Background

Mental health issues in the workplace are now the largest cause of absenteeism in the UK.  

It is estimated that around 91 million working days are lost due to mental health problems each year. There still however remains a stigma attached to mental health, this is often fuelled by negative media coverage and the misunderstanding of medical conditions by fellow work colleagues

The most common forms of mental ill health are:

 

Stress

This is when a person feels they are not capable to cope with the pressures and demands placed against them

Causes

Excessive pressure to perform at work, Threats of violence, Money worries, Arguments, Family conflicts, Divorce, Bereavement, Unemployment, Moving house, Alcohol or drug abuse.

The symptoms of stress

Periods of irritability or anger, Apathy or depression, Constant anxiety, Irrational behaviour, Loss of appetite, Comfort eating, Lack of concentration, Loss of sex-drive, Increased smoking, drinking or recreational drug-taking.

Physical effects

Excessive tiredness, Skin problems, Aches and pains resulting from tense muscles including neck ache, backache and tension headaches, Increased pain from arthritis and other conditions, Heart palpitations, For women, missed periods.

Tackling Stress

Delegating or sharing their responsibilities at work, Avoid confrontation with difficult colleagues, Learning to be more assertive, Taking regular exercise, Not using drink or drugs to cope, Eating a healthy and balanced diet (rich in fruit and vegetables), Finding humour or absurdity in stressful situations, Never taking on more than they know they can cope with, Organising their time better to get as much done as possible, Talking to friends or family (and sharing their thoughts and fears),

Listening to music or relaxation tapes, Tensing and then relaxing their muscles (starting at the toe and working up to the head and neck), Risk Assessment in the work place (identifying causes of stress and managing them).

 

Depression

Literally means “low spirits”

Symptoms

Restless, Agitated, Abnormal sleep patterns, Constant lethargy, Exhaustion for no apparent reason,

Anxiety, Tearfulness, Forgetfulness, Preoccupation with illness, Loneliness even in company, Low self-esteem, Loss of identity/worth, Negative thoughts about the future, Difficult making decisions,  Inability to enjoy things, Frustration/hopelessness/despair, Loss or increase in weight, Loss of appetite, Feeling guilty or to blame, Lowered libido, Short temper/mood variations.

Causes of depression at work

Undue pressure, Repetitive work, Uncertainty about job security, Uncertainty about ability, Difficult bosses & deadlines/targets.

Effects at work

Lower performance/productivity, Making mistakes, Poor relationships with colleagues,  Forgetfulness/lack of concentration, Absenteeism/irregular attendance/late for work, Deliberate isolation, Disciplinary action/dismissal, Unprovoked anger, Emotional outbursts, Targets for taunts/harassment/bullying.

Treatments

Talking to someone with similar experience, Professional help (psychiatrists/Cognitive Behavioural Therapy), Continuous treatment and close working with helpers, Samaritans, MIND support groups,

GP/Community psychiatric nurse, Anti-depressants, Counselling, Self help: monitor thinking, balance frightening thoughts, occupy your mind/lift your mood, physical exercise, avoid alcohol, alternative/complementary therapies, and eat whole foods.

 

Anxiety

Anxiety attacks are a symptom of what are called anxiety disorders. This group of conditions includes Panic Disorder, Agoraphobia, Post Traumatic Stress Disorder and OCDs.

Anxiety can manifest itself in any number of ways, but the symptoms can include:

Shortness of breath, Racing heart, Slow heart beat, Palpitations, Chest pain, Blanching (colour loss in the skin), Excessive perspiration, Shaking or shivering (visibly or internally), Rapid gastric emptying, Indigestion, Heartburn, Constipation, Diarrhoea, Sexual dysfunction, Dramatic increase in sexual feelings, Skin rashes, Dry mouth, Insomnia, Nightmares, Fears of going mad or losing control, Increased depression and suicidal feelings, Aggression, Distorted vision, Disturbed hearing, Hormone problems, Agoraphobia, Hallucinations, Hyperactivity, Derealisation and Depersonalisation.

Anxiety symptoms have never harmed anyone. Although anxiety symptoms feel horrific and scary, the effects are harmless and are simply exaggerated experiences of normal bodily sensations and reactions

Causes

By a hormone imbalance in the brain. Specifically within the Amygdala which controls responses by acting as a “switch” which is activated when needed, releasing hormones into the blood stream. The problem arises when the “switch” is jammed to lock on in the on or off position

Treatment

For anxiety disorders is as varied as the individuals who have anxiety disorders. You may find relief from medication, therapy, self-help, alternative medicine, or a combination of several methods. Your GP should be able to recommend the best course of action from the above option

Impact on Work Life

When the workplace is stressful the ability to manage the symptoms could be diminished. The individual may feel that they cannot cope with day-to-day situations. Unable to perform in interviews or presentations. Fear of dealing with people, worrying about social acceptance and approval, or about failure, criticism or rejection from others.

 

Bi-polar

Around 1% of people worldwide develop this disorder in their lifetime. The risk will be higher if relatives suffer from this too, (around 12% with a sibling with bi-polar develop the condition)

Depressive Symptoms

Low mood, Sleep disturbance, Loss of appetite, Sense of pessimism, Hopelessness, Reduced sexual drive, Reduced ability to concentrate, Recurrent thoughts of death and suicide.

Manic Symptoms

Described being like a tornado, Elevated moods of euphoria, Increased activity, Pressured/fast speech, Self-important ideas, Hallucinations, Reduced sleep, Increased appetite for food and sex, Overspending on a wide scale.

Mixed Cycle

Symptoms of mania, Severely depressed thoughts, Losing control.

Cycles

Symptoms of mania can be followed by depression in regular patterns. Some people may only experience depression or mania but within recurring pattern.

Impact in Workplace

Individuals need to take things slowly (avoid stressful situations).

You may want to go part time to start.

Treatment

There are many forms of treatment. GP’s can refer individuals to a psychiatrist to discuss the treatments available.

Medication may control the disorder but cannot provide a cure.

Lithium is often prescribed in two forms, Lithium Carbonate and Lithium Citrate, taking these drugs will require regular blood tests to ensure safe levels. These produce side effects of Weight gain, thirst and tremor.

Alternatives can be Anticonvulsants; these are more effective for the rapid cycling.

Counselling and psychotherapy can assist in tackling the condition.

 

Schizophrenia:

Schizophrenia is generally regarded to be a brain disorder.

The word “schizophrenia” comes from the Greek roots schizo (split) and phrene (mind)

A person with schizophrenia has an altered perception of reality.

Schizophrenia appears to be a failure of the brain’s chemicals or electrical systems to function properly, resulting in a variety of unusual neural twists, such as disjointed ideas, confusion or disconnected thoughts, sounds and sensations experienced as real when they exist only in the person’s mind.

There is often a misconception that schizophrenia is a “multiple personality” this is incorrect and completely unrelated.

Symptoms

Sleep problems, Social isolation, Hyperactivity or inactivity, Hostility, Paranoia, Unusual emotional reactions, Deterioration in personal hygiene, Unusual sensitivity.

The Treatment

The cornerstone of the treatment for schizophrenia is medication.

The impact, both positive and negative of the medication must be discussed with the GP before the correct medication and dosage is chosen.

The medication is not a cure; it merely supports the brain to function normally again, and re-establishes certain balances of chemicals in parts of the brain.

Medication can control the condition to a high standard.

However, difficulties with social contacts, motivation and day care can still remain difficult.

Psychosocial Treatment

Rehabilitation:

• Program focus on social and occupational training, such as improving job skills, money management, use of public transport, social skills and problem solving.
• Individual psychotherapy.
• Regular talks with a physician, psychologist or social worker.
• Sessions may focus on present or past problems, experiences, feelings and relationships.
• Gives a feeling of support to overcome barriers.

Family Intervention:

Family “psycho-education” can assist families with a family member suffering from this condition. It highlights coping strategies and problem solving skills

And the impact on work life

Schizophrenia will cause disruptions in work, both because of the difficulty of maintaining relationships, but also because everyday talks become hard, if not impossible to do. The individual’s delusions or hallucinations will often lead them to stop doing normal things, like bathing, eating, going to the bank, driving or walking down the street

Schizophrenics frequently develop problems with drugs and alcohol, which are often used in an attempt to self-medicate to relieve symptoms

However, with medication and treatment the majority of suffers can achieve genuine improvements in their symptoms over time and lead stable, productive lives.

 

Self-harm/suicide:

Self injury is something a person does to their body as a way of managing expressing intensely difficult feelings, without intending to kill themselves.

In situations were a person sees no way out of a difficult situation or has lost control of their life and finds it difficult to remember anything good then suicide can occur

Support

Direct the person to professional help.

Assist them to create a “coping mechanism” other than self harm/attempting suicide.

Risk Assessment.

Workplace Pressures

Often the workplace can have an adverse effect on mental ill health. This is particularly the case where staff face targets, control measures, sickness warning trigger points, progression rating and performance related pay

Disclosure

Once in employment, disclosure of mental health can be a difficult issue for the person concerned. Often the person will fear an adverse reaction from the employer and colleagues. The choice to disclose is entirely the persons, the TUC does recommend disclosure to enable the employer to make reasonable adjustments.

 

Helplines & Websites

Rightcore Care: Counselling, Advice & Information Helpline: 0800 652 3304

PCS Union Helplines:  PCS Health: 0870 523 4998          PCS Welfare:  01273 716700

Contact relevant support/charity organisations/helplines:

Equality & Human Rights Commission                       www.equalityhumanrights.com

MIND – 0300 123 3393                                                        www.mind.org.uk

Bi-polar UK – 08456 340540                                             www.bipolaruk.org.uk

No More Panic                                                                   www.nomorepanic.co.uk

Alzheimer Society – 0300 222 1122                                www.alzheimers.org.uk

Depression Alliance – 0845 123 2320                            www.depressionalliance.org

Rethink Mental Illness – 0300 5000 927              www.rethink.org

SANELINE                                                                            www.sane.org.uk

Hearing Voices Network                                                  www.hearing-voices.org

Samaritans – 08457 909090                                              www.samaritans.org

National self-harm network – 0800 622 6000               www.nshn.co.uk