To look at her now, you would never know dental hygienist Laura Thompson has experienced a mental health crisis. Here, she explains why self-care in dentistry is so important…

Patients and colleagues always comment on my bubbly personality and ‘can do’ positive attitude – the latter inherited from a Northumbrian working class upbringing and my Royal Navy days. I’m someone you can depend on. Empathetic and a good listener, I can be very sociable and I love to chat. I have always worked hard to be the best version of myself. Little did I know, this could all change and my world was about to come crashing down around me.

In October 2018, I lost my mum to alcoholic liver disease three days after her 62nd birthday. Three months later, I lost my dad (my hero) also from alcohol abuse, aged 63.I think during this period – and for some time after – I was consequently on autopilot.

I have always been strong; stoic of sorts. In my personal life, I have family and friends who depend on me and, in my work life, I have an obligation to my colleagues and patients. I love being a dental hygienist and making a change in patients for the better and, apart from aged 13 where I had an ambition to become a Navy fighter pilot, I never wanted to do anything else.

Hiding being a ‘mask’

I spent the months following the death of my parents hiding my pain behind a ‘mask’. As dental professionals, I think we are all honed to develop the skill of being a good actor – I know over the years I have put in some Oscar-winning performances, but none as acclaimed as those I delivered during this period of time.

Bereavement impacts people in different ways. For me, I threw myself into work – treating patients was a welcome distraction and most of them didn’t know what had happened to me, so I could pretend all was normal. I’d enter the surgery, put on my ‘pocket smile’ and carry on as if I didn’t have a care in the world.

As the months wore on, appointments became more challenging. I was trying to be the perfect hygienist, keeping my frustrations inside during difficult appointments and therefore putting a lot of pressure on myself. I became increasingly stressed but took on extra hours as I felt guilty about taking time off when my parents passed. I felt guilty patient appointments had been cancelled so my waiting list was busy. I started working 12-hour days, which were more like 14-hour days with commuting. I kept my pain buried from everyone – even my family and friends. I withdrew, had short lunches and even stopped attending social engagements. I always had an excuse in my back pocket to avoid socialising. I am lucky enough to live rurally in the Forest of Dean and I thought my home was my oasis – in reality, it was becoming my prison.

My days became darker and my ‘mask’ started to falter. I started hating being a hygienist – patients were irritating me and I’d be physically sick before work. Family and friends started to notice I was withdrawn, irritable and short tempered. When asked if I was OK, I’d simply reply: ‘I’m fine, I’m just tired’, which I was – all the time. Sleep was erratic and I was so exhausted, I’d fall asleep on the sofa. When I would head up to bed, however, sleep would pass me by and I would be consumed by my thoughts and grief. On my working days, I would drag myself out of bed, shower and head to clinic and pretend everything was OK. On my days off, I would get my daughter to school and then the rest of the day would be a blur. I would spend hours on social media and start projects and not finish them, flitting from one thing to another. My personal hygiene slipped and there were days when I failed to pick up a toothbrush!


Carry on

I was trying to carry on as normal. I tried to be kind to myself but the reverse was true and I had become my own worst enemy. I hated myself, hated the way I looked and what I had become. I started exercising a lot – I’m sure my little dog shrunk by two inches with the miles we put in – but it didn’t help. I would spend my walk consumed by my negative thoughts. On my darkest day, I wanted to just lie down in the woods, fall asleep and not wake up. Then I thought of my daughter, of my friends and family – I knew the pain they would feel and I didn’t want them to feel even a small amount of the emotions.

Things finally came to a head in January 2020. I had, as usual, dragged myself out of bed and carried out my commute to work. I dusted off my 'Oscar' and put on my ‘pocket smile’. The day started with two difficult patients. During the opening conversation with my third patient, she simply asked if I was OK, as I wasn’t my usual self. I broke down and months of pain started to escape. My heart was rushing, my head was pounding, the world went dark and I collapsed.

Fortunately my patient (unbeknown to me) was a retired mental health nurse. I couldn’t have asked for anyone better to be with me at that time.

That day I emailed my doctor. I found it easier to write down my feelings than to speak them out loud. I felt guilty for taking up his time and was sure he would think I was making a fuss. I saw him the very next day and, within a week, I had an assessment with the mental health team.

I have to say my GP and Gloucestershire NHS mental health team have been fantastic. At the start, I felt weak as if I was a failure. I assumed people like me didn’t struggle with their mental health. Until you have been through it, you don’t fully understand the impact mental health struggles have on your life. I was given immediate support and we formulated a short-, medium- and long-term plan. In an early conversation with the mental health nurse, I was encouraged to read Depressive Illness: The Curse of The Strong by Dr Tim Cantopher. It was written in a way that I could understand the science behind mental illness and realise that I wasn’t being weak and that pesky chemicals played their part, too.

Hardest part

Initially, I went through a period of self-care. I was encouraged to talk about my thoughts and feelings with those close to me and this was the hardest part. I felt like I had let down my family and closest friends, but they surrounded me with so much love and played a large part in my recovery.

I tried to do things I enjoyed – reading listening to music and long baths. During this time, I felt guilty every day. I felt lazy and still tried to push myself, which made my recovery difficult and I felt permanently exhausted.

In February, I attended an eight-week stress and anxiety management course. I was so nervous I nearly didn’t attend. After the first session, I cried all the way home and it made me realise how bad I had got. This hadn’t just been a recent thing – it had been an accumulation over a number of years. I guess I had previously just had a bit more spare capacity to be able to cope.

In the following weeks, we used a cognitive behavioural model to understand how thoughts can affect emotions, physical feelings and behaviours. It felt like an epiphany. On completion of a lesson on worry management, I knew this would be life changing for me and I learned skills I knew I could pass on to others.

Creative therapy

In the weeks that followed, I focused on my self-care, made a plan and started to finish projects. I tapped into my creative side and started working with textiles and interior design again. I still got very tired very quickly, but I didn’t beat myself up about it. If I needed to rest, I listened to my body. One of my best friends suggested using a meditation app, which I used every bedtime and my sleep pattern improved.

I also meditated during the day when I started to feel life was overwhelming me. My darker days were becoming fewer and my guilt was becoming less. I had never thought that making time for myself would be the most valuable thing I could do.

Coronavirus and quality time

I was due back at work at the end of March but then the world became very different. The coronavirus pandemic hit and everything started to close whilst dentistry ground to a halt. I had my worries but decided to make the most of the situation.

My daughter was at home with me, we were both safe and had a rare opportunity to spend quality time together as I have always been a working mum, albeit part time.We kept going with academic home schooling and then decided we would spend some of our time tackling a neglected bramble-filled part of the garden. We would spend afternoons with dirty hands and would get into bed with aching muscles but also a huge sense of achievement. We could see our vision unfolding. My external stresses had almost disappeared overnight and my worries were manageable. During the evenings I used my spare time and seamstress skills to make scrubs for local healthcare professionals, so even though I wasn’t seeing patients I still felt like I was contributing.It was amazing how my life was changing, I was becoming more mindful and was paying more attention to myself, as well as the people and environment around me. My mood started to improve dramatically and I was glowing. The old Laura was starting to return.

I consider myself very lucky. Lockdown has allowed me to take some time away from dentistry, regain my strength and realise what I need to do to manage good mental health. I was fortunate enough to be supported by the NHS mental health team. They enabled me to help myself and I’m now happy to say I have been discharged into the care of my GP.

I am ready to again take on the challenge of saving the world of dental disease one patient at a time. If anything I have fresh eyes and a new vigour. My battle will continue. I know that I’m not going to feel good every day, but I now know that this is OK. Just because I have one bad day doesn’t mean I will feel like that forever.

Dentistry can be a stressful and lonely profession, which is why self care is so important – and it is another reason to be kind to others. You never know what is being felt under those pocket smiles.

It’s only when I reached out that I realised how many other people suffer with mental health challenges. The hardest thing for me was to ask for help.

If you are struggling speak to someone you trust, or speak to your GP. Please don’t suffer in silence. Better days will come.

Contact information

For information on mental health and available help, visit:

https://www.nhs.uk/conditions/stress-anxiety-depre...

www.mind.org

http://www.mentalhealth.org.uk

http://www.rethink.org

http://www.sane.org.uk

www.samaritans.org

For information on bereavement counselling:

http://www.cruse.org.uk

Mental health and wellbeing

The Society of British Dental Nurses (SBDN) has trained Mental Health First Aiders to hand and knows how important good mental health is at the best of times.

In these unprecedented times, the team understands everyone reacts to situations differently and that there are many challenges that you are or could potentially be facing.

Social media has brought a new way of communicating, but with it comes the opportunity to scaremonger and create more anxiety. The SBDN has a number of strategies to help you keep some perspective. Its big message is that ‘it is OK to not be OK'. It also has a ‘no turn away’ policy.

Call the helpline on 07437481182
The team will be available to book slots to talk at admin@bdns.org.uk

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