I can now see that depression crept up on me slowly and silently. Despite 30 years’ experience as a registered mental health nurse I didn’t recognise, acknowledge or even notice the range of symptoms I had been experiencing, or how they had been affecting me. It was only when I finally cried at work that I realised something was wrong.

At the time I was working as an executive director in a London mental health NHS trust. There had not been any obvious feeling of being extremely sad, just a slow downhill trundle and loss of enjoyment in life. My symptoms included being overly self-critical and a loss of interest in things I usually enjoy. I was tired but not sleeping, procrastinating and felt I was a failure.

I was very surprised by the rapid decline in my mental health and how it affected every area of my life so quickly. In the space of just 10 days, I went from working as a director to being almost mute, constantly crying, unable to care for myself and wanting to kill myself.

I was referred to the local crisis response team and assessed as needing admission to hospital for my own safety.

I couldn’t understand how this was happening to me. I had worked on a crisis response team, and as a community psychiatric nurse for eight years. I was an expert in mental health – particularly depression and being suicidal. At least I thought I was, until I myself fell into that hideous, deep, groggy, terrifying pit. I

As a clinician I have been taught not to use the phrase “nervous breakdown”, as it is not a clinical diagnosis and is seen as outdated. But this is the most accurate description of what I experienced on the day of my admission. I was shattered inside, I had nothing left to give. I was completely broken.

Depression sucked the life and soul out of me. Within a week of admission I was almost unable to function at all, wringing my hands in despair and almost constantly crying. I lost all interest in myself and in my personal hygiene. I didn’t care about anything.

The suicidal thoughts were constantly at the front of my mind. I was so absorbed with my depression that I thought the only option I had was to kill myself. My clinical experience and professional knowledge kicked in. I knew from training and from seeing hundreds of patients fully recover from depression, that I would be OK again. But the depression was telling me I was a bad person, that there was no point in living anymore, that I was a burden and a nuisance to people around me. This was in complete contradiction to what I knew was the truth.

It was the firm knowledge of recovery and the wonderful care I received that stopped me from taking my own life. I kept bargaining with myself and buying time: I’d tell myself “just wait until after lunch and see how you feel” or “see how you feel after you’ve seen the psychologist tomorrow morning”.

The care I received through the NHS was first class. The compassionate nurses, thoughtful and careful doctors and an impressive array of healthcare professionals were consistent, recovery focused, caring and just amazing.

My clinical experience informed my recovery plan – not just appointments and medication, but a whole-person approach, including mindfulness, gym, social life, managing stress and increasing social contact again. It was full of ups and downs and didn’t go smoothly, but throughout this time I was rock solid in my knowledge that I would be me again. Nine months after being admitted, I was fully recovered and I went back back to full-time work a month later.

Stigma surrounding mental illness is alive and kicking. Initially I was slow to tell people as I felt too vulnerable. However, after I spoke so openly and publicly about my mental health I received nothing but support, love and kindness. I am not proud that I have mental health problems, but I am certainly not embarrassed about it.

I also found that many people approached me to talk about their own experience too. The more we talk about our own mental health, the easier it is for others to start conversations about theirs.

• In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.
  

Mandy Stevens is an NHS director of nursing and mental health services. She will speaking about her experiences at the Nuffield Trust’s health policy summit on 1 March.

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