Here I sit, staring at the words I’ve been writing in my diary of the last year, with tears rolling down my cheeks.
These are not tears of joy, for there is little in the words before me.
The past year has been sheer hell. Not for any one reason, but a multitude of big & little things. These sneaked up, built walls & built ditches but never built bridges, until the “inevitable” happened.
I spiralled into anxiety, depression and to the verge of a nervous breakdown.
Looking back, I can place the seeds of my illness at a time well before I became aware of it. It was during a period two years ago when a colleague suffered depression, and refused to seek help. In the end I had to stage an intervention to get them the help they desperately needed, but it also meant pressure on the rest of us to cover the patients as we could not secure a locum.
Following that event there have been repeated episodes of depression which have resulted in a lot of time off, which again put undue pressure on the other dentists in the practice. We were perhaps too “nice” in trying to keep the pressures from our colleague to not hamper his recovery, thus failing to see the impact on ourselves.
A year ago, at home we went through the sadness and trauma of my wife’s first miscarriage. My colleagues and staff were wonderfully supportive at the time, but I failed to realise that such an event doesn’t leave you as you were before. It isn’t in the same category as losing a loved one, but the emotions are still the same.
Early this year, we suffered a second miscarriage and the unexpected loss to cancer of a good friend at the tender age of 36 within a couple of weeks of each other. My normally stoical demeanour was starting to crack, and I know now that my behaviour toward others, including patients, altered. I strongly suspect that some of the newer patients I saw in that period will not be attending for recalls with me.
All it took from there were a few arguments with my colleagues, typically regarding minor practice protocols, website updates, staffing, etc and I became constantly irritable, short-tempered and prone to episodes of deep melancholy – especially at home. When one evening I broke down in tears while regaling the events of the day to my wife, she knew it was time for me to seek help. I’m now ashamed to admit that I didn’t agree with her. Fortunately, she persevered and ensured I made an appointment with my GMP. That is where my blog will begin.
Over the next few weeks/months I will relate to you my thoughts & feelings, recalled from the diary my therapist (that would be the psychotherapist, not a DCP!) encouraged me to keep. I have her support in providing this blog to my colleagues as a part of my continued recovery, and in the hope that it will assist others in our profession who may find themselves in a similar situation.
Firstly - congratulations on having the courage to share your ordeal. I had my share of "black-dog" days, weeks and months before I finally gave up clinical dentistry. It's a very difficult thing to acknowledge, understand or let alone share.
Secondly - thank you for sharing. It is very important that everyone in dentistry (and beyond) recognises the signs and symptoms of the illness.
Depression is widespread in dentistry for a number of reasons. It's a solitary job - even if you're working in a group practice (I was not). It's incredibly stressful and it's easy to let yourself be exposed to increasing amounts of stress if you don't say "no" to things on a regular basis. It's very easy to get caught in the cycle of never getting away from work: "clinical all day, paperwork brought home, journals to read, computer open all evening, get up & do its again". The result can be that when something extra arrives e.g. a family illness or other crisis (which can seem relatively small to an outsider) it is enough to push you over the edge into illness. That fall can be quite a sudden one and it can take a very long time to recover.
The other ways that the illness can manifest itself (which I have seen in dentistry) is through displacement behaviours - alcohol, drugs, sex, spending money etc.
I hope that you are well on your way to recovery and that your story will help others who may be suffering as you have or have a colleague who is similarly afflicted.
By very best to you.