Behavioral Health Brief: Roses and Thorns
By Danielle Perron-Roach, MSW, RSW
Social Work Today
Vol. 22 No. 2 P. 10

A Social Worker’s Experience With Burnout and Depression

I never knew that you could be so sick from depression. I was diagnosed with severe recurrent major depression, anxiety, and obsessive-compulsive personality. I had experienced anxiety and depression in the past, but nothing as severe as my last episode. Having worked for 27 years as a social worker in a hospital mental health unit, you would think that I knew all there was to know about the early signs of depression, the healing process, and the reintegration journey to normal life.

I am here to tell you that you never know what it’s like until you have lived it yourself.

Oddly enough, my values and ethics as a social worker may have led to my downward spiral. However, at the same time they facilitated my recovery.

I am a 52-year-old white woman who has had the good fortune of working as a social worker for the same hospital for the last 27 years. As a matter of fact, I was hired right out of my master’s program. It had always been my dream to work in a hospital setting. I decided my fate when I was 10 years old. After a serious car accident, for which I was hospitalized for one month and bedridden at home for several months, I remember lying in my hospital bed making the conscious decision to one day work in the health care profession as a way of giving back to the field.

Many social workers refer to their choice of profession as a calling. It has been my experience that social work’s values and ethics have soaked themselves into every realm of my life. However, as much as it has been personally validating and gratifying, it can be draining and exhausting. For almost three decades, I sought to support the people in every area of my life, both personal and professional, until the day that I broke and just could not do it anymore.

Can Social Work Values Lead to Depression?
As a social worker, obtaining justice for our clients, our friends, our families, and our community is what drives our passion. There is never an insurmountable problem. With a good analytical mind, great problem-solving skills, and resourcefulness, social workers can find solutions to most problems. Justice for fair and equal treatment, justice for safe housing, and justice for the right to services are among some of the issues which we fight for our clients to obtain.

Few of us will let obstacles, whether they be small or large, prevent us from achieving our goals. But in the end, this type of conviction takes its toll. Unfortunately, as we take on these huge responsibilities, we often neglect to take care of ourselves, putting other people’s needs before our own.

As a matter of fact, I used to consciously avoid saying no to any requests. However, the more I did, the more that was expected of me.

I was at the service of others in my own home, at work, and within the community all the while navigating everyone’s expectations, which did not always align. At home, I would try to please everyone to avoid conflict. At work, I would put in the extra time and effort, even if it went beyond the realm of my duties, to accomplish my tasks. For example, if my employer set a limit of spending one hour per client per day but the endeavor required more time, I would volunteer my own time outside of my regular work hours.

Filling out reports, applying for services, and strategically composing letters to appeal the ministry’s decision to deny my client a disability pension were some of the tasks that filled my spare time. I would justify the overtime by noting that the task needed to be accomplished in a short period. Since the waitlists for housing and community services can be extremely long, I believed that completing the application in a short amount of time would grant the client access more quickly.

A Revelation
For 27 years, that was my life.

I now realize that for approximately two years before I was forced to stop working, I had been gradually developing burnout syndrome. At first, I started to depersonalize from my clients, not “caring” about their situations as well as blaming them and everyone else for their problems. I isolated myself from colleagues and avoided participating in departmental meetings. Coworkers commented that they missed seeing me smile and hearing me laugh. Most importantly, I no longer felt passionate about my work and became disenchanted with the system as a whole. Finally, I was physically and emotionally drained and my sleep was disrupted.

These burnout signs crept up on me, slowly and gradually.

The Pandemic’s Effect
Then along came COVID-19. It brought new restrictions, more isolation, an increased workload, and changes to our mode of functioning—not all of them efficient. Add worrying about the well-being and safety of clients, and it was all too much to handle.

My symptoms worsened quickly. I became apathetic, unable to concentrate. In fact, I started making mistakes that were having serious consequences for my clients’ well-being. I was constantly overwhelmed, crying every morning as I looked at my increasing workload.

Being a Social Worker Helped Me Recover
My sick leave was supposed to last a month, but it ended up being 11/2 years. I became one of those patients whose depression was hard to treat. Now, I am on a cocktail of antidepressant,
antipsychotic, sleeping, and anxiety medications to help me feel “normal.”

But through it all, I leaned on my social worker skills. I was resourceful, was unafraid to ask for help, and advocated for myself. At first, I was unable to do these things. As a matter of fact, I tried the traditional approach to treatment initially, but professional help was, at times, unhelpful. One person told me that I should be feeling better after having been off work for six months. I had done all that they had told me, but because it did not fit into my reality, it did not work. It’s like a carpenter using a plunger to mount a cupboard. The tool must fit the job.

I did not want someone telling me what to do. In fact, being given advice only made me feel worse. When I was deep into my severe depression, my negative thoughts were real to me. I believed that I was a bad person and a bad mother, and that I was never going to get better.

My social work training and experience had taught me that feeling validated, empowered, accepted unconditionally, and encouraged were key to developing and maintaining hope for the future. Without hope, it’s hard to move forward on the recovery journey. As a social worker, I knew that peer support would provide me with the tools to get better. Professionally, I had witnessed firsthand the positive impact of recovery-oriented support in the lives of my clients. This approach likely also resonated with me as a social worker since many aspects of the recovery principles resemble those of my profession. Thanks to my work, I knew where I could get this type of help in my community. That is when I called MDO (Mood Disorders Ottawa), a volunteer peer-run support group for people with mood disorders and their loved ones. The programs, activities, and support groups are free; there is a $15 yearly membership ($5 for those with low income).

Peer Support
For once, I felt like people understood me and did not judge me or what I was experiencing. Listening to others with similar experiences helped me identify how I was feeling, normalize my experiences, and encourage me toward accepting my mental health issues. At that point, accepting rather than changing my situation was more vital to my recovery journey. Trying to change only reinforced that I was wrong, while accepting my situation helped diminish my self-hatred and negative self-talk.

Everyone in the peer groups is equal. There are no hierarchies between the participants and the facilitator. Everyone believes their contributions to the discussion are important. I learned to set limits for myself. In fact, I learned to say no for the first time in my life without feeling guilty. When you say no to peers, they do not expect an excuse or an explanation. All experiences are valid. I feel accepted by my peers and learned that I do not have to try to fix others.

Knowing that receiving advice can trigger me, I learned not to take that approach with others. I developed hope through peer support and by seeing others more advanced in their recovery process. I accept that variations in my condition are normal and even expected.

A New Normal
My recovery is an ongoing process. Although I am back at work part-time, I continue to depend on my peers and MDO support groups for comfort and reassurance. My recovery journey does not end with my return to work. However, my experience with mental health has changed how I work and live my life. I no longer live with a sense of urgency. I have learned to slow down. Above all, setting my limits is crucial.

Over time, I had to accept that I was not a “superwoman” and that I needed to overcome my need for approval. Once again, I started to take breaks and to socialize with my coworkers for support. Of course, I still “care” for my clients’ wellbeing, but I can no longer do the work at the expense of my health. For the first time in my life, I find my joy not in the doing, but in feeling well.

If I want to continue being present at work and in my personal life, I need to take care of myself first, with peer support there to help me.

— Danielle Perron-Roach, MSW, RSW, has been a social worker since 1994, working primarily at Montfort Hospital in Ottawa, Ontario, Canada, in the mental health program, where she is the current community treatment order coordinator. She volunteers as a member of the board of directors at Mood Disorders Ottawa, where she participates in various peer-support groups and recovery programs.