At what point do I say enough?

[sickleaveornot]

Not completely sure where to post this but need some advice because I really don't know what to do.

I have bipolar - it was very well managed until August of this year, and then out of the blue my meds stopped working as effectively, so far it's been nothing to crazy, some slight elevated mood and some low mood but not suicidally low. I've had my meds reviewed and they've changed them a little. It's to early to know if they working but it's a start.

Now the issue - over the last 2 weeks I've started having panic attacks - this is something I'm working with my team around. But work is a major trigger point, I actually work in the mental health field now and I'm finding it really difficult to manage my anxiety while talking about suicide and hard topics like that with clients - I'm fine in front of clients and manage to just about hold it together - but as soon as they leave I'm a mess.

Work aren't being the most supportive - I've said several times that I'm really stressed but not alot has been done, they're also aware of the panic attacks and med changes. We are insanely busy right now - and it's all hands on deck.

3 weeks ago my GP suggested I get signed off for a week or 2, and at the time I thought I could push through so turned this down, he mentioned again last week and then again today strongly suggested that I need to look at giving myself a chance to just stop and try and regulate more.

But at what point do you accept that being signed off is for the best? I feel like I can't see the wood for the trees anymore and I really don't know what I'm meant to do

It sounds like you’ve reached that point OP. You need to look after yourself otherwise things at work will spiral.

I think I'm just afraid that if I get signed off it's me being more unwell then I think I am? Idn if that makes sense, like I know I'm not exactly stable, but compared to what I have been at the past I'm not that unwell?

But I also don't know how much more I can push myself

You need the time off imo.
I'm bipolar and tried working in a field that was triggering for me (criminal law) and it was worse for my bipolar than anything. My body tried mania to deal with the stress of it but kept crashing so I was rapid cycling. I suspect you are doing the same.

Being regulated is really important, and working in a low stress environment is also hugely important.

Take some time for you to recover.

Now is the time to get signed off and focus on your own health.

This is the point. You need a rest. What would you tell a friend in your position?

You don’t want to get to a point where you have been in the past. Take some time off and allow yourself time to rest.

@Cupofteaforyouthats exactly what's happening - the rapid cycling is horrendous I feel like I'm going into hypomania at work to get through - and then crash because I've got overwhelmed.

@Krakinouid definitely be telling them to go off and recover.

What is your job OP? If it’s a HCPC regulated role you need to be in good mental fitness to undertake your work. That you’re struggling to accept that you’re struggling too much to work tells me that you have reached the point when you should step back. You’re losing objectivity. Trust your GP. Your employer should be much more proactive here too, they should be safeguarding both you and their clients.
Just take the time you need. There is no shame in it. Even for a MH professional. We’re human after all.

It's a support role within a charity. I accept that I'm struggling, what I'm struggling with is is at what point does struggling turn into being signed off.

I don't really have anyone to talk to about this properly which is why I started this thread. But I think I've realised from the replys on here that I'll speak to the GP again tomorrow and get signed off

Now is the time to prioritise your own health.

You’re not in a position to help your service users when you’re this unwell yourself.

Listen to your GP and accept that you need to step back from work for a little while.

Sending love xx

Do you have a union rep who could advise you?

Not in Union unfortunately x

what I'm struggling with is is at what point does struggling turn into being signed off.

I left it too long and couldn’t go back. Escorted away from the premises in bits. I was ill for months and I doubt I’ll ever to be able to work at the same level again. Get signed off, if you quickly feel better you can go back to work.

And please do consider joining a union.

Good luck-wishing you better very soon.

IMO you either trust your doctors judgement for your care or you don't..

They've got your meds right in the past, they are making adjustments now and they are advising time off.

From where I'm sat you need to just do the hard thing and make the decision to take that health advice and switch off to the work viewpoint.

Just decide now, I'm getting signed off. Don't think about how you'll do it or tell work, that's tomorrow's problem.

Today you take care of you. Make the decision and the rest will fall into place.

MH professional here - you need to get signed off.
Look at the worst case scenario hypothetically (trigger warning)

Youre stressed, you miss something, a pt completes suicide and you were the last professional they engaged with. You're in coroners court. Your GP provides testimony that you wouldn't take time off. Bang goes your career.

Just take the time off, there's no shame in it, regulate yourself, and get it in writing to your employer that you don't feel supported. It doesn't sound like you're very senior (I'm not being nasty at all), so your line manager has to take responsibility for you (as long as you are taking responsibility for your own MH and following your your GP advice.
Take the two weeks off - a week isn't enough for your nervous system to regulate.
I hope you're feeling better soon, much love x

I waited far too long. I didn’t go off until I was told categorically by someone in occ health ‘Why on earth are you at work? You’re not fit. You’re off sick from this moment’. I’m quite amazed in retrospect I came to no harm.
If you’re looking for a sign to go off sick - this is it. Take time for yourself to recuperate.

You’re not supposed to wait until something is as bad as it could possibly be before you allow yourself time to heal. You need the time to heal to prevent it from getting as bad as it could be.

Okay I get that. I’m glad you’re going back to your GP, I hope the time off does you good and you manage to get back on an even keel.

For what it’s worth, I have been in your shoes in the sense that I didn't think I was ‘ill enough’ to take time off until it was too late. Unfortunately with that mindset, you keep going until you are forced to take the time off because you have reached failure point. Don’t wait for that day, it might be that you will not manage to hold it together with a client for example. And if that happens, it won’t be ‘the sign’ you need time off, it will be the sign that you have needed time off for ages and didn’t act on it and in doing so failed in your duty of care to a client. That’s so much worse. You’re doing the right thing by stepping away and looking after yourself first. Well done and get well soon 🌷

I just thought I'd come back and update - Ive been signed off, I spoke to the GP again today and they did it immediately. I've also reached back out to the private health insurance I have and they've agreed that I can start counselling - only 4 sessions but it's better then nothing

Not answering your post but:

Have you ever been assessed for ADHD? There's increasing evidence that many women diagnosed with bipolar (and who dont respond "normally" to medication do respond very well to ADHD medication and on further investigation may actually have ADHD rather than bipolar).

@User0nei was diagnosed with ADHD in July actually! They aren't sure if it's a dual diagnosis at this stage though - because my mood stabilisers did work pretty well for several years. I'm on the waitlist to start meds for that (my private insurance doesn't cover ADHD so I have to wait)

Well done, proud of you

That's really interesting. I hope you find something that works for you

I just thought I'd come update again - I've made the decision to start job Hunting today... While I absolutely love my job and adore the people I work with - I have come to the realisation that maybe this job isn't for me, I can forsee a situation in which I get myself level, go back be ok for a period and then this cycle repeating because we're only getting busier. It's shit and not a decision I thought id be making but for the best