Day by day by day – Living with mental ill-health Part 1: Work

day by day 01 work

Other Chapters: Introduction / Part 2 – Help vs The Enemy Within / Part 3 – PTSD Rituals

Part 1: Work

Work  (which here means “holding down a job which enables me to pay my rent and bills”)  is one of the first things that I wrote down on my list of ideas for this blog series, with my Anxiety and depression affecting my work day in myriad ways.  The bright lights and constant buzzing noise of my open plan office are irritants on good days, migraine inducing on bad ones. Being surrounded by people – particularly in a country where “how are you?” is a standard greeting, with “fine thanks, how are you” the expected response – is a huge challenge on days when I am a slight breeze away from tears or shouting. You’d be surprised how difficult it is to say “fine thanks” when you’re anything other than fine and replying with “pretty dreadful, I’ve cried three times already today  and it’s not even 10am and now I just feel existentially dead and have been having idle fantasies of throwing everyone’s laptops out of the window and setting them on fire using my office chair as kindling. How are you?” is generally frowned upon. Some days I consider surviving the journey to work without having a meltdown is a success; but then I have at least 8 hours of Being A Normal Human In An Office Environment to get through. 

I have been at my current workplace for coming up to 9 years, the longest I’ve ever remained at one place. In this day and age of job insecurity, this is notable even for someone without mental health difficulties; but there are all sorts of reasons that “job security” is a huge issues for those of us who suffer from mental ill-health.

One of the reasons I have been at my current workplace for so long is because there are understanding managers, with a good attitude towards ill-health in general, not just mental illness. I know that if the worst happens, and I fall ill again, my work will try to help me by allowing me to work more flexibly, honouring notes from my GP signing me off, and not blaming me for my own predicament. I appreciate how enormously lucky I am in this respect, because have previous workplaces which haven’t been so understanding.

Poor sickness policies at work can lead to what I call a “stress loop” – where you’re going to work when you’re not well enough because you’re worried about not being at work, doing your job badly because you’re not well enough to be at work which makes you more stressed and more ill, getting to the bitter end before you take time off, coming back too soon because you’re worried about not being at work, which makes you even more ill… I guess it’s less of a “loop” and more like a spiral, because you keep getting more stressed and ill until you reach a point of the spiral where you simply cannot go further down, and you break.

Related to the stress loop is the “bad job trap”. When your self-esteem is all time low and your ability to cope with even simple things like, say, not crying at your desk, it makes it hard to search for, apply for and interview for jobs. A job application is a sales pitch, and the product is you. It’s pretty damn difficult to sell a product you don’t believe in.  On the flipside, you can also end up trapped in a job even when your mental health is good. If you find a workplace that works well with your needs, understanding bosses who apply the sickness policies in ways that help you stay healthy, it can be frightening to leave that security when you are in a good place mentally. The thought “what if I get sick again” is never truly that far away, and can stop ambition dead in its tracks. It feels so much safer to be stuck in a job you’ve outgrown or where you’re undervalued than risk a leap to the unknown in order to progress in your career.

For me, knowing that I have a job, a way to pay the bills and my rent, and knowing that if I get sick my workplace (probably) won’t fire me and will be understanding while I recover is far more important than climbing up a career ladder. Perhaps family and friends are disappointed in me, and pictured a better carer trajectory for me than the one I’ve been on, but my choice is always going to be the place where I most protected from falling ill again. Many people with mental health instability make this choice – to be “secure enough” because the risk of gambling our mental wellbeing on our career is just too high.

With the Conservative government rhetoric of “scroungers” stronger than ever, and daily horror stories of people being refused support via unfair assessment tests, the pressure to remain healthy enough to work can itself have a huge impact on people with fragile mental health. People with mental health difficulties are forever walking that narrow line between wellness and survival.  The fear I hold of getting sick again is always there, huddling in the back of my mind, and the knowledge that there’s simply no safety net in the UK any more makes it so very much worse. I have no savings, no means of financial support from anywhere other than income from my job.  If were to fall ill and lose my job, I risk ending up ill and broke and homeless. The fetishisation of “work” and the relationship between “personal worth” and “economic contribution” that is a feature of capitalism can’t be ignored here, although it’s worthy of a post all to itself. It’s such a powerful narrative in society that even if you are aware of it, and critical of it, you are susceptible to feeling like a “failure” when you can’t work  due to ill health.

day by day - work _ ecardsanxSo, faced with so much bleakness, what is my advice for those of you struggling? This advice is less “what do I do?” than it is “what do I not do that I know I should?” because those of us who are horrible at following our own advice are always best at offering it.

Something I have always struggled with when on a low is knowing when to take time off and when I need space for me. Work can help me focus and give me routine, taking time off sick can lead to formlessness and lack of a reason to get up. However the work office environment can be unhelpful, particularly when a job involves having to do a passable imitation of a functional human. If you’re fortunate enough to have an understanding boss, perhaps you can discuss a working from home arrangement, flexible working hours, starting late and leaving early or vice versa. Regular breaks away from your desk are a must – this is non-negotiable (and supported by law). Self care at work – the little wins – can help.  A big one is learning what your pitfalls are and working around them. For example, one of mine is that I struggle to get out at lunchtime sometimes, which means that I’ll skip lunch or just eat biscuits all day. I work around this by buying lunch before I arrive in the office in the morning. Of course, the best thing would be to make a big batch of something earlier in the week and sticking it in a tupperware each day, but that’s a level of planning ahead that’s pretty much impossible for me when I am low, so I stick with buying a tin of soup and a bread roll. It’s still better than a packet of biscuits. Spotting your “loops” and trying to find exits for them is key to learning to live with your mental health difficulties, rather than fighting against them; and your “loops” at work can be the easiest to identify, as there tend to be more obvious patterns.

The best advice really though is if you are sick, you are sick. Learn to identify when you need a break and if you need a break, take time off. Go to your GP. Ask for help. Remember, if you have a broken leg no one (no one reasonable, anyway) is going to expect you to ignore it and drag yourself into work without getting treatment. Mental health is physical health, and not imaginary, or weak.

In my utopian magical unicorn future world “work” wouldn’t mean “holding down a job which enables you to pay rent and bills” and would mean “doing something that you enjoy and are good at that benefits the world in some way”. I imagine that even in that utopian magical unicorn future world mental illness would still be a problem, in the same way people would still probably break their legs, but removing the economic pressure of having to work wouldn’t half make a big difference to our mental wellbeing. Until that utopian magical unicorn future world comes to pass (and doesn’t it seem a long, long way off right now?) the best way to survive is to be as kind to yourself as you can be.



  1. Yeah i got bullied out of work by an evil machivalian boy boss after the death of a friend. I still don’t want to return to work. I hate it and i don’t feel very confident. I’m lucky that the bills can be paid. But many peoples mental health is bad because of work and the pressure to pay the bills.
    Your lucky to have managers who understand.

    1. I am so, so lucky where I am right now. Although I have also not had a long bout of poor mental ill health where I am now, only a few weeks at a time. I’ve been allowed time off for therapy sessions which has really helped.

  2. A really spot on description of kind of where I am. My mental health meant I chose, nearly 8 yrs ago now, between a PhD and being a mum who didn’t feel like crying everyday. I took pay cuts as the meds meant I was bit brain foggy so academia wasn’t an option. I’ve learnt a lot about me and work over the past year or so and I’ve been proactive. I’ve given a line-manager a one page profile which highlighted the best way to work with me (clear commentry on my work, no ambiguous ‘can I speak to you in my office’ encounters). I sometimes wear headphones to escape the noises that rub against my anxiety and I tell my colleagues if I’ve started new meds and how I’m feeling. I changed jobs recently as the long commute was impacting on my mental wellbeing as I was tired. My new job is very supportive and my colleagues are too. I think my mental health has given me an awareness of my boundaries in relation to workload, I could do with a better wage and I know I could earn a better wage – but my health and wellbeing are much more important. It can be hard to be open about your mental health but when you’re in the right place of work being open can pay dividends.

  3. Wow, I really really needed to read this, thank you so much for writing it.
    I hope your writing counts as “something that you enjoy and are good at” because it does benefit the world in some way – I only wish it paid your bills. Like other commenters I have been stuck in a cycle of chronic under-achievement, with mental health and associated treatments making everything a struggle, and the struggle fuelling a depression-goggled idea that there is really no point in me trying anyway because I am worse than useless.

    1. thank you! The next blog I am trying to write right now is very much about that “depression-goggled idea that there is really no point in me trying anyway because I am worse than useless” and how it makes it hard to get the help you need even when it’s there in spades.

      I hope you’re doing ok today! Alas, this blog doesn’t pay my rent or bills, but it’s opened up opportunities and connections to me which are completely precious,and worth more in a way. Although of course I am able to say they’re worth more because I am lucky enough to be employed doing something I don’t hate that does pay those bills…

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