This post originally appeared on VICE UK.
The highs and lows of your mental health may not define you, but they can certainly shape your life. Work, in particular, insistent and inflexible, is deeply bound up with how close to the edge you happen to be at any particular time.
I can trace my own life back in this way. I left home and started work at 17, having already had treatment for mental health issues. There's definitely a link between this, my 15 years of uncontrolled "self-medication," and the fact that, until I was 26, none of my means of income can be put in black and white on a résumé. After that, I worked full time in a bar for a few years. It wasn't until I was 30 that I began attempting a career in journalism.
Since then, with drinks and drugs demoted from daily to "recreational," I've steadily upped my dose of SSRIs as I've tried to keep the balance between sanity and earning a living. I managed nearly four years in an office but found it hard—I virtually stopped sleeping, meaning days at my desk felt as though I was on acid—so I decided to go freelance.
In this, I join many others who've decided that the relative flexibility and privacy of self-employment is the best option for managing mental health. And often, it is. The stress of deadlines and hustling new work, for me, pales in comparison to dealing with Other Human Beings when I'm anxious or depressed.
The trouble is, drumming up new work—be it pitching features or picking up fares for Uber—requires a degree of self-belief and togetherness. Drop below a certain threshold and it all falls apart. I've been there; feeling too shit to pitch anything, too mental to write. Like most people I know, I have no savings so I have to keep working to pay rent. I spent four months staying with a friend at the beginning of this year as I tried to get myself back on working track.
As of 2016, the UK has record numbers of self employed workers. An estimated 4.6 million—around 15 percent of the workforce—now work for themselves. Two-thirds of new jobs in the UK created in recent years belong to the self-employed.
But is this a brave new world of enthusiastic entrepreneurs, setting up mini empires from their kitchen tables? Not entirely. The Chartered Institute of Personnel and Development has described the new self-employed as "odd jobbers, desperate to avoid unemployment." An in-depth report by Co-operatives UK called them the "self-employed precariat."
According to the TUC, "Self-employment appears to be a key factor in the UK economy's shift towards low-paid work." Around half (49 percent) of the UK's self-employed are in low pay, compared to around a fifth of employees (22 percent).
Given that there's a growing crisis around mental health care, and knowing that poverty has a direct impact on wellness, it's inevitable that these upwards lines on the graph—self-employment, mental illness—will intersect.
Charlie, 41, says that, for her, work and mental health were "bound up in one another."
"I graduated from my PhD and found there were virtually no academic jobs in my field," she said. "I was left struggling on zero hours contracts. The effect on my finances was calamitous, and the stress of working so hard, with so little employment stability and so little income, led to anxiety and depression. This downward spiral continued over a period of three years, until I had a complete breakdown and attempted suicide."
By this time, Charlie's local authority had taken out a court order and sent bailiffs to her home to recover goods equivalent to her council tax arrears. "I began planning my own death again," Charlie says. Finally, she saw a sympathetic doctor and was referred to a crisis team. Through them, an advocacy worker from Mind helped her apply for benefits. She now receives ESA and PIP and is registered disabled.
Kate, 28, is a self-employed dog walker living in Essex, England. Her depression and anxiety has recently escalated.
"I just managed to keep working with my regular clients," Kate says. "But I had to drop out of a part-time course and I haven't managed to generate new business or do any promotion. I think my reputation has suffered as I've been scatty with getting back to people. I feel like I have so many plates to spin and have to keep on spinning them or everything is going to crash around me."
Kate is currently waiting for support from her local NHS counseling service.
Andy, 27, had set up his own business—a shop—when his mental health took a turn for the worse. "I had three months of not being able to do anything," he says. "I couldn't think or focus or do anything other than feel like my life was a pointless waste of time. I had to borrow money to pay bills and struggled continually to pay it back. I even resorted to payday lenders, which has left a long-term stain on my credit rating."
Other people I spoke to had similar stories. A therapist from the southwest was forced to live with her ex-husband again as her depression meant she was unable to work enough to cover costs. A painter and decorator from London said he has to just "push through," although "talking with clients can help."
People's outcomes vary. Andy got involved in amateur boxing and says it "helped my physical condition and that helped my mental state". Charlie says, "My mental health, although fragile, is better now than it's been in the last five years, but I have no career."
Mental health charity Mind says it's aware of the problem. "We know that money and mental health are linked," said Emma Mamo, Head of Workplace Wellbeing at Mind. "If you've just set up your own business, money is likely to be an issue while you're getting established. And if you're a freelancer, it can be difficult to get stability."
Mamo suggests basic self-care as a first step: make a conscious effort to schedule in relaxation time, take breaks, stop for lunch, get outside, try not to work stupidly long hours, work through tasks one at a time rather than flitting between things in panic. Get in touch with your doctor if you're not coping.
In London, Carmen D'Cruz, 30, has created a workshop on getting organized when you have depression or anxiety. Key, she says, is remembering you don't have to do everything: "Strip back those layers of fake obligations and unnecessary goals." Also, ask for support: "Friends, family; get them to help."
But the problem also needs to be tackled on the work side of the equation. Does it need to be this precarious, this poorly paid? According to Co-operatives UK, there's an urgent need for co-operatives, trade unions, and mutual organizations to "form cohesive institutions to unite the self-employed precariat."
Where the US, Denmark, the Netherlands, Germany, and Spain have growing unionization movements for the self-employed, in the UK, support is patchy. Unite, which covers industries including building, agriculture, and the service industry, told VICE it doesn't, as yet, have many self-employed members. GMB is likewise not focused on the self-employed, although it represents workers in similar positions, such as Addison Lee, Uber drivers, and people on zero-hour contracts.
Industry-specific unions may be more helpful. Tim Dawson, president of the National Union of Journalists (NUJ), said: "My anecdotal experience is that a considerable proportion of freelancers suffer some kind of mental or psychological issues All NUJ branches have a welfare officer who should be in a position to provide discreet advice and help. They can also provide access to the NUJ's charity, NUJ Extra, which helps scores of journalists with financial issues every year."
The number of freelancers is growing; there's been a permanent change in the way we work. It's time to create some new structures of support if we're going to pay our rent, meet deadlines, and avoid, if possible, completely losing our minds.
If you're self-employed and struggling with your mental health, you can get support from organizations like the National Alliance on Mental Illness or the Money and Mental Health Policy Institute.
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