that I am just tagging along with her, and therefore the pressure to be social is lessened. But still. I haven’t been out with friends for two months. Two months. I feel so out of sync, like I’ve forgotten how to have relationships with people. Isolation is unhealthy, especially when you are suffering from depression. I know that. I know that the longer I continue isolating myself, the worse the social anxiety is going to get. As my school counsellor in high school said, exposure is the only way to overcome social anxiety. But I am far more comfortable continuing to hide inside my cocoon, than to attempt breaking out of it.

Then there is the issue of food. Out of all the places they could choose to go, they chose a buffet. One of the worst places you can put someone who is bulimic. With the abundance of food, and as much as you can eat, the temptation to binge will be far too much. I will not be able to resist. And hey, I’m Asian, I like to get my money’s worth. Funnily enough, the last time I went out with my friends two months ago, we went to a buffet too. The inevitable happened, I went, I binged, I purged. I’m envisioning the same thing happening this time.

With all this in mind, um, why did I agree to go again?

Listening to GP, Work Party: KFC, Pdoc Costs & Study Break

When I left the Medical Center and I wrote my previous post, I was feeling upset, frustrated, misheard and misunderstood. I came home, felt really awful about it all, cried and ended up self harming. I have since calmed down and have been trying to do what he has instructed me to do…even though I don’t like it. Two out of three days so far, I have done the one hour of walking. Yesterday I did not do it because honestly, after spending eight hours at work the last thing I want to do is spend another hour of the day exercising when I am completely out of energy. I have bought fish oil capsules: ones that are ‘super small’ and ‘super concentrated.’ Got a bit scared of swallowing a capsule yesterday and bit into it. Eww. Enough said. Tried to swallow it today and found that swallowing the capsule is not as hard as I originally thought. Problem is that the directions on the packaging tell me to take one capsule daily, GP told me to take three capsules daily. I said that I dislike ambiguity, see, this is why! As for the three meals, I have been eating three meals a day. Admittedly, my portion sizes are a lot smaller than what the average person eats. Still, it’s three meals that are nutritionally balanced…just small. Today was a bit of a fail though, ate a small peice of apple pie at friend’s house, counted it as lunch, and purged after eating dinner.

As for everything else…

At work, another person is leaving. They mentioned the word ‘party’ and I brightened up at the idea of a party to break up the monotony of everyday work. That lasted until I realised that party equals food. It just happened that the party will be happening the one day in the week that I am at work. Last time it was pizza and I couldn’t do it, ended up bringing my own lunch. This time they are talking about buying KFC. I think I fear KFC even more than I fear pizza. So here we go, another party where I bring my own lunch, this WILL be a fun party once again.

Received a letter from the psychiatrist’s secretary confirming my appointment. The initial consultation fee for an hour is $330. Medicare rebate for this is $209. That’s still about $120 out of my own pocket. Ouch. To be able to access adequate mental health care in Australia, you have to be pretty well off it seems. There are public services, but it is not easy to access these services. My friend has tried to see a psychiatrist through the public system for depression, and has been rejected a few times. She ended up going private in the end. $120 gone from just an hour of consulting with a private psychiatrist. I earn less than that in a week, with only being able to work 5 hours when I’m at Uni. I feel so guilty already that after all the money spent by my parents on GP, psychiatrist and psychologist appointments during 2008 and 2009 I’m still no better. My father has already said something to me in the past about the money spent on me and my appointments. And now I’m needing round two and even more money spent, I feel absolutely terrible. It reminds me of my aunt saying that my parents are ‘lucky’ because they do not have to pay for expensive dermatalogical products for my brother and I, unlike she does for her children. It’s ironic that my parents are probably thinking the same thing about her, that she’s lucky because she doesn’t have to pay for mental health treatment for her children.

These past couple of weeks have been study break and this weekend concludes this, I am back at Uni next week. Met a friend today for a study session. Was nice to meet up with a friend, even if it was to study. Was probably the most study I had done the past couple of weeks. With working four full days in this past fortnight, and everything else that has happened, I had not found the time/been motivated/been in the right headspace to study at all. I fear failure is coming at me fast and will hit me hard. My friend was telling me about hanging out with her friends, going out at the middle of the night at 3am to talk, barbeques with friends, staying over at friend’s houses and going shopping together during her study break. Made me feel pretty wistful. The last time I hung out with friends was over a month ago. Pretty much my own doing though, have rejected a couple of invitations from friends to hang out. Today was the first time in over a month that I have met up with a friend outside of Uni. “So what have you done this study break,” she asks, “Have you studied a lot?” “Nope, not at all. Besides work, I have managed to overdose, sleep an entire day away due to the OD, had an ambulance come, had parents find out about my mental health issues once again, attended GP appointments and been referred to a psychiatrist once again.” But of course I don’t tell her that. Instead I say, “I have tried to study, and have worked four full days.” Yep, my life is comparitively dull. Though, I’d prefer dull any day rather than what I am going through now.

*Possible Trigger* Start of Uni 2010

I’m back at Uni this week and I’m hating it. If last year was bad, this year is even worse. I actually had friends last year in my lectures and classes. But now that I’m stuck in first year and my friends have moved on to second year, I have no one. This semester I am doing two first year units and one second year unit. I’m not doing enough first year units to make friends with the new first year students, not doing enough second year units to keep the friends that I made last year. I’m feeling really lonely and last year the fact that I had great friends is one of the only things that was going well for me and I was happy about. And now I don’t even have that.

If we fail a unit twice we may get kicked out of our course. I’m feeling the pressure now, fail chemistry and human bio again, and I get kicked out of pharmacy. Part of me thinks that it may not be so bad, right now I hate studying pharmacy anyway. But then I think about the fact that it would mean I failed something and I think about what my parents, relatives and friends would think of me, I think about the money wasted on my study and I freak out. Plus, I don’t know what I want to do instead of pharmacy. I’m afraid that even if I apply to study another course at Uni, I won’t even get accepted because I’m failing the course I’m currently in.

My mood has been pretty low this week and I’m afraid of falling again. Was crying at Uni yesterday and close to crying again at work today. I don’t know how I managed to go that four months I did without cutting. These past few days when I’ve been at home and I have my blade, I’ll end up giving in. At Uni and at work when I don’t have my blade with me, I’ll wish I had it so that I can self harm. It’s difficult to care about recovery when I’m feeling low and I’m anxious and alone.

At work today, at the pharmacy, I was packing the medication into Websterpaks as usual. And I was imagining what I could do with all those pills I was packing. But not to worry, it’s not like that’s something I would ever dare to do while at I’m work.

Right now there is also way too much junk food in our house, food to binge on. We have cake, chips, cookies, chocolate hot cross buns, lamingtons, ice cream, cereal bars plus more, it’s food galore. If the food is accessible and right there it makes it that much harder to resist eating it, which leads to bingeing and purging. I don’t know how to tell my mother to not buy that food. I tried asking her why she buys so much of this food. She then asks ‘It’s not a lot, it’s just one packet (one packet of each of those food equals A LOT). I thought you like it?’ I tried telling her, ‘I do, but I don’t want to have it in the house.’ It’s hard enough trying to resist buying binge food when I’m out shopping by myself. But for my mother to buy it and have it in the house, makes it so much harder to resist bingeing and purging.

I managed to go without laxatives for a few weeks. And this week after coming back from Sydney I got some sort of food poisoning, which is strange. Food poisoning from being in Asia I can understand but Sydney? I must’ve ate something that didn’t agree with me. Weighed myself afterwards and found that I weighed less. In fact the last time I weighed that number must’ve been almost a year ago. And since recovering from the food poisoning my weight has gone back up. Which is triggering and has led me to use laxatives again. Which is stupid because I know it’s only water weight that I’ve lost and using laxatives again is only going to get me back on that cycle of constipation, using laxatives, trying to stop, constipation, using laxatives again and so on.

I had a dream last night. I dreamt that my mother was comparing a photo of me that was taken when I was younger and a photo taken of me recently. She was pointing out that compared to when I was younger, I’ve gained weight and now look fat. Which is something that my mother wouldn’t do, so I don’t know why I dreamt it. Think it stems from my own fear that I’m fat and other people also see me that way. It doesn’t help either that I’ve had a couple of people who’ve commented before that from looking at my face, it seems like I’ve gained weight. I look at photos that have been taken of me and I look at them and think, ‘I wish I was skinnier.’ Strange how our fears come to light in our subconciousness when we are asleep. I remember in the past dreaming of people seeing the scars on my thighs and finding out about my self harm, that used to be a big worry of mine.

Sorry for the negativity and my rambling, my posts aren’t so intelligent when I’m not in a good headspace. Should probably just write in my private diary…