As part of MAS Equality, Diversity & Inclusion group, we asked for collaboration in ‘bringing your whole self to work’. Mark provided us with the following very open and honest article which we would love to share to promote discussion around mental health journies and the support available. As part of National Inclusion Week, this article has been re-shared to a wider audience.

A story about a mental health journey at Siemens

Written by Mark Bickerstaff

After 45 years of knowing that I was a little bit different and finding the best ways that I could to deal with that day to day; I finally found an environment at Siemens where I felt I could safely delve into myself to gain a better understanding of how my brain works and I wanted to share that journey with you all.

The pivotal moment for me was in a 1-2-1 with my line manager at Siemens. I remember saying “I know this sounds irrational but I can’t not express these thoughts” (please forgive the double negative…). I was “on one” and ranting a little about a difficult work situation and while my rational brain was telling me the right answers, I had so many other, irrational, thoughts in my head that I just need to release them in some way. In a very kind way, my line manager said to me, “Have you ever spoken to anyone about this?”. One sentence, but for me it was life changing… although I had felt like this many times before.

It wasn’t just that sentence, of course, but a combination of factors. I am in a really loving relationship at home with a very understanding and supportive partner; over the years I have learned coping mechanisms to minimise the impact of my differences so I am getting better and better at managing myself; I am in an organisation and a job role that I truly love and enjoy; the fact that I knew my line manager had completed a degree in psychology and that we had built enough rapport for me to be open and honest. All of these things meant that I was finally comfortable to explore my differences. This was back in December 2019, so still fairly recently…

Since I began at Siemens, I have selected the BUPA medical option through MyChoice each year and both my partner and I have used their services in the past, to great satisfaction, for relatively minor physical conditions. So, I went to see my GP and asked for a referral for some cognitive behavioural therapy (CBT). Initially, I was offered some medication but having had a spinal injury some years ago and 18 months of strong painkillers before corrective surgery, I did struggle when I stopped taking the prescribed tablets. I also think that I viewed medication for mental health conditions as the easy option (more on that later); I didn’t want to treat the symptoms but the root cause. I have been fortunate enough in my career to study some very basic neurolinguistic programming and to have bought into the concept that it is possible to change one’s thought processes so for me it seemed like the right option. The doctor was understanding and completed a referral for me.

CBT is fantastic, I have to say. If it is something you have considered, then I cannot recommend it highly enough. Through BUPA, you can choose a therapist with the right expertise at a location that suits you. I chose someone qualified that practised very close to my home for convenience. I was also quite lucky; probably the biggest take away from receiving therapy is that it is necessary that you have a good rapport with your therapist; total and complete honesty is vital, even if it means being very self-critical. I was fortunate with my first attempt at finding someone with whom I could build such a rapport, but I do think that my line manager’s open door and life experience had increased my preparedness for this…

The first couple of CBT sessions are really about establishing what the problem is and through a mixture of discussion and truthfully completing questionnaires, you work with your therapist to find the thought processes that are unhelpful in your life. Your future discussions are then tailored toward working through these thought processes to view your problems differently and to work toward taking a different approach. In my case, I have limped along for over 40 years so some of the changes are quite significant and you have to be prepared to question some of your beliefs and your coping mechanisms in a really objective way. Of course, this is not easy.

It can take a few days to really resolve a session in your mind; some of this is associated with my conditions but others that I have spoken to who have received CBT have expressed similar feelings. I was having weekly sessions which meant that it was quite fast and furious, no sooner had one session finished; you complete working through it and then another is upon you…Siemens once again supported me by allowing me to work my hours across 4 days so that I could take a day to work through each session without any distractions.

Through the “identification sessions” with my therapist, we identified 8 symptoms / behavioural reactions that were not helpful to me. Some, I had effectively created coping mechanisms for, others were a constant battle and one or two I had been unable to effectively address.

So, to get to the point, my GP has formally diagnosed me with anxiety and depression and (EID) Emotional Intensity Disorder (this is what I was referring to with 8 of 9 symptoms). There are other names, but experiencing the condition, this is the closest description that I can find; however, it is also referred to as Emotional Dysregulation Disorder and Borderline Personality Disorder.

At this point, for anyone wishing to research EID, I should say that the one symptom of the nine that I do not display is suicidal thoughts or self-harm and that many of my symptoms are relatively mild (most of the time). Also, that the condition is commonly associated with childhood abuse or deprivation – in my case there is a different root cause alongside the genetics, I was fortunate to have a very loving upbringing.

Borderline Personality Disorder was so called because it was observed that people with this condition sometimes experienced symptoms somewhere between the borderline of neurosis and psychosis. I think, in simple terms, that the former describes delusional (irrational) thoughts but where your rational brain helps you avoiding losing touch with reality and the latter where you have a radical loss of reality as a result of delusional thoughts. For the most part I am fortunate to have a strong rational brain and although every day is an internal battleground, for the most part, I do manage to “win” the internal battle in the right way.

Edvard Munch had also EID and I believe his picture “The Scream” perfectly visualises the internal struggle that EID sufferers endure every day:

The reason that I prefer Emotional Intensity Disorder as a term is that, for me, this really describes the condition in the best way possible. In very simplistic terms, I feel emotions much more intensely and for much longer than is normal. Anxiety and depression are very common comorbidities (simultaneous medical conditions) as you try to cope with the primary root cause. The increased intensity and duration of emotions means that there are occasions, and I emphasise, only when extremely stressed, that my brain overloads and I begin to have unresolvable irrational thoughts.

This is when it gets tough; I have a very strong and almost constant internal dialogue and I use the term earlier “internal battle” because it perfectly describes the conflict in my head between irrational and rational thought. The problem is that both messages, rational and irrational, are in my own voice. You trust yourself so even the irrational can become plausible.

Recently, I used up my allowance with BUPA and my CBT came to a fairly hard stop (my own fault, I wasn’t tracking my allowances closely enough and I have had a huge amount of therapy compared to what is available on the NHS, for a very reasonable monthly cost, so no complaints). My line manager and our on-site HR representative worked very hard to try and secure me some further sessions and although it was ultimately not to be, it is a fantastic example of the support that I have received. I was also hooked up with EAP and signed up for a crisis line in case I was really struggling and they have also offered some CBT sessions with a different therapist after a 3 month break – which is widely acknowledged as the right break period when you switch therapists. So, it is fair to say that Siemens have been truly wonderful in my search for answers.

It is quite difficult to describe what it is like to live with EID but I found this passage written by a person who shares depression/anxiety and emotional intensity disorder but who also has post-traumatic stress disorder. I have edited to remove references to PTSD and to make more relevant to my own problems but otherwise this perfectly describes my day to day life, so I wanted to include it to try and help you understand the world through my eyes:

I feel emotions for longer than you may do. Now if you think about how many emotions you feel throughout an average day, happy, sad, indifferent, joyful, annoyed etc. Then let’s say that’s a few hundred emotions a day. I may have felt each one longer than you and what that means is that I feel fear longer, I feel sadness longer, I feel shame, humiliation, guilt and loneliness longer.
But the important thing to understand is that I do not choose to feel those emotions for longer. My brain interprets emotion differently to how yours might. My emotional senses are overloaded and because of this, I have coping mechanisms that you may not have, that you may not need and behaviours that may not make sense, that may make you despair at me.
There is an enormous plus side to this and it is something I am very grateful for. I also feel positive emotions for longer as well. I feel love so very intensely, compassion powerfully, happiness is almost delirium, and joy is a different level, I see beauty in things, with a depth that you may not have experienced. Anyone that who has reported into me and received positive feedback will have heard my voice breaking and my eyes welling up with emotion because I am so sincerely proud of the hard work and effort – I really do appreciate people. It is the part of the condition that makes me “sensitive” that makes me care, understanding of others, hopeful and kind. It is my superpower as well as my curse – I can almost feel other people hurting and I think I may have helped one or two people toward mental health progress themselves. At least, I have recognised when they need support and a friendly face. It is because I feel this spectrum of emotion that I am who I am and yet it is this same overloading of feelings that can be very confusing to process and respond appropriately sometimes. Occasionally, I can just be plain horrible, when my thoughts cross into the psychotic realm (at times of mega-stress) and I really don’t like myself very much.
Nobody is more upset than me after I have behaved in a way that has hurt someone. I feel regret very deeply, for a long time and more often than not I feel despair because I cannot make people feel what I feel. I cannot show them, I cannot explain properly, I am very alone a lot of the time. It is not me, in my heart, but I also must recognise that it IS part of me and to take responsibility for that. This is what drives me to seek therapy and to improve myself as much as I am able.
I am very lucky, many people have not given up on me, when all the logic in the world tells me they should. Sometimes, when I can’t process the overload of emotion, I just don’t know why I am doing what I am doing.

This is neither a cry for help nor a request for sympathy, it is a thank you to Siemens and my intention is to just talk about mental health. Everyone says it is ok to not be ok, but we don’t see enough openness about it and frankly it is so very difficult to talk about. I also don’t want a carte blanche to behave in a horrible way to people. I am acutely mindful that the world is not all about me and that my irrational responses, if extreme and unmanaged, could (and on occasions have) impact upon others’ mental health in a negative way. I absolutely don’t want this which is why I have decided to be open but I also believe that this impact on others is why mental health problems are so taboo, misunderstood and a source of fear for many.

Part of my realisations have come following the cessation of my CBT sessions when I switched to medication. I said earlier that I viewed medication as the “easy option” treating the symptom rather than the cause. How wrong could I be? I was prescribed anti-depressants and warned that my symptoms could worsen for the first few weeks; unfortunately, this turned out to be very true. I have explained that CBT is impactful and can take a few days to work through; well for me, tablets were like condensing a years’ worth of therapy into 2 weeks with all of the associated emotion and sadly, negative behaviours on my part.

In one week, I called the pharmacist and the doctor twice concerned about how I was feeling, and I was on the verge of giving up on medication. I hit out at work at two people that I have a huge amount of respect for with utterly non-sensical allegations during a psychotic episode – I was having verbal hallucinations in my own voice and some very deluded thoughts that I was unable to control. Of course, I then feel utter shame and guilt very deeply and for a long period but make no mistake that the responsibility is my own – I am utterly mortified.

Since that event, the medication (which was prescribed for anxiety / depression) has really levelled me out and that’s why I can write this now, it has been worth working through the initial very difficult period. It is like a cloud has been lifted. There is no medication approved specifically for EID but I feel confident that I can fight this into remission and feel very close to doing so. Depression and anxiety can creep up on you in so many ways, I will leave you to research that but I have found that after a difficult initial period that depression / anxiety medication has allowed me an awful lot more clarity to manage by emotional extremes. I might (and probably will) falter again but I am working on it and determined to minimise any impacts on the people I love and work with.

I guess the final thing that I wanted to talk about is the recognised strengths that my conditions bring to the workplace; Siemens have come out and embraced neuro-diversity; I am not sure this exactly fits but I have referred to this as “my superpower” so I should probably explain from other’s writings, so you don’t think it another delusion…

Resilience

Many people with EID are survivors of trauma and therefore the ability to manage the emotional dysregulations on a daily basis is nothing short of being warriors.

Empathy & Compassion

People with EID experience greater internal and external turmoil. However, this in turn allows for the ability to recognise and have greater insight for others in similar situations. Sharing stories of lived experience about emotional pain encourages others to open up and gives a sense of belonging and freedom from stigma. People with EID are able to read facial expressions and emotions better than those without EID.

Curiosity

Being extra sensitive and connection emotions, senses and surroundings allows for greater curiosity in the minds of those with EID.

Bold

Impulsivity is a EID trait that can be positively linked to being bold, courageous and having the ability to speak one’s mind.

Creative

The high intensity of emotions can be released into creative endeavours. Many people with EID put their entire emotional expression into music, art, performance and writing. (Think X-factor!)

Intuition

High sensitivity to surroundings learned from childhood means people with EID are more aware of other people’s emotional states. Sometimes the intuition may be overwhelming but when managed, people with EID can help others in distress rather than exacerbate the pain.

Compassionate & Emotional

When a person with EID loves, the love is deep, highly committed and loyal to the relationship. When the emotions are managed, liveliness and wittiness become the dominant qualities.

Scenario Consideration

Typically EID sufferers see everything only black and white with very little grey – when pitching for contracts, resolving disputes this can allow and unique clarity and perspective.

If you want to ask me about anything please feel free; please don’t try and accommodate me; it is for me to work through my own issues but if I do have a bad moment, please could I ask that you leave me to work through it; I promise I am not sulking; sometimes it just takes my rational brain time to take hold. I am getting better and better at learning when I am struggling, so I hope you won’t have to see too much of my bad side. I want to help others if I can whether that’s from a fellow sufferer, someone who has to manage a person with a mental health condition or even a mental health sceptic. I do want some good to come out of all of this if it is possible.

I am always going to be mildly eccentric Mark and I do embrace my differences but please believe that I do have really kind intentions in my heart; I know that this description will make some uncomfortable, perhaps some will offer support, some will nod knowingly acknowledging my obvious differences and some will avoid me but nonetheless I’m not ok but I am trying to be, so there you have it… but for the first time in my life I can, at least, be open and bring my whole self to work (well, hopefully not too many of the bad parts :D).