or just messed-up and pathetic to get yet another sick note?

[somewherebeyondthebarricades]

I'll try not to make this too long...this is a name-change so some of the story may be familiar.

I have a teenage son with autism. I split up with his dad before he was born, amicably. We have stayed close and parent together. I got pregnant by him again last year when we went on holiday (unplanned). After quite a drawn-out and stressful decision-making phase, I decided to go ahead (without telling ex) but then miscarried at 11 weeks. Still didn't tell him or many people except the few I'd trusted about my pregnancy in the first place.

It happened during the Christmas holidays so didn't need/ take any time off work. I went back to work and tried to get back to normal and pretend it hadn't happened but I wasn't sleeping or eating and was being a little unstable at work. I am a secondary teacher with significant management responsibilities so I can't really have an off day. Teaching was fine but then I'd just go and cry in my office. My friends at work who knew what was going on were really worried and kept telling me to be off, eventually going to the head to get him to talk to me.

I didn't want to be off because it felt like failure and I had too much time to think, but, at the same time, I couldn't really cope with the pressure of work. I agreed to go to the GP who asked a lot of questions and diagnosed depression (I didn't accept that label for months but have had to now). She was firm that I should take a few weeks off and I did.

Being off wasn't healthy except I got sleep. I cut myself off from even then people who knew and were supportive (though they didn't give up on me and I'm grateful for that). I went back to work after a few weeks but struggled again with the demands of the job and lack of sleep and was then off for a couple of weeks again. In the meantime, work had sorted out counselling for me and the GP had described anti-depressants.

To cut this long story a little shorter, I went back on a phased return (reduced hours and responsibilities) after Easter and that really helped as I did my teaching but could escape to work at home or sleep if I needed to. It was the GP's suggestion as I was talking about suicide and feeling like a failure by not working but also feeling like I couldn't cope in work. I then didn't have any time off for that whole term and coped with life in general a little better.

But I do accept that I'm not properly better. I can't cope with pregnant people or babies or talking about them. A colleague was showing his wife's scan photos in July and I had to leave the room and sobbed. I can't get over the fact that I should have been having a baby and don't and feel guilty that my unhealthy lifestyle during the pregnancy because I was so stressed by the decision that I wasn't eating or sleeping might have contributed to the outcome.

The counsellor says I've made no progress whatsoever in dealing with my feelings about the miscarriage and won't talk about it. The GP is concerned that none of the anti-depressants have significantly lifted my mood. Everyone says that my anger/ guilt/ feeling like a failure is unhealthy and we all have these brief periods of hope (usually coinciding with sun or a holiday) that I am better and then something shifts and I go back to hating everything.

Doctor has arranged CBT which was supposed to start this week but got cancelled. I don't know how to rearrange it as when term starts (7 days), the head says he wants me 'back to normal' with no time off.

I can feel this panic rising at the thought of going back to work full-time, something I've not done for months. I have had more sleep and more of a break from the real dark thoughts this summer but I'm not 'fixed' and I don't know what to do. Saw my GP last week and she's talking about a referral to a psychiatrist and also saying she really doesn't want me to go back to work full-time. She is seeing me again this week for my decision so she can write a sicknote if I accept her advice.

My worry is that my boss will be furious and my job might be at risk. Work was never the original problem; I have always been good at my job, but my boss was new last September and so has only really seen the distracted (pre-January), crying, time-off (post-January) mess that I have been this year. I tried to swap my role for a less demanding one in June but he wouldn't let me. The role I am going back to is harder with less time to do it. Even 'normal', I would be slightly apprehensive about the workload this coming year.

He has been good about time off but I know that he expects me back properly on 1st September and all that is in my head right now is 'I can't go back'. I might not have made progress with some things but I am currently able to manage my house, my son, my friendships etc. without crying (often) or hiding away. I agree with the GP that going back to work full-time might jeopardise that recovery but NOT going back or going back less than full-time will definitely jeopardise my career stability. Financially, I have to work. I do WANT to work. I want my old life back. I am angry that I don't have it. But I have got better at accepting my current state and wary of jeopardising it.

What the hell do I do?

[Finola1step]

I'm SLT in a primary school. 2 years ago I had a period of time off due to depression and anxiety followed by a phased return. What helped for me was that I was making the decisions about how long the phased return should go on for. I think a big issue for you is that your Head is making the decision about when you are fit to return to full time. It is not his or her decision to make. If you are not ready, then you are not. You make this decision in consultation with your GP and employer.

Go back to your GP. Discuss phased return again. And try Vitamin D supplements. I had being having health problems in and off for 6 years after having ds. I had very blood tests over the years. My new lovely GP ordered a VitD test, the levels were on the floor. Ask your GP for a test if you have not had one.

Very few teachers are jumping for joy at the prospect of September, that's natural. But if it makes you this upset, then listen to what you are really trying to tell yourself.

[QOD]

You mention your son has autism, how is your day to day life with him? Uneducated guess here that perchance some of the depression is not just the loss by miscarriage of your child, but your loss of an nt child?
I am in NO way putting your DS down! being anti austism etc! but I have read post after post on mn that talk about stages of grief when your child doesn't have the future you thought.
I really think you should talk to your ex too?

[somewherebeyondthebarricades]

Thank you all.

The head has been good up until June/ July. He was very understanding and kind at the start and it was only when I (on the advice of the GP) started to raise the idea that I was worried about the prospect of September that he became quite firm about the need to 'get back to normal'...which of course has then put loads more pressure on and made things worse.

I think I've technically not been off sick at all since before Easter as my current sick note (that runs out on Friday) is just a 'you may be fit to work with reduced hours/responsibilities' and so I didn't really require cover or official time off. But yes, capability on health grounds would of course have to become an issue if I can't do my job long-term :( . I cannot let that happen.

I have been having counselling but she doesn't feel I'm making progress because there are so many things I won't/ can't talk about and she believes it's best not to force me. The GP wants me to dump the counsellor and start CBT because she feels the root of the depression is the miscarriage and it needs talking about. She thinks that I might have some form of PTSD mixed in and that CBT would help with that. Sorting another CBT appt needs to be a priority but seems really really hard right now.

What I want is a baby, but the one I was supposed to have at that time. For all the same reasons as at the time, it would be very hard for me to have a baby (my son would HATE it) and even more so right now when I'm such a mess. But knowing logically that it's a bad idea doesn't stop me wishing that what was supposed to happen had actually happened. I had a few plans about just getting pregnant again straight after it happened but a very wise and sane friend made me stop and think and now I take my Pill religiously.

I've not told my ex because of many things. We really argued about the decision to keep our son and it was a very difficult time. With this pregnancy, I thought I was miscarrying at 5 weeks and did tell him then. We both knew that we'd not used contraception and, while I did take the MAP, I took it late. I realised a couple of weeks after the bleed that I was still pregnant but went deep into denial for a bit until my friend dragged me out. I then couldn't face the rows with my ex until I had decided what I wanted. I then deliberately wanted to wait to tell him until 12 weeks when it would be hard/ pointless to try to convince me to change my mind. The problem now, and all the way through, is that he would know that I had been dishonest and would know from the timing why. He knows I'm unhappy and is sympathetic and supportive, but he thinks the cause is work. He doesn't know about any of the time off. All the lies, if revealed, would cause a real rift between us that would be the opposite of helpful and damage how our 'family' functions.

QOD, to be honest, autism is so strongly inherited in my family that I figured there was a strong possibility that the baby would have it. That fuelled most of my ambivalence about the pregnancy because, while my son is doing very very well now, it has taken a lot of battling with the council over the years to get him what he needs and there have been some bad times. But I had in my head that the baby was a girl and autism is different in girls.

I am going to the GP at the end of the week and, bar some miracle happening, I will ask for an extension of this same sicknote that gives me flexibility. I can see how the first couple of days go and then produce it if needed. It feels like failure but partial and planned failure rather than unplanned and total. You are all right that I need to listen to the GP and I think she'll go for this.

Wish me luck and thank you all again.

[SofiaAmes]

Sorry to repeat myself but please get your vitamin D levels checked (or even just start taking 5000iu a day of vitamin d). My father has just published a paper on the link between vitamin d deficiency in the pregnant mother and autism. Perhaps there is something in your family that causes vitamin d not to be absorbed well, or maybe you all just live in very unsunny places, but fixing the vitamin d issue is cheap and easy and might just solve more than just the depression.

[SofiaAmes]

Also, I would highly recommend DBT (dialectical behavior therapy). It started as a treatment for borderline personality disorder, but is now being used very successfully for bipolar and ptsd, the latter of which it sounds like your are experiencing. You can even get a workbook on amazon and work on it yourself while you are waiting for a referral. Here's a link.

[somewherebeyondthebarricades]

I've heard of DBT as a relative was looking into getting it but it's not available easily here and GP is pushing CBT. But the link looks good - thanks. Vitamin D is on my list to talk to GP about this week.

Perpendicular, I have had to let go of the perception thing but I don't want to and can't let go of my job so, in that sense, the Head's feelings are important if he decides he wants to get rid of me. And I would :(

[Viviennemary]

I think if you can't face going back to work then get a sick note and take it from there. And have a serious think about whether this stressful job is really what you want. I know the bills have to be paid and so on. And I also agree that trying for another child whilst you are still feeling so fragile would not be a good idea at all. You must get well first. Hope things improve soon.

[GoblinLittleOwl]

You are clearly not in a fit state to return to teaching yet; you must consult with your union to see exactly what your options are with regard to sickness/leave/ returning to work.
You must see your Head ASAP and tell him how you are feeling, and discuss with him your work options; take your union rep if possible or a supportive colleague (line manager).
He will need to make arrangements for cover for you, whatever the outcome, and the more notice you can give him the more productive your discussion will be.

[somewherebeyondthebarricades]

He is my line manager :( I am, sadly, that senior, so there's no buffer.

I did try to have the conversation that things might not be OK in September in July but he said that was negative thinking.

I cannot contemplate leaving teaching. I (usually) love it and am good at it. I like the management stuff less but can/ could do it.

It just all changed when everything fell apart and I hope that it will all improve when everything stops feeling so broken and fucked-up.

[somewherebeyondthebarricades]

Someone on the employment section has given some very clear advice that leads me to think that I am possibly setting myself on the path to dismissal if I can't get properly back very very soon. Having also looked at my work sickness policy properly today, I have had far more 'phased' return or reduced timetable than would normally be allowed. I should probably have had an occupational health assessment before now.

All that this does is make me think that I am totally stuck. I wish that I was better but I'm not and the effort that needs to be put into either path just seems so tiring and not actually worth it. If it wasn't for the effect it would have on my son and (possibly) my friends, there wouldn't really be anything worth making this effort for.

I resent them sometimes for existing because it forces me to have to keep trying when I would honestly just prefer to be dead.

[somewherebeyondthebarricades]

People know. The GP knows. Like I said, there are brief periods of feeling ok or even good but the default setting is just feeling shit and hating everything. Especially me and the place I've got myself into.

[ilovesooty]

I'm really sorry to hear you're still feeling unwell and I don't think you sound pathetic at all. However the school can move to dismiss you on ill health capability grounds and I think the HT may do so if he can't see a time when you can resume full time work.
You have some difficult decisions to make here, and I feel for you.

[somewherebeyondthebarricades]

Well I'm just going to have to go back and try. I can do the public face OK and, as long as I do what I need to, the Head won't have to be bothered by my pesky crying, suicidal thoughts and sleeplessness out of school.