How can we take better care – of not just ourselves, but each other? That’s a question that has absorbed Randi Bitsch since her own depression.
In December 2012, Randi opens a Christmas card from her workplace. She heads up the rehabilitation unit of a mid-size Danish municipality. The unit provides physical and occupational therapy to citizens ranging from disabled children to elderly people with chronic illnesses. In the past year, Randi’s overseen numerous organisational changes, and her unit has won high praise for their results. Thank you, her boss has written, thank you for your dedication.
But all is not Christmas cheer. Her team has lost a key employee to a round of budget cuts, and the unit is scheduled to join forces with a rehab unit from another municipality on a major area of activity. Both changes are designed to save money, and together they mean one thing: a decline in services. Randi has three ways to tackle the problem. The therapists can reduce the time they spend writing up case notes; they can provide patients with less treatment; and they can
all push themselves to work even faster.
One therapist refuses to take on extra tasks, so the others have to pull even more weight. Randi can feel the team’s frustration – just as she can feel her own doubts about getting everything to function. But she’s the one in charge. She can’t lose her enthusiasm.
Just before the Christmas holiday, her boss calls her up and says she needs the unit’s programme development officer for other assignments. This tells Randi that her boss is under a lot of pressure herself and is struggling to make departmental ends meet. And two realisations slam into her: she hasn’t been consulted about this decision, and her unit’s progress and innovation will now grind to a halt. The only thing left is day-to-day operations, and there’s no way she can work her way out of the professional decline that will ensue. “When I hung up,” Randi recalls today, “I could feel the energy drain out of me.”
Randi didn’t know how it would end
It was a classic managerial problem and in retrospect, Randi sees the problem as geographic. Unit managers all worked at city hall – except for her. She worked off-site, together with her team. To prevent other decisions from being made over her head, she’d have to insist on being part of the managers’ community. Was it possible for her to sit in city hall once a week? The answer was no. And she noticed an ominous development: her boss became harder and harder to get hold of.
Meanwhile, Randi kept an eye on all her employees, but their attention was also directed her way. After one team meeting, one of them said, “Randi? You’ve gotten so quiet.” Randi thinks it’s rare for pressure to come from just a single source, and she thinks back to a certain winter evening. Her father-in-law had died, and after the burial she had a falling out with her husband. And the family that had just sat together in church now watched her explode with so much fury that afterwards, Randi didn’t know how it would end.
“Something burst in me that day,” Randi says. A few months later, she had a breakdown.
She has a hard time remembering what actually happened. What she knows is that it was early on a weekday morning, and that her body started trembling. That she couldn’t get out of bed. And that her husband came rushing out of the bathroom and tried to soothe her while she shook and made sounds she cannot recall.
Things came to an impasse
The mornings were the worst. Randi was on sick leave, down with depression. If she got up, she knew she’d have to pick out some clothes to wear, and that decision was so paralyzing that she would remain in bed. She longed for someone to send her a text or an email, to visit her. But it grew very quiet around her.
When she returned to her job, her staff showed such concern that it still moves Randi when she speaks of it today. And the therapist who’d upset the rest of the team by limiting her workload earlier now approached Randi privately. She told Randi, “I went through the same thing.”
Organisationally, however, everything was exactly the way it was before.
Less than six months later, she was forced to go on sick leave once more, this time due to stress. Her relationship to her workplace was never the same again. Things came to animpasse that was broken only by Randi being fired. At the disciplinary meeting, she brought a union representative to do the talking. Silently she listened to the statement from HR, saying that her illness had turned Randi into an employee they could no longer use. A year previous, she’d been a valued employee. And silently she observed how ill at ease her boss appeared to be.
How can I get well again?
Should others know that Randi’s suffered from depression? or not? Randi tries to balance openness and privacy. When she applied for a new job, the word depression never passed her lips. “I knew that if it did, they’d take someone who’d always been well,” she says. But her new employer knows about it, as do her co-workers. One of the reasons is that Randi has spoken publicly on several occasions about the course of her illness.
When she lay ill, her thoughts had circled around one thing: How can I get well again? Will I ever get better at all? She did get well, but she isn’t the same. It’s like having a ruptured muscle in her brain, she says. When she notices herself getting tired and unfocused, she has to listen to her body. She’s chosen not to take another leadership position. She meditates. But it’s not only herself that she wants to be aware of. If another person seems unwell, it’s easiest to ignore it. Easiest not to risk being rebuffed, to tell yourself it’ll only make things worse. But Randi has decided that she won’t look the other way. She walks over and she asks, “How are you feeling?”
Randi has had three episodes of moderate depression – the first in 1999, the second in 2004 and the most recent in 2013. Shortly after reporting back to work after recovering from the last episode, she was diagnosed with stress. Mindfulness meditation has helped her look after herself since then, and Randi feels well these days.
Physiotherapist, master’s degree in the psychology of organisations
Treasurer, Depression Association of Denmark
Project manager for a municipal health team
Two adult children
One thing I believe that healthy people frequently don’t know about depression
A person with depression will often back out of the things you usually do together. It may seem as if you’re being rejected, and perhaps you feel nervous about making the depression worse by persisting. Yet it’s very likely that the person is longing for company and just can’t deal with the practical aspects. Don’t be afraid to say, “I’ll come over then, and help you get your jacket and shoes on.” You’re not doing them a favour by leaving them alone.