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Mind, Body, Work: The Connection Between Mental Illness, Stress and Performance in the Workplace Presenter: Roberta Sue Buckner, J.D., M.F.C.T., Los Angeles County Child Support Services Department, [email protected] CSDA Annual Conference October 2009 1 Business and Professions Code Section 6230 “It is the intent of the Legislature that the State Bar of California seek ways and means to identify and rehabilitate attorneys with impairment due to abuse of drugs or alcohol, or due to mental illness, affecting competency so that the attorneys so afflicted may be treated and returned to the practice of law in a manner that will not endanger the public health and safety.” 2 Mental Illness Mental disorders, including disorders of thought, mood or behavior. Condition must result in reduced ability to function socially, psychologically, occupationally or interpersonally. 3 Common Causes of Mental Illness • • • • Biological factors Psychological factors Environmental factors Medications and substances 4 Some Categories of Mental Illness or Impairment • • • • • • • • Depression Generalized Anxiety Disorder (GAD) Specific Anxiety: Phobias Panic Disorder Bipolar Disorder Obsessive-Compulsive Disorder (OCD) Eating Disorders Borderline Personality Disorder 5 How Does Mental Illness Interfere with Professional Competency? • • • • Screening out environmental stimuli Sustaining concentration Maintaining stamina Handling time pressures and multiple tasks • Interacting with others • Responding to negative feedback • Responding to change 6 Mental Illness Affects Work Productivity: Changes in Performance & On-the-Job Behaviors • Decreased or inconsistent productivity • Absenteeism, tardiness, frequent absence from work station • Increased errors, diminished work quality • Procrastination, missed deadlines • Withdrawal from co-workers • Overly sensitive and/or emotional reactions • Decreased interest in work • Slowed thoughts • Difficulty learning and remembering • Slow movement and actions • Frequent comments about being tired all the time 7 Depression Screening Test I am really sad most of the time. I don’t sleep well at night and am very restless. I don’t enjoy doing the things I’ve always enjoyed doing. I am always tired. I find it hard to get out of bed. I feel like eating all of the time. I don’t feel like eating much. I have lots of aches and pains that don’t go away. I have little to no sexual energy. I find it hard to focus and am very forgetful. I am mad at everybody and everything. I feel upset and fearful, but can’t figure out why. I don’t feel like talking to people. I feel like there isn’t much point to living, nothing good is going to happen to me. I don’t like myself very much. I feel bad most of the time I think about death a lot. I even think about how I might kill myself. 8 Recognizing the Psychological Symptoms of Depression Feelings of worthlessness Excessive or inappropriate feelings of guilt Thoughts of death or suicide Loss of interest in or enjoyment of your favorite activities Trouble making decisions Sadness throughout the day, nearly every day Fatigue or lack of energy Sleeping too much or too little 9 Recognizing the Physical Symptoms of Depression • • • • • • • • • Headaches Back Pain Muscle aches and joint pain Chest pain Digestive problems Exhaustion and fatigue Sleeping problems Change in appetite or weight Dizziness or lightheadedness 10 Depression and Professional Competency Some people will experience depression once in awhile and will still be able to do their jobs. For some people, depression can affect various aspects of their lives and have a serious impact on professional competency. Work problems related to depression may include tardiness or absenteeism because of chronic health conditions, drug or alcohol dependency or anxiety disorder. 11 Depression Affects Professional Competency in Many Ways • • • • • Emotions Thinking Task Performance Work/Professional Relationships Physical Health 12 Depression in the Workplace: Strategies • Pursue jobs that offer opportunity to develop skills • Clarify performance expectations • Seek assistance to meet expectations • Educate yourself about new technologies • Learn new skills • Take advantage of resources 13 Depression and Anxiety • Depression and Anxiety seem like opposites – Depression: saps you of energy; nearly impossible to get out of bed – Anxiety: makes you keyed up and afraid; leaves you sleepless, pacing all night • Depression and Anxiety often go together – More severe symptoms, impairment, difficult to diagnose and manage 14 Generalized Anxiety Disorder (GAD) • • • • • • • • • • • • • Restlessness Feeling of being keyed up or on edge Feeling a lump in your throat/shortness of breath Difficulty concentrating Fatigue Irritability Impatience Being easily distracted Muscle tension Trouble falling or staying asleep Excessive sweating Headache Gastrointestinal discomfort or diarrhea 15 Anxiety Disorders: Some Common Phobias • • • • • • • • • • • Agoraphobia Claustrophobia Acrophobia Mysophobia Xenophobia Necrophobia Brontophobia Carcinophobia Aviophobia Arachnophobia Zoophobia 16 Panic Disorder and Panic Attacks Signs & symptoms: - Rapid heart rate - Sweating - Trembling - Shortness of breath - Chills - Hot flashes - Nausea - Abdominal cramping - Sense of impending death - Chest pain - Headache - Dizziness - Faintness - Tightness in your throat - Trouble swallowing - Lightheadedness - Tunnel vision - Feeling like having a heart attack 17 Panic Disorder: Control of Symptoms Methods and Techniques: • Diaphragmatic breathing or abdominal Breathing • Staying in the present • Acceptance and acknowledgement • Floating with the symptoms • Coping statements • Talking with a supportive person • Taking anti-anxiety medication 18 Bipolar Disorder • Manic phase of Bipolar Disorder - Euphoria - Extreme optimism - Inflated self-esteem - Racing thoughts - Agitation - Risky behavior - Poor concentration - Drug abuse - Tendency to be easily distracted - Spending sprees - Poor judgment - Rapid speech - Aggressive behavior - Increased physical activity - Decreased need for sleep - Decreased sexual drive - Increased drive to perform or achieve goals 19 Bipolar Disorder • Depressive phase of Bipolar Disorder - Sadness - Guilt - Irritability - Sleep problems - Appetite problems - Loss of interest in daily activities - Anxiety - Problems concentrating - Hopelessness - Fatigue - Suicidal thoughts or behavior - Chronic pain without a known cause 20 Obsessive-Compulsive Disorder Obsessions (common themes) • • • • Fear of contamination or dirt Having things orderly and symmetrical Aggressive or horrific impulses Sexual images or thoughts 21 Obsessive-Compulsive Disorder Compulsions (common themes) • • • • • • Washing and cleaning Counting Checking Demanding reassurances Performing the same action repeatedly Orderliness 22 Eating Disorders • Anorexia Nervosa Relentless pursuit of thinness Distorted body image • Bulimia Nervosa Binge eating and purging Feeling a lack of control over eating 23 Borderline Personality Disorder Signs & symptoms: - Impulsive & risky behavior, such as risky driving, unsafe sex, gambling sprees or taking illicit drugs - Strong emotions that wax and wane frequently (wide mood swings) - Intense but short episodes of anxiety or depression - Inappropriate anger, sometimes escalating into physical confrontations - Difficulty controlling emotions or impulses - Pattern of unstable relationships - Fear of being alone (intense fears of abandonment) - Suicidal behavior or self-injury 24 What is Stress? Early warning signs…. • • • • • • • Sleep disturbances Difficulty in concentrating Short temper Upset stomach Job dissatisfaction Low morale Headache 25 Signs of Job Stress • • • • • • Work performance Withdrawal Regression Aggressive behavior Physical signs Other behaviors 26 Causes of Stress • Individual characteristics • Working conditions 27 Work Conditions That Affect Job Stress • • • • • • Job Insecurity High Demand for Performance Technology Workplace Culture Personal or Family Problems Job Stress and Women 28 What are Health Effects of Job Stress? • Cardiovascular disease • Musculoskeletal conditions • Psychological disorders 29 Why Should Employers Be Concerned About Workplace Stress? • Financial reasons • Emotional reasons • Safety concerns 30 Workplace Stress Reduction What can management do to reduce stress at work and increase levels of productivity? • Opportunities for career development • An organizational culture that values the individual worker • Management actions consistent with organizational values • Recognition of employees for good work performance 31 Workplace Stress Reduction Job Conditions and Job Stress • • • • • • The design of tasks Management style Interpersonal relationships Work roles Career concerns Environmental conditions 32 Stress Management 10 practical & beneficial ways to reduce stress: 1) Decrease or Discontinue Caffeine 2) Regular Exercise 3) Relaxation/Meditation 4) Sleep 5) Time-outs and Leisure 6) Realistic Expectations 7) Reframing 8) Belief Systems 9) Ventilation/Support System 10) Humor 33 Employee Assistance Programs (EAPs) • Employees can learn about stress, time management, and relaxation • Provide counseling for employees with work or personal problems • Stress management training can help to rapidly reduce stress symptoms - anxiety and sleep disturbances • However, benefits of stress management often shortlived; often ignore root causes of stress because focus on the employee - not the environment 34