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Could Compassionate Employers Support Greater Economic Recovery: time to end presenteeism!

The idea for this article came to me on my morning tube ride into Westminster. We are closing in on the end of Covid (or at least I hope we are!) and there was someone on my tube that was sniffing and snorting copious amounts of phlegm. Whist this could be caused merely by sinusitis and pose no risk at all to anyone else, it could also be some sort of bug!

We have seen a significant decrease in presentations for influenza since the introduction of measures to reduce the spread of coronavirus. This really gives us an idea that social distancing and good hygiene could reduce instances of flu in a post-covid world. Same with other infectious bugs such as norovirus, which has seen a reduction in outbreaks, and when they occur, they affect less people.

It makes perfect sense! A little respect for others when you’re not well, keeping your distance, and maintaining good personal hygiene, can reduce the prevalence of viruses that cause illness and death.

So, what does this have to do with work, presenteeism, and the economy?

Flu and The Economy

I shall mostly focus on the common problem – Flu. Influenza accounts for approximately 159 million lost working days in people aged 50-64 (internationally!) having a global economic cost of $39bn. In the UK alone the estimated human capital costs of influenza are £90m – £270m per annum.


The prevailing problem of presenteeism… Surely dragging yourself into work is, even when on death’s door, a great thing to do? Sick days are expensive! And some people don’t even get paid sick days.

If we can learn lessons from this whole coronavirus debacle, it is:

All of these people that have, for years, been dragging themselves into work whilst full of flu and infecting everyone on public transport and in the office can now have an option! They can work from home. Or they can be off sick. No more necessity to take everyone else down with you when you’re sick and feeling too important to stay away from the office.

This could have a knock-on benefit for other forms of presenteeism – those who go to work due to long-term health conditions when they could equally be doing a better job working from home; and, people going in despite psychological challenges out of fear of repercussions. Presenteeism results in reduced productivity, and can have a damaging impact on corporate culture.

Compassionate Employers

It would be amazing if, out of this pandemic, compassionate and realistic employers rose up and recognised the challenges their staff have been facing for decades. Might be a touch too optimistic though.

Yet, maybe if they are shown the cost benefits?

By actively promoting the option of working from home they allow staff to feel empowered. They also allow employees to feel like trusted and respected members of the team. As long as those homeworkers are actively involved within office communications, invited to team meetings virtually, and generally not forgotten! I suspect many have fallen into the forgotten camp during the coronavirus pandemic!

By actively allowing homeworking there will be less of a drive to come into the office with infectious diseases! This will likely reduce the prevalance of office-based outbreaks of illnesses such as flu and norovirus (although i honestly cannot imagine ANYONE going into work with norovirus!).

By recognising that homeworkers are often more productive due to less distractions, homeworking can be championed. I have heard of some antiquated employers/managers banning home working as they believe their employees will be lazy, sit around, and watch tv all day. The evidence-base refutes that. Although, maybe their employees would do that due to other cultural issues!

And, by treating employees with care and compassion, as humans who are allowed to be sick, and allowing them the time to recover, companies would likely avoid the need for presenteeism. They avoid unproductive staff. They mitigate the risk of unmotivated staff. And reduce the spread of illness which can significantly impact the economy, along with their own bottom line.

In Conclusion

Companies that have punitive policies discouraging staff to be sick are likely damaging their own productivity levels, and thus their own profitability. By encouraging home working they might get less people bringing in infectious diseases into the office; increase productivity; have a happier workforce; and, increase profitability.

We have an opportunity to learn from this devastating year and a bit. It would be a travesty to ignore the important lessons and return to life as it used to be.

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(originally posted on 10/10/2017)

So today is world mental health day and it is estimated that there are 300 million people globally suffering with depression, and more than 260 million people suffering from anxiety (1).

The old ‘1 in 4’ experience mental health concerns within their life is, in my view, very conservative.  Especially as 1 in 5 people are reported to experience suicidal thoughts (2).

photo of man leaning on wooden table
Photo by Andrew Neel on

I understand why these statistics are created as they are intended to normalise mental health issues so that there is, rightly, no shame in experiencing challenges and thus seeking support if and when required.  

From my point of view, and I don’t have evidence for this, yet I believe that the way mental health issues are framed within business and life, there is still a stigma surrounding them and therefore some people still experience shame and will not speak up.  

I truly believe the 1 in 4 is highly conservative.  I would anticipate that, at at least one point during their life, everyone will experience some form of anxiety, and potentially the symptoms of depression.  These are very human experiences that become problematic in life when they persevere.  

There is research at present into the causal factors of the symptoms of depression and it has been suggested that the presence of suicidality within people with major depressive disorder (MDD) have inflammatory markers, suggesting that the inflammation rather than the MDD may not be causing the suicidal thoughts (3).  This ties in with the increasing evidence that people with depression have neuroinflammation leading some to think that depression may, in fact, be an inflammatory disorder and thus the current treatment pathways are ineffective (45).

Are there benefits of this potential revelation?  Yes!

It means you can make some changes that could significantly improve the symptoms of depression.

  1. Exercise 2-4 times a week.  It has been shown that exercise reduces the symptoms of depression more than things like meditation and relaxation, and definitely more than not exercising or doing nothing (6)
  2. Eat a Mediterranean style diet.  It has been shown that a med-style diet consisting of very few/no processed foods, oily fish, olive oil, red wine (in moderation), dark chocolate (over 70%), low sugars, and a variety of fresh fruit and vegetables, increases the B vitamins and omega oils and contributes to a reduced risk of depression (78).  A wonderful side-effect of eating this way is you generally experience some weight loss too which can make you feel more self-confident.
  3. Sleep!  Sleep is another factor in mood and psychological resilience (9).  It has been estimated that 90% of those experiencing symptoms of depression, sleep is a problem (10) and therefore improving your sleep hygiene could make significant improvements to the symptoms of depression.  Simple changes such as having a note pad next to your bed to put your thoughts onto paper before going to sleep, rather than ruminating on them for hours on end – you can deal with them in the morning!  Switching off electronic devices an hour before bed and reading a book instead.  Making sure your bedroom isn’t too hot.  These simple changes can make a big difference.
  4. Relax.  A variety of studies have shown how beneficial relaxation is in improving the symptoms of both depression and anxiety.  It is a skill that must be learned, and often the harder you try, the harder it is to do.  Yet by mastering this skill you can help yourself reduce symptoms of depression (1112).

There is no shame in experiencing symptoms of depression, anxiety, or any other mental health condition.  If the symptoms persist then take action and seek support.

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Leisure sickness: the joys of getting sick when you relax

(article originally written on 4/9/2017)


This year I have been fortunate enough to do a little travelling.  Not the type that involves backpacks and hostels for months on end, just the typical brief vacation that many find beneficial in their lives.  In April I went to Brazil for a friend’s wedding, and then in August I spent a delightful week in Budapest.

These were my first holidays since I started my training, many years ago.  I had not really had the opportunity to get away.  I immersed myself into the culture, enjoyed the relaxation, and realised what I had been missing all these years.  Until I suddenly noticed, when I landed back in Heathrow after the trip to Brazil my sinuses flared up and I had to make a trip to boots to take immediate aversive action.  I couldn’t stop sneezing and I felt as though I had a cold.  This stopped pretty quickly.  I thought nothing more of it.

That was until my final day in Budapest.  On the 7th day I started to experience flu-like symptoms.  I have had the flu jab so I knew it was not flu.  All sorts of things were running through my mind – maybe I have an allergy to air conditioning!  I do often hear of people getting dry tickly throats from air conditioning (1).  When I arrived home the symptoms persisted and are only starting to ease off now – over a week later.  

I spoke to friends and family about this and noted that some family members, especially those that rarely travel at all, got cold and flu-like symptoms, chest infections, and suchlike following a holiday.

A holiday is supposed to refresh you, isn’t it?

I posted this concern into a group of fellow psychologists and someone piped up with a diagnosis.  You have “Leisure Sickness!”

​I have never heard of this, how on earth can I have that?


Interestingly (maybe not), the term ‘leisure sickness’ was Webster’s Word of the Year for 2010.  Although technically it is not a word!  

Leisure sickness is where some people report feeling or becoming ill during weekends, or vacations/holidays.  This generally occurs for people classed as ‘workaholics’ according to the dictionary definition, although nobody I know would class me as a workaholic.  

Whilst leisure sickness is a new term to me, it has been floating around for many years now.  Dutch Health Psychologist, Professor Ad Vingerhoets, is probably one of the most prolific researchers in this area and has found that, based on Dutch populations, around 3-4% of the population experience leisure sickness either at weekends or when they go on holidays.  It is something that tends to occur more frequently in males than females too.  It is thought that the challenges arise in the transition from busy workloads to stress-free environments with those experiencing leisure sickness displaying an ‘inability’ to relax (2).  

There are numerous possible explanations for people experiencing leisure sickness.  Some possibilities are as follows (3):

  1. People really dedicated to their work may experience feelings of guilt should they take time off, this can cause stress and thus reduce the immune function.
  2. When people are busy they do not have time to notice symptoms of ill health.  By relaxing their bodily perceptions and awareness increases and therefore they become aware of the symptoms of illness.
  3. People with a high workload run off adrenaline during their busy times (which may be all of the time!).  These people can experience high levels of adrenaline even during the evening hours (hence an inability to relax when not at work).  As some forms of stress can actually improve immune function, surprisingly, when the stress function powered by adrenaline is reduced, illness prevails.
  4. A high workload predicts a potential dehabituation to stress during a holiday. Ultimately, your body gets acclimatised to the stress and when you give it a rest, when you return to work you may experience challenges with insomnia, mood, and symptoms of ill health.  This is not found in people with a low workload.  
  5. It is also thought that some people postpose their illness to a time where they have time to be sick!  Some older studies have found that people who deem themselves irreplaceable at work may potentially be able to delay health problems, and even death.  Although I am less convinced about this as I managed to get tonsillitis whilst writing up my doctoral thesis.
  6. Personality traits/characteristics may play a role.  It is thought that those with perfectionist traits, a high workload, a strong commitment to work, and an overdeveloped sense of responsibility to work are with the high-risk group.  People falling within this group may struggle to switch between work and non-work situations.  Perfectionism is a trait that predicts burnout, exhaustion, and conditions such as chronic fatigue.  


My recent travels have taught me a few things.  

  1. I need to allow myself more time to relax.
  2. I need to give myself time each week where I am not working.

I am a self-employed psychologist & coach and as such it is my responsibility to earn a living for myself.  To put a roof over my head.  I have noticed that I am ‘always on’.  All of the books I read are work-related.  When I am attempting to relax, I am thinking about work, strategies, developments, products, etc.  How to create a sustainable business and income.

The key point I was missing was my health.  Pretty ironic for a health psychologist!  If I do not look after my psychological and physical wellbeing then I am unable to work, thus unable to earn.  

My trip to Budapest was based on the insight I had during my trip to Rio – the insight that I need to have more holidays.  I need to have more time away from work.  That was not sufficient though.  I have now booked myself piano lessons to give myself time each week where I am focusing on something totally different.  A sacred space where I am not thinking about work.

So, for me this is still a work in progress, yet my tips to avoid leisure sickness would be:

  1. Ensure you build in some leisure time into every single week, not just the weekends.  Maybe that is enrolling in a night class, starting a hobby, buying a dog so you have a reason to walk in all weathers.  Something that results in you taking time doing something other than thinking about work for 30-60 minutes a few times a week.
  2. Ensure you sleep well.  If not, look into your sleep hygiene.
  3. Have some breaks away, although these will only be beneficial if you have already built in a better work/life balance.
  4. Do some exercise at least a few times a week.  Exercise is a great way to reduce stress, although it does not have to be an expensive gym membership!  It can be walking 10,000 steps a day – this can be extremely beneficial to your health.

If you still struggle then consider engaging in some mindful activities, mindfulness meditations, or if you are really struggling with stress then consider making some time to see a psychologist or a coach.  We can often help you to look at your life from different perspectives so you can make changes to lead a more healthy and prosperous life.