A Personal Account of a Psychologist’s Breakdown During the Pandemic

Diana J. Smith

This pandemic was coming for all of us. For those of us working in health and social services sectors, it came for our mental health in profound ways — and it still is.

I recently had a breakdown which led to needing to take short term disability and time away from my business. I am registered psychologist and own a private clinic. Why am I writing about this publicly? To put it simply – I think my story might help others. I believe firmly in transparency, taking accountability wherever that needs to happen, the importance of deep communication, and the need to push back against mental health stigma. These beliefs inform how I live my life personally, as well as professionally. I’m also in a privileged position as the founder of a company – I don’t need to live with the very real fear of work-related repercussions that many people need to wrestle with when going through something like this, and those values I live by are baked into the core of our workplace culture and how we approach our work as psychologists.

I will first talk about the context that led up to this, how it happened, as well as some of the things I’ve lost and what I’m working to repair. I’ll end this post by talking about my roadmap to recovery.

As a Psychologist I have encountered the view in my personal life that I should somehow be immune to these sorts of difficulties. The reality is, we are much more susceptible to mental health related struggles due to our occupation which comes with the risk of vicarious and direct traumatic stress injuries. Especially during times of global crisis like a pandemic, or during more localized crises like the opioid epidemic here in Western Canada and other parts of North America.

Where I believe we do have an advantage, is that those of us who work in applied fields of Psychology (Clinical/Counselling, Forensic, Industrial/Organizational, etc.) are skilled at navigating the complexities of the mental health care system. For me, this translated into a quicker pathway to healing. I’m still working on that, but happy to say after 3 weeks away from my company, I will be returning sometime next week and I have achieved stability again, after multiple weeks of being unable to sleep and multiple panic attacks per day along with difficulties with mood and grief. Many of the people I have worked with through similar circumstances take much longer to gain stability and achieve readiness to return to work – this is not a comment on some sort of strength or difference personally comparing myself to them. It is a call for us as a society to do better with simplifying access to care, and to not only talk about mental health, but take better action to address disparities in access to care, and shift the narrative more completely toward mental health difficulties as the same as any other health related issue that requires time off and recovery.

As for the context that led up to reaching a crisis point where I had a breakdown, a good starting point would be to describe the realities of my work. My clinical work focuses on obsessive compulsive disorders and eating disorders. While I do not have research to support it, my opinion is that these two issues saw a large increase in severity during this pandemic. Working with these presenting concerns means a difficult caseload to begin with, given that these two concerns often come with difficult co-occurring issues, and the reality that eating disorders are the most lethal of psychiatric disorders. During the pandemic, the demand for my services rose substantially and the individuals I would work with required more of my time and energy to get them the level of care they deserve and to optimize their treatment. This led to a gradual increase in stress and working longer hours with less time to take care of myself. I did not prioritize things that matter — important people in my personal life, and finding time to play, relax and take care of myself.

In this pandemic I finally recognized my most toxic trait: that historically when things become difficult, I throw myself more into work and isolate myself from leisure and connection with others. This is not uncommon for people who are motivated by achievement. I dislike the term workaholic, but I’ve recognized now, in the hardest way I could imagine, the destruction this pattern causes for families, spouses, colleagues, friends, and for the person who relies on work and achievement to feel better. Perhaps the workaholic term feels a bit better to me now as a descriptor. In any case, as the pandemic wore on, and with my heavy caseload, I made some decisions to try and make myself feel better which I would be concerned about if I were talking to a client in the same situation I found myself in: I resumed working on the thesis for a second graduate degree in Women & Gender Studies, which I had taken a leave from. I concurrently entered a post-graduate level program leading to board certification in school neuropsychology. I took on an involved volunteer role with the Psychologists’ Association of Alberta as the Chair of the Social Justice, Equity & Inclusion Community of Practice. I decided to also expand my clinic from myself, a student and a casual staff member using a small space into a much larger clinic: that involved hiring and coordinating with an architect, changing our marketing plans, developing internal policies from scratch, setting up a human resources program, finding an accountant and lawyer to work with, and hiring and onboarding 4 new permanent fulltime employees. I found myself moving from doing one full-time job early in the pandemic, to doing 2 graduate level degrees, carrying a more than full-time equivalent caseload, chairing a committee, and doing a large and involved expansion of my business.

I somehow managed to hold all of that together for months and it felt good. Until I wasn’t holding it together anymore and it felt like the world was coming apart. Early on, I told myself this would not lead to burnout: I was doing a variety of things, and there wasn’t much else to do anyway during this pandemic. I enjoy my work and I enjoy academia. The reality was, when I told myself this I didn’t pay attention to what I was losing by working so much. I am not exaggerating when I say, I would work 14-hour days 6 days a week. My mental health deteriorated substantially — slowly at first, and then more rapidly around the Holiday season. My relationship with my partner suffered terribly, I withdrew from the hobbies I could have still maintained despite lockdowns, and I became anxious all the time — not only was I having difficulty sleeping most of the time, but I was having panic attacks and my world felt both small and dangerous all of the time. Instead of acknowledging and acting on the warning signs, I kept working.

Things really came to a breaking point for me nearly a month ago now. After almost an entire year of feeling like I was managing things, I had a full blown mental breakdown. The panic attacks started back in December, and my long-term partner was becoming more concerned, but I ignored those warning signs and told her and myself in another few months I’d be wrapping up the grad programs – it’s wild to look back as a psychologist and say that, but… it is always much easier to have insight about someone else’s behavior than your own.

What pushed me over the edge were two things: A reaction I had to news of some tragedies in my personal life related to the deaths of someone I knew and their children which made the world feel that much more cruel, unpredictable, and scary. The second thing was the images of swastikas showing up in the nation’s capital during anti-mandate protests — seeing thousands of people rallying with this hate symbol present touched a nerve that was already raw.

I was over the edge at this point: I was having panic attacks constantly, unable to sleep for more than a few hours at a time, was terribly depressed and having constant anxiety and fear about me or those close to me dying. I could not function any more at work, and the most important person in my life had to step away because my panic attacks, anxious thinking, and overall mental health were impacting and triggering fears for her in addition to the damage done to our relationship over the months leading up to this, with me working all the time and being fatigued or unavailable. It felt like I had lost everything and had failed everyone. My employees, my clients/patients, my partner, and my family.

As a psychologist, I am in a privileged position in regards to my ability to both navigate the system of care and my knowledge of the available resources, as well as my economic privilege which affords me the ability to access services that cost far too much money for what is an essential part of care for many people. This is my roadmap to recovery:

1: In my panic attacks I had been reaching out to people who I knew could help me, but they had set a clear boundary because of my mental state, the impact it was having on them, and that they felt powerless to help or support me. After realizing that boundary and that I was hurting these people, I started to contact the Distress Centre Calgary instead. They provide 24-hour support in my community, and can be reached at 403-266-HELP (4357). I often recommend this resource to my clients and encourage them to call for any mental health or social related supports and to call before it becomes an emergency. This was hard to do as a professional and ran the risk of perhaps talking with someone I knew. The fact is, though, I needed help and they were there to get me through for part of this. I am grateful, and I’m glad I pushed through the hesitations I held as a mental health professional. Thank you, Distress Centre Calgary.

2: I set an appointment with my family doctor. For Albertans, your primary care provider – whether a family doctor or nurse practitioner – should be your first point of contact in situations like this when you do not need to go to an emergency room. Do not ever hesitate to start the conversation if you’re experiencing anxiety, stress, depression, or other mental health symptoms. Your primary care provider can facilitate referrals and access to the care you need, as well as start discussions around medication and prescribe medications to you.

3: Due to the difficulties with the strain on the care system from the pandemic, I was unable to see my family doctor for several days after realizing how much I needed help. I reached a point where the panic and lack of sleep was too much to handle and I was making very poor decisions. I was also not feeling safe anymore — I did not have a plan, but I was having suicidal thoughts. Rather than sit with it, I contacted a former colleague and friend — Kate Todd — who is an amazing social worker who I am lucky to have in my life. I told her I needed to go to urgent care and was not thinking clearly. I was in a very bad place. We made a plan, and she drove me to see a doctor at a walk-in clinic and I got necessary medications – a start on an SSRI (this is a common class of antidepressant/anti-anxiety medication) to help with the depression and anxiety, a fast-acting medication I could take when panic attacks came on to help get me through those, and a sleeping medication.

Medication, after a week or so, gave me stability and clarity back — I was no longer having such frequent panic attacks, and I was sleeping. The SSRI also started working after another week and I felt like myself again. The fear went away for the first time in months, and I was able to start doing normal activities again. We often say it as professionals, but medication is a very important part of mental health treatment. There is no need for hesitancy, or stigma around these treatment options. I know that I would not have made it through this and be able to write about it without medications and that these medications got me back to feeling not only normal, but being able to laugh again and be in public spaces and feel at ease.

4: My company provides great benefits and as a psychologist I have economic privilege, so I was able to access a private psychologist. This is not always so readily available to everyone. We need better access for all Canadians, so they can get support before needing to be admitted to hospital or to intensive publicly funded programs. You can find a psychologist if you have benefits on the Psychologists’ Association of Alberta website. You can also find psychologists and our excellent colleagues in the areas of social work, occupational therapy, etc. on the PsychologyToday website, which provides a listing service for clinicians. If you do not have access to benefits, here in Calgary the Calgary Counselling Centre is a great option for free or low-cost counselling. CARYA also has a number of great programs for counselling services and family supports.

5: I leaned into my community of friends for support and was open and honest with what was happening to me. I’ve benefitted from meals when I couldn’t cook for myself, chats over coffee, and support with getting rid of this belief that had developed over COVID that the world is a much more dangerous and dark place than it really is. That was a tough one for me, as I’ve always found life to be beautiful and genuinely enjoy time with other people, new experiences, adventuring, and appreciating the little moments. That is who I really am, and I lost that over the months leading up to this crisis. Thanks to my friends for getting me back out, and back to that important part of myself.

6: Lastly, I made some hard decisions. I realized during this crisis that I had pushed myself so hard with trying to achieve and do my best work for everyone that I reached a point where I could no longer handle day-to-day life, and I had no breathing room left when life threw some curveballs my way. Some terrible things happened, sure, but I was the one who turned myself into a ticking time bomb. I was the one that ignored all the warning signs that I was in trouble for months.

I needed to correct this quickly, and for the long-term. After getting some stability back, and starting to feel like myself again, I’ve cut back on work. While away on short-term disability, I made the hard choices that ultimately will protect me and what I’ve learned from this. I stepped down from a number of work related roles, hired additional staff at our clinic, scaled back my clinical work and made plans to transfer many of my files, exited one of my graduate programs, and left many other responsibilities behind as a mentor and volunteer. For my other grad program, I spoke with my faculty mentor and adjusted things to part-time status. I can now look at my schedule and breathe again – I have time to manage my business, support my team, work on my board certification in school neuropsychology, and see a couple of clients, and get regular breaks in an 8-hour day. For the first time in a very long time, I have space to actually live life.

Sometimes if we are lucky, when life shakes us so violently, we can pull a lesson out of all the rubble and devastation after the fire stops. This was the case for me. The lesson is not just the realization that is somewhat comical to have taken so long to realize: That no one can do it all and the answer to stress, discomfort, and vicarious trauma is definitely not to add more work in the mix. It goes deeper than that for me.

The deep thing that life has taught me from this experience, is that there are more important things in life than work and education. Like a lot of life lessons that stick, it comes from something traumatic. Sure, this breakdown was horrible and I’m still picking up the pieces and trying to understand how I got there. But, it’s more of the realization that I lost someone I loved through all of this, and I do not have control over whether or not that will be repaired. The hard lesson is this:

Work and education are tools that help us build and protect the life we want and need. What good is a box full of the best tools, if you have forgotten, lost or never really knew in the first place what you were building? What is the point of all this hard work building and achieving in a difficult profession or as an entrepreneur, if it is not for ourselves and the people we love? I’ll never let this happen to myself again, because this realization is so visceral for me that it is encoded into who I am now: no amount of success or feeling useful and needed by society is worth my life or losing sense of who I am, or losing the people I love.

In the end, life does go on. And life is beautiful and great again for me — or, it is at least getting back to feeling that way alongside all of the grief and loss. I’m still working on healing fully from this but feeling positive again about my future and not feeling afraid all the time. I’m able to sleep and eat, maintain a routine, look after myself, laugh again, and the panic attacks have gone away. I’m happy to get back to work. I’m even happier though, to have my life outside of work back for the most part.

If you are struggling and you are in Alberta, contact the Alberta Mental Health Help Line at 1-877-303-2642. If you are in Calgary, contact the Distress Centre at 403-266-HELP (4357). If you are reading this elsewhere, do a quick internet search for your local helpline, write it down and put it somewhere – you never know when you or someone you know might need it. If you are experiencing fatigue from this pandemic, difficulties with the transition back out of pandemic restrictions, or stress, anxiety, or other mental health symptoms – talk to your doctor right away and don’t let it get out of hand to a point you lose yourself or others who matter.

If you need to access low-cost or free counselling services in Calgary, contact Calgary Counselling Centre at 1-833-827-4229, or CARYA at 403-269-9888.

Stay kind and strong for everyone – you never know when you’ll need that in return from others. If you’re struggling, or if you’ve lost something or someone important – don’t give up hope for whatever is coming next. Even the most difficult storms end.

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