In her latest blog, Rae Ritchie writes about how finding time to attend mental health therapies – and recover from them afterwards – can be difficult to fit into a regular working life.
The new year brings a new phase in my mental health journey as I’m soon to start emotional regulation group therapy. I desperately need this support. Life with borderline personality disorder is a rollercoaster of fluctuating mood, bouncing around like a pinball hitting one bumper after another, reacting and over-reacting to even the most seemingly trivial situation. A loud bang, a particular turn of phrase, the sight of a certain physical feature even on a stranger, all and any of these – as well as a whole host of other triggers – can set off a completely disproportionate reaction.
For me, one of the worst parts of these huge mood swings is knowing that my reaction is out of proportion. Forgetting a cardigan or phone and having to return to the restaurant to collect them is a human mistake that we all make, only when it’s me that’s the culprit I condemn myself as an utter failure and may take hours to recover from my sense of failure as a person. I know this is a ridiculous response but I feel powerless to control or limit how I react. The best I can do is try to manage the aftermath of emotion.
When I feel in a good place, I can mop up reasonably well. I’ll come round fairly quickly and return to an even(ish) keel before the day is out. During difficult times I’m getting better at eventually switching to self-soothing mode but I need all the help I can get to improve further. Going from drafting your suicide note to laughing heartily at a fortuitous coincidence within the space of a few hours is a draining – never mind unhealthy – way to live.
I’m looking forward to the group sessions beginning but apprehensive at the demands it will place on me. The preparatory material has made it clear that participation demands a commitment to doing the emotional and mental work between sessions; turning up for the group each week isn’t enough. How hard will it be? Undoubtedly it’s a challenge to question ingrained thought patterns and face up to – or more like face down – the triggers that set off a chain of predictable responses.
There is the time commitment too. As well as the emotional work between sessions, there is the group meeting itself: 2 hours per week for 6 months and I could choose either Monday AM or Friday PM. I’m a freelance writer so can schedule my paid employment around these slots but even so it’s awkward, particularly if I have another mental health appointment in the same week. So before it’s even begun I’m having to juggle other commitments because of it.
While I’m able to accommodate the daytime programme, what about others who work more regular hours? We know that it’s good for our wellbeing to work if we are able to, but does standard employment preclude much of the treatment offered by the NHS as it runs during working hours? Not every employer is willing or able to grant regular time off for treatment that goes beyond 10 minutes for an early morning GP appointment. It feels that the entire support system is based on an assumption that service users are not working. Surely this cannot be the case?
There’s also the question of the emotional hangover from the group therapy session. How will I feel afterwards? This will probably vary from week to week, but I doubt it’ll always be easy to slip back into work mode. The hours needed to regroup and recuperate represent more time that I can’t dedicate to gainful employment, another aspect of the negotiation that comes with living with mental health issues long-term.
Negotiation, scheduling, juggling: it is hard to avoid a mental health issue becoming a defining feature of one’s life just in terms of administration, let alone the symptoms. Fitting in the appointments, preparing for them, recovering from feeling drained when you’re finished. Picking up meds, setting alarms to remember to take them, the inevitable and well-meaning but still irritating ‘Have you taken them?’ from your partner twice a day. Trying to continue a conversation with friends when your legs won’t stop twitching because you’ve stayed up late and the meds’ side effects are kicking in (a low point before Christmas for me). Even when we’re feeling okay, well even, it can be difficult to move away from the constant reminders of our condition(s).
Managing ourselves and our treatment can feel like a full-time job in itself. In fact, after I’ve submitted this piece I’m off to meet my case manager for another hour, plus there is travel and recovery time. These appointments may fall during the typical working day, but we have to work – or not work – around them.
About the author
Rae Ritchie worked as a historian for a decade before leaving academia to become a freelance writer and coach. Whether in the past or the present, she is fascinated in how people make sense of themselves and their lives. This professional interest has undoubtedly been encouraged by her own wrangling with depression, anxiety, post-traumatic stress disorder and borderline personality disorder. These struggles are ongoing but writing about her experiences – and the not necessarily related topics of gender, fashion, beauty, women’s magazines and mindful living – is saving her soul.