DR ELLIE CANNON: How you can prevent workplace stress

Towards the end of my first year as a junior doctor, I got sick. Really sick. My mental health plummeted. I had an overriding sense of not being able to cope, which was a real surprise to an A-grade Cambridge graduate who had always wanted to be a doctor.

I had always been able to manage pressure but a drowning sensation began to permeate everything – not just work but home and my social life. Even making plans to see friends seemed too complicated.

I constantly felt as if there was so much to think about: I couldn’t concentrate and felt out of control, my heart raced and I couldn’t sleep.

And what was the cause? Well, it was the job I loved.

Looking back now, more than 15 years later, it’s easy to see why I became ill: the main causes of job-related stress across all sectors are workload and I had signed up for week after week of seven-day shifts – emotionally draining jobs and night work meant a poor work-life balance. My job was ticking every box it could to induce classic symptoms of stress and anxiety.

Ultimately, I was lucky. My senior tutor arranged some time off and encouraged me to have therapy, which I reluctantly accepted.

I was of course worried about being labelled ‘weak’ at the start of my recovery. But looking back now, that move stopped me from spiralling into a worse state of mental health, allowing me to recover and keep working.

This experience is something I often recall in clinic today. As a GP at a busy London practice, over the past 15 years I have seen first hand just how common, and increasingly so, work-related ill-health is.

Not long ago, on a totally normal Thursday in clinic, out of 40 patients I saw, three discussed with me how their job was making them ill.

This is significant when you think that in a typical day, I would see only three or four cases of conditions you would consider very commonplace, such as asthma or diabetes.

One woman had been on antidepressants for years, ever since a bullying manager triggered a change in her mood. She’d basically taken it on the chin, been prescribed pills, and carried on.

Another, a very hard-working young man, was suffering terrible back pain but was afraid to ask his boss for any special treatment that would aid his recovery. There is a misconception that work-related illness, particularly in younger people, could just be malingering. I do not believe that.

‘I thought I was having a heart attack,’ was how the third patient described the way he felt when he went back into the office to face a colleague who had tormented co-workers for five years.

Job mental ill-health accounted for an astonishing 11.7 million lost working days in the UK in 2015, with the average worker taking more than 23 days of sick leave.

It can happen to anyone, from the highest-earning CEOs to the those at the bottom of the office ladder.

Yet it need not be this way – and it’s certainly nothing to be ashamed of. There are ways to survive, and thrive, if it happens to you.

HOW WORK CAN DESTROY YOUR HEALTH

WE all have a moan about going to work, especially on a Monday when we long for it to be the weekend again. Work takes up the majority of our week – and sometimes the majority of our socialising – and for all of us it provides that vital aspect of day-to-day life: income.

So a gripe here and there is expected. But for many people, the negative effects become far more detrimental to wellbeing than just Sunday night blues. For them, the job starts to make them mentally or physically unwell.

‘Overwhelmed’, ‘I can’t concentrate’ and ‘I can’t cope’ are words and phrases I often hear from patients suffering work-related stress. Insomnia, palpitations and full-blown anxiety and depression are typical symptoms for people who are at their wits’ end. High blood pressure, irritable bowel syndrome (IBS), headaches and coughs and colds are also common.

YOU DON’T HAVE TO TAKE TIME OFF TO COPE

There is no one-size-fits-all approach to treating job-related ill-health. Workload, tight deadlines, too much work, or too much pressure and responsibility and the support available to employees are all causes. Relationships with colleagues and team issues – from bullying bosses to toxic colleagues – are also, in my experience, a huge factor. I had one patient, a teacher, whom I treated for years with high doses of multiple blood-pressure medications. When he went part-time, in his late-50s, we halved his drug regimen almost overnight.

I loved teaching… but it broke me 

Karen Whybro, 38, resigned from her primary school teaching position in 2012 after suffering stress-related ill-health. She lives in Chelmsford with husband Chris, 39, and their two-year-old daughter Nancy.

Karen, who started teaching in 2005, says: ‘For the first few years I loved my job. Like every teacher, I was working stupid hours, but I loved the challenge.

‘The turning point was when a new head started in 2010, who made everyone feel insecure about their abilities and wanted to bring in loads of changes.

Karen Whybro, 38, resigned as a primary school teacher because of stress-related ill-health

‘There was endless, pointless paperwork thrown at us, which tipped me over the edge. I’d cry before work and found it hard to sleep. In the spring of 2012, I went to my GP with symptoms it was hard to describe – like I was getting a migraine, I was foggy-headed and spaced out. He diagnosed labyrinthitis, an ear condition that can make you feel dizzy, and prescribed me medication, but that didn’t help at all. I Googled my symptoms and came across derealisation and depersonalisation, conditions that often happen with shock or trauma. It’s commonly seen in soldiers returning from war.

‘I went back to my GP with my research who said I should try to speak to the head – but it didn’t feel like an option.

I knew I had to quit so handed in my notice, and almost overnight I felt better.’

Karen now runs a bridalwear firm Rock The Frock and says: ‘Being self-employed is liberating. I have a work-life balance a teacher could never have. I’m sad to have left teaching, but without the right management it broke me.’

Now retired fully, he’s only on a low dose of one medicine.

He actually enjoyed his job, despite saying he felt ‘frazzled’. And his case illustrates a pretty stark cause and effect.

But my first message is: You DON’T need to find a new job or stop working in order to combat work-related ill-health. In fact, being out of work with nothing to do can make things worse.

There are people who do survive incredibly stressful jobs, from teachers in tough inner-city schools to news reporters in war zones, because they build up resilience, seek out and build supportive relationships, eat well, sleep well, get proper relaxation and have goals outside of work. Of course, tackling work-related illness, physical or mental, isn’t all down to the patient. Once you’ve identified there is a problem, help can be found in a variety of places from your GP, your employer, occupational health services, unions and advice services. But there are self-care methods everyone can benefit from.

Patients often tell me they’re so busy and stressed they don’t have time to sort out the problem. But small changes – psychologists use the term ‘micro-actions’ – can be as effective as the big ones and a key part of the recovery process.

IDENTIFY THE TRIGGERS

Symptom diaries are commonly used in medicine and can be a useful diagnostic tool. If you feel you’re suffering from your job, I would recommend starting one. Memory is notoriously unreliable at the best of times – was it really a Wednesday after the weekly planning meeting that you got those headaches? Do you always feel better on a Sunday? It is useful to see what is going on in black and white as part of your acknowledgment of the situation.

Make sure you include date and time, the situation – as simple as ‘work’ or ‘meeting’ or ‘day off’ – the symptoms you feel and their severity. And remember to note when there are no symptoms.

FRIENDS, FAMILY AND COLLEAGUES ARE KEY

We know from countless studies that support, family and relationships are good for our health: a vital part of our ability to survive difficulties at work. Social isolation and loneliness have the opposite effect. Talking to people close to you really can help you accept the problem and find support and advice.

Also, we can sail through busy weeks and think we’re spending time with our family when we’re actually just living together. Stop what you’re doing and make space for them and your relationships – every day. It can be hard to motivate yourself to see friends when you feel depressed. Start with a regular phone call and build up and make time to socialise.

Even if work is a source of tension, spend time with colleagues. Connecting with people at work is hugely important for resilience.

EAT PROPERLY, EXERCISE … AND SLEEP BETTER

Prepare for a hard day of work with a proper breakfast, even if it means getting up earlier.

Sit down to an energy-filled meal – porridge, eggs, fruit or wholegrain cereals – and give yourself the time to eat it. During the day keep blood sugar levels stable by opting for slow-release energy foods such as brown complex carbohydrates, wholegrains, vegetables and proteins. Avoid quick bursts of energy from sugary drinks and treats.

Cut down slowly on caffeine – found in coffee, tea, cola, chocolate and energy drinks. It increases your heart rate and blood pressure. If your body is already in a heightened state from stress hormones or anxiety, you’re simply fuelling that state by adding in caffeine. Don’t eat at your desk, either. Even if you just have five minutes, take the time to sit down, enjoy your food and eat mindfully.

Try to exercise – it really does increase energy levels in the long run. And this doesn’t have to involve the gym: it’s as simple as walking, taking the stairs and ensuring you are moving around. Your mood will improve, you’ll get thinking time if you spend time outdoors enjoying your surroundings, and end up sleeping better.

USE YOUR COMMUTE TO RELAX YOUR MIND

Whether your commute is ten minutes or more than an hour, you can use the time wisely to help your mind relax at both ends of the day. Commit to leaving earlier so you start the day feeling ahead – not already on the back foot.

Many people trudge through the same awful journey each day, not considering there could be an easier one. Don’t discount a longer journey that’s less stressful. And can you walk to the next bus stop, park further away or cycle?

MAKE SURE YOU DISCONNECT

As great as technology is, there are many disadvantages. Constant connectivity is a source of anxiety: heart rate, blood pressure and stress hormone levels can all go up with each email or text message.

Ring-fence time during the day when you will not look at your phone and also when you will be on the phone.

Plan a set period when you will look at messages and create boundaries between time online and time offline every day.

And try to carve out a day when you will turn everything off and be disconnected. After all, in emergencies, people can always reach you on a landline.

Finally, try quitting social media – just about everyone I know who does this tells me that it instantly makes them feel better.

© Dr Ellie Cannon, 2018

Is Your Job Making You Ill?, by Dr Ellie Cannon, is published by Piatkus, priced £14.99. Offer price £11.99 (20 per cent discount) until March 4. Order at mailshop.co.uk/books or call 0844 571 0640; p&p is free on orders over £15.