Sick leave due to anxiety, been back at work 5 weeks and struggling again :(

[ple]

I had around 2 months off of work due to anxiety and depression. I posted on AIBU at the time and received a lot of helpful advice so I hoped I could return and ask for some more support/advice as sadly things aren't going well again.

I returned to work as I felt ready to and I was given such a slow, gradual return that it felt really feasible. I'm 5 weeks into my back to work plan and working 4 and a half days and I'm starting to really struggle again and I don't know what to do or say.

I have weekly calls with an occupational health advisor person my company referred me to, and it's helpful but most of the time the advice is to try breathing exercises and mindfulness, which did help me in my first few weeks but I feel like I'm struggling again and that's not enough.

I have weekly meetings with my manager and HR and they are keen to support me, and I have mentioned I have had some bad days in the last couple of weeks. They ask me how can they help support me and to be honest I don't have any idea what to ask for. My work has been really stripped back and simplified, a lot of things removed from my calendar and I'm still struggling. The anxiety hits me at weird times, and I don't really understand it. Today I was in the office and was able to chat to colleagues and go for lunch and from the outside I looked ok/normal. But I had to keep going to the loos as I kept feeling like I was going to cry, I just had this awful homesick feeling of wanting to go home and I started crying on the train home. I just feel awful again and I don't know why. I handed in my notice when I was off sick as I didn't think I could return, and now I feel like I need to hand in my notice again and tell my manager that the return to work isn't working out.

I feel so completely hopeless and can't stop crying. I don't know what happened today to trigger all of this

The best thing for me that helps anxiety is plenty of exercise. It burns off all those over-thinking feelings and boosts all the feel-good hormones. Improves my confidence and makes me focus on other things rather than worries. Makes me sleep better.

Exercise doesn’t change the problems in life but it makes me feel way more able to cope with them. Could you say go for an early morning gym class before your day in the office? Or a walk / jog?

I think for one you should try to keep this job, they are very supportive despite your own doubts. Instead of working up to a full day work towards two half days.

Someone above mentioned masking and it seems to me this is what you are doing which will be exhausting and it will be why it’s becoming harder the longer you are back at work. Taking longer to do tasks is expected as you will be processing information slower.

So basically you are pretending to be ok as much as you can, while the real cause of the anxiety is not being addressed. Do all of the doubts relate back to the childhood that you mentioned?

Go to your GP request proper assessment and referral, however MH are very stretched and the waiting lists for proper treatment are very long. Meanwhile glean as much help as you can from HR etc.

OP it sounds like this dates back to starting on this new project a month before you went off? How long had you worked for this employer before that?

Is this particular project a type of work you don't feel is a strength for you, and it's making your worry as it's overwhelming?

Try breaking overwhelming stuff down into much smaller tasks that you can get a mental sense of completion from as you finish them. Is it possible to ask for some extra training if there are particular workflows that overwhelm you?

Things last week felt better. I feel like things are starting to come back to me now so I feel like I'm getting more confident in my ability. The next couple of weeks are due to be quite busy for me as a few colleagues are away on holiday so I'll be covering for them. I've felt a lot more confident in establishing stronger boundaries with work, as I know I'm being 'monitored' by my manager and HR, so they are taking what I say seriously - for example, on Friday there were a couple of deadlines and it wasn't achievable to meet both deadlines, so I mentioned it to the project manager and got a deadline moved to tomorrow. The 'old me' would have just worked late until both deadlines were met (and there are times when this will be needed as part of my job), but I feel like I need to take some responsibility at being more proactive at noticing when things may start to become more stressful.

I also think the new tablets are starting to work which is helping.

I know a lot of this anxiety does come from childhood stuff, but I'm not really sure how you go about addressing it? I'm quite self-reflective and I journal a lot, so I have quite a deep understanding of where the anxiety originates from. For me it comes from being raised in quite a chaotic, stressful household (poverty, a mentally ill parent with NPD, and a large family with a sibling with ASD) and having to be the good, helpful one. As you can imagine, it was all quite stressful and I remember when we were out if I needed the loo or was hungry I would almost get told off for it as it was another stressor to add to the list. My parents and the sibling with ASD were also quite unpredictable, the slightest thing could trigger a meltdown so I learnt to just be quiet and keep to myself. I seemed to just get told off for things that weren't even misbehaviour, and in a completely disproportionate way. As a result I'm a people pleaser terrified of making mistakes.

I'm glad to hear you had a better week and that the medication is settling in.

I have found that proper psychotherapy has made more difference than anything else, but it's not cheap. Does your employer offer anything in the way of assistance or wellbeing inputs?

Do you think there's any chance you might have undiagnosed ASD too, which was overlooked due to a louder sibling?

I don't think so. I have read up on how it presents in women, but I don't really relate to a lot of it. Sometimes I have wondered whether I'm masking as when I'm anxious in social situations I feel like I'm masking, and I become overly aware of my facial expressions and level of eye contact, but when I'm not anxious I feel like that all disappears and everything is more natural and spontaneous.

I know that people with autistic siblings can adopt some of the traits without meeting the diagnostic criteria themselves, so I suspected that is probably the case.

Sertraline is quite a mild AD and I didnt find it much help, if you had to reduce the dose because of the side effects I wonder if its worth trying a different type instead?