It goes without saying that 2020 has been a dreadful year. Although I’ve enjoyed my work and have been lucky not to share the suffering that so many people have endured, I still say that this year has been hard. I have had to work hard to maintain my mental health through the stresses and strains thrown up by Covid-19, and as BOOST&Co’s organisational psychologist, I have helped my colleagues to do the same.
While thinking about what to write for World Mental Health Day 2020, however, I found myself feeling more positive than ever before. The reason is that, despite all that has happened, something wonderful has occurred: our mental health has become something that we can speak about openly. As someone who hid her diagnosis of bipolar disorder for almost two decades, I still pinch myself when I think of how discussions around depression, mania, insomnia, anxiety, compulsive behaviours and more have emerged into the open. I honestly believed I would never see such a revolution in my lifetime.
I want us to make the most of this positive change. In this series of articles, I’m going to cover the following areas:
- Why mental health is no longer a difficult subject: it is important that we understand the change, so we don’t slide back into our old ways when the pandemic is over;
- Practical tips for getting everyone into the habit of using the mental health spectrum to judge our mental wellbeing;
- Why we can often spot changes in our mental health most clearly against the backdrop of our workplace; and
- Understanding how changes in our mental health can seem to others at work, to help us to convey the right message when we need to speak up about how we’re feeling.
At the end of this piece, you can find practical ways to access help with mental ill health right now.
Part 1: Mental health is no longer a difficult subject – let’s keep it that way
There are many cultural reasons why we shy away from the topic of mental health. These aren’t to be ignored in the wider world, but I will stick to the subject against the backdrop of the workplace, so that I can look at the practical reasons. These include the following:
- Frequently, our symptoms are obvious to others before we see them ourselves. With pain, we feel it first every time, but we don’t have the same warning system built in for issues with our mental health.
- Our symptoms often don’t look like symptoms to others: they can resemble odd, or even bad, behaviours. This is a nasty trick of nature, but we can beat nature if we are aware of these differences.
- Symptoms usually creep up on us. They can be caused by a single event – anxiety can appear because of one fight/flight/freeze situation that was so terrible that the mind cannot readily adjust – but often they wear on, almost imperceptibly.
- Mental ill health can seem like a problem that cannot be solved: there may be no definite start to the symptoms, but there is also no definite end. As humans, we hate unsolvable problems, even those of us who like to keep our options open for as long as possible. It is unfinished business.
- Symptoms can be caused by something definite, like the fall-out of a pandemic, or they can be caused by nothing at all. If we don’t like being unable to solve a problem, we really, really hate problems that we cannot define.
- This touches on the cultural aspects, but we tend to assume that the journey from mental wellbeing to mental ill health is a one-way street. Many people believe that it requires just a single ticket, but this is, in truth, an all-destinations ticket for a journey we take back and forth throughout our lives.
Why it really is good – and normal – to talk
Previously, because of these issues, even the most enlightened among us wanted to either solve someone’s mental ill health with a neat fix or help the sufferer to push it away. If the person travelling towards the wrong end of the spectrum didn’t know what they were facing, we wanted to haul them off that train and on to the other platform (I’m warming to this theme).
We saw every issue of mental ill health as potentially severe, and as something we shouldn’t touch because we weren’t the expert. We assumed that if someone suffered depression once, that made them “depressive”, and that those with anxiety were either unpredictable and therefore dangerous or, alternatively, “just a nervy type”. It’s no surprise that this has been a difficult area for such a long time. As someone with bipolar disorder, I learned to take this as read and keep quiet.
Now for the great news! During the pandemic, we have seen an unbelievable level of openness around mental health and ill health. I’ve seen adverts dealing with the topic, I’ve seen organisations going all-out to help people who are suffering and I’ve seen storylines in popular TV shows reinforcing the message that we all experience mental ill health.
Sometimes we’re a little up, sometimes a little down, and that’s normal. Sometimes we’re a lot up, and sometimes we’re a lot down, and although this may indicate mental ill health of a more severe nature, we have learned that this is still normal. Wherever we are on the spectrum at any time of the day, on any day of the week, at any point in our lives, we can share our mental health levels with others – and these conversations are normal.
Part 2: How to use the mental health spectrum – make it a healthy habit
There is an amazingly easy way to start thinking about our mental health. During lockdown, we may have noticed changes in ourselves, leading us to wonder whether we’re doing as well as we might be. However, we don’t need lockdown to justify this exercise. Simply get used to putting yourself, every so often, on the spectrum of mental health. If you regularly weigh yourself, do this at the same time.
The diagram below is a simple one. Although there are lots of symptoms of mental ill health, all that matters is that you can put yourself somewhere on this spectrum.
Only you are qualified to use this spectrum for yourself. The comedian Micky Flanagan jokes about how women say to each other: “How are you feeling? How are you feeling in yourself?”, which makes me howl with laughter. I’ve seen the same from Peter Kay, and he makes it sound daft. But it is a sensible question, because it means: “How do you honestly judge you are feeling, without any external influence?” Without giving reasons, or even excuses, as to why you feel a certain way, put your finger on the spectrum. This is the first step to considering your mental health.
I love this spectrum because it doesn’t show anything quantitative: for example, it doesn’t ask you to rate your mental health out of ten. What is a rating of zero and what is a rating of ten, anyway, if you have to give it a score? Does ten mean “blindingly ecstatic, never been better, could run out into the street to give the neighbours a rendition of ‘Hooray for Hollywood’”, or is it “I’ve just had a nice cup of tea, my biscuit stayed whole when I dunked it and I’m about to fire up the iPlayer”?
Trust your instinct to tell you if you’re coping
I’m being flippant, but if you’re asked to score your mental health out of ten, that is exactly what you need to ask yourself: “What is a ten, what is a zero, and if I say seven, what does that mean?” With this numberless, barely defined scale, however, you don’t have to think about any of that. You can even take away the words and just look at the colours. You’re doing this for your own benefit, so you can point where you choose.
You don’t have to think about it too deeply and you certainly don’t need to compare yourself with anyone else (remember that there is no clear definition of “good” or “bad” mental health). For some people, nothing but the green end of the spectrum feels good enough, and that is right for them. Others are happy with the yellow. Having been all the way to the red end a few times, I am delighted to put my finger on “coping”!
The key is that you take the time to consider whether your mental health is in the green area; if not, you can then start thinking about why this might be. If you are sitting on the right of this spectrum – anywhere to the right of “coping” – then you might consider that your mental health isn’t as good as it could be. You may be able to identify a change that has brought you to this point, but it may have been a slow shift.
Part 3: Spotting changes in your mental health in the context of work
Sometimes, it can be helpful to judge our mental health against the backdrop of the workplace. Why is this? First, we need to keep well at work, for the sake of both ourselves and those around us. Second, work is a place where we can view ourselves objectively, because we aren’t there all the time. This helps us to recognise how our mental health might be affecting us, before we reach any sort of crisis.
Everyone who has a job needs to know how mental ill health can rear its head in the workplace. That’s a bold statement, but mental ill health can affect us all, and even if we never experience it ourselves, we should be able to spot the signs in others. For a long time, in my previous role in HR, I thought only about what I could do to support people with mental ill health. Now that I have shifted towards organisational psychology, I see that this topic is relevant to the entire workforce.
This isn’t a question of becoming an expert in the subject: mental ill health is often hard to recognise in ourselves, and its causes and cures can be difficult to pinpoint, even for professionals. However, my experience shows that when an employee’s behaviour and/or performance declines, for no obvious reason, those around them usually think the worst of them first. All too frequently, I have seen staff branded “lazy”, “unreliable” or “disengaged”, although it has transpired that the person in question is, in fact, suffering from mental ill health.
In the UK, it is an individual’s responsibility to tell their employer if they are unwell (although this is not an obligation), whether the problem is physical or mental. This puts the onus on the employer to help people to work through their illness, but often, the individual does not know that their mental health is deteriorating until it is too late, especially if this is the first time they have become mentally unwell. Their performance and/or behaviour will have dipped to a point where their reputation with their manager, their peers and even business leaders has been damaged, seemingly beyond repair.
Watch out for these warning signs
There are some clear indicators that both the individual and those around them can look for. These can be quite easy to spot against the backdrop of the workplace.
We all have our own sleep patterns and we know what works for us. If your sleep pattern has changed, and you are concerned that the change is not a positive one, this could be a sign that you aren’t feeling quite yourself. It can alter suddenly, in response to a particular incident, or over time.
Changes that can happen to sleep include:
- Less sleep than usual
- More sleep than usual
- Finding it harder to get to sleep
- Finding it harder to wake up
- Waking up feeling less rested
- Experiencing more disruption during the night
- Dreaming more
- Dreaming less
You get the picture. The fact that there is a change is the most important point.
Lockdown will have changed some of our sleep patterns for the better. Several of my colleagues are sleeping for longer than they did previously, and they wake up feeling great.
Energy levels and concentration
Perhaps linked to sleep, but perhaps not, a change in our energy levels can mean that our mental health isn’t what we would like it to be. Changes in energy levels can go both ways. Becoming less energetic, even lethargic, can be a sign that we’re down. Becoming more energetic, even frenetic, can mean that we’re anxious. Feeling a little down, or a little anxious, is part and parcel of normal life, and living through a pandemic can easily create either feeling. Annoyingly, you can even experience both at the same time.
These changes in our energy levels often have a knock-on effect on our ability to focus and to concentrate. Believe it or not, this too can go both ways. Yet again, we’re looking for changes. Even increased concentration levels can be linked with mental ill health, particularly if you are able to focus well in one area, but then neglect others. I have seen people in the workplace become amazing at the things they find easiest, but very bad at everything else, as they put all their eggs in one basket before a breakdown in their mental health.
Increased energy levels can sometimes be coupled with a rising sense of stress, even leading to panic. This happens when our fight/flight/freeze mechanism goes into overdrive. If the pressure we usually feel in carrying out our work starts to flip into stress and, beyond this, into fear, then this mechanism may be misbehaving. We may notice physical symptoms – anything from sweaty palms and cold feet to an upset stomach and even raised glands without a temperature. Again, it’s the change that is important.
Relationships at work
Quite often, a dip in our mental health is played out in how we relate to others at work. Again, you’re looking for changes. Have you noticed that:
- someone (or more than one person) is irritating you more than usual?
- you are experiencing anger at work, either towards others or in regard to situations that you would normally take in your stride?
- you are worrying much more than usual about some people’s opinions?
- you are finding it harder to understand what people are really saying?
- you are experiencing frustration when trying to get your points across?
- you care much more, or less, compared with those you work with?
- you are chewing over what people say, looking for hidden meanings?
If you are experiencing these changes, it may be a sign that you are tipping towards the red end of the mental health spectrum, which we learned to use in last week’s instalment of this article (scroll down to read it). Anger and frustration are often overlooked as aspects of mental ill health, especially if they are seen in people who are typically considered to be more aggressive than others, but they are part and parcel of the whole.
Diet and exercise
Lockdown has prompted many of us to change our eating and exercising habits. The initial problems we had in obtaining our usual groceries from supermarkets led us to discover new things or go back to old favourites. We may have chosen to spend more time cooking, or we may have accepted ready-meals where once we prided ourselves on making everything from scratch.
This is all well and good, but we may also have experienced a change in our appetite. A lot of people are joking about the lockdown pounds they have gained, but this is something more. If your appetite has changed and you aren’t happy with the change, this may indicate a dip in your mental health. It isn’t all about putting on weight, either; losing weight may also signal a decline in your mental health, especially if your BMI indicated that you didn’t need to lose any weight in the first place.
Exercise is another key area to watch for changes, and here, there is a difference between changes that may cause our mental health to deteriorate and the signs that it already has. This can show up in the workplace if you have to do a lot of exercise in order to cope. You may feel that you need to walk your 10,000 steps before you start your day, or that you can’t wind down after work unless you go to the gym each night and follow a strict routine. If you’re using exercise to cope at work, or if a lack of exercise is making life harder, these changes can highlight a dip in your mental wellbeing.
Part 4: Train yourself to think of mental health first
When we think about where we sit on the spectrum of mental health, and then consider our sleep patterns, energy and concentration levels, and relationships at work, we may be able to spot changes. Unfortunately, we then have to be brave – often when we’re feeling the opposite – and speak up. If any of these factors become so bad that others notice, things may have gone too far. This isn’t such a big deal, especially after experiencing a lockdown, but we still need to speak up.
Mental ill health appears first in our internal world, where no one else can see, so no one will know. As it gets worse, people may notice something different about us, but this doesn’t happen until we are having quite a tough time, and their initial, unguarded responses can be negative.
I support people who are having a difficult time at work, and more often than not, the first time I hear about someone’s mental health challenges is when a manager comes to me, annoyed about an employee’s changed attitudes or behaviours. This is because mental ill health in the workplace, seen from the other side, often looks like a person who no longer cares, or someone who is failing to keep themselves fit for work.
Here, I want to show how mental ill health in someone’s internal world can appear very different to the people around them.
Changes you might experience include:
- Feeling unusually tired, due to a lack of good-quality sleep
- Feeling slow in the morning or sluggish in the afternoon
- Experiencing a growing anxiety, which feels nagging but formless
- Feeling fearful about things you used to take in your stride
- Experiencing poor concentration and a fogginess in the brain
- Doing amazing and terrible work at the same time
- Experiencing decreased appetite and/or compulsive exercise
How these changes are interpreted can be difficult to predict:
- To people who don’t know your internal world, how do these changes look?
- Will others automatically understand what you’re going through?
- Will people know why you’re going through these changes, especially if you don’t know yourself?
Without knowledge or understanding, people can react in any way.
Be kind to yourself – and those around you
We need to get to a place where we make no assumptions at all when a person’s attitudes or behaviours change for no obvious reason. This is the fundamental change that must come from society’s growing awareness of mental health issues.
Here is what we should aim for, in our various roles:
- Learn to check yourself against the mental health spectrum as soon as you sense that you’re below par (scroll down to part 2 of this article for the diagram and an explanation of how to use it);
- Learn to spot changes in yourself, including your sleep patterns, energy and concentration levels, and relationships at work;
- Commit to discussing your challenges at work with those who need to know and can support you while you recover.
- Learn to spot changes in team members without passing judgement on the potential causes;
- If you are concerned about someone, learn to ask “how are you? How are you feeling?” Learn to listen to what they say, without justifying why you asked or trying to solve their problems;
- Work with the individual and your People/HR team to take the appropriate next steps;
- Be open to making changes, temporary or otherwise, in the workplace to support individuals who are suffering from mental ill health.
- If you are concerned about someone, don’t be embarrassed to ask “how are you? How are you feeling?” Listen to what they say and encourage them to seek help;
- Mention your concerns to your manager or your People/HR team.
- Ensure that you are trained to support people who are suffering from mental ill health;
- Put in place a suite of tools to assist anyone who comes to you for help;
- Be open to making changes, temporary or otherwise, in the workplace to support individuals who are suffering from mental ill health.
- Ensure that everyone is trained to understand the mental health spectrum and the ways in which mental ill health presents itself in the workplace;
- Encourage constructive discussions around mental health and mental ill health at work;
- Ensure that your People/HR team is fully equipped to support anyone who needs help.
It’s good to talk, so don’t stop now
At the moment, we feel more comfortable talking about mental ill health because we are sharing our experience of the lockdown. Any dip in mental wellbeing has, on the face of it, a cause that we all understand, which helps us to be kind to both ourselves and others.
After the Covid-19 restrictions ease, this shared experience will shift into the past, and mental ill health that occurs either for an unknown reason, or for no reason at all, will return to the fore. Some people will instinctively want to push the topic away, because it “belongs” to something that has gone, and good riddance.
Instead of pushing it away, we must continue to embrace the subject of our mental wellbeing. There will be plenty of people – health workers, parents, leaders, managers – who kept themselves (and those around them) going during the lockdown, and may only experience a decline in their mental health at a later date, when it is safe for them to do so. Then there is the large percentage of people who have not yet experienced mental ill health but will do so in the future, and who need this to remain the openly, honestly discussed area of life that it has become.
Building on the lessons of lockdown
As I have written before, the economic benefits of tackling mental ill health are immense. Jobs are no longer for life, but many people have had to change jobs unnecessarily because a dip in their mental health has been handled badly, by themselves, their organisation or both.
Anecdotally, I would put this at around 10% to 20%. I know that, as a People manager, I have “saved” at least 15 people during my career, and I have only ever supported small offices, making this a decent percentage. We now have a chance to build on what we learned during the first lockdown, if we can continue to support those facing changes in their lives and recognise changes for the worse in ourselves.
I hope these tools will prove helpful to every reader (and there are many resources available to anyone who needs help – for details, scroll down to the bottom of this page). We should all be using the mental health spectrum to judge how we’re feeling. We all need to be alive to changes that happen in life and at work, so that we can spot when our levels of mental health change. And if we suspect that someone else is having a rough time, we just need to ask how they are, and “how are you, in yourself?”, even if Micky Flanagan and Peter Kaye think we’re daft.
Help is available – here’s how to access it
If you’re worried about your mental health, you don’t need to justify yourself to anyone. If changes in your life are worrying you, please ask for help. I would be a statistic had I not done so 20 years ago, and a few times since, which is why I can say with authority that not one of the following services is waiting for you to be in crisis before they deem you to be ready for help.
- Tell someone at work. This can take bravery, but attitudes have changed for the better. Unless you have trust issues, tell your manager, your closest colleague, someone from your People/HR team or one of your leaders about the changes in your life. They don’t need to know the details; you just need to explain how the situation is affecting you at work. It is their responsibility to alleviate any problems in the workplace that are making you feel worse.
- Tell your HR department. They can ensure that any changes are dealt with appropriately and will also be able to support your manager and anyone else who needs to be involved.
- Tell your GP. In the past, if we asked for help with our mental health, our GPs reached for the prescription pad. This is no longer the case. If you are in a rough patch, they have a lot of suggestions to make, from different types of therapies to exercise and diet. They will work with you to get you back into the green end of the spectrum.
- Call your employee assistance helpline. If your workplace provides an employee assistance programme (EAP), you will probably be able to access some talking therapy, even without visiting your GP first. It’s amazing how helpful it can be to offload our concerns to someone who just helps us to order our thoughts. Check your employee handbook or ask your HR department for details.
- Call your private healthcare provider. If your benefits package includes private healthcare, the provider will supply an EAP or may have a separate helpline that you can call for psychological support.
- Use your local services. You can use this NHS webpage to find a local helpline that will offer support during any mental health crisis.
- Use free listening services. The Samaritans and similar organisations are not just there for you if you are suicidal. This is a popular misconception. Their helplines are staffed by experienced listeners who will help you to frame the changes you’re experiencing. Call 116 123 to talk to the Samaritans or email email@example.com for a reply within 24 hours; text “SHOUT” to 85258 to contact the Shout Crisis Text Line or text “YM” if you’re under 19.