A few months ago, I was interviewed for Stella (the Sunday Telegraph’s Magazine). Here is the result.
Mental illness at work: the last taboo
Mental illness – be it schizophrenia, depression, autism or OCD – needn’t be the end of a career. Far from it, say these women.
When four MPs stood up in the House of Commons in June to talk about their mental-health problems, it was to introduce a private member’s Bill to remove laws that restrict ‘mentally disordered persons’ from doing jury service or becoming a member of parliament or a company director.
But when Sarah Wollaston MP told of her severe depression, anxiety attacks and suicidal thoughts, and three of her colleagues talked about their experiences with obsessive compulsive disorder (OCD) and postnatal depression, their words had a far wider reach than simply highlighting prejudice and introducing a bill to halt it. It was a brave and surprising thing to do and they met with warm applause from around the nation.
Not least from Caroline Ashrafi, a 49-year-old tax manager who had staged a ‘coming-out’ of her own a couple of years earlier.
In 2010 Ashrafi’s employers, KPMG, had sent her on a course designed to tackle the issue of how to retain talented women in her industry. ‘It was 20 women shut up in a room for two days, and I thought, “Oh, God, do I really want to sit in a room with 20 women?” But it was brilliant – a very motivational, far-reaching two days. One of the main topics was “Why do women reach the glass ceiling and what are your barriers?”’
As the women talked about childcare and family commitments, Ashrafi thought, ‘None of this applies to me. I have one son but having a child hasn’t been a barrier to my career progress. My biggest barrier has been my illness, my depression.’
Ashrafi didn’t feel ready to share that at the time, but the support and affirmation she received from her peers on the course worked on her and a week later she woke up thinking, ‘Today’s the day I am going to tell the world.’
‘I sent an email to the 20 people on the course and 10 other colleagues, telling them, “This year is the 30th anniversary of my being diagnosed with clinical/reactive depression, which has been, at times, disruptive, upsetting and has often wreaked complete havoc with my very existence.”’
As the morning passed, responses pinged into Ashrafi’s inbox. ‘They were unequivocally supportive. It took my breath away. Oh, my, it was very powerful. I learnt that day that the most effective way of getting rid of stigma and changing attitudes is by admitting and telling your story.’
Which is ironic, because for years Ashrafi had been locked in silence about her condition for fear of the repercussions. ‘I genuinely feared the prejudice,’ she says. ‘I have seen instances during my career of people being treated badly because of their mental-health issues, and I was never confident enough to be open about it before.’
Ashrafi is far from alone. One in three women have taken antidepressants at some point in their lives, according to a report by Platform 51 (formerly YWCA). The mental-health charity Mind estimates that, at any given moment, one in six workers are experiencing depression, anxiety or stress. Emma Mamo, the charity’s policy and campaigns manager, says, ‘Mental health in the workplace is the elephant in the room; too often it is ignored. But we think some problems are too big to ignore.’
It turned out that Ashrafi’s employers felt the same, and since her confessional email they’ve co-opted her on to their disability steering group as a mental-health champion. However, she says the most surprising by-product has been increased vigour. ‘Living a lie takes a lot of energy. The exhaustion of pretending can be overwhelming; take that away and you can channel your energy.’
Covering up at work has never been an issue for Rachel Waddingham, 34, who lives with her husband in south-east London. ‘Everyone knows,’ she says, ‘and it’s not the most important thing about me.’ Waddingham says that, of all the mental-health conditions, hers – schizophrenia – carries the most stigma.
‘I am at the severe end of the spectrum where most employers won’t give people a chance . It shouldn’t be like that. It was amazing to see the MPs come out and talk about their issues. But the day an MP talks about hearing voices will be the really big day for me.’
Waddingham works full-time managing support groups for people who are affected by psychosis and hear voices, including one in Holloway Prison. She also trains mental-health professionals and is studying for an MSc in psychological research methods. In her spare time she sings in pubs.
Leading such a busy life actually increases the voices. ‘I have them pretty much all the time,’ she says. ‘It might sound distracting, but it makes me good at my job. I have 13-odd voices, some of whom are challenging to deal with, but I am the mediator; that helps me deal with difficult situations at work because it uses the same skills. I am also great at focusing, because I have to be good at putting those voices to the back.’
The voices started in her teenage years, but she traces their origins to a time when she was seven and ‘saw a monster’ in the mirror. ‘I suffered sexual abuse in my childhood, and my way of carrying it was to squish it down into that monster. When I was that young I was so invested in being a strong child that I wasn’t able to tell anyone, and that is why I started to have the voices.’
Waddingham ‘limped on’ through her school years until everything went ‘colossally wrong’ when she got to university. Having found her diagnosis of schizophrenia initially helpful, she now feels it is irrelevant. ‘It’s just a label. It technically still applies to me but it’s not something I find it particularly helpful to dwell on. I no longer need medication and can still live this life that I am really happy to live.’
For Robyn Steward, 25, life started precariously. She was born prematurely with 10 disabilities including cerebral palsy, dyslexia, dyspraxia, dyscalculia (number blindness) and Asperger’s.
At school she was bullied and ‘just felt thick all the time… but my IT teacher found things I was good at, and encouraged me to do them.’ This led her to study IT at college where for the first time she felt that if she worked hard she could do well. She spent a lot of time explaining computers to other students and realised she had a natural bent for teaching. Through contacts in the National Autistic Society she began coaching people about autism.
‘The key to being successful is finding your niche, and I am good at public speaking,’ says Steward, who finds eye contact with an individual problematic but has no trouble addressing 500 people. ‘Occasionally I get over-stimulated and have information overload, which makes me very anxious. When that happens I paint or listen to Pink Floyd, which are both really calming for me.’
Steward now runs a business training teachers and healthcare professionals about autism, but is frustrated that others have not been so lucky. ‘Only 15 per cent of people on the autistic spectrum are employed, says Steward. ‘A lot of that is down to employers’ fear. We need bosses to realise autism can be a massive advantage. I can be a bit monotropic and concentrate on one thing to the detriment of others, but the flip side of that is that I get a lot of things done. It’s just a case of having employers open their minds a bit.’
Jane Harris, the associate director of communications at the charity Rethink Mental Illness, agrees: ‘There is a misconception that if you have a mental illness you can’t work, but many people with mental-health problems hold down high-pressure and demanding jobs. Anyone can be affected by mental illness. We all fall somewhere on the spectrum.
‘Women are more likely to be affected by depression, anxiety and psychological distress. They are also more exposed to problems such as poverty, discrimination, overwork, domestic violence and sexual abuse, and as a result they potentially face even greater barriers when it comes to employment. We need to overcome the stigma and misconceptions to ensure that everyone affected by mental illness gets a fair chance in the workplace.’
Popular culture has picked up on the message, too. Two recent primetime dramas, Homeland and The Bridge, feature tough women in tough jobs who also happen to be dealing with mental illness: bipolar disorder in the case of Homeland’s Carrie Mathison, and Asperger’s for Saga Norén of The Bridge. They are both depicted as using the characteristics of their conditions to good effect as tools in their work, but are also at times overwhelmed by those same characteristics.
This strikes a chord with Heather Call, a 29-year-old pharmacist. ‘My job is a recipe for OCD,’ she says, ‘because you are under pressure and you have to make sure you are giving out the correct medicine and the right advice, so you have to check. When I wasn’t well I would check and check and check until I was overchecking and couldn’t stop. But now, when an OCD-type thought comes in, I can recognise it and deal with it. I have learnt to stop myself and say, “That is adequately checked. You need to give it out now.”’
Call’s symptoms first emerged at university, where she found herself trying to solve vast questions such as ‘Does God exist?’ in her head over and over again. She managed to carry on until she was pregnant with her third child and realised that she couldn’t deal with her symptoms on her own anymore. ‘I’d be driving along and hear a noise and think, “Have I just knocked somebody over?” – a totally irrational thought. But I wouldn’t be able to dismiss it and would find myself driving back to where I heard the noise to check.’
She told her GP and then a specialist, who prescribed an antidepressant called sertraline. ‘I was a bit nervous and wondered if it would change who I was. But it’s just replacing a chemical that is deficient in your brain, and because of that you can think clearly again. It brought the old me back .’
Call has just come back from a year’s sabbatical in Uganda, with her husband, a doctor, and their three children, working in the slums of Kampala. She says this would never have been possible before she started her treatment seven years ago.
Her condition makes her better at her job, she now believes. ‘As a pharmacist I can be more understanding of people who are prescribed drugs for mental-health conditions. When I first had symptoms I was scared to talk about it, and felt I was going mad, but the more I find out about how easily treatable it is, the more I’m prepared to let people know about it. It isn’t a life sentence – you can get help and move on and lead a full life.’