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Work and mental health
Work and mental health

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2 Employment and mental health problems

Nick and Louis both have mental health problems and could not continue with full-time employment. They both attend the mental health charity Restore, an organisation that supports mental health recovery. For many, recovery includes work of some kind with an ultimate goal of finding paid employment. This goal may be very challenging to achieve and some people may require a lot of support. You will learn about this support later but first you need to get to know Nick and Louis.

Activity 2 ‘… and I sorta lost everything really.’

Timing: Allow about 30 minutes

Watch the video of Nick and Louis. Identify:

  • what benefits Nick and Louis gain from working
  • what factors contributed to Nick and Louis becoming unwell.
Download this video clip.Video player: Video 1 Nick and Louis
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Transcript: Video 1 Nick and Louis

LOUIS:
I was a head chef. I sort of worked with children. I had my own business and stuff, a house down by the sea as well. Yeah, that I renovated. I had my family and everything. And then I just got ill. Yeah, so I lost everything, really.

Three years ago Louis developed serious mental health problems and had to give up work.

LOUIS:
I was diagnosed with anxiety, depression. And I sort of … sorry. Anxiety, depression, and post-traumatic stress with a personality disorder also, as well.
NICK:
After 10 years of being a self-employed piano player, I think the fact I’ve been in quite a difficult relationship which had caused a lot of anxiety, and also the stresses of looking for work and not knowing how much work you’re going to get, how often, and when, I think those two things combined to overload my nervous system. And I woke up one morning feeling absolutely terrible, in a very bad place, and went straight to the doctor and got prescribed antidepressants.
It was certainly a totally different experience to episodes of melancholy or unhappiness that I’d had before. I had been to therapists in the past because of anxiety and depression. This was a totally different experience, waking up with clinical depression. I’d clearly been pushed over the brink by the nature of my lifestyle, the difficulties of surviving as a jazz musician in this society.
And so those things compacted to essentially push me over the edge.
INTERVIEWER:
How stressful is it, being a professional chef?
LOUIS:
Really quite stressful, especially when you’re a perfectionist. Because you put too much pressure on yourself, which doesn’t work very well with mental health issues. Mainly because you’re constantly … like I used to do roughly 70, 74 hours a week, and sort of go in on my day off to do paperwork and stuff.
NICK:
I did try to carry on working. I took antidepressants, which you were hoping would kick in all the time. But my sleep was reduced to a virtual two or three hours if I was lucky.
The musical engagements I had were pretty traumatic. I was inwardly sort of shaking and terrified, just about managing to get onto the scene of the engagement, driving probably precariously at times, I think. It was a case of sort of toughing it out. I thought I might get better. But of course, if you keep piling on the pressure, you don’t get better.
INTERVIEWER:
What were the good parts about cooking?
LOUIS:
Good parts were, I suppose … well, yeah. It used to make me feel really happy, really accomplished, really passionate about it, very willing to teach others and stuff. I used to teach kids how to cook as well as drama and stuff. And I was a proper foodie who just loved growing stuff and cooking stuff and, like, putting myself on a plate, really. So that was sort of one of my nicest achievements really to cooking.
NICK:
This was the first experience of clinical depression. There was a gradual improvement. And I started working again about six months later. But it certainly took six months before I was in a place where I could work again. And this, I would have to say, has been pretty much the pattern with three subsequent episodes of depression that I’ve had over the last 10 years. So it’s disrupted my musical career. I think it’s made a lot of people that I probably would have been working for, and with, wary of my reliability because it’s happened now on four occasions.
But having said that, I now feel in a better place than I was before. I feel I have a lot more self-knowledge as a result of those experiences. And hopefully, my career will now proceed, if not at a meteoric rate, it will slowly progress, I would hope. The main thing is to avoid another clinical depression. And then all should be reasonably smooth.
INTERVIEWER:
Could you go back to cooking as a career?
LOUIS:
No, never.
INTERVIEWER:
Why not?
LOUIS:
Because I don’t want to. I don’t want to. Basically, I’ve achieved so much in my career, and I’ve done everything I wanted to do. Now I want to do something for me. So that’s what I’m going to do because I’m worth it at the end of the day. But it’s taken me years to realise that. So I’ve done what I wanted to do, so now I’m going to do it. I have to again.
What job I really want to do is be a train driver, because that was an ambition I had when I was a child. But whether that’s going to be possible, now I’ve been labelled, I don’t know, but I don’t see why I can’t do it.
NICK:
You have to take it easy to start with. I mean, you need to, sort of, in my case, I needed to do just the very lightest musical engagements, playing in nice community environments. And that sort of helped me to ease my way back into it and to look at myself again as a professional musician.
I think it’s difficult to change your image from somebody who’s mentally ill, who has a serious problem with depression, anxiety. Changing that perspective to one of being a creative, dynamic, and useful member of society, you need to change your self-image back to being somebody who can make a real contribution.
LOUIS:
I’m a bit scared I’m going to break again. But then I’m putting in the hard work here and group therapy. So hopefully, so that will stand me in good stead hopefully. I’m nervous, but I think everybody gets nervous going back into society, so to speak.
End transcript: Video 1 Nick and Louis
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Comment

What benefits do Nick and Louis gain from working?

For Louis, working was extremely beneficial. It not only brought him the material benefits of a ‘renovated house by the sea’ but also was important to his identity and self-esteem. He loved being ‘a real foodie’ and gained considerable self-esteem from doing a job well.

In Nick’s case, he gained the satisfaction of using his musical skills in a job which gave others a lot of pleasure. He had the opportunity to socialise with people. For many, being a working musician is a valued social position.

What factors contributed to Nick and Louis becoming unwell?

You need to pay attention to both what Nick and Louis say and what they imply. Louis’ lifestyle as a chef – long hours, little time off, the need for perfectionism – undermined his mental health. For Nick the uncertainties of living as a jazz musician ‘overloaded his nervous system’ and he became unwell.

For both, ‘keeping going’ piled on pressure, which made things worse. This is where the Centre for Mental Health’s (2013) claim that most people with mental health problems can work becomes quite provocative. You might ask, and only Nick and Louis would be able to answer, what kind of work situation would accommodate their mental health needs? What kind of support do they need? You will come back to these questions later.

Nick and Louis’ mental health problems are not simply a reflection of their employment circumstances. For example, a difficult relationship was a significant contributor to Nick’s decline. Employment is only one factor influencing their experience of mental health problems. However, employment is often seen as a significant part of mental health recovery.