Returning to work after severe depression

Doctor Cathy Wield shares her journey back to treating patients after recovering from her own ill-health

I started on my quest to return to work as an A&E doctor, exactly a year ago. I had booked myself onto an ‘Advanced Paediatric Life Support’ course (required training for A&E) and so last January started in earnest to revise skills I had not used for the preceding seven years.

I had retired on grounds of ill health, from a psychiatry post after we moved to Scotland. I had tried a new specialty because I couldn’t face continuing my career in A&E as I was no longer enjoying it - something I now realise was more about my illness than about my career choice. 

So getting through the APLS course gave me a much needed boost in my confidence. I met with the Lead Consultant at Watford General Hospital A&E department; David was incredibly supportive, especially as he had not met me before. He did not see my time out of medicine as an insurmountable barrier, although not surprisingly he did express some caution, saying that we should find out whether or not I really wanted to return.

I started as a ‘clinical observer’ in A&E under an honorary contract with the Trust, but after one day of literally observing, I was keen to get going and see patients – reporting to a senior afterwards, before any decisions regarding their care were taken.  Meantime I kept up the studies at home, revising what I needed to about the myriad of conditions patients present to A&E with.

Finding my feet was not easy, but I felt such a thrill when I found that my basic skills as a doctor were still there, just beneath the surface. However now the rules to encourage thorough hand washing meant you have to be ‘bare below the elbows,’ which immediately led me to worry over the faded but still very present scars on my arms; they were left from a regretful 10 minutes, over 10 years ago when I had experimented with the pain and relief of tension afforded by cutting.

I was anxious about how I would be perceived, judged even and I soon saw evidence of how stigmatising these type of scars still are. The reality is that they are ready signs that lead to a conclusion that the patient bearing them is an emotionally unstable person. It is an unfair though occasionally a correct assumption of course, but still grates when a person is judged to be ‘overreacting’ to pain for instance, because of them. This sort of stereotyping happens with anyone who has a history of mental illness, though fortunately I noticed that attitudes had improved and now staff seemed much more understanding.  

I had made up my mind that I would be open about the reasons for being off work for such a long time; though Depression is still seen as something to keep quiet about, even a sign of character weakness, by the medical profession as a whole, so also not surprisingly by the general public and disappointingly by many fellow Christians.

I celebrated when at last I was ready to do locum posts in A&E at WGH, although I have to confess, so far the experience had been akin to eating humble pie. I had to do business with myself over how I felt – I could easily be demoralised at how slow it seemed for me to regain my previous levels of competence and confidence.  I am still on that journey; much has changed in the finer detail of current treatments, also getting to know the local hospital, policies and protocols and of course the many other staff I work with has been a challenge.

One of the real treats in being able to do locums was to come off Incapacity Benefit.  I had been on this for a while and in fact it meant that even as an unpaid clinical observer, I could do no more than 16 hours a week at the hospital. A very nice lady from the Benefits office asked me how I felt now I no longer required the benefit and I gladly shared with her - it was liberating. I was so chuffed, I felt free at last –  it was a real step forwards.

I believe all our abilities are God given and the very fact that I was yearning towards using my skills as a doctor again was enough for us to believe they were not lost.  I have battled with low self esteem during the periods of illness, but I had come to the point where I realised I had value like every human being, just because I am – in my spiritual eyes, created by Him. 

I do not wish my particular set of circumstances on anyone and nor do I see them through rose tinted spectacles, but I have a deep knowledge that somehow the suffering that I and my family went through, can be and is positive. I am not a better person for it, though maybe a more thoughtful and compassionate person. I have noticed that chatting about my depression at work starts conversations and allows others to speak of their own unique experiences. It’s good to talk.

Returning to work is also symbolic – many people think that mental illness is for life, which is not true in the vast majority of cases. I have a diagnosis of Recurrent Depressive Disorder since I have now had two serious episodes; however, I am in remission - hopefully for the rest of my life.

But now I am on preventative treatment in the form of antidepressants and I have agreed to protect myself from stress. You may think that a job in A&E is not exactly restful, but it is the career I previously pursued and for me, it is the area of medicine where I have received most training, so this speciality is actually less stressful for me than others might be; even more than that, I enjoy it. If that stops then I need to seriously look at my mental health!

However I do recognise that I need to take care of myself. Phil, my husband is a counsellor and has also led sessions of Mindfulness and Christian Meditation.  I have received much benefit from these disciplines and he has taught me the value of Silent Prayer, incorporating them in a search to come close to God. This is a way of grounding me, taking me off the fast lane and benefits my mental health. Keeping close to my family and friends, running our Depression workshops and being an active member of our church soon fills up the remainder of my week; prioritising adequate rest and relaxation is vital.

I have been in a substantive post since the end of October and all the hard work has been worth it.  I work part time on designated days of the week and for this I am very grateful, even though it meant I was working through the Christmas and New Year period.

I am glad that God gave me this opportunity to work again; though I cannot predict the future I do know that my life is truly in His hands.

Cathy Wield, a wife and mother of four was a Specialist Registrar in Emergency Medicine before her second bout of serious depression.  She has written two books about her illness and remarkable recovery. She wrote the second book particularly for Christians, to share and at the same time to educate her readers about the stigma attached to mental health conditions.  Life After Darkness (Radcliffe 2006) and A Thorn In My Mind (Instant Apostle, 2012) are available from Amazon in printed & kindle form.