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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.

Presenteeism

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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What books are good for people with chronic illness?

Chronic illnesses are difficult to manage. People often report being bounced from consultant to consultant, hospital to hospital, and still end up without resolution.

Unfortunately, many chronic conditions are likely to be lifelong companions with the person experiencing them. That can be frustrating, and can result in a feeling of utter hopelessness.

As a health psychologist I regularly work with people with chronic illness and chronic conditions. Many have spent an absolute fortune on supplements, new diets, complimentary therapies, courses, etc. All with the aim of trying to recover.

Obviously, why wouldn’t someone want to recover from any illness? Yet some are with us.

Myself, I have a long-term health condition in the form of a degenerative retinal condition. Mine is only going to get worse and no amount of supplementation will really make a difference. Positive health behaviours, such as exercise and a diet including a naturally colourful dose of fruit and veg can support the system and may mitigate and speeding up of the degeneration. But my condition is currently incurable.

I’m including below some links to resources that help people develop skills to deal with chronic conditions. I hope, if you’re reading this, and you are experiencing a chronic condition, that you find at least one of these a useful resource. I know that not everyone gets offered psychological support via the NHS, and many cannot afford a private psychologist to support them to adapt.

Ray Owens’ Living with the Enemy is a compassionately written self-help resource for anyone experiencing chronic illness. Drawing on acceptance, compassion, CBT, and mindfulness it can help you to navigate the stresses of chronic illness.

Russ Harris’ Happiness Trap isn’t just a book that people with chronic illness would benefit from, but possibly one that almost everyone would benefit from. Russ talks about how the strivation (yes, i made this word up!) for happiness can shine a spotlight on anything that isn’t happiness. The result is that we can really highlight suffering and overly normalise happiness as an ideal. The reality, life is a spectrum of experiences: good, less good, painful, grief-ridden, sadness, excitement, anxiety, lowness, high, and possibly happiness, mixed in with the wealth of other experiences that humans can have. By recognising that happiness and positivity can, in themselves, be problematic aims, and then learning how to live with all the other experiences that life affords us, we can learn to function better. The aim of Russ’ book is to help people to identify what is important in life and to do more of what is important, no matter what life throws at us.

A highly recommended book that has helped hundreds of thousands across the globe already.

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I AM NOT SURE I WAS HYPNOTISED

(Originally posted 12/3/2017

The title of this blog post is a phrase I hear all the time. 

As a psychologist, hypnosis is a tool I use to deliver my interventions.  I don’t always use hypnosis, and I do give clients a choice.  There is a massive benefit to hypnosis.- it helps the clients to make profound changes, sometimes in as little as 10 minutes.  

When I first mention the use of hypnosis to clients they will often say to me ‘I don’t think I can be hypnotised’ or ‘well, I went to x and I am not sure I was hypnotised’.  There is a perception that hypnosis (a word derived from the greek ‘hypnos’, meaning ‘to sleep’) means a deep sleep, or even a coma, where the client has no awareness throughout the process.  And maybe in some instances this is almost true (the Esdaile state, also known as a hypnotic coma), yet the majority of hypnotists/hypnotherapists (or whatever they want to call themselves) will not use these levels of depth.  

WHAT WILL I HEAR IN HYPNOSIS?

During hypnosis it is very common to hear every single word the hypnotherapist/hypnotist utters.  It is even more common if it is your first session with them as people tend to have a sense of curiosity.  The more you allow yourself to relax into it and get guided along on the experience, the deeper you will go, and potentially have a stronger sense of amnesia.  

WHAT WILL I FEEL IN HYPNOSIS?

That is an amazing question, and ultimately whatever your experience, it is the right one for you.  Some people do report a sense of heaviness, as though their entire body is made of lead.  It can also feel as though the body has vanished and your head is floating around above your shoulders. 

Others report a sense of lightness.  Sometimes that lightness is suggested, or appears after the problem has been removed or resolved.  

Hypnosis isn’t relaxotherapy, sometimes you may feel relaxed, sometimes you may not.  I can do long relaxing sessions, and it can be a wonderfully indulgent treat, just like a psychological massage.  Often the fast work is more therapeutic.

SO, WHAT IS HYPNOSIS?

I could give standardised definitions:

The Mayo Clinic defines hypnosis as a ‘trance-like state in which you have heightened focus’.

The American Psychological Association state that hypnosis is a powerful and effective technique for dealing with a wide range of issues such as pain, anxieties, and mood.  And for dealing with behavioural issues such as smoking.

Both of these are fairly accurate.  I always explain to my clients that hypnosis is a state of deep focus and is one that you have experienced in the past.  When engrossed in a good book, movie, or box-set on Netflix, you are in an altered state of consciousness where your imagination is extremely powerful.  A great book is the best example, where you are so involved with the characters and story, and can envisage the entire story as though it were a film playing out in your mind.

UNCONSCIOUS/SUBCONSCIOUS MIND?

Does the unconscious or subconscious mind exist?  Who knows.  What I do know is that there is a part of us always listening in an unconscious manner.

That part of you that hears your name mentioned across the room when you’re at a party.  That part of you that wakes when it hears a baby, or puppy, murmur.  

That part of you that continues searching for the name of ‘that song’ when your conscious mind has given up, then throws it into your conscious awareness hours later and you get that ‘ah yes’ moment.

It is this part that we communicate with in hypnosis.  The part of you that has the power to work away in the background making real changes.  I have seen the true power playing out in front of my eyes as I asked the subconscious mind to release any blockages within a client – this resulted in them convulsing as their body released the trapped energies causing negative feelings – these had existed for 30 years!

LOOK INTO MY EYES…. NOW

Hypnosis is not a state of the eyelids – as stated by some of my friends and colleagues who are amazing hypnotists.

I often use ritualistic rapid inductions during hypnosis as I enjoy them, and so do my clients.  There are occasions when some clients aren’t happy to close their eyes and therefore I use open-eye hypnosis.  This is still incredibly effective.  

CAN I BE HYPNOTISED?

Everyone can be hypnotised.  I have proven that to many in the past that have told me that they cannot be at all.  As a hypnotherapist, my job is not actually to hypnotise you.  It is to dehypnotise you.  Your problematic beliefs, issues, anxieties, etc, are all the result of an event or some faulty programming that’s occurred during your life.  Similarly with chronic pain – often there is no pain stimulus, just the pain experience.  With hypnosis we dehypnotise you from all of this faulty, no longer helpful programming, and you come out feeling absolutely amazing.

I say this with confidence as clients in the past have come in looking forlorn and left my clinic laughing.  Feeling lighter, feeling free.  

WHAT CAN HYPNOSIS HELP WITH?

Hypnosis in itself is just the tool used to allow the work to be done.  I use various methods whilst the client is in hypnosis to help you to make changes.  

I will give a brief example of issues that I have dealt with using hypnosis in the past couple of weeks:

  • Trauma
  • Fear
  • Anxiety
  • Health Anxiety
  • Imposter Syndrome
  • Eating Disorders
  • Pain
  • Lack of Motivation
  • Anger
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IBS – ALLOWING IT TO CONTROL YOU?

(Originally posted on 30/4/2017)

Today marks the end of IBS awareness month and in reality I have not seen anything online raising the awareness of IBS.

I help clients internationally, in Guernsey in my clinic, as well as across the world via Skype, to manage their IBS and regain ‘control’ of their life.  IBS can be a debilitating condition that results in people becoming fearful of what may happen should their guts flare up whilst out and about.

IBS impacts around 10-20% of the public, with a higher proportion of females being affected – or at least reporting being affected.  And age of onset is likely to be prior to the age of 50 – it is very unusual that someone experiences their first symptoms of IBS post-50.

out of order text on persons belly
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IBS Symptoms can result in a massive life-disruption, with IBS increasing the likelihood of absenteeism from work, missing out on social occasions, and concentration levels (source).

As IBS impacts the lifestyle of the individual significantly it is not uncommon for someone with IBS to experience depression and anxiety.

It is very important to ensure you do have a proper diagnosis prior to seeking support for IBS as whilst there is no specific test for IBS, the symptoms can be mistaken for conditions that need medical intervention.  When clients present to me for IBS I always ensure they have had other conditions ruled out by their GP and preferably a gastric surgeon.

What I find, with many of my clients, is that the IBS symptoms are intertwined with a bundle of other emotions, fears, concerns.  These physiologically exacerbate the IBS symptoms – it becomes a viscous cycle.  Many clients have reported that when they do take a leap of faith and have a holiday, their symptoms disappear!  This demonstrates the power of the mind-gut connection.  When the mind is calm, the body calms too.

The work I do with people with IBS is evolving.  Historically I have used the accepted protocols – the Manchester Protocol and the North Carolina Protocol for IBS.  Both of these have fantastic efficacy rates, and resulted in Hypnosis being deemed an effective treatment for treatment-resistant IBS by the National Institute for Health and Clinical Excellence.

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DOES HYPNOTHERAPY WORK?

(Originally posted on 13/5/2017)

If you speak to the majority of my clients that have experienced hypnosis within my sessions the answer would be a resounding

YES!”

Hypnotherapy works!

Even clients who have thought during the session that the hypnosis element was a total waste of time, have the following week(s) contacted me to state how many changes they keep noticing.  

The funny thing is, I am bound to say this.  I do back up these statements with the occasional testimonial/review from clients, and now I shall do similarly with a little science.  I’m a scientist and an evidence-based practitioner so it makes perfect sense for me to demonstrate that.

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THE BRITISH PSYCHOLOGICAL SOCIETY

Hypnosis is a valid subject for scientific study and research and a proven therapeutic medium.  

BPS (2001)

The use of the word ‘proven’ is an unusual one as many people debate the notion that anything can be proven – only that it can be demonstrated to be effective at that particular time, and place.

In a balanced review of the literature, the BPS explore hypnosis and discuss what it has shown to be effective in, and what it has not.

What they declare hypnotic interventions are effective for include:

  • Chronic pain
  • Acute pain
  • Stress
  • Anxiety
  • Tension
  • Insomnia
  • Headaches & Migraines
  • Irritable Bowel Syndrome and other Gastro-intestinal complaints
  • Asthma
  • Warts, and other skin complaints such as eczema, psoriasis, and urticaria.
  • Smoking Cessation

I have been successfully using hypnosis to help people with chronic pain, stress, anxiety, and IBS for the past two years and love seeing the relief in the clients’ faces when they experience relief for the first time in a long time.

The BPS also state that it’s likely that both children and adults can benefit from hypnotherapeutic interventions.  

This is a 2001 article from the BPS and hypnosis has come on leaps and bounds since then.  

THE AMERICAN PSYCHOLOGICAL ASSOCIATION

(article: ​http://www.apa.org/monitor/2011/01/hypnosis.aspx)

In this 2011 article the author talks about how stage and tv hypnotists have damaged the reputation of the professional hypnotherapist.  I do think to some extent this is true, and as a psychologist I do find myself defending the method to my clients, explaining what hypnosis is, and what it is not.  

The article discusses how hypnosis can be used to help cancer patients recover post-operatively by experiencing less pain, nausea, fatigue, and discomfort, requiring less analgesia (pain relief).  There was a net financial saving post-operatively compared to those who did not undergo the brief pre-operative hypnotic intervention.

Whilst the evidence for the treatment of pain, anxiety, etc is strong, the article discusses how the evidence for smoking is not quite so strong. I suspect this is due to the nature of the beast – smokers sometimes like smoking.  The smokers I accept into my clinic room prove to me that they are determined to succeed – that they really want to become non-smokers.  I do not see many for stop-smoking work yet when I do they are successful.  

HYPNOSIS CAN RESOLVE ISSUES FASTER

A study (originating from 1970) published in the American Health Magazine in 2006 found that people tend to deem hypnosis as a last resort for changing habits, resolving anxieties, stopping smoking, etc.  Yet the study demonstrated that people experience a 38% recovery after 600 sessions of psychoanalysis (the freudian approach to psychotherapy that often involves 2-3 sessions per week – an expensive luxury).  People tend to experience a 72% recovery following 22 sessions of behaviour therapy.  And people tend to experience a 93% recovery after just 6 sessions of hypnotherapy.  This is quite staggering.  

As a psychologist trained in various behavioural therapies, hypnotherapy, and solution-focused therapies, I tend to bespoke my approach to the client and as the hypnotherapy component can occasionally last just 10-15 minutes, I combine behavioural therapies into sessions and increase efficacy significantly.  Some extremely serious conditions have been resolved in just 2-3 sessions.  There are some people with whom issues take longer to resolve – yet it is not uncommon for 6 sessions to be the most someone would need.

​To back this up, the Washington Post reported on a German Meta-Analysis of 444 studies  concluding a 64% success rate for hypnotherapy with Anxiety, Stress, and Chronic Pain.  

CONCLUSION

Hypnotherapy is an effective therapeutic tool to help people recover from a wide array of issues, including chronic pain, IBS, anxiety, stress, and many other issues.  The key is to choose a good hypnotherapist or therapist – one that you know will help you on the recovery journey.

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CHILDREN & MOBILE DEVICES

(Originally posted on 24/7/2017)

SAFE? NOT SAFE?

In a recent article in the Journal of Child Development it was suggested that children’s use of a mobile phone during the nighttime can lead to increased risk of anxiety and depression (1).  

There are some obvious differences between the childhoods of the younger generations, and generations born in the 80s.  When I was younger there was no such thing as a mobile phone – you saw them occasionally in brief cases that housed the battery.  

children lying on sofa and using gadgets
Photo by Jessica Lewis on Pexels.com

Mobile gaming came out in the late 80s (2) and they were basic monochrome games.  Even games consoles were totally different with the NES (I used to love Duck Hunt), the Sinclair Spectrum, and the Mega Drive.  

The world of mobile gaming that the children of today experience and expect was not even really imaginable when I was a child.  The thought of having a mobile phone would never have crossed my mind.  I did actually get my first mobile phone when I was 16 – an Ericsson GA628 and I loved that phone.  Not sure it had SMS though as it was a feature not yet introduced.  

Anyway, it is quite difficult for modern parents to fully comprehend the lives of a modern child as the things that are now available were not even featuring in our childhood dreams.

If we ditch the mobile phones and other devices, then we risk throwing the baby out with the bathwater.  Research presented at the 2016 World Congress of Anaesthethesiorogists suggested that children that play on an iPad before surgery experience lower anxieties and thus experience a better anaesthetic induction (3).  This suggests that mobile devices do have some benefit for children.  Mobile devices are also increasingly used as tools to deliver psychological interventions and engage children in therapy.  There are many benefits to be had, yet they have a place within life – they are not the be-all of life.

One of the reasons why iPad use reduces anxieties before an operation is due to the child being distracted from a potentially scary event – being cut open!  Distraction from unpleasantness can be functional as a behaviour, yet if used too often can become dysfunctional.  In the same way that alcohol can be a functional way to reduce stress, yet persistent use can become dysfunctional – it can become an addiction without you even realising.  Children are not the only ones at risk of addiction to smart devices, adults are severely prone to it too.  I am sure we have all seen groups of people in a restaurant, heads down on their mobile phones all night, no interaction with the human friends and family around them.  An article in the Journal of Cyberpsychology, Behaviour, and Social Networking found that parents who themselves have addictive patterns with smartphones are less likely to perceive their children’s addictions as problematic and also less likely to be a good role model for their children (4).  The Journal of Child Development suggests that parental use of technology has a negative impact on child behaviour (5.).  Some seem to believe this new connected world keeps us connected with friends and family yet another recent study suggests that is not necessarily the case, with the compulsive use of mobile phones being related to lesser feelings of connection to friends and family (6).

It is important that technology is incorporated into life, yet doesn’t take over life completely.  Face-to-face social interactions, outdoor playtime, technology-free family time (such as board games), reading, physical exercise, and conversations all play a vital role to child and adult development.  Having a full and varied life increases the chances of intellectual development, and a fit and healthy child (7).  I would suggest, as I would with any adult suffering with anxiety and insomnia, that tech gets switched off 30-60 minutes before bedtime so you can settle down with a book – allowing the brain to start preparing for sleep.

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WORLD MENTAL HEALTH DAY

(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 Pexels.com

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)

THE REVELATION!

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?

SO, WHAT IS LEISURE SICKNESS?

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.  

HOW CAN I PREVENT THIS?

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.

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FAKE NEWS?: ANTIDEPRESSANTS EFFECTIVE FOR DEPRESSION – HYPERBOLIC CLICK-BAIT IN THE MEDIA.

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(post originally posted on 22/2/2018 and moved over to this new website)

I wake this morning to cries of horror from colleagues and friends over the news headlines:

I am very opposed to the use of such hyperbolic language within healthcare, and the media reporting on things they clearly have not understood.  

Do antidepressants work better than placebo?  Yes, and no.

The article published in the Lancet talks about Moderate to Severe Major Depressive Disorder and how antidepressants are more effective than placebo for the people with this diagnosis.  This information is not new nor revolutionary – it has been acknowledged for many years.

Lancet Article:  Link

My frustration is that the media has conflated Severe Major Depressive Disorder with the word Depression as a whole.  

It is estimated that 3 in 100 people in the UK will experience some form of depression, and around 7 in 100 will experience a mix of anxiety and depression (mind uk).

What it is difficult to do is strip out non-clinical depression, mild cases of Major Depressive Disorder, and the Moderate to Severe cases from the prevalence statistics to give a real picture of the issue at hand.

The evidence shows that antidepressants increase in efficacy as the severity of the condition increases, yet for milder cases of depression there is no real basis for giving antidepressants as they are not shown to work (links 123).

I really do wish the media would report accurately, although I guess if they stated the facts cleanly and clearly the headlines would be less sensationalist.  We live in a click-bait society where people want their adverts read and that is more important that reporting the facts.

Antidepressants do work better than a sugar pill (in some cases) with increasing levels of efficacy as the condition severity increases.  

Yet they are also missing out something.  

The result they are looking at is comparing pharmacological interventions against the imagination!    

There are other things that can help improve depression:

St John’s Wart – there is a fair amount of research that states that this can be effective (links: 123 4).  Some studies show it is useless, no different to placebo (as is something like cirtraline), and others show it can benefit people with mild to moderate clinical depression.  There are possible side effects so caution should be taken before any supplement is consumed.

Exercise – there is evidence that exercise is more beneficial than placebo, meditation, and relaxation therapies.  It may also help, where depression is due to an inflammatory response, reduce inflammation and thus act as a prevention and a treatment for depression (links: 123)

Talking Therapies & Hypnosis – hypnosis can be effective with the treatment of major depression although at present the quality of the research is quite poor.  Despite this, some research shows that hypnosis can have a fairly rapid impact on the client (1).  One flaw that appears to be present within the current IAPT system is the manualised approach.  When a psychologist uses talking therapies effectively, developing a bespoke approach for the individual sitting opposite them, the work can be effective, long-term, with no reliance on medications for life (1).  

My preferred option:

I would prefer a blend of approaches.  I am not averse to antidepressants as a short-term resolution to provide some stability and to support the individual to start making changes within their life, yet a long-term biopsychosocial plan would be optimal.  Using and building on your support networks to ensure you have friends and family around you that will provide support, laughter, and comfort.  To exercise, have a good diet, and look after your health to provide a good environment for your body.  A positive psychological outlook, dealing with the challenging thoughts in a sustainable way and changing the filter which you look at life through.  Our minds give us a lot of information each day, most of it is not necessarily true, fact, nor useful.  By doing what is important to us and finding some purpose we can plough forward and have something to give us a sense of satisfaction.