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depressive illness

07 Oct 2020 / Wellbeing Print

Same as it ever was

You may find yourself behind the wheel of a large automobile, in a beautiful house with a beautiful wife. And you may ask yourself – as Richard Martin did following a panic attack at a toll booth in France – well, how did I get here?

Until 2011, my story was a pretty standard one for a law firm partner. I had worked hard at school, got to a good university, studied law, got a good degree, trained at a good London firm and progressed to partnership there.

A merger with a US firm followed and, after three years, I left to join another London firm where my interest in moving into law-firm management was more likely to be met.

I had a lovely wife, three equally lovely kids, a lovely house and I was involved in our community as a school governor and much else. I was your archetypal insecure over-achiever and, as with many such people, from the outside my life looked pretty sorted.

It looked pretty sorted from the inside too, if I ignored the ever-present feelings of stress and of guilt, and a gnawing feeling that my personal sense of purpose wasn’t really aligned with what I was doing day to day, a day to day that increasingly absorbed all my time and energy, leaving little for my wife and kids, and none at all for me.

But hey, I thought, if I just can get through the next week, month, year, somehow it would all get sorted, right?

Burning down the house

In his seminal book Depressive Illness – the Curse of the Strong, psychiatrist Tim Cantopher describes the kind of person who presents to him in clinic with stress-induced depressive illness:

“He or she will have the following personality characteristics:

  • Moral) strength,
  • Reliability,
  • Diligence,
  • Strong conscience,
  • Strong sense of responsibility,
  • A tendency to focus on the needs of others before one’s own,
  • Sensitivity,
  • Vulnerability to criticism, and
  • Self-esteem dependent on the evaluation of others.”

Cantopher says that this is the sort of person to whom you would turn if you had a problem to sort out upon which your house depended, a safe pair of hands that you could trust, and who would often be taken for granted. And when they get ill, people are often very surprised.

But – and here is the crux of it – he says that it isn’t so surprising when you consider that depressive illness is a physical condition.

If you give a set of stresses to someone who is ‘weak’, cynical or lazy, they will probably give up quite quickly and never get stressed enough to become ill.

A ‘strong’ person, on the other hand, will react to these pressures by trying to overcome them, as they have overcome every other challenge they have faced in the past through diligence and effort. This person keeps going, absorbing more and more, until, inevitably, symptoms emerge.

Cantopher continues: “At this point, most people would say: ‘Hang on, this is ridiculous, I’m doing too much, I’m getting symptoms! You’re going to have to help; it’s about time you pulled your weight and, as for you, you’re going to have to sort yourself out.’ So they pull back from the brink before it is too late.”

But the sensitive person, without a very solid sense of self-esteem, can’t stop struggling, fearing other people or (worse) themselves, and are disappointed in themselves. “So [this person] keeps going, on and on and on, until suddenly: bang! The fuse blows.”

Road to nowhere

The accuracy with which this described me when I first read it brought me to tears. The only problem was that I was reading it too late – a couple of months after my fuse blew.

We had been driving back from a May half-term holiday in France and I started to feel a little uneasy. Nothing too dramatic, but enough that I was thinking that I would ask my wife to take over the driving when we next had cause to stop, but, of course, I did not want to mention anything, because that’s not what we do, right?

A few minutes later, we were approaching a toll plaza on the motorway when suddenly it felt like I had exploded. I was feeling sick, my breathing was out of control and my heart was racing like I had never known, and I had this desperate desire to escape from where I was.

So that’s what I did – I stopped the car in the middle of a number of lanes of still quite fast-moving traffic and started walking to somewhere, anywhere, I thought might be safe. Fortunately, it was not long before someone stopped me, and closed the motorway, and took me to that somewhere safe.

Once in a lifetime

I never went back to work. Within a few weeks, I was in the Priory Hospital as an in-patient, where I stayed for a month, followed by nearly two years off work, recovering, learning about what had happened to me, and working out what to do next – because the one thing I was sure about was that I could not go back to law.

There’s a lot of stuff along the way I could mention, but that’s not the point of this article. (If you are interested, I wrote a memoir, This Too Will Pass – Anxiety in a Professional World.)

The one anecdote I will mention, because it is the point I want to get across, and because it is a big part of the reason I wrote the book and informs much of the work I do now, is a conversation with my psychiatrist shortly before I was admitted to hospital.

He had asked me whether I wanted to be admitted, and I had no idea. All I knew was that I was completely broken and my family was struggling to cope with me, and I with them.

Having assured me that I was definitely ill enough to be admitted to hospital (I didn’t like to make a fuss, you understand), I asked him what the patients in hospital were like. He said, “They are like you,” and that’s the point – mental illness does not happen to ‘other people’.

It happens to us, to our friends, our colleagues, our family members. I was the last person anyone would have thought would get ill in this way – the truth was, I was at the front of the queue.

This must be the place

The work I do now is all around mental health in the workplace. I spend a lot of time in classrooms (virtual at the moment, of course) raising awareness of mental health, encouraging people to be more aware and to take greater care of themselves and others, and helping them have the confidence to engage in conversations about this still too-stigmatised subject.

I co-chair the Lord Mayor of London’s campaign ‘This is Me’, which uses the power of storytelling to break down that stigma. I am a coach and a mental-health first-aid instructor. But more and more of my time is now taken up with the Mindful Business Charter in Britain.

For many years, there was some great work being done around stigma and raising awareness. There always seemed, however, to be an elephant in the room.

Although work can be a great contributor to positive mental health – through the connection, sense of purpose, and achievement it can provide – it can often be a source of problems, and no one was talking about that or trying to do anything about it.

Legal work is often hard, complex, demanding and highly pressured. It is also very important, to our clients and also to wider society. It is vital that lawyers and in the best state possible to take on this work.

Take me to the river

We know that when we are stressed, however, our brains do not work so well, our cognitive functioning is impaired, such that we are less creative, more aggressive, less efficient and much more besides. That is not good for us as lawyers, but it is also not good for our clients or the quality of work we provide to them.

There is a difference between pressure and stress – we need some pressure to perform at our best. Stress is something else – it is that state of mind we get into when we think we cannot meet the demands being put upon us, often because the pressure has got too much and our brains have begun to lose perspective.

Some stress is unavoidable, given the work we do, and the sort of people we are likely to be. Some of it is avoidable though, and that is what the charter focuses on – seeking to remove the avoidable stress so that we can work more effectively and healthily.

Critical to the approach that the charter advocates is the understanding that a major source of stress is the way in which we work with other organisations – as lawyers, it will often be our clients and other lawyers.

And she was

The charter creates a framework and a permission to allow us to be brave enough to speak up about our needs, to push back where necessary, and to empower us to create the best environment for ourselves to be able to do the complex and demanding work being asked of us.

To use a well-worn metaphor, if you required surgery, you would not want your surgeon to be tired from ‘dropping another all-nighter’, distracted by a number of different operations they were performing at the same time, breaking away every few minutes to answer the phone or respond to an email, worrying that they hadn’t seen their partner or children for a week, while also under the cosh from the hospital director to get the bills out before the end of the day. I don’t want that person negotiating the finer points of my merger or divorce either.

The charter does not claim to have all the answers – it is one part of a broader wellbeing strategy – but 55 organisations are now on board and we are getting traction internationally, as well as throughout Britain. It is making a difference and is a great example of the profession (and wider business community) coming together to solve a problem that affects us all.

There remains a huge amount of work to do in terms of ensuring we have a safe and sustainable profession, but it is encouraging to see the amount of focus and thought that is now being devoted to it.

It was a pleasure to be part of the Law Society of Ireland’s Business of Wellbeing conference on 30 September to learn about all the work that is being done in Ireland, as well as sharing some of what we have learned from the charter in Britain.

Richard Martin
Richard Martin is the director of the workplace behaviour consultancy Byrne Dean in London