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E#162 The Link Between Stress and Mental Health Issues

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The Link Between Stress and Mental Health Issues

Mental illness is a significant global issue. If we want to take a preventative approach, we need to understand the factors that lead to mental health issues. 

In any one year, 1 in 5 Australians is affected by diagnosed and undiagnosed mental health issues.

Mental health is a global issue, having the third highest disease burden of all diseases in Australia and globally. The World Health Organisation (WHO) predicts that depression (in particular) will be the leading health concern in both developed and developing nations by 2030[1].

In this episode, I’ll talk about 
* What Causes Mental Health Issues?
* How Does Stress Affect Mental Health?
* Workplace Impacts
* What We Can Do

We know that mental health issues affect a person’s thinking, emotional state and behaviour and disrupts their ability to work, carry out daily living activities and engage in healthy relationships. We also know that early, effective prevention or intervention programs maintain good mental health[2].

In that sense, if we can understand the causes and etiology of mental health issues, we are better placed to reduce and manage them better.

What Causes Mental Health Issues?

If we are to intervene early and effectively to prevent mental health issues, where do we start?

A logical place is the link between stress and mental health. There is overwhelming evidence that stress is a precursor to mental health issues and is tightly linked to mental health decline. Stress is also strongly related to depression[3].

Since 15 – 45% of mental health issues are attributable to workplace conditions, understanding the workplace risk factors seems to be a logical next step[4].

How Does Stress Affect Mental Health?

One model of stress and ageing/disease suggests that an individual’s perception of stress and prolonged exposure to stress can change the brain, body and behaviour, all of which perpetuate a vicious cycle of excessive response, damage and poor recovery3.

In the brain, an enlarged amygdala and diminished hippocampus are related to memory loss, reduced learning ability, and depression. The longer a person is highly or chronically stressed or depressed, the smaller their hippocampus gets.[5]

In the body, elevated cortisol levels and a chronically active fight or flight response can cause symptoms such as elevated resting heart rate or blood pressure.

A chronically stressed person may change their behaviour to help them cope or adapt[6]. Behaviour changes may include decreased exercise and sleep, increased smoking, changes to diet and reduced adherence to medication, all of which contribute to mental and physical health decline.

In other words, an employee who faces stressors such as constant overwork, prolonged screen time, sedentary work behaviours, feeling pressure to work or respond to emails outside working hours, discrimination, bullying or harassment, constantly facing disgruntled customers or workers, or long/irregular working hours, is at risk of chronic stress, and both physical and mental health issues[7].

The initial signs of mental health decline in the workforce may be subtle and therefore hard to detect at first, but over time will become more obvious in terms of health metrics and behaviour change.

Workplace Impacts

Chronic stress and mental health concerns in the workplace result in increased absenteeism, reduced contribution and participation, reduced productivity, reduced cohesiveness and cooperation and high staff turnover.

There are concomitant increases in the cost of health services, insurance and supplementary employment benefits to the tune of $17.4bn per annum in Australia4.

What We Can Do

As a starting point, the hierarchy of control is a useful framework to identify and reduce stressors in the workplace, to reduce the risk and development of mental health issues.

If workplaces can eliminate, substitute, or reduce exposure to stress and mental health hazards, provide protection and treat the negative impacts, then we may start to see mentally healthier, happier workplaces.

But let’s go one step further.

We all know that prevention is better than cure. From a preventive standpoint, workplace programs and initiatives that are proven to build employee resilience and improve individual stress responses will create a workforce where employees cope well, bounce back better, are happier and more productive in their roles.

Summary

Mental health issues are a global concern, and they have a significant impact on both quality of life and workplace productivity.

An individual’s perception of stress and prolonged exposure to stress are key factors in the development of mental health issues, via changes in the brain, body and behaviour.

We know that workplace conditions strongly linked to both chronic stress and the development of mental health issues. This provides us with a golden opportunity to get on the front foot by better-managing existing risks and by taking preventive action to improve resilience and create healthier, happier workplaces.

[1] https://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf?ua

[2] https://mhfa.com.au/

[3] Epel, S. et al., (2018). “More than a feeling: A unified view of stress measurement for population science,” Front Neuroendocrinol, vol. 49,   pp. 146-169, Apr 2018, doi: 10.1016/j.yfrne.2018.03.001.

[4] Carter, L and Dr Stanford, J (2021). Investing in Better Mental Health in Australian Workplaces. The Australia Institute, Canberra, ACT.

[5] Doidge, N. (2007). The Brain that Changes Itself. Scribe Publications, Melbourne, Australia.

[6] Cohen S, Janicki-Deverts D, Miller GE (2007). Psychological Stress and Disease. JAMA. 2007;298(14):1685–1687. doi:10.1001/jama.298.14.1685

[7] Johnson, a. et. al (2020) A review and agenda for examining how technology-driven changes at work will impact workplace mental health and employee wellbeing. Australian Journal of Management

2020, Vol. 45(3) 402–424

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Episode 85: What You Can Control

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In pandemic times, there are four skills you can use in a four-step process to dial down the intensity, feel calm, take charge and gain a sense of control.

I’m not sure about you but sitting at home in isolation has bought a bunch of things to the forefront of my mind, and my life.

I think right now we are all faced with it – the overwhelm of all the unfinished things in our house and in our lives, the clutter we have accumulated, and the onslaught of media and negative headlines.

We normally have the ability to physically escape these things and to continue on with the doing work of life, rather than attending to this unfinished business. 

But now living in pandemic times, it’s an extreme experience to face the internal clutter as well as the external tragedy, risks, loss, grief and uncertainty. 

Few people have prepared themselves for these times. 

It’s more than just stocking your pantry – it’s also about feeling in control.

After all, right now we are winging it, pivoting, adapting and trying to take steps toward our goals in a new way. And we may also have had to throw our goals out the window!

That’s why I want to talk about feeling calmer and less overwhelmed – by taking control of the things that we CAN control.

What’s really in our control?

If you think about it, most circumstances are outside our control.

Six months ago you had no idea this pandemic was coming – and that’s just one of hundreds of things you could never have predicted in life.

What is within our control is what we think about things, and how we act.

And, we create certainty and a sense of control by making decisions about what we do and don’t want, and what we will and won’t do.

What is within our control is what we think about things, and how we act.

So right now is the perfect time to stop thinking about what we can’t do, and to get clear on what we can do, so we can take back control of our thoughts and actions.

It’s time to stop the spread of fear, anxiety, and worry, and instead of just coping, we need to bounce back and start thriving, coping with challenges and feeling strong.

It’s all in the mindset.

Let’s stop letting our thoughts run wild, unfettered. 

Let’s talk about the skills we can develop to manage our minds and to actively cultivate healthier thoughts.

Compassion

Firstly, we can develop compassion for ourselves and for others. Compassion is a practice as well as a response to the circumstances around us, but it starts with self-talk.

Compassion is being kind to ourselves and others (instead of judging). It’s about recognising the common humanity (we are all suffering and it will pass) and to be mindful of what we can do in this moment (I can control my thoughts in this moment).

We can only focus, think straight and make decisions when we are calm.

Factualising

The second thing we can do is to stop catastrophizing. 

As an expert in catastrophizing with many years of experience, I want to take you through a three step process I have developed to calm things down – a process I call factualising.

The premise of the model is that catastrophizing is a sense of heightened emotion that we create in our brains. It’s exaggerating and expecting or even predicting the worst possible outcome.

Obviously, that’s very unhelpful!

So this model I’ve developed helps us to step back from that heightened emotional state and out of our ‘feeling brain’, into a more neutral, calm and logical state, by engaging our more logical, ‘thinking brain’.

The three steps to the model are to 1. write down your negative, catastrophizing-style thoughts, 2. trim it down to just the non-emotive facts, and 3. to reframe it with an ‘even-though’ statement.

Here’s an example.

Negative thought:

I am so irritated with myself because I didn’t do my exercise session today. I was too cold and tired, and now I feel terrible.

       Just the facts:

       I didn’t do my exercise session today.

       Reframe:

Even though I didn’t do my exercise session today, I feel determined to do my session tomorrow.

Finding Strength

The third thing we can do is to find strength, because this helps us to feel grounded, and to gain a sense of our capacity to cope.

The process to finding strength could include reflecting on past challenges and how you overcame them.

Maybe it’s identifying all the people and networks around you who can support you, and who have been there for you in the past.

Strength also comes from cultivating positive thoughts. This could include practicing gratitude each day, creating an oasis for yourself at home – a quiet place to rest, relax and reflect.

Strength includes looking at the upsides and shifting attention to what has been learned or discovered despite the challenges. 

Strength can be more easily maintained when you are consistent with self care. We gain physical and emotional strength and resilience by going to bed early, waking up at a consistent time, eating nutritious food, doing exercise, breathing deeply, meditating, thought modelling, journalling, factualising and practicing self-regulation.

Make Decisions

The fourth thing we can do is to make some decisions about how we will think and act in the next period ahead. 

When we have no plan and have made no decisions, we are floating around in the sea of chaos, feeling helpless.

But when we decide what we will and won’t do, how we will do things for the next week, what we will experiment with, and which tools, support or resources we will use to give our plans a good chance of success, it feels like we’re taking charge again.

A lot of people think that decision making is where they should START in the process of taking charge.

But in uncertain, pandemic times, decision fatigue is a real thing. It means you don’t have the capacity to make decisions.

That’s why I started with the three steps of compassion, factualising and finding strength – because these are the foundation of good, rational decision-making and planning. 

As you might have noticed, there are a lot of things that ARE in your control right now.

Probably more than you imagined!

If you follow this four-step process, it will help you to take charge of the things that are in your control so that you can feel calmer, more confident and more resilient in the face of uncertainty and chaos.

Summary

In any case, even the most calm, balanced people may struggle in uncertain, stressful times. 

My four step process for taking charge of the things that you can control is:

  1. Practice compassion and self compassion
  2. Start factualising instead of catastrophizing
  3. Find strength in the past, your networks and appropriate self-care
  4. Make decisions for the next period of time to regain your sense of control.

Instead of just coping, we need to bounce back and start thriving, coping with challenges and feeling strong.

In the longer term, consistent self care is the foundation of mental wellbeing. It is therefore an essential precursor for building resilience, for effective decision making and for remaining calm in the face of adversity.

If you would like to find out about working with a coach, visit melaniejwhite.com/contact

Ready to feel calm and in control?

Focus on the things you CAN control. If you’re truly ready to break old habits and get out of the rut I encourage you to check out the Habitology membership.

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Episode 81: How To Run A Business In Stressful Times.

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This episode describes three levels of resilience and helps you to get clarity on what to do at YOUR level to keep your business on track in stressful times.

Everyone responds differently to external pressures. The way you respond depends on your personality, your thought processes and your personal circumstances.

But at the core of things, stress starts in your mind. Your perception (thoughts) determines your resilience. Resilience simply means the resources and capacity you have to cope with the circumstances around you. 

When your resilience is low, it affects your ability to make decisions, to think clearly and to be fully present with your clients – all of which are obviously important in relationship-based businesses like coaching.

When you’re running a coaching business in stressful times, there are different approaches you can take to support your wellbeing and to feel at peace with your business decisions. 

Your best approach depends on how resilient or stressed you feel. Most people will fit into one of three categories.

Three Categories of Business Owner Resilience

Category 1 – feeling resilient, seeing opportunities to be of service, and feeling ready, willing and able to reach out and help others. These people may have fewer external pressures, may be more extroverted, or could be people who have done a lot of their own coaching around beliefs and behaviours. In any case, they have the resilience to be able to cope with stressful times.

Category 2 – feeling fearful or overwhelmed, seeing roadblocks, and feeling unable to cope with the responsibilities of both business and life. These people may have more challenging circumstances, may be more introverted, or are yet to master the skills of emotional balance. They are unlikely to have enough resilience to cope with stressful times.

Category 3 – wanting to help, seeing opportunities but becoming easily overwhelmed. These people may be managing internal and external pressures but are close to capacity. They may have some skills around emotional balance and some level of stability in life. This means they feel resilient at times and are able to cope, yet can fall back into overwhelm. Their resilience is ‘inconsistent’.

These are generalisations but they may help you identify yourself for the purposes of making rational decisions about what to do with your business.

Let’s look at some approaches for each category.

Business Approaches for Stressful Times

If you’re in category 1, seize the day. Despite stressful times, you are best positioned to continue running your business or even expanding it, so that you can help others.

You may offer services that help others to;

  • Get some respite (e.g. online retreat)
  • Cope better (e.g. plans and strategies)
  • Maintain positive habits (e.g. visions and goals, accountability groups)
  • develop new habits or routines (e.g. challenges or programs)
  • create more joy, fun, freedom (e.g. uplifting classes or events)

Remember that showing up for others in stressful times takes time, energy and effective planning.

Showing up for others in stressful times takes time, energy and effective planning.

You may tend to attract clients who have similar resilience to you, but be mindful of others who are struggling and may have less capacity to cope with higher energy activities or sharing of information in a group setting.

If you are in category 2, your primary concern is your own wellbeing, stability and your loved ones. In stressful times you probably have limited capacity to truly be of service to your clients.

You may like to define a period (e.g. 2 – 6 months) to focus on your own physical and mental wellbeing, during which time you:

  • close your business temporarily (e,g, block your calendar)
  • Subcontract another coach to service your clients
  • Reduce business activities to a minimum (e.g. working with a few select clients)
  • Consider Centrelink or other options for financial support if needed. Business offsets, grants or hardship payments are sometimes available.

Remember that as a business owner you may have legal obligations to clients such as coaching out their contract, refunding them, putting payments on hold or suspending memberships.

There is also the common courtesy of emailing your clients to let them know that you are taking time off, and to let them know what to expect from you in the interim.

Maybe that’s nothing, or you may continue newsletters, or you may schedule social media posts, podcasts or have a VA do that for you. Just make sure you tell your clients how they can stay connected or when you’ll be back in touch with them.

If you’re highly stressed then it’s likely you’ll be in decision fatigue, so you may find it easiest to discuss a strategy with your business coach or mentor to help you develop a clear plan going forward.

If you’re in category 3, then your biggest priority will be emotional balance. 

That’s because you may feel motivated to make offers in the heat of the moment, or be super responsive to clients, but then realise you lack the energy or capacity to follow through with an appropriate level of service.

Your best approach will probably be to:

  • create a clear schedule of work and non work activities and stick to it (e.g. a weekly plan)
  • reduce the number of clients you see each week, and set a maximum number of sessions per day
  • pause and reflect on your capacity when a client asks for help rather than just responding  
  • pause and reflect on your capacity when you get an impulse to offer help or run and event, rather than just rushing into action  
  • Automate your marketing activities.

Remember that a successful business is consistent how it shows up. It underpromises and over delivers in value, not the other way around.

If you run your business in fits and starts, it may damage your reputation. You’re better off to dial down your activities and be consistent with them. 

SUMMARY

Those of us who serve others can fall into the trap of overhelping, overcommitting or overextending ourselves, and burning out.

The most important thing for us all as individuals is to check in with ourselves each day and reflect on how we are holding up, what our capacity is, and to maintain our own physical and mental wellbeing habits. We must do this to meet our own needs and to have the capacity to serve others.

The most important thing for any business – in good times and hard times – to be is consistent. Consistency builds a sense of trust, reliability and professionalism.

In times of stress, I encourage you to reflect on your resilience and make a decision as to what your business approach will be. Decide how long you will do this approach for. (E.g. 3 months? 4 months?) then take the appropriate actions.

The most important thing for any business – in good times and hard times – to be is consistent. Consistency builds a sense of trust, reliability and professionalism.

You can revise your plan at any time but definitely at the end of your defined time period, and get clear on how you’re feeling and what you will do next.

If you need support with your business in stressful times, these resources may help.

Summary of state-by-state stimulus measures, Australian Tax Office information for COVID 19, Business support for sole traders

Small Business NSW (includes info on financial hardship and bank loan deferment), Business Qld (includes information on economic relief, payroll tax relief,  power bill relief and support facts), Business Victoria (includes different support options including low cost business mentoring), Telstra small business support, Tips for coping with COVID anxiety (Psychology.org, includes a list of resources)

Ready to navigate your business through this stressful time?

Now is a time to have a clear and realistic picture of what your business can do. If you’re looking to break old habits and get through this, I encourage you to check out the Habitology membership.

Learn more here:

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