From cancer to diabetes, we have barely scratched the surface of anxiety’s multiple health risks
The economic impact of burn out is immense when one considers how contagious anxiety is. Employees who are struck with anxiety and never deal with it will often choose to transfer their workload and anxiety to other employees, as a coping strategy. Pretty soon everyone is stressed, and this creates toxic office cultures where stressful lifestyles become the norm. This is our situation today.
The ground is slowly shifting in how employers deal with cases of occupational anxiety: some of them are actually dealing with them. This is not a result of better awareness, but of a rising epidemic that is impossible to control anymore, despite well-established cover-up operations within corporations. Thankfully occupational health professionals often take the side of the victim and landmark legal cases are being won, which raises hope that we could be seeing significant changes in the near future. Although more people are coming down with stress, this also means that more of them are choosing to speak out, and even find the confidence to demand compensation settlements from employers who, as a result, may now think twice before they exploit staff. A recent survey I ran across found that employees are now more worried about their mental than their physical health at work. This is a huge sign of a shift in our mindset.
But this recent momentum feels already long overdue. After all, our mental and physical health have always been intertwined. The impact of stress on society may be far greater than we think, and we are only in the beginnings of understanding the direct links that exist between anxiety and all the big killers: diabetes, heart disease, cancer, obesity, kidney disease as well as asthma, depression and gastrointestinal disorders. More recent evidence on the effects of sleep deprivation, a key symptom of anxiety, demonstrates the link between anxiety and cancer: more anxiety means less sleep, which means a weakened immune system, which means reduced ability of our body to fight-off cancer. The same study has brought to light a link to Alzheimer’s, which finally may explain why it has reached epidemic proportions: it may be caused by an epidemic of anxiety and sleep deprivation. Finally, self-harm linked to work-related stress is also on this list, based on evidence from suicide hotlines and my own personal experience.
The bottom line is that anxiety is a severe risk to our health, and this will become increasingly apparent in the next few years. As medicine becomes better at solving the problems of our physical health, we are putting so much pressure and expectation on our brains that our mental health may soon be the new medical frontier. We need to start facing up to the truth that our mental health is physical, and our physical health is mental. Only then will we see the connection between mind and body that has always been there, and which is key to creating complete solutions that tackle both at the same time.
But there is another frontier to cross that is even more difficult: the shame and prejudice that still surrounds anxiety. Lack of education and official guidelines mean that the victims are stigmatised, and often regarded by employers as “injured horses” that will never recover and are better to be put down. They have become “too smart”, and not willing to push themselves beyond their limits anymore. We need more science, more education to break down the taboos. Sickness days, sickness benefits and legislation and regulation in the area of workplace mental “injury” are inadequate to say the least. Speaking from my personal experience, in terms of prevention we are in the dark ages. In terms of awareness, anxiety is even more of a taboo than rape. And in terms of rehabilitation, there are no set universal guidelines as strict as those that are in place for “physical” disease. We have a lot of work to do.
My employer did their very best to pretend to acknowledge my anxiety after I provided a doctor’s note and an official diagnosis. A meeting was held behind closed doors where I was offered tons of warm and enthusiastic verbal support and empathy, and a few extra days off. But there were no official records, or referrals to Occupational Health, neither was there any Human Resources involvement. It was clear that they just wanted to keep this under wraps, for it to go away as soon as possible and never even be discussed again. There was to be some time off, and then I was expected to come back all recovered and we can all just pretend that this had never happened.
Being an optimist, and genuinely wanting to forget this and go back to work as soon as possible, I went along with this short-term recovery plan. However there was one important part of the plan that the employer failed to implement, which was to provide reasonable adjustments to my role in order to enable my recovery. Since this would have meant me doing reduced work for a certain time, my employer found an ingenious way to pretend that they had made adjustments: part of my workload was removed, only to be replaced by an equally demanding workload. I was basically a donkey that got sick and was switched from carrying oranges to carrying apples. It was only a matter of time before I would relapse, which I eventually did four months down the donkey road.
The next few months further confirmed that denial and silence was the name of the game, as there was also never any plan to further monitor my health progress, since this would probably build the case for an actual investigation. There was never any query into the causes, into the fact that my role had “drifted” and become busier with additional responsibilities. My new job had been set up hastily and “off the record” during a frantic company restructure without a job description or revision to my contract. A picture was starting to emerge that the silence and denial of responsibility aimed to cover up the multiple breaches of my contract that had led to my sickness. The implicit company line was “I’m sorry that this happened to you” as opposed to “I’m sorry we created the conditions that led to this happening to you”. Much like a rape victim, I was the one being stigmatized instead of the perpetrator. Moreover, I could sense a change in the air on how I was being treated in my professional relationship with the management: I was now dealt with from a distance, as if I was a dangerous whistle-blower that was about to make a revelation. Trust had broken down on both sides.
As I became more and more suspicious, I started conducting my own investigations by talking to other people about their personal stories, stories that the management didn’t want anyone to find out about. They included previous sufferers as well as people already on their way out. This was my makeshift support group, now secretly running in the hallways and meeting rooms of the company. Aside from sharing and caring, this was also a time for answers, and the more I investigated the more vivid a picture emerged: based on my calculations the anxiety statistic within my own team was staggeringly high, shockingly unacceptable, witness to a management that had failed to accept, learn, address and prevent. There was also a sad connection between all of the other “patients” I discovered: most of us were highly accomplished, in a senior position, and well respected. We were victims of our success, our cases representing the mere 13% that come to light according to an official statistic. We were only the tip of a deep and sinister iceberg.
Although the submerged part of the iceberg was dark, cavernous, and treacherous, the top was a sparkling pearly white. On the surface, a delightful culture of “hypernormalisation” had been built by the company’s HR systems around occupational mental health: focusing on what happens after, rather than preventing what happens before. This consisted of “wellness” initiatives put together by people who are not health professionals, frequent e-mail memos about mental health in the workplace (just to acknowledge its existence), and helpline numbers that probably no one ever called for fear that they would be monitored by HR. My favourite of all was a lunchtime “card-making workshop” where staff were given coloured pieces of paper, blank cards, glue and scissors and were encouraged to “have fun” so that they can take their mind off work, while their inbox accumulates more e-mails that they would of course have to stay late to respond to. Badly thought-out approaches such as these only work to boost the image of the “benevolent” employer and are no substitute for professional assessment and help. They minimise the seriousness of anxiety, making a joke of what is a very dangerous mental condition that can lead to suicide. Putting together a collage over lunchtime is like putting a plaster on a leaking pipe. Despite guidelines prescribing workload reduction as the most urgent step in recovering from anxiety, staff in some of our corporates today are treated by HR gimmicks that serve to say “look, anxiety could happen to you at some point, but don’t be alarmed, it’s all part of life”.
As the current situation stands, those of us who are struck with anxiety in their work environment are faced with multiple hurdles. First of all, only few of us are able to overcome our own shame, be honest with ourselves and recognise what we are going through — but also that this is not our fault, and that we can and will recover. Of those of us that do cross this internal barrier, even fewer have the courage to speak to their employer for fear of the impact that this will have on their career development, a fear that is real and justified. If and once they do come out, they are then faced with wall of denial, given the invisibility treatment and downgraded to a lesser value employee almost overnight.
As our society demonstrates signs of becoming more active in the anxiety conversation, we need to keep up the pressure until businesses begin to put serious steps in place for what is the number one health risk at work. Equally, employees should feel empowered to say ”I am here, I’m stressed, and I’m not invisible”.
Technology has been one of the reasons why stress has been on the rise. Collaboration platforms such as Skype and Slack allow for round-the-clock remote monitoring of employees, while automation creates unrealistic expectations for humans to work in machine-like accuracy and consistence. But ironically, it may be technology that may help us in the future with tackling anxiety. I dream of a day when there could be sophisticated AI systems in the workplace that pick up on our vital signs, even the intonation of our voice, to tell if we have been becoming increasingly irritable and stressed. Regular medical checks in risky professions such as busy deadline-driven offices could become compulsory by law, and employees themselves would be encouraged, rather than discouraged, to self-care before their condition gets worse. There is so much that can be done and that needs to be done to minimise occupational mental health risks.