“Anyone can have a nervous breakdown – I’m a therapist and even ignored the warning signs”
Paul McCann knows more than anyone about how to take care of his mental health, but that didn’t mean he was immune to a nervous breakdown.
It wasn’t an event that rocked Paul (52), who works as a psychotherapist with youth services in Wicklow and Kildare, and 2019 has been the perfect storm of a year for him. The sudden death of his older brother, the suicide of a close friend as well as other significant changes in his life – all of these massive life events, combined with too hard work and a feeling of exhaustion, have him. rendered unable to cope.
The lowest point came after he didn’t sleep well and had nightmares. Life seemed unbearable and having woken up at 5 a.m. one morning, realizing he might have some serious problems, he headed to his GP before they opened the doors. His GP arrived to find Paul sitting on the doorstep requesting an emergency appointment.
As someone who helps people navigate their own mental health journey, Paul recognized the signs that he was getting very weak. He had ignored the warning signs, feeling he had to continue. That was until he couldn’t continue and literally stopped.
Part of his recovery consisted of finding things to do that made him feel better, like walking his dog with other dog walkers, singing in a choir, and writing creatively. These activities were part of a social prescribing initiative that examines a person’s interests and helps develop those interests so that they can once again feel in control of their life.
Paul is hoping that by sharing his story and letting people know that anyone, even someone who knows what they should be doing to take care of their mental health, can hit rock bottom.
If the social prescription model is not new, the HSE has just launched a national framework in collaboration with the community and associative sectors to generalize and perpetuate it. The idea is that no matter where you are in the country, you will be able to connect with the Prescription Liaison Social Worker in your area to access non-medical support services, from yoga to driving lessons.
According to Anne Sheridan, head of the mental health and wellness program at HSE, social prescribing doesn’t work by asking yourself ‘what’s the matter with you? but rather by asking “what matters to you?” For Paul, his journey to social prescribing began after hitting rock bottom and trying to persevere long after noticing the warning signs.
He left his Tullamore home to study in Dublin before moving to Denver, Colorado, meaning his ties to his hometown had weakened. The death of his father when he was just four and his mother in 2005 also meant he was not a frequent visitor to Tullamore.
His work in the improv theater in America had taught him that there is no failure, that if you take whatever comes, you can build on it. The lessons had served him well and he found he was able to draw inspiration from them when it came to training as a psychotherapist.
By 2018 he had worked hard, but the relationship he had been in for eight years was not going so well. The death of his brother in May 2019 and the suicide death of a friend, who had helped start the improv theater company with him, left Paul in shock. When his relationship ended, he found himself returning to Tullamore after an absence of over 30 years.
âIt’s just that everything started to take over me. I had reached the point of saturation. I started to feel bad and depressed. I was advised to take time but felt I had to keep going, âsays Paul. Very quickly, he realized that he was not succeeding. He couldn’t see a future. His GP wanted him to be hospitalized, but he refused. He agreed to stay with friends in Dublin and see his GP a few times a week for a period of six weeks.
From March to November 2019, he was on sick leave. He began to realize that he had continued for years. He adds, âTherapists are great at giving advice, but we are the worst patients. If I had a client sitting across from me, I would have insisted he stop and take time off. I received this advice, but was afraid that if I quit, what would happen? “
The unprecedented period of loss in his life left him feeling detached from any future he had foreseen. Finally, he just had to stop. âIt’s unusual. I’m a mental health service provider, but even in my profession we don’t talk about therapist burnout. We’re supposed to handle it. It was interesting to go from service provider to service user. But it also really influenced my practice, âhe says.
Even though he knows all the best ways to manage his mental health, it wasn’t working out well for him. In the normal course of things, he says that the house is a place where you can go to rejuvenate and rest. Her home had become a pressurized environment. The only time he had any room to debrief was on the drive home or a brisk walk with his dog, a cavachon named Poppy.
âEverything was coming to me. I was walking on the water. When I moved to Tullamore, I collapsed. You can only push the body that far, âhe says. Although returning to Tullamore was not part of the plan, it allowed him to bond with old school friends and solidify relationships with his siblings.
He had heard about the social prescription model in his training as a psychotherapist and his general practitioner had also told him about it. Back home, he got in touch with the local social prescriber who mentioned the group of dog walkers.
Even though he was nervous about going out, he describes Poppy as very encouraging and slowly but surely the two met other dog walkers in the social prescription group. âWe were walking and talking. There were a lot of people in the group; each was there for their own reasons. I got to know people. It was nice to be able to be honest and say how I was doing, âsays Paul.
In addition to the dog walker group, he followed his own interests to join the creative writing group and the choir group. It gave him the freedom to be himself and to relax.
âI guess I would have been a very spontaneous person. In many ways, I had a very serious profession and had lost much of my spontaneity. I became very regimental and I compartmentalized myself to function. These groups allowed my creativity to express itself. I got out of the box others had put me in, âhe says.
Over a six-month period and with the help of medications prescribed by his GP and social prescribing groups, Paul says he gradually started to feel better. âThere’s an old adage that goes ‘it doesn’t get better but it gets better’, and every time I saw my GP she was really encouraging. I started to find my feet and I started contributing to prescription social groups, using my talents to do some volunteering, âhe says.
Paul says others began to see him as a valuable resource, something he had stopped doing. He started to reconnect with his friends and spoke honestly about how he felt. For months he had completely shut himself down and withdrawn from those same friends.
âI was embarrassed. I’m a therapist, I’m not supposed to have depression. Therapists are human and they have breakdowns. I said I had to break it before I pierce. You sometimes forget that the last thing to to come out of Pandora’s box was hope â.
Paul is also adamant that it’s so important to talk to people and have honest conversations about how you really feel when it comes to taking care of our mental health. âIf people can read this and say, ‘even a counselor can have a hard time,’ that demystifies the whole process.
âThe social prescription brought me back to the fact that relationships are essential to everything in our lives and to building that relationship with myself,â he says.
Now back to work full time, Paul says he’s more proactive in dealing with his mental health. He always meets with the members of the dog walker group individually. He’s more connected to his community after meeting people from the choir and creative writing group. He also takes the time to prepare nutritious meals and when he is tired he goes to bed early.
âI am very aware every morning that the evenings are mine and the weekends are mine. I take my breaks at work. I have always been very good at listening to my body and I got back in phase. I use mindfulness-based stress reduction a lot. I’m saying if it’s good enough for my clients, it’s good enough for me. The three pillars of my life – home, work and friends / family are good. Three years ago, zero in three were working, âhe says.
According to Paul, by tapping into the proposed social prescription activities, he was able to get out of the grip he had carved out for himself. âSocial prescription consists in bringing things back to oneself. It’s about saying “this is what I like to do”. It’s really about empowering rather than relying on someone else to fix you. It’s about healing yourself and using your own resources. It’s about being part of something â.
He advises people to notice the warning signs that all is not well. He says it’s important to pay attention to your mood, your level of fatigue, and watch things like drinking. “We are devils to come out of ourselves to fill this hole when the answer is ours,” he said.
For more information go to hse.ie/eng/about/who/healthwellbeing/our-priority-programmes/mental-health-and-wellbeing/social-prescription