Saved from Burnout

An all too familiar story.
Joe came to see me. He looked tired. He told me he had been off work for 18 months because of mental illness.
“ It was a good thing my doctor spotted it.” He said. “He got it right first time.”
“He told me I was suffering from work stress and depression, and I was getting burnout. He said I needed time off. I got time off but every time I tried to go back to work I got worse. He said I was getting a clinical depression and had to give me medication. That helped a bit but then I got panic attacks whenever I tried to go back to work and he had to give me something to sleep and he had to up the medication. Now I can’t go out without getting panic attacks. My doctor also thinks I have got phobic anxiety. They’re not going to keep my job open anymore, I’ve run out of sick pay and had to make do on the benefit. “
I asked him what went wrong with his job.
“It was my boss.” He said. “He just had it in for me.”

The story gradually unfolded in our talking together.
I found that two years ago Joe had been a middle manager in a fairly large firm. He had done pretty well. He was married with two children on a good salary. No history of mental illness.
“What had happened” I wondered so that he was now jobless, on a sickness benefit, because of multiple mental illnesses. Ie Stress, depression, phobic anxiety.
Two years ago nothing had seemed to alter this tranquil existence. He liked his work seemed to get on well with his staff, and met all his deadlines. Then his line manager was replaced.
This man had a completely different agenda from his previous manager. He was very officious in his manner and had a completely different way of doing things. He wanted a lean mean machine. Joe went out of his way to please him and show him he was up to the job.
None of his efforts seemed to satisfy this man who seemed to continually find fault with his work. The new manager kept laying blame with Joe’s attitude but Joe could never find out what he meant. He made repeated efforts to find what this meant but this only reinforced his manager’s opinion that his attitude was at fault.

He began to get worried that his job might be at stake and wondered it the new manager had an agenda to restructure and get rid of him. He knew that if he shared these misgivings with his boss it would only reinforce the adverse opinion he had about his ‘attitude’.
He discussed it with Rosie his wife. She was sympathetic and very supportive.
However as the situation at work continued Joe began to worry more about his predicament. He was not used to being continually the subject of criticism especially when he was doing his best to take them on board.
He began to worry at night and wake early in the morning dreading the day before him.
He took a vacation for a couple of weeks. He and the family had a great time but as the time approached to return to work the worry began once again.
Rosie was concerned about his health and suggested that he see his GP.
Joe was couldn’t see what the GP might do but decided it wouldn’t do any harm.
His GP checked him out physically and then began to ask Joe a lot of questions.
‘How long had he been worrying? On a scale of 0 to 10 how bad was the anxiety. Did he wake early in the morning? Had he lost any weight?
What were his energy levels? How was his concentration?
Did he think life was worth living? Had he ever thought of taking his own life?
His GP seemed to concentrate on Joe and said little about the situation at work with his manager even when he explained it.
Finally his GP announced
“ I think you have an early clinical depression triggered by work stress. It is just as well you came to see me otherwise you could have gotten burnout’.
“Hang on said Joe. You mean I am mentally ill?”
“ Yes you might say that” said his doctor.
“How do you know?”
Well because you have many of the symptoms of depression.”
This came as a revelation to Joe. He had never thought he had a mental illness.
“What do you think I should do? He asked.
“Well I think you should start medication and take at least a month off work to allow the medication to take effect. If you don’t you run the risk of burnout.”

This was a revelation to him. He was getting depression all along. Maybe it was that his new manager had seen in him, right at the start. Of course!

He went home buoyed up by the fact that the medication would soon get him back on board.

He had enough sick leave and took the time off. He began to feel better anticipating the effect of the medication. The weeks went by. Yes he did feel better but as the deadline approached for returning to work he started to become more anxious. His Boss said he was not to return until he was completely well. Yet Joe knew he would be coming back into the same environment. He began to worry and pace anxiously about the house in anticipation of returning to work. Maybe this meant he was not quite better. Because he knew he had a mental illness he began to doubt his own thinking and his own feelings. He would frequently have to check things out with Rosie to make sure he had got it right. She became exasperated with his ruminations and he in turn began to get panic stricken.

Finally she took him back to their GP.

He listened to all their concerns and to the tales of anxiety and finally said that Joe was suffering from phobic anxiety, and that he would have to change the medication.
Joe was aghast. I have phobic anxiety as well as depression? He asked now completely demoralized.
Yes unfortunately they can go together but they are well recognized.

“When can I go back to work?

“Well I wouldn’t recommend it. It would only exacerbate the illness and you could end up with burnout he said.

Once again the medication was changed and Joe returned home. He wrote a letter to work saying he would return as soon as he was able. He decided he could stay home until he had used off all his sick leave. This extra time off helped but once again whenever the deadline approached he became anxious. By now he was also angry about had had happened to him but was persuaded by the GP that this anger was just a symptom of stress.

By now he had used all his sick leave and was on a benefit. He got a letter from his boss saying that they could only hold his job open for six months on leave without pay after which they would have to replace him.

So there he was sitting across from me asking for advice.

I thought to myself
“How to turn someone from a well off productive business man to a hard up sickness beneficiary in only eighteen months.”

As I was thinking he remarked “Just as well my Doctor caught me just in time. I could've got burnout!”

I felt sick and sighed. Maybe I should have been a lawyer.