Where are the therapists?

I was told that because it can take months to a place for therapy I should get a place in several waiting lists. But I couldn’t get a place in any waiting lists. All the waiting lists were closed.

It’s so hard to find a therapist. They are only available to answer the phone at certain times and you always get answering machines telling you ‘if you’re calling about a therapy place, I’m sorry to inform you that I have no free places and the waiting list is closed’. It’s so demotivating to keep calling and keep being told that there’s no room for you. When you have depression the last thing you want to do is to make more calls and get rejected again. For long periods of time I would give up and not bother calling. It was January when my doctor gave me a list of therapists and until yesterday I couldn’t even get on a waiting list. If you have public health insurance in Germany it’s so difficult to find a therapist. There are so many people needing therapists and so few public therapists. If I still had private insurance that would be a completely different story (in fact I had been lined up with a private therapist last year until my insurance fell through).

When I got the therapist list off my psychiatrist, my initial plan was to seek out a therapist with good reviews. I went through the list crossing off any therapists which were difficult to get to and male therapists (I thought I would feel more comfortable with a woman) and I narrowed the remaining list down to therapists with good reviews. I was told that because it can take months to a place for therapy I should get a place in several waiting lists. But I couldn’t get a place in any waiting lists. All the waiting lists were closed.

One therapist I sent an email to told me that unfortunately she had no places available and she gave up with her waiting list because it grew very long, very quickly. But she encouraged me to keep calling therapists and keep trying because places would open up. Every therapist had the same story ‘no places, no waiting list’. It seemed so unfair to me, I was just supposed to keep calling and hopefully get lucky? At the end of the list was an organisation which was supposed to help with finding a place. I tried calling them as well but they simply told me that there were no places.

My depression has kind of relapsed recently (I say ‘kind of’, because it never really left), I’ve been getting upset about the most ridiculous, arbitrary things. Last week I had a breakdown because I entered the time for my physio appointment into my calendar wrong and ended up being fifteen minutes late. I was absolutely devastated that I could only have a ten minute appointment. Then there was the breakdown the week before after I bought a new pair of glasses and then later found out that I had bought a very expensive pair and could have saved a lot of money (it was my first pair of glasses and so I didn’t know what a normal pair costs). To top it off, my computer decided to breakdown on the weekend, and when you take online German lessons that’s really not great. (At the moment I’m using my very old, slow, clunky laptop which at any minute is going to overheat and turn itself off and has an English keyboard, which I haven’t used in years -I can actually change it to a German keyboard but then an important key is missing.)

After crying on Sunday for about four hours over something stupid and knowing that I was in a really bad state, I decided it was time to do something to change the downward spiral. I contacted my friends. I asked them to pray for me. It was also time for me to try and find a therapist again (it had been a week or two since I’d last tried to make enquiries).

I sat down yesterday with the list of therapists and decided to call every therapist in my city from top to bottom. I had a pen in my hand and if they said their contact hours, I would write that down. I would call them again, even if their answering machine would tell me they had no places. I would take breaks after every couple of calls but I would keep making more calls.

(It’s actually strange how determined I was. Normally when I’m depressed I have no determination what so ever. I’ve been especially unmotivated to do anything lately; my household chores have been extremely neglected as of late, I haven’t spent as much time learning German as I normally would, and I haven’t had much interest in leaving the house. But yesterday I managed to achieve a lot, even if it was very slowly thanks to psycho-motor retardation.)

With each phone call I got the same response ‘Hi, this is the practice of …. Unfortunately I can’t answer the phone during therapy hours, you can reach me on… at…. If you’re calling about a therapy place, I’m sorry to inform you that I have no free places and the waiting list is closed…’. I reached the seventh therapist in my city on the list. I had made some notes about her; she had a perfect rating on the infamous German doctor rating website and she had no free places. It was 12.30pm. Her answering machine picked up. ‘Hi, this is the practice of …. Unfortunately I can’t answer the phone during therapy hours, you can reach me on Mondays between 13.30-14.15…’. Strange, she didn’t say anything about not having a place. I set an alarm to call back at 1.30pm.

In the meantime I complained to one of my friends over WhatsApp about how difficult it is. ‘Germany needs a better system for getting therapy. I can’t find a place because there are none and I can’t get on a waiting list because there are none and when I called the organisation which is supposed to help me find a place they couldn’t help me’. Then we prayed together.

I called the therapist again at 1.30 but the line was engaged. I decided I would keep calling until I got through.

1.32pm: engaged

1.34pm: engaged

1.39pm: engaged

1.42pm: engaged

1.45pm: engaged

At 1.48pm she picked up.

‘Hi… I’m looking for a therapy place.’

‘Yes, that’s difficult. How flexible are you?’

‘I’m very flexible, I’m a freelancer.’

‘Ok, could you come in last minute tomorrow at 8am?’

‘Yes, that works for me.’

‘Just so you are aware, this is only a preliminary talk so we can get to know each other. This isn’t therapy. I probably won’t have a therapy place for six to eight weeks.’

‘Yes, I’m aware of that.’

‘Ok, then see you tomorrow.’

So today I met with the therapist just so we could get to know each other… not for therapy. I nearly had a panic attack on the bus on the way when my phone decided to throw a temper tantrum and Google Maps stopped working so I didn’t know how to get to the appointment (I had a vague idea where the street was, but I couldn’t just wander in the vague direction and hope to magically arrive and I’m terrible at following directions, so even if I called the therapist and asked for directions, who know’s if I would arrive). Luckily it started working well enough that I could at least SEE the map, even if it wasn’t giving directions. I probably need a new phone though.

So I arrived for my appointment with three minutes to spare. She told me to hang up my coat and take a seat, offered me a drink and took my insurance card. All the usual things. Of course, she then reminded me that this was not therapy yet and she couldn’t say when a place would open up.

‘Are you nervous?’

‘No’

‘Have you had therapy before?’

‘No… actually yes, when I was in care…’ (the phrase ‘in care’ makes more sense in German).

‘Were you an inpatient?’

‘Yes, I was an inpatient for seven weeks. And a part time inpatient for thirteen weeks.’

‘In a day clinic?’

‘Yes.’

‘How old are you?’

’24’

‘And what has happened in your life that has made you so unwell?’

I started to tell her everything: being told I was a bad teacher, failing my placements, having three of my classes ask for a new teacher in the space of a month, being afraid of losing my job… (I’ve only been wearing glasses since Wednesday but I’ve already learnt that crying and glasses don’t match. I took off my glasses, placed them on the coffee table and reached for the tissues.)

It continued for 45 minutes. She asked about my family, my relationship to my family, if depression runs in my family (yes). She would respond to my story and say ‘poh’ (which the occupational therapist in the day clinic used to say too), as if to say ‘wow, that’s heavy’. A couple of times times the therapist told me she needed a second to take in what I’d said and that my story was a very sad one. She told me I was strong and I was a fighter.

‘I’d be lying if I said you were an easy case’, she told me, ‘you’re not, but I think you know that.’

‘Yep’

‘I want to help you. I’m taking time off next week for the Easter break. I can see you in a fortnight on Wednesday at 8am. Are most of your classes in the evening?’

‘Yes, most of my classes are in the evening, sometimes I have morning classes, but most are in the evening. I have no classes on Wednesday mornings at the moment.’

‘Ok, then Wednesday at 8am or do you prefer Friday at 8am?’

‘I’d prefer Friday…’

‘Ok, then I’ll see you on April 21st at 8am.’

And that’s how in the space of 24 hours I went from not being on a single waiting list, to having a preliminary appointment, to scheduling my first appointment before a space even opened up.

It’s impossible to get a therapy place in this city. But somehow I did the impossible.

Living abroad with depression

Full steam ahead.

One and a half years ago I moved to Germany. Around the same time my depression got out of control. I wouldn’t say that moving to Germany caused my depression. It had been around long before, but it definitely contributed to it.

Moving countries is hard enough as it is. There are different procedures, visa regulations, possibly a different language, and you’re in a different environment and culture. Throw depression and anxiety into the mix and you’ve got a cocktail for danger.

I think the biggest problem for me was moving out of home. My large family lived in a small house and now I had not only a bedroom and a bathroom to myself, but a whole floor. I shared my new home with a family, so I wasn’t completely alone, but going from having my sister sharing my room and always being in my pockets to having my own space was a big change that I struggled with.

To top it off the German authorities forbade me from working until my visa was approved so I had nothing to do for two months. That only made things worse. Boredom is the fuel to the fire of depression and anxiety. It gives you time to think, or as the German psychiatrists say ‘grübeln’. Grübeln is a fantastic word that doesn’t really translate well in to English. It means to ponder or brood very deeply and it usually has a negative connotation.

When you’re depressed, deep thinking can be dangerous and damaging.

Once I got my visa I found out that it would need renewing in a year’s time and that for it to be renewed the authorities would assess if I was earning enough to support myself. Naturally as a freelancer I didn’t have stable work and so whenever I didn’t have as much work as I wanted I would ‘grübeln’ and worry about whether I would have my visa renewed the following year.

That lead to me to hospital.

It wasn’t just my visa that fanned the anxiety and depression. Moving overseas meant lots of paperwork; paperwork I couldn’t do. If you think paperwork is difficult in your own language, try doing it in your second.

There was a letter I received from the tax office which I simply ignored for quite some time until a social worker stepped in and took care of all my paperwork.

Then there were the assumptions. Often people thought that I was depressed because I was in Germany. Often people would tell me to ‘come home’.

‘I am home’, I would tell them.

Other people would think I was escaping something in Australia. Some people suggested moving city instead of country and one psychiatrist asked me, ‘what was so bad in Australia?’.

Nothing was bad about Australia. But when I was 16 I fell in love with Germany and ever since then it had become my dream to live here. 

My Mum has supported me ever since I bought my plane ticket to Germany. Even though she would love me to move back, she knows that home is where the heart lies and that my heart lies here. She knew that moving back to Australia wouldn’t fix my depression, in fact we both feared it would make it worse.

So I stuck it out.

It got better over time. I got used to living alone and I got very good at asking for help with paperwork when I need it. Sometimes I ask one or my landlords or a friend or even the company I’m filling the form out for. The other day I left a checkbox unchecked on some paperwork. But that was ok, they just resent the paperwork with the field highlighted. It’s no big deal.

I’ve also learnt to simply trust God that I will have enough work to provide for myself and have visa renewed.

That said though, sometimes Germany throws me some curve balls. Recently I’ve been struggling with the language. After set backs in finding a fully contracted job last month, I decided that would do what it takes to become a recognised school teacher in Germany. The first step is learning German to a point that I will speak like a native (CEFR C2). I set myself the goal of reaching that level within in three years. So, I started taking an online German course and was told I was at level B1. It was a whole level below what I would have picked for myself and that was a huge disappointment. Still, even though the company allowed me to move up half a level it is still very upsetting to be told you’re not as good as you thought.

Now as I actively learn German l get angry with myself every time I make a simple mistake. I criticise myself. ‘I should know better than to use the singular form of the verb with a plural noun.’ ‘I should know better to put than to put the verb in the middle of a subordinating clause.’ ‘I should know better that it’s ‘wurde’ and not ‘würde’.’

I’ve been speedily learning German. I feel like it’s a comfortable pace for me. I don’t feel rushed or that information isn’t sinking in. Quite the opposite actually. If there’s one thing I keep getting wrong I practise it again and again until it becomes second nature. But yesterday my tutor implied that I’m racing through the course too quickly. It made me feel judged and bad about myself. For the rest of the day I couldn’t even think about learning German.

My mum said not to listen.

Earlier this week my mum told me I shouldn’t drive faster than 100 km/h, maximum 110 km/h. I simply laughed and when I was on the Autobahn I drove at speeds of up to 170 km/h (for the tiny section of road that had no enforced speed limit). When I told her I was upset at what my tutor said, she told me:

When I make comments about you driving “too fast” on the Autobahn you laugh at me – and do it anyway. So that’s the attitude you need to have about some German language tutor saying he thinks you’re going too fast. It doesn’t matter what he thinks – that’s the whole point of online learning modules – you can do them at your own pace!!! It would be different if you had enrolled in a class and was trying to work ahead of the class.

So it’s time for me to stop worrying what other people think.

Full steam ahead.

The Do’s and Don’ts of Employing Someone with Mental Illness.

It’s been a while since I posted. While I always had the blog in my mind, unfortunately my life just got too busy and for personal and health reasons I had to step back from my writing for a period of time.

I’ve had some very interesting experiences with work over the past twelve months with two very contrasting workplaces. On the one hand, I had an employer take me back on as a freelancer after I took 20 weeks off while in hospital and on the other hand an employer fired me without providing notice or a reason (however, I’m sure that reason is related to a stigma towards mental health).

Based on my two very different experiences, I’ve compiled a list of the do’s and don’ts when employing someone with a mental illness. Every point on this list is taken from real life experience and written from my point of view.

Taking time off work

Do

Allow me to take a couple of weeks off work if I say I’m feeling a little bit stressed. When do I come back after two weeks I’ll be fighting fit again and allowing me to take time off will prevent things from escalating.

Don’t

Tell me that you’re glad I’m ‘finally admitting’ that I’m not ok. I was ok before, now I’m not. Depression isn’t one of those things that is consistent, it comes in waves, and you’re really not helping.

Do

Welcome me back to work after 20 weeks off and allow me to decide when I need time off. It really helps me when I feel supported.

Don’t

Force me to take a week off based on your own assumptions. Only I know how I’m feeling. Not even my psychiatrist knows how I’m feeling. He can only make conclusions based on what he sees and I tell him and he has a medical degree, you don’t.

Talking to other colleagues

Do

Tell the other schedule planner that I’m taking some time off for stress. It means that she’ll understand when I have to decline a shift because I’m finding it too much at the moment.

Don’t

Tell my coworkers that you think I’m incapable because I have depression behind my back. That’s crossing a line and you should know that.

Giving feedback

Do

Tell me that if you had have known how this would effect me you would have made different arrangements to support me. Do tell me that you wouldn’t have hired me if you didn’t think I wouldn’t be good at my job.

Don’t

Tell me that you knew I was going to cry. Again, that’s not helpful.

Do

Tell me what I’m doing right and give me areas to improve on and suggestions on how I can learn what I need to improve.

Don’t

Keep repeating over and over that you are going to give me criticism and draw it out. Just tell me what you want to say.

Communicating

Do

Ask me how I’m doing and tell me I’m looking really well. It really helps me feel better and reminds me how much I’ve improved.

Don’t

Tell me you know that my headaches are caused by my depression because you did some first aid classes. They’re unrelated, my headaches are caused by sinus infections. One of my psychiatrists even sent me to an ENT. If my psychiatrist isn’t linking my headaches to depression, then you shouldn’t be either.

Do

Send me emails asking if I’m ok to take on more work. Do ask me if you can rely on me for a shift. It shows that you trust me to make my own decisions about when I can work.

Don’t

Tell me to take a rest when I first arrive at work. I haven’t even started work yet, I don’t need a rest.

The road to hospital

At home I would just lie on the floor crying. I couldn’t get up, no matter what I told myself.

I could have died last year. I’d thought about killing myself so many times. Sometimes on the way to church, I would think about getting on the wrong train and heading in the opposite direction to a place where I would end it all. I remember once thinking ‘at some point I’m going to kill myself, why should I wait?’. In December I wasn’t just thinking ‘I want to kill myself’ or ‘I should kill myself’, I was thinking, ‘I’m going to kill myself. Yes, I’m going to kill myself. I’m going to kill myself. I’m going to kill myself. Yes, I’m going to kill myself. I’m going to kill myself. I’m going to kill myself…’. You probably get the picture. But seriously, this went around and around and around in my head like a broken record. By Christmas I had been fighting suicidal thoughts for months and I was at breaking point. I couldn’t go on anymore.

Anxiety was building inside of me like a large pressure cooker about to explode. I would look ok on the outside, but I would be screaming on the inside. At home I would just lie on the floor crying. I couldn’t get up, no matter what I told myself. Over and over I would tell myself to get up. Get up. Get up. You can do this. Get up. But I just couldn’t. It was like my arms and legs couldn’t hear my brain. Get up. Get up. I’d walk so slowly too. I’d tell myself to go faster. Come on you can do this. You can walk faster than this. But I just couldn’t. My legs were so heavy. They just couldn’t move. Everything was so challenging. Household chores just weren’t happening and a few times my dishes only got done because a friend would do them for me.

I hated myself, I couldn’t love myself. In fact, I couldn’t love anything or anyone. All the joy was sapped out of my life and I had such an ugly idea of myself that I couldn’t understand why anyone would want to be friends with me. People I didn’t know would come to me in church and ask if I was ok. It was obvious something was wrong. I was always crying and I was always looking down. People kept telling me to look up, but what they didn’t understand was that I couldn’t. My head was just so heavy and when I tried to look up I just felt this enormous weight. That was one of the physical effects of depression.

At this stage I had been taking medication for months. I was on a herbal anti-depressant called ‘Laif’. It was great because it had very few side effects, but it was designed for mild-moderate depression and I’d surpassed moderate depression a long time ago. I was also receiving counselling which likewise wasn’t helping. My counsellor told me my sessions weren’t going to work until I had the right medication and although my GP had referred me to a psychiatrist, the appointment wasn’t for another month.

Over Christmas, I stayed with a friend in the Black Forest. She probably couldn’t see it, but I enjoyed my time there a lot for someone with such severe depression. However, this was my breaking point. I had severe depression and anxiety, I wasn’t thinking straight and I came the closest I ever came to killing myself. Fortunately, being in the Black Forest and in an unfamiliar house meant I had fewer methods available to kill myself and so I didn’t make any attempts.

I doubt I will forget that moment when my friend, cried and made me promise not to hurt myself. She was afraid to leave me alone and the next day, on Tuesday the 29th of December, 2015 she gave me no other option and brought me into hospital. I was not happy about going to hospital, but I was unable to think for myself anymore. Neither of us spoke during the whole car trip from the black forest back to my home. I couldn’t. My brain was too busy processing a billion thoughts of why I knew I needed to go to hospital and why I didn’t want to go. My friend took me home and told me to pack my bags. I just complied. The decision wasn’t mine anymore. I was too sick to make a decision. Everything was just too hard or too scary and I am thankful that she stepped in and made the decision for me.

During my first night in the hospital I just laid in bed and cried until I fell asleep. That was quite early mind you because I was on a high dose of medication to calm me down, which also made me drowsy. I spent the next 7 weeks in hospital and a further 13 weeks in a day clinic. Hospital was absolutely the right place for me; I was put on medication which really helped me and had various therapies. Over the 20 weeks I had psychotherapy, art therapy, music therapy, occupational therapy, enjoyment classes, depression classes, role plays, social competence training, dance therapy, movement therapy, and outings. I didn’t enjoy all of my therapies, but some of them definitely helped.

I have been out of hospital now for 7 weeks and life is better. I still have off days and am still learning to deal with the side effects of my medications. But I know how to deal with my illness now and what to do if I’m upset.

If you are suicidal or know someone who is suicidal, seek help immediately. Call a suicide hotline or if a life is in danger call emergency services. Mental illnesses do not need to be fought alone. Don’t wait. Get help.