Thursday, March 3, 2011

When the social worker has mental illness.

One post in the entire month of February? I know, right?! The truth is, I've been pretty checked out of everything. I tell most people that what I'm in right now is a "funk"; more accurately, I'm in the midst of a depressive episode.

I've suffered from major depressive disorder most of my life, sprinkled with bits of generalized anxiety and post-traumatic stress. I've been in and out of therapy for what feels like forever, and up until about a year ago, I could have sworn the stuff would never work for me. Fortunately I am in treatment, and I have a rad therapist. Which brings me to wonder, why in the hell did I decide to be a therapist?

At NYU, we had a presentation that kicked off our professional development day, and a few of the speakers touched on the topic of secondary trauma. It got me thinking a lot about how I've been processing stress. My placement aside, I've been experiencing a lot of loss in my personal life. That coupled with the stories I have to hear and process at work--it's a lot for me to handle being only 5 months into this gig. It makes perfect sense too, because as studies have shown, listening to traumatic stories will cause trauma for the listener--or secondary trauma.

For the month of February, I really disconnected from a lot of this social work stuff. It's not to say I've been up to nothing--more on that later. I really need a chance to recharge my batteries, to get myself up and running again post-burn out. This whole situation though has me wondering--if I am struggling this month during grad school, what is my career going to be like? How can I possibly hold down a job? How can I ethically allow my patients to count on me when I could at any moment spiral into another depressive episode and need to take this time to recharge? Recharging and time away from things is absolutely vital for my depression. How do I prepare my clients for this without causing doubt in their minds about quality of treatment or going a little deep in the self-disclosure wing?

Sometimes I wonder, maybe I shouldn't be a social worker.

But the reality is, there isn't much else I can do. First, I would be doing social worky type of work regardless of whether or not I was a social worker. At least this way I can get paid for it. Secondly, what field besides social work is going to be as accommodating to mental illness? Can you see me walking up to an investment banker boss and saying "Yo boss, I have this disability that you can't see, and I swear I'm not lazy, but I really need some time off to get my shit together." Oh hell no! I'd be fired on the spot. I won't even get into right now about how being fat complicates my depression in so many ways. In the health advocacy and social work scene, my disability, while sometimes misunderstood, is still respected. Most everywhere I've dealt with this has been willing to work something out. So I guess, really, I'm in the best possible spot.

That doesn't mean I am going to stop thinking about these issues. Dealing with your own mental health issues as a social worker I think is a really unique thing. I am really fascinated about how to best approach this with client relationships. Do any of you have experience with this sort of thing? How did you approach it? If you don't have experience with this necessarily, how do you approach needing to temporarily break a client relationship, due to health issues or a death in the family or anything that will cause you to be away for some time? How do you do that without damaging the relationship?


  1. Social Work can without doubt be emotionally draining and you do need to look after yourself although I'm sure they teach about that at college! As for absences, I just deal with them honestly. I fortunately haven't had to deal with mental health issues but I had a really detach and a lot of difficulties when my father died and when he was dying - possibly exacerbated by the fact that I work with older adults so I looked around and constantly saw old people and children and felt upset and almost resentful that I didn't have any living parents (my father brought us up as a single parent).
    One of the most difficult things I've ever done was on the first day back after compassionate leave after the death of my father, going to speak to a woman I'd been working with for a while about her dying son and her own feelings. My manager said she would send someone else but I bravely went on, thinking, I'd built up a relationship with this woman and to 'abandon' her when her son was dying wouldn't be helpful to say the least.
    I cried before I went in, managed to keep it together when I saw her and sat in the park next to her house and sobbed my heart out afterwards. Every time I go there, I still look at that bench in the park and it always reminds me of my dad and how I felt in the days after his death.
    Anyway, one thing that absence taught me was that sometimes you can plan sessions and interventions but you can't always plan your own life and things that happen in it. You just have to go with it and do the best you can in all situations but you can't do more than your best.
    Another personal story but I also had to go into hospital last year for some unexpected surgery. I had some clients who were almost angry with me for 'leaving them'. I found it much easier to walk away and trust my colleagues to pick up the slack.
    I try and compartmentalise work into two categories. Things I can change and Things I can't change.
    As long as I do my absolute best to work on the 'things I can change', I have to mentality divest myself of responsibility for the 'things I can't change'. That includes my health and family.

    A bit rambly but it's still early here. Good luck with the studies. Love the blog's look!

  2. Thanks for the comment on the blog's look! I just spent a good hour tinkering with it!

    I guess I hear you on the angry clients. I have one in particular who was confronting me every time she saw me about this ONE time I missed our session (it wasn't a huge deal logistically--she saw her counselor who she needed to see anyway). She misses appointments with me all the time, but I just thought it was so fascinating how she zeroed in on this with me. And I feel guilty. I'm not sure how to process that yet. She definitely has some abandonment problems going on (I'm at a DV shelter--there's a lot of self-victimizing that happens), so I guess in some ways this could be good for her. She will learn to see that there are others to help her when I'm not around.

    Thanks so much for sharing your experiences with me.

  3. I've been dealing with a lot of stress as well (unemployed, starting school, worrying about my dad's health) and I'm surprised I'm not having many depression symptoms right now. I am definitely focusing on self-care things like getting enough sleep, eating regularly, exercising, and making to-do lists so that I can SEE the progress I'm making when I check things off.

  4. Thanks for sharing your story. I, unfortunately, have been unable to manage my depression and a career. I left social work over 3 years ago due to the stress. Im pretty sure I suffer from secondary trauma which has complicated my recovery from depression. Im on new meds which has helped tremendously. I also believe I suffer from compassion fatigue. I do care about people, but detach from other people's pain. It is just too overwhelming. The fact that I suffer from social phobia doesn't help either. I dont know if I could ever practice again in a clinical setting, but I dont know what else I could do non-clinically. Nothing interests me anymore. I wish you luck and thanks again for blogging your experience.

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  7. I appreciate you sharing your story with me. Your situation sounds tough :/ I wish you the best, and feel free to contact me if you ever want to talk. I hope you find something that helps.

  8. I just have to say.... you are wonderful. Thank you for sharing your self.

  9. I remember my first practicum. I worked with refugee mothers who spoke no english and whose husbands had either been killed in front of them or 'disappeared'.

    It was such hard, but amazing work. I felt honoured to be a part of it.

    And then I noticed that I was shutting down more, easily overwhelmed, and getting less done. My supervisor brought in a counsellor to do a workshop on vicarious trauma and it all made sense.

    How do we leave the soul-breaking work behind at the end of the day? what meditation, ritual, or activity to we engage in to bring closure to our work and open the door to living our lives to their fullest? How do we maintain cohesion in the face of such tragedy and inhumanity?

    I'm not sure yet. But a lot of bubble baths, breathing, cognitive shifts, silver linings, and keeping my eye on my big picture is moving me forward so far. Oh, and a good therapist.

    You're not alone in that fight.