For almost two years, Ian Mallon tried to pretend there was nothing wrong. Despite the anxiety, sleepless nights and loss of appetite, he still turned up at the school gates every morning ready for a day's teaching. There came a point, though, when he realised he could ignore it no longer.
"I was sitting behind my desk doing the register and I couldn't stand up," he says. "The children were all looking at me but it was a struggle just to get through the 30 names. I thought `What the hell is going on?' I could not understand it."
His headteacher sent him home. The following day he went to the doctor, was diagnosed with clinical depression, prescribed anti-depressants and signed off sick for three months. Three months stretched into four, then five. He made it back for the summer term, but two days into the new school year he was signed off again. Still he refused to recognise that his job might be the cause of his mental ill-health.
"I was in denial. I loved my job and I thought it could not have anything to do with teaching, but eventually I realised it must have. Since I left I have been OK, so I guess that proves it."
Mr Mallon believes the day he "froze" in his classroom was the culmination of a process that had started with an Ofsted inspection several years earlier. His school, a primary in Coventry, was classified as having "serious weaknesses". It placed a burden on the teaching staff that Mr Mallon, now 49, found intolerable. In one week his lessons were observed on five separate occasions.
"It was endless paperwork. We were going through hoops and there were people coming in all the time with clipboards. They are scribbling away and you start doubting your ability," recalls the father of two.
The level of scrutiny led to situations that would be farcical if the consequences were not so serious. In one instance, the teachers were asked to estimate how many children would reach level 4 in their Sats. They discussed each child in turn and came up with a figure of 58 per cent. The local authority adviser said this was too low and suggested 75 per cent. The results came back at 58 per cent and the adviser said the school had failed to reach its target.
"That was what it was like all the time: they kept moving the goalposts," Mr Mallon says. "There are all these new initiatives. You think you are doing OK, you just get used to something and then it all changes."
His anxiety levels started to become unbearable. He spent sleepless nights worrying about what the next day would hold. His stomach was churning so much he was unable to eat before 7pm, when he would binge on snacks. He lost two stone in six months.
When he went to the doctor he was signed off sick and prescribed Seroxat, an anti-depressant. "It takes the edge off," he says. He also had counselling and did a relaxation course run by Mind, the mental health charity. He likens his depression to the Dementors in the Harry Potter books, creatures that suck out happiness. "Everything goes icy cold," he says.
His head was supportive. On one occasion, she visited him at home with a bottle of red wine and flowers. Ironically, this only made him feel worse about being away from school.
Two years after his diagnosis, and after several unsuccessful attempts to return to school, he realised that teaching was part of the problem. He decided to leave the profession and is now stacking shelves at Tesco. "It's what I can cope with," he says. He has also turned to writing and has just had his third book published, a children's novel called Matthew, Mark, Luke and John.
He finds it hard to cope with stress and gets palpitations at any hint of confrontation. He recognises that he will probably never be able to go back into teaching. "I loved going into school and working with kids," he says. "It was so rewarding, but then I would go home and worry. If you have an off-day and you work in an office you can take it easy, but in a school you still have 30 children in front of you."
Having to perform in front of a class can make it harder for teachers to seek help for depression, says Julian Stanley, chief executive of the Teacher Support Network, which runs a counselling service for teachers. About 44 per cent of respondents to its survey who reported suffering from depression said they did not speak to anyone about it in case it was taken as a sign of weakness. "There is an unfortunate culture in some schools of soldiering on, and that accentuates the problem," he says.
Teachers are aware that if they are absent someone else will have to cover their classes, and the fear they may let their classes down means they are particularly reluctant to take time off in the run-up to exams, he says. Schools can also be good at making it clear if an absence is inconvenient, making teachers feel guilty for being ill. Mr Stanley cites one caller to the helpline who said that every time she was off sick she was phoned at home about her lesson plans.
"Schools are very focused on trying to achieve results and while leadership teams can often mean well, if a teacher is poorly it means they have a gap in their workforce," he says.
The consequences of not getting help are severe. Depression can damage relationships, both at home and at school, and can prevent people doing their job. "Depression can be very debilitating," Mr Stanley says. In extreme cases it can drive victims to take their own lives. The suicide rate among teachers, at 14.20 per 100,000, is substantially higher than the England and Wales average of 10.25 per 100,000, according to figures from the Office of National Statistics.
For Chris Danes, depression meant the end of his teaching career and his marriage. He believes his illness was triggered by a combination of pressure of work and being repeatedly turned down for promotion.
Mr Danes, now 48, was head of RE at a secondary school in south east England and was twice asked to step into the role of acting deputy head. On both occasions his application for the job on a permanent basis was turned down, only for the successful candidate to pull out. Mr Danes was asked to continue to fill in.
During this period he was also expected to combine both roles without any additional support. He raised the issue of workload with his headteacher, to be told that if he couldn't stand the heat he should get out of the kitchen.
It was when his application was rejected a third time that he had a breakdown. "I felt I was being completely undermined and the headteacher just cut me loose," he says.
Unlike Ian Mallon, he says he received little support from his colleagues. "Their attitude was that it was a moral and professional failure to be ill," he says. The only contact from the school was phone calls to his then-wife saying he ought to come back to work.
He was prescribed anti-depressants and later admitted to a psychiatric hospital, where he was diagnosed with bipolar disorder, also known as manic depression. This was thought to be a pre-existing condition that he believes was brought on by his experience at school.
Realising he would be unable to return to teaching, he took early retirement. His marriage broke down under the pressure.
He now survives on what he describes as an "extremely poor" pension, supported by handouts from what was the Teachers' Benevolent Fund, now the Teacher Support Network, for items such as a washing machine. He also has a small income from writing RE textbooks.
It is now 12 years since his breakdown. While he recognises that attitudes may have changed, he says at the time of his illness he was shocked at the way he was treated. "There was a complete lack of understanding of mental illness," he says. "Before it happened to me I would probably have been as guilty of that as anybody, although I would hope I wouldn't have treated someone with so much cruelty."
John Illingworth, who left teaching after a breakdown, says the way schools deal with mental illness, and staff well-being, varies widely. He now travels around the country talking to teachers about stress at work and says the feedback he gets suggests that some schools are much better than others at easing the strain on their staff. School leaders who feel under pressure can transmit this down the chain, in some cases resorting to bullying staff.
"Good schools go out of their way to check the mental well-being of their employees," he says. "The problem is that it is the schools with a bullying management style that are least likely to do that, so you have this polarisation of healthy schools and unhealthy schools."
And as teachers come under more pressure, this pressure is transmitted to pupils. Mr Illingworth believes stress is one of the main causes of the high drop-out rate among teachers. A study by the University of Buckingham, published in August, found that almost 40 per cent of university-trained teachers left the state system within six months. The think-tank Politeia claimed earlier this year that between 30 and 50 per cent of teachers left the profession in their first five years.
There is also the financial burden. Depression is estimated to cost about pound;8.6 billion a year in lost working time, inefficiency and unemployment, according to government figures. On top of this is the annual pound;515 million the Department of Health estimates it costs the NHS to treat the condition, in GP appointments, hospital consultations and prescription drugs.
Schools need to be more alert to the dangers of stress and depression among their staff, says Mr Stanley of the Teacher Support Network. The network's survey found 66 per cent of those who had experienced depression rated their school as "not helpful at all".
"Schools should be looking for symptoms and looking to see if there is support they can offer if they see signs of anybody struggling," he says. Talking about the dangers of mental illness and recognising that it is a problem that will affect a sizeable section of the population at one time or another will also help reduce the stigma around depression, he adds.
The survey found insomnia to be the most common symptom, with 90 per cent of those suffering from depression saying they had trouble sleeping. This was followed by mood swings (70 per cent); headaches (67 per cent) and lack of concentration (66 per cent). Four out of ten had suffered panic attacks and a quarter experienced chest pains.
It was the sleeplessness that drove Catherine Paver to her doctor. After a month of lying awake at night, she sought help, but her GP's questions revealed it was more than just a case of insomnia. "I told her I didn't want to talk to anyone," she says. "I'm normally quite sociable, but I started avoiding people at lunchtimes."
She was signed off work, initially for three weeks. She was later prescribed anti-depressants and was referred for cognitive behavioural therapy (CBT), which focuses on positive ways of thinking and behaviour and is widely used to treat depression and anxiety.
Ms Paver, a secondary English teacher in London, believes her depression can be traced back to anxiety over a complaint from a parent that she was not setting enough work. "It was quite a small thing but it made me lose my mojo a little bit. It was the sense of having to perform without any leeway for mistakes," she says.
Once she recognised that she was depressed, she realised the symptoms ran wider than just insomnia. "There was lots of crying, over-reacting to things and a feeling of shame," she says. "You feel as if you don't measure up and everything you do isn't good enough."
She says this feeling of inadequacy is particularly hard for a teacher to take, leading them to conclude they are letting down their class. She believes the stress of teaching made her illness worse, but the thought of leaving the profession only increased the pain. Instead she opted to go part-time. "It's less money but I get my sanity back," she says.
Five years on she is still on anti-depressants and sees a psychiatrist twice a year. Although when she first went off sick she told her school she was suffering from insomnia, now she has no qualms about saying she had depression. "It's so common and a lot of people know someone who has experienced it," she adds.
But talking about depression to help reduce the stigma around mental illness will not deal with the underlying causes, argues Mr Illingworth. He says efforts to tackle depression in teaching concentrate on alleviating the symptoms instead of asking why so many teachers are suffering in the first place.
One step would be to thin out some of the accountability measures, but in practice the tide is flowing the other way. Proposals to introduce a licence to teach, with five-yearly assessments, will create an additional hurdle. In addition, a revised inspection framework based on raw results instead of how much progress children make will heap extra pressure on schools in challenging areas, he says.
"The Government is in denial," he says. "It knows there is a problem with teachers and mental health but all their (ministers') advice is about teachers managing their time; none of it is about what is putting them under pressure."
Until the causes of stress are addressed, the onus will be on schools to help their staff, and teachers to help themselves.
What the research says
Research suggests that depression is widespread in the teaching profession. A survey carried out by the Teacher Support Network last year found that 42 per cent of teachers had experienced depression in the previous two years. Of those, 63 per cent put it down to work and 33 per cent said it was a combination of work and personal issues. Just 4 per cent said work was not at least a partial cause.
The high incidence of depression is a sign of the level of stress in teaching, according to John Illingworth, a past NUT president. Mr Illingworth, who left his job as a primary headteacher after suffering a breakdown, led an NUT working party on mental health and teaching that reported to last year's union conference. It examined the causes of stress, which it found to be a major factor in triggering depression.
"Our teachers are the most measured, inspected and tested in the world," he says. As well as Ofsted inspections and performance management, teachers are also judged on test results and by local authority advisers and school improvement partners.
Increasing pressure on school leaders can often translate into more pressure on classroom teachers, Mr Illingworth adds. On top of that there are concerns over pupil behaviour and the fear of being the victim of violence in the workplace. Comparisons across occupations lend weight to the suggestion that teaching is a high-stress occupation. An estimated 36,000 teaching professionals report suffering from stress, depression or anxiety caused or made worse by their job, according to the Health and Safety Executive. At 2,630 per 100,000 people employed, this is 50 per cent higher than the average across professional occupations, and two- thirds higher than managers and senior officials in public and private sectors (see table, page 18).
An average of 0.88 days per education employee are lost every year through stress, depression or anxiety, compared with an average of 0.56 across all industries. Only those in public administration and defence have a higher rate of stress-related absence. Secondary teachers are almost five times more likely than the average across all occupations to have seen a psychiatrist in the previous 12 months.
Reasons to be cheerful
Rokeby School last year launched a concerted drive to improve well-being after carrying out a survey on how teachers felt about their work. The result is a range of measures aimed at supporting staff.
The school, in Newham, east London, signed up to Worklife Support, set up by the Teacher Support Network, which offers advice and counselling to individual employees, among other things.
Social events, including an "Oscars" night and a staff barbecue, aim to promote a communal spirit, while the school now offers massages, beauty treatments and activities such as yoga, pilates and spinning. Next term sees the launch of a laundry service, while a catering company will give teachers the opportunity to have their lunch delivered. The school has negotiated with local companies for a reduced rate for staff.
Senior leaders encourage departmental get-togethers, while on the Friday before half-term there is an expectation staff will be off-site by 3pm. "Staff sometimes get forgotten about, but we want to make their life at work a bit more pleasant," says Gurjit Shergill, deputy head.
"It is a way of recognising what a great job they are doing. They put a lot of time in and this is the school's way of giving something back."
Who gets most depressed?
Cases of self-reported stress, depression or anxiety caused or made worse by current or most recent job per 100,000 employees (averaged 200506 to 200708)
- Source: Health and Safety Executive.