Mental health - Don’t suffer in silence

Some of you may have read editor Kerry Haywood's book review of Ian Darler's Life's a Pitch in the last issue. It's in Chapter 11: Life Changing that Ian speaks about the life-threatening incident that nearly ended his career and plunged him into a very dark place. Here, Ian describes the incident in detail and explains the intensive surgery and recovery process he faced.

I remember the date vividly although, at first, it seemed like any old day at work. It was 6th August 2013 and life was just about as good as it gets. I was working on the pitch when my volunteer secretary phoned to ask if I could go to the club office and collect an advertising sign that had just been delivered.

I made my way to the office, checking all the corridors were clear as I went. I took great care in picking up the thin metal sign, which was about five feet by two, and was careful how I carried it too - these things can be very sharp, as we'd often found when fitting them around the pitch perimeter.

Meanwhile, someone had placed some boxes in the walkway in the direction that would take me back towards the pitch. I never saw them. Stumbling over the boxes, I nosedived forward and hit the deck. It was over in a second but I remember watching, as if in slow motion, the sign's sharp edge heading towards my face and throat as I was falling. A thought flashed through my mind: if I fall on that my time could be up.

The last thing I heard before the darkness descended was an almighty crash. Then, the club marketing manager was holding my head and telling me to lie still. I'd smashed my head on a wall and terrible pain was slicing through my hip and stomach. Some teeth were broken and there was blood all round my mouth and neck. Gingerly, I felt my throat to see if I'd cut it open.

A first-responder paramedic was on the scene within a couple of minutes. He administered some morphine for the pain and stabilised me, and an ambulance crew then whisked me off to Addenbrooke's, where more tests were carried out. Before I was discharged several hours later, I was told I was passing blood.

There followed a night of terrific pain and precious little sleep, and by the morning I was wondering if I'd had a stroke. I had no feeling in my right arm and three fingers of that hand, and the neck pain was excruciating. The problem, which later proved to stem from a neck and back injury which plagued me for months, until I had surgery.

It would be weeks before I could return to work on light duties. Even then, I was limited in what I could do due to hip pain and had to get friends to help out. I knew almost from day one that something besides the physical damage was very wrong, but I couldn't put my finger on it. I just tried to get on with things.

In January 2015, every small club's dream came true for Cambridge United: a home draw in the third round of the FA Cup against the world's biggest club, Manchester United. It was fantastic for the club and supporters but a nightmare for me.

I would have to prepare the pitch in what I knew would be sub-zero temperatures. Still, at that time, I was matchday safety officer and I would need to schedule a series of meetings with the local authority and police. A number of staff had just started working at the club and had no knowledge of what working big games required.

We knew we were facing a battle with Mother Nature. Temperatures were forecast to drop as low as minus seven and frost could have put the fixture in peril. The BBC, anxious not to risk losing such a high-profile live match, asked us to cover the pitch with an inflatable balloon and pump hot air under it, and I complied.

Before we knew it, match day was upon us. The Beeb's Match of the Day host, Gary Lineker and his pundits were casting admiring glances at the playing surface and commenting on how good it looked. In view of what happened after the game, their opinions were helpful.

The evening was very challenging with supporters trying to force their way in all over the stadium: attempting to surf over the turnstiles, climbing over walls and even the Supporters' Club roof, and invading neighbouring residents' properties.

During an incident when the turnstiles were stormed, one of my stewards was injured, pinned against a bridge. But, it was what happened after the game that would later cause me immense emotional distress, whilst also perhaps helping me to find a long path to aid my recovery.

During the debrief, the injured steward described what had happened and showed me his injuries. He said he'd been so scared at one point that, pinned against the bridge's steelwork and struggling to breathe, he thought he was going to die. Those words echoed in my head and refused to go away. I'd felt precisely the same thing at the time of my accident when I thought I was going to die.

I'd known that all was not well in my mental processes from a few weeks after the accident, but it wasn't something I wanted to talk about. As I finished the debrief, I felt dark shadows closing in around me. I had known that I had been wearing a mask making out that I was fine, over compensating how I felt by throwing in extra smiles, when really I was climbing a greasy pole and never reaching the top; the harder I tried to climb the more tired and fed up I became. Before the accident, whilst always happy to help anyone out, I would have my say if I felt I was in the right. Now I felt I had become like a limp, wet lettuce and would do anything to avoid confrontation in any form.

I know now that the cocktail of drugs I was taking to combat the pain from my injuries and various surgical procedures was a major contributor to the way I was feeling. Waking up every day in pain and discomfort takes its toll. Little was I to know that I would be diagnosed with post-traumatic stress disorder and would undergo harrowing, intense therapy that would challenge me to the very core of my soul.

As if I didn't have enough problems … the day after the Manchester United game, I was made aware that their manager, Louis van Gaal, had complained about the pitch. I found that mystifying when his backroom staff had nothing but praise for the surface, but my surprise and gratification when the media came out in support of me,

I've never had the pleasure of meeting Mick Dennis, at that time the football correspondent of the Daily Express, but if I ever do, I'll shake his hand. I'll always be grateful for his support in the story published four days after the game, from which I'm quoting large chunks below.

Under the headline 'Louis van Gaal is the loser in this pitch battle', Mick wrote: 'Let me tell you about Ian Darler. He's the man whose life's work was gratuitously insulted by Louis van Gaal.'

The 'supremely arrogant' van Gaal was, he said, dismissive of all the hard work I'd done and too self-absorbed to offer any congratulations to our team. 'Instead, a predictably familiar bleat about the referee was embellished with a needless and inaccurate moan about the condition of the pitch. And that traduced Darler's achievements and efforts.'

It was after this game that i made the club management aware that I was struggling and that I had to undergo more surgery. I'll be honest: I was disappointed that no assistance in any form was offered and I was left to fend for myself.

I was expected to be off manual work for six weeks, but I'd planned the appointment so that it would cause as little disruption as possible to the club. I wouldn't be able to cut the pitch for six weeks, but I reckoned I would be back at the club to run the office side of things, act as Stadium Manager and matchday safety officer and cope with the other paperwork at home.

The operation went ahead, but I struggled with the after-effects of the anesthetic and was kept in hospital for an extra twenty-four hours. I was glad to get home, but then I was taken ill and the doctors were concerned that there was a blood clot on my lung. There were a series of tests and scans to endure, at the end of which they found that I'd picked up an infection,

I'm not exaggerating when I say that this experience was a life changer. I struggled for months with pain from the hip surgery and seemed constantly to be on antibiotics for the lung infection. I would finish each course believing the infection had gone, only for it to make itself felt again a week or ten days later. I was undergoing challenging physiotherapy for the hip recovery, and one day I broke down and wept in the middle of treatment. I just couldn't cope with feeling so poorly and my frustrations at not being able to get on with my life poured out of me in a torrent.

I was experiencing frequent torrid flashbacks to the accident, although I kept them to myself. They were wrecking my sleep patterns and, when I did manage to drift off, I was restless and sweating, sitting bolt upright in bed and shouting. Lisa, my wife, kept asking what was wrong with me. I couldn't tell her. How could I begin to tell anyone what had turned a proud, strong, fit man striding confidently through life into a shambling, shuffling, weeping, twitching and trembling excuse for a human being?

My physio had set me a number of exercises, some at home and one involving a short walk through the village streets on crutches. It was whilst I was struggling on one of these excursions that a solution revealed itself: all the excruciating pain, grief, mental torture, feelings of inadequacy and frustration would be over in seconds if I just stepped out in front of a car.

It was thirty seconds before I was able to banish the destructive thought. It was enough to think about what effect my suicide would have on Lisa and my children, Liam and Ruby, for me to snap out of it. I demanded of myself: what the hell is wrong with you?

I returned home shaken and called my GP, only to break down whilst I was on the phone. An emergency appointment was made for me at the surgery, and there I answered a series of questions about my state of mind. Everything around the accident had caught up with me; I sobbed. From the first day I'd struggled with pain and discomfort. I was told that what I was experiencing was not uncommon and I was put on the list for an appointment at Cambridgeshire and Peterborough NHS Foundation Trust (CPFT).

Several more weeks, during which I continued to battle the lung infection, went by. It had knocked me for six and some days I was so poorly that I struggled to get up the stairs. And, without me being aware of it, I had become snappy, raising my voice and generally being unaware of what was going on around me. I can now see, and admit, that I was very scared.

The appointment with CPFT came through and I had to summon every scrap of courage I had left in order to attend. But at least I was acknowledging that I couldn't get through this nightmare on my own and needed help.

At the first appointment, the therapist asked me to recall, in minute detail, every second of the accident and its aftermath. I found it incredibly difficult to relive an incident that had devastated my life, but I managed to struggle through some of the details.

I told her I had fallen over some boxes at work, suffering a number of injuries including a cut head, broken teeth and damaged hip and elbow. The ambulance crew had given me morphine. I'd been passing blood and feeling generally unwell, and the following day

I'd woken with no feeling in three fingers and unable to move my neck. This had led to several medical procedures to remove nerves in my back and neck to relieve the symptoms, and then three procedures on my right hip, whilst taking a cocktail of pain-relieving drugs. Since the bang on the head, I said, my memory had been shot to pieces, which bothered me massively.

There were a few things I couldn't talk about as to do so would make me feel ill, set my lips tingling and send me into a panic. I couldn't tell the therapist that I was carrying a very thin piece of metal Dibond two feet by five when I fell, or that as I was falling all I could see was the razor-sharp metal in front of my face, or that I was thinking if I fell on the sheet it would cut my head off and I would possibly die. I couldn't tell her that when I came round from the bang on the head I had blood in my mouth and on my face, and could remember running my fingers around my throat, thinking I had indeed landed on the metal.

I attended these appointments for several months before being referred to a consultant psychiatrist, Dr Louisa Mann. A psychiatrist? Had it come to this? I had little knowledge of what a psychiatrist actually did and didn't have a clue what to expect. Attending my first session with Dr Mann was one of the scariest moments of my life.

The appointment involved a number of tests and a series of questions, and then Dr Mann told me she would refer me for a brain scan due to my loss of memory. She also said she believed I was suffering from depression. I failed to accept her conclusion.

I went back for several more appointments and each one was more difficult than the last. Time after time, Dr Mann asked me to consider medication to help me sleep, but I declined. Then, one day, I said the solution to the whole sorry affair was simple: I just needed to 'man up'. Wrong answer, but it was a turning point. It wasn't easy, but Dr Mann convinced me that trying to 'man up' wasn't a helpful approach. Finally, I surrendered to her advice. Finally, I accepted that I was suffering from depression. Finally, I agreed to take the antidepressant mirtazapine.

The next few weeks were some of the toughest of my life. The thought of setting foot outside the house filled me with fear. I would avoid anywhere where there were likely to be other people, which is pretty much everywhere.

A number of very close friends started coming round to see how I was. I appreciated these visits but found them enormously difficult experiences.

My matchday medical officer and deputy safety officers visited several times and, to my surprise, one of them revealed that he had been through depression himself and knew exactly what I was going through. One of my most loyal friends, a steward at the club for forty years, came round and told me he had suffered terribly during his depression.

Whilst these reassurances went some way towards persuading me that depression is a distressingly common disease, I'm sorry to say that at the time they were like water off a duck's back. I couldn't see a way out of what I was feeling; I had no interest in anything; if somebody had presented me with a million pounds and asked what I would like to do with it, I would have replied 'nothing'. My life had no meaning and even less purpose.

But, I had another huge surprise when one of my visitors, before I'd said a word, described my symptoms in precise detail and said he'd also been through a rough spell. I wasn't alone, he stressed.

He was a serving police officer and real hard nut who was always the first to put his head above the parapet and deal with crowd disorder; he was the last person I would have suspected of suffering from depression. His revelation had an impact on me and I found it so much easier than usual to talk to him.

It sounds ridiculous now but at my lowest point I couldn't get out of the house, so I was set a challenge: going to the Co-op twice a day to start engaging with people in public places. But I found myself cheating. If the car park was busy I would wait until it was quiet, and I would have the right money ready in my pocket for a quick exit at the till. There were times when my lips felt three times their real size, I had the shakes and panic attacks were common. Having dealt with large crowds at work for decades, I found these especially hard to deal with but there I would be, struggling to breathe, convinced I was having a heart attack and was going to die.

At one appointment a colleague of Dr Mann's was in the room. Dr Kim asked if I would return to the clinic with a family member or friend. I couldn't bring myself to ask Lisa as I knew I'd already put her through hell, so I asked my good friend Andy if he would come.

We were both asked a series of questions and Andy said I'd had an amazing memory before the accident; something had changed since then. Once again, I was asked to relive everything that happened on the day of the accident and, as I recalled the events of those awful hours, I broke down in a flood of tears. Dr Kim asked why the tears had come, and for the first time I talked about the flashbacks to that terrible moment when I thought I was about to die. It was likely that I was suffering from PTSD as well as depression, Dr Kim told me.

There followed weeks of exhausting therapy that involved reliving the accident several times a week, as well as exercises to be completed at home, and the trips to the Co-op continued. But I found it impossible to go anywhere near the Abbey Stadium and I couldn't bring myself to watch football on TV.

In the latter part of the treatment for PTSD, Dr Kim asked me to relive the accident on the council sports pitches on Coldham Common, behind my stadium, with the floodlights in full view. All the distressing symptoms came flooding back. Then an ambulance siren shattered the air and in an instant I was back at the accident.

But gradually the sessions on the Common began to help and I felt my life was finally beginning to improve. It wasn't the end; it wasn't even the beginning of the end; but it might have been the end of the beginning.

Then came the acid test: Dr Kim asked if I could arrange a treatment session in the stadium's control room. At the point at which I was reliving falling over the boxes, Dr Kim created a deafening crashing sound by dropping a large bag of steel cutlery, I was instantly paralysed. In my mind the accident had just happened all over again, with terrible clarity.

I was hypersensitive to crashing sounds and noise, the good doctor concluded. My brain recognised these noises as signs of danger and reacted accordingly.

As I was going through this treatment, I was made aware that the pitch at United had deteriorated, and I was asked what could be done to improve it. I'd only seen the pitch from a distance during my therapy, but I could identify the problem and was able to call in a few favours to help improve it.

Then, following a meeting with club officials, I took a phone call out of the blue, followed up by a letter, informing me that the club had engaged an occupational health nurse who would be in touch to see when I could get back to work. The news caused me so much stress that I couldn't stop shaking and could hardly speak. Why now, I wondered, after all this time? And why at a time when I was starting to recover?

I had to wait for a week or so for the phone call, but the nurse was kind and understanding. She explained that the call would take around thirty minutes and that she'd been asked to assess when I would be back to work following my hip surgery.

I stopped her there. 'Are you telling me,' I asked, 'that the club think I'm off work just because of my hip?' Her affirmative reply staggered me and I almost dropped the phone.

I spent well over an hour recounting yet again what had happened: I'd been through seven medical procedures; I was still fighting an infection; I was still undergoing post-operative physio; I was undergoing treatment for depression and PTSD.

Despite all that, I'd been working from home and had processed more than 1,200 emails whilst away from the stadium, whilst the club had received sick notes containing all the necessary information. I finished by explaining that I'd asked the doctors several times when I could return to work and had been told that I was nowhere near fit enough. 'Right,' said the nurse, 'you've told me quite enough. I'm stopping any further work from home whilst you're receiving treatment for PTSD.'

She called a few more times, saying my doctors at CPFT had provided her with documentation of my therapy and had confirmed that they were very disappointed by the letters I'd received from a manager at the club. Considering my condition, they were unhelpful.

My treatments continued and I continued to improve. Finally, it was agreed that I could get back to work on a phased return basis.

I believe that I am now a far better person who is far more considerate and understanding and would ask that if anything comes out of this article it is this ... If you have a family member or member of staff who appears not to be working to their normal ability, don't think they are being lazy or on a different planet - ask them if they are alright and then ask them 'again are you really alright'? It is so easy to dismiss the first enquiry when someone asks - believe me, I did it several times when friends asked how I was doing. Since my challenge with life, I have helped two people who were struggling in silence with depression and pointed them in the right direction - one of whom said that I saved his life.

Cambridge United

I am pleased to say that Cambridge United now have an excellent mental health programme in place and they are going to great lengths to offer help, both within the club and within the community through the charitable division; Cambridge United Community Trust. This uses the power of sport and the brand of Cambridge United to have a positive impact on the local community. www.cuctrust.co.uk

They also undertake EFL mental health awareness sessions and, are possibly, one of the leading clubs in the country at this present time.

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Life's a Pitch is published by sports and special interest publisher G2 Entertainment and you can purchase it here from Amazon.co.uk

Read Kerry Haywood's review of the book here