I had a panic attack last night. I lost my breath. My lips went numb. My teeth clacked. My body shivered. I couldn't stop, and I felt the most overwhelming pit of despair somewhere inside my rib cage. The whole thing lasted about half an hour, and I spent that half hour choking and sobbing, shaking and sure that my throat was going to close off, certain that I was going to die.
I've suffered from panic attacks, debilitating anxiety disorder, major depression, and complex PTSD triggers since I was eleven. Now I am an accounting professional living and working with mental illness, and I am not alone. I'm not even the only Going Concern contributor with anxiety disorder. Greg Kyte detailed his struggles with anxiety disorder back in 2012.
Unfortunately for Greg, for me, and for others who struggle with mental illness, we work in an accounting culture that stigmatizes and perpetuates mental illness.
For one thing, the accounting culture seems to marginalize mental illness. We don't talk about it. Researching for this article, I found article after article about depressed, overworked, and suicidal lawyers, and I even found a 2014 Canadian CPA Magazine article called “The Last Taboo” that talks about not talking about mental illness. Aside from that article and Greg's 2012 article, I was hard-pressed to find anything detailing a CPA's struggles with mental illness. Is that because mental illness doesn't strike CPAs? Of course not.
Like Greg and me, millions of other Americans live with some type of mental illness. According to the National Alliance on Mental Illness (NAMI), “one in five adults in the U.S. experiences mental illness in a given year.” While many of those living and working with mental illness manage to function, it will impair major life activities of ten million US adults and will cost the US $193.2 billion in lost earnings in 2015 alone.
We don't talk about mental illness in the accounting profession, even though it affects 20% of us, because mental illness comes with a stigma. When I slunk off to hide in the back of a bathroom stall three floors down from the audit room at the client site to have panic attacks, I certainly wouldn't advertise it to the team. I wanted the team to think I could handle the stress of 80 hour weeks. (I couldn't.)
Why didn't I tell the team that I was having panic attacks? Because I was embarrassed. Because of the stigma. We laugh and use words like “weak” or “cray-cray” to describe mental illness, but when's the last time you heard someone tell a well-timed leukemia joke? Why do we take cancer so seriously but sideline mental illness, which is just as serious? Leukemia can kill you, but so can depression. Suicide is the tenth leading cause of death in the United States, says NAMI. Remember the tragic suicide of Deloitte partner Daniel Pirron? Are you still laughing?
Because we don't talk about it, because mental illness comes with a stigma, and because, as the Chartered Professional Accountants of Canada article says, “employers aren't perceived to be as accommodating to mental illness as they are to other health issues” (like leukemia, for instance), CPAs often don't seek help. NAMI reports that only “41% of adults in the U.S. with a mental health condition received mental health services in the past year.”
We all know that accountants are generally overworked and underpaid. But instead of promoting mental health treatment and awareness or suggesting that employees take time off to avoid dying, the accounting culture seems to perpetuate substance abuse as a coping mechanism for overwork.
My old firm's culture was chock full of substance abusers, and according to NAMI, 40.7% of substance abusers suffer from some sort of mental illness, too. That firm worked its teams so hard that one of the managers passed around Ritalin so that associates and seniors could focus well into the early morning hours. When the team did have time off, they'd spend it at the bar. “Team bonding with a bottle of Hot Damn!” they called it. That April, the firm threw an end-of-busy-season-party with a firm-sponsored open bar. The day of the party, HR sent out an office-wide email saying, “Don't drive home wasted; bill the cab fare to the office, and we'll pay it. No questions asked.”
At first I thought, “Wow, they really care about me. They don't want me driving drunk.”
Then I realized that my employer had A) worked its CPAs so hard that they needed an open bar to cope, B) provided copious amounts of free alcohol, and C) basically said “It's totally okay if you're too impaired to drive. Here's some cab fare.”
The firm's message: “Stressed out? Have a free drink… or eight… and a free cab. LOL.”
What the firm's message SHOULD have been: “Stressed out? Here's a day off of work and a list of mental illness warning signs and mental health professionals in our area covered under our insurance plan. Bill your co-pay to the office, and we'll pay it. No questions asked.”
While the accounting culture continues to marginalize mental illnesses and then perpetuate a toxic “free-cabs-home-from-the-open-bar” culture, the 20% of us living with mental illness will continue to suffer.
How can we change? By ending the stigma. By talking about anxiety disorder. By talking about depression. By spreading mental health awareness. By admitting that “Hey, Greg Kyte. You're not alone. I have panic attacks, too.”
Beyond spreading awareness to end the stigma, learn the warning signs of mental illness. A few signs are substance abuse, inability to handle daily stress, exhaustion, excessive worrying or fear, excessive sadness, confused thinking, changes in thinking, changes in sleep, sex drive, or appetite, anti-social behavior, suicidal thoughts, or difficulty in relating to people. You can learn more at the National Alliance on Mental Health.
Finally, if you need help, please seek it out. I've been seeing a psychologist weekly for the past year and a half, and it's the best thing I've ever done for myself. Your insurance provider or primary care doctor can help you find a mental health professional in your area, or you can contact the NAMI helpline at (800) 950-6264 or email@example.com.
If you or someone you know needs helps now, you should immediately call the National Suicide Prevention Lifeline at 1-800-273-8255 or call 911.