Keeping your head above water

EVEN before the COVID pandemic, the increasing concern about dental professionals’ mental wellbeing can’t have escaped your notice.

During lockdown, whilst the internet and media was awash with suggested projects to do, classes to take, virtual choirs and language apps, dentists were frantically trying to keep pace with new guidance, standard operating procedures and triaging, all while juggling their finances. The dental advisers at MDDUS have never been busier, listening to your concerns, fears and, at times, distress.

In 1953, during a period of deep depression, Stevie Smith wrote the poem Not waving but drowning, which describes a man drowning amidst onlookers. The central theme is that our capacity to empathise and care for one another has diminished and we are distanced from each other’s reality. As a dental team we work together closely, but do we really talk to and listen to one another? It’s possible we have colleagues struggling with family, money, professional or health worries, and yet we are oblivious to their plight. Or perhaps we are that person, surrounded by others but alone. In the poem the man drowns because no one comes to his aid and afterwards the onlookers provide various reasons for their lack of action.

The Office for National Statistics found that, in 2019, 18 people a day in the UK were lost to suicide. Among those people have been some of our own. No matter how many support or online groups we create, these statistics will continue unless all of us change the way in which we relate to not just one another, but ourselves. We need to stop and wonder whether a colleague is not waving but drowning. But there is no use jumping in to save someone from drowning if we can’t swim ourselves.

If we are to help one another we need to start with our own mental wellbeing. Consider these five ways to wellbeing created by mental health charity Mind:

• connect
• be active
• learn
• take notice
• give.

Now pick one and explore it. If I were to recommend one, it would be 'take notice'. Take notice or be aware of your internal world. How do you feel physically? Do you feel exhausted but can’t sleep? Are you mentally exhausted?

Those of you trying to return to “normal” practice could be at full capacity mentally as much as physically. Often when we say we are exhausted we are in fact suffering from cognitive or emotional overload, whilst our bodies have done little. Take notice of how much physical activity you are doing and whether in fact you need to get out of the practice or your home. Why not do something as simple as take a walk around the block each day? When you do, take notice of how the air feels, what sounds are around you, notice the impact of your feet on the ground, be in the moment, rather than back in the surgery.

Change is difficult and COVID has radically altered our working environment. Everyone will struggle and react in different ways. Take notice of your own reaction and give yourself time to adapt to the new way of working. Don’t expect to instantly be carrying out a crown prep in 30 minutes. PPE is hot and restrictive, so take notice of your hydration and set time aside for self-care. Keep your goals small so that you experience successes.

Nobody heard him, the dead man, But still he lay moaning; I was much further out than you thought... And not waving but drowning.

Stevie Smith 1953

Once you have taught yourself to swim, take notice of others. Do you work with someone who eats their sandwich in the car, does not engage well with others, and is dismissed with ‘oh that’s just the way they are’? Sometimes it is easier to believe that someone doesn’t really need help to avoid an awkward conversation. But how many of those 18 people a day in the UK could have been saved by someone brave enough to reach out?

When you notice someone struggling, the Zero Suicide Alliance (ZSA) recommend three things:

• See – recognise the signs. Withdrawing, expressions of self-loathing, guilt, lost purpose or hope.
• Say – let’s talk. Ask how they are feeling and be patient. If necessary ask if they are suicidal. Doing so does not increase the chance someone will act, it may save a life. Listen without judgement.
• Signpost – share useful contacts (see below). Post these in your practice in areas where colleagues can access the details discreetly.

Lastly, if you or a colleague are experiencing any of the following, speak out and ask for help:

• exhausted despite sleep
• feeling a failure, or that people would be better off without you
• inability to concentrate
• making careless mistakes, letting things slide, being an outlier
• fed up with life, work
• feeling lost, distanced from your colleagues, not part of the team, voiceless
• taking things to heart
• losing civility.

On a lighter note, my dressage coach bought me a pair of pink pants emblazoned with the word ‘brave pants.’ Tacky, yes, but I wear them to every cross country I do on my horse Paddy. Brave pants are great when they work and I would encourage you all to be brave. I am not suggesting you need to buy yourself a pair quite like mine, but do what makes you feel brave. Above all, be kind to yourself and reach out to others.

Useful links

• MDDUS member wellbeing and mental health resources
• The Dentists’ Health Support Trust
• Confidental – support for dentists in distress
• Mind – the mental health charity
• Samaritans – 24 hours a day
• CALM – campaign against living miserably
• Dan 24/7 support with drug and alcohol in Wales
• SOBS survivors of bereavement by suicide
• Men’s Shed – community support project.