Report on Dr Rob Waller’s talk – Fostering Health in the Workplace:
Helping colleagues with depression – 5 December 2007
For the very first time, business matters held a lunchtime talk outside the city centre. We are indebted to the Scottish Health Service Centre on the site of the Western General for inviting us and for treating us and all our guests so well. Never have we had soup at a business matters lunchtime talk! And this soup was particularly delicious. So if you ever want a conference facility outside but near the centre, do contact Vivian Maeda on 0131 275 7754.
We welcomed Dr Rob Waller to Scotland. He is a Consultant Psychiatrist at St John’s Hospital, Livingston. He has a particular interest in how communities and voluntary organisations can help with depression and stress. One way he himself helps is by salting his undoubted expertise with an attractive sense of humour – this was one of the more enjoyable talks any of us will ever hear on depression! Something else about him: he is a good role model for those of us who struggle to achieve work-life balance, e.g. fitting in cycling. In his welcome to Dr Waller, Iain Archibald also alluded to an outstanding sporting achievement in Dr Waller’s student days, but we will not embarrass him by giving you the details here…
Dr Waller started out by mentioning a voluntary sector website he has helped set up: www.mindandsoul.info In this short lunchtime opportunity, he had to spare us a plethora of statistics, saying simply that 1 in 4 people may suffer from depression across their lifetime and that some studies indicate that 1 in 10 people may have a degree of clinical depression at any one time. This obviously impacts the workplace – employees and employers. Employees still feel wary about mentioning depression anywhere in their CVs. Employers can run up huge bills if they do not care for employees suffering from depression.
Coming then to the topic of stress, Dr Waller pointed out that a degree of stress is not only good but desirable. Giving a lunchtime talk is stressful, but the stress involved helps the speaker to do what is hopefully a good job (Dr Waller’s certainly was.)
But stress can become over-stress and over-stress can lead to certain warning signs of depression setting in, e.g. consecutive nights of sleeplessness. People can then run on empty, get “burnout” and this can end in a breakdown. Surprisingly, Dr Waller said that such an event can be useful in a person’s life, i.e. it is an opportunity in fact to change direction / life-style / ways of thinking and feeling and then to head, not back to the old familiar road, but to a new one taking you into the future. This comment struck a positive note of hope for the guests present. Most of us had not thought of depression as having a positive side.
Depression can come about in a work context through inordinately adverse working conditions – likened to the Hebrews of old having to make bricks without straw. Today it can be: “Deliver more in less time” or “Deliver more with less resource”. Depression in the work context can be aggravated by misinformation, e.g. the stiff-upper lip approach which says: “This ongoing feeling low is just unhappiness; it will pass.” It can be further aggravated by mishandling: e.g. the manager who may say: “It’s not my job to hear out and deal with people suffering from depression. I just expect them to get on with their work somehow.”
How do you tell depression from unhappiness? Well, ask yourself this: how is the person overall as compared with say a year ago? Being simply grumpy is not to be equated with unhappiness, far less depression, for a person may just have a grumpy personality. But if there has been what one may call a “global” change in a person, this may be a sign of depression. So: loss of appetite over a long period, absence of a sex drive, indifference to what has until now been an absorbing hobby; or just not coping with everyday issues and pressures – any of these can be a give-away.
How can you raise this with a colleague as their manager? You may wish to protest that you can do no such thing, that you just do not have the resources to help. In one sense this may be true, but then again you do have access to your HR department, also a service like business matters, the great NHS of course, and in some bigger companies and offices to Occupational Health. You yourself can talk things over with any number of people / services and be of at least some help to your colleague.
So, how do you personally help as a manager? Here Dr Waller suggested something new for many of us: do not so much say “you” to the depressed person, rather say “I”, as in:
“I’ve noticed that…”
“I don’t understand…”
“I am available…”
“I need to talk to someone about this…”
“I need some help in supporting you…”
Whatever you do, do not come out with platitudes like, “Try not to think about it.”
Rather: have an open door policy. Let it be known you really are approachable and willing to listen. Do not be scared of people expressing difficult, bleak emotions.
How do you tell the difference between mild depression (common and not debilitating) and severe depression (more unusual and incapacitating)? A good place to start is the Beck Depression Inventory on Wikipedia. There is a guide scoring system there for minimal, mild, moderate and severe depression.
What one resource can you recommend to a person struggling with depression? Dr Waller cited an outstanding home-grown self-help resource here in Scotland which has been acclaimed well beyond our border: www.livinglifetothefull.com
This excellent site has been set up by a Dr Chris Williams of the University of Glasgow, author too of a good book: “I’m not supposed to feel like this”. On the site you will find a 10-module self-help course, also access to a buddy if the suffering person may benefit from such. (In this regard, Iain mentioned that a friend of business matters in the city centre of Edinburgh has offered to meet up with anyone struggling with depression at work, e.g. perhaps finding their way back in to the workforce. This friend himself has had depression, knows what it is like and can offer encouragement and speak out of hard-won experience.)
One way of understanding depression is to see life as a balancing act. Imagine a see-saw. At one end you have the resources to meet the various demands made on you at any given time. At the other end are the demands being made on you at this particular time. Is the resources side of the see-saw “heavier”? – i.e. are your resources greater than the demands being made on you right now? If so, great! But if the demands side becomes heavier than the resources one, demands can be said to outstrip resources and there are consequences to this… You certainly need to take action / have someone help you take action. Either you increase the resources or you decrease the demands. Somehow you must get back to a situation where resources are more than a match to meet demands. Resources, and indeed demands too, are of two types: internal to yourself (e.g. stamina, resilience, etc.), and external to you (e.g. a supportive partner, understanding boss, etc.)
As a boss you really can make a big difference for e.g. someone suffering from even mild depression. “Take a couple of days off to recover from that unusually hassled end of year pulling out of all the stops”, may be just what the employee needs to hear from you in order to tilt the see-saw back into a state where demands do not outweigh resources.
Said another way: get the priorities right. First, decrease the demands or even allow them to be eliminated pro tem. Then, when resources are back and outweighing demands, that is the time to look at further paths to health and wholeness. – e.g. diet, meditation, etc.
The trick is to catch / help catch depression early, in other words “to get the wheels back on” and then move towards healthy stress levels as one may call them.
The Q & A time included:
What drew Dr Waller into Psychiatry?
He wanted to offer hurting people more than e.g. antidepressants, and in some cases at least to help them get to the bottom of their ill-health and back to overall good health. Going for the quick-fix by only alleviating the surface / presenting problem was not satisfying.
What further comments could Dr Waller offer about employee support?
First, when an employee may be depressed, an employer or a boss has the opportunity of examining the person’s workload, perhaps realising they are being asked to do too much. Offering counselling can be missing the point. The employer may need to reallocate responsibilities. Second, the employer may need to encourage the employee to see their GP.
Surely depression is always a bad thing?
No. It can be “the best thing to happen to a person.” There is in it the potential to visit / revisit an aspect of their life or life-style that is overdue for attention. Inherent in suffering from depression is opportunity, opportunity to reassess, develop, move on, mature even.
One person commented that their perception was that the NHS seemed to prescribe pills, pills, pills, but that this lunchtime talk made them realise that, happily, some within the service are clearly looking at the whole person, their wholeness, and want to help them get to the roots of their problems. Yes, said Dr Waller, psychiatrists are typically very interested in helping people face issues and then rediscover / develop e.g. healthy work-life balance, supportive friendship circles and community, also life-giving hobbies etc. as a counterpoint to e.g. overwork.
One person later asked him: inherent often in depression is a very real chemical imbalance of one sort or another; can depression come about purely from a chemical imbalance developing, i.e. with no trauma or stress provoking it?
This, said Dr Waller, brings up the age-old debate in psychiatry: is depression biologically or psychologically caused? Of course, the answer is it can be either and it can, and often is, both. In other words, there is a complex interplay of factors, from genetic disposition, to the impact of major traumas on a person’s life. The work of the psychiatrist is to help discover what the trigger or triggers may have been and to equip the sufferer to understand, face and deal with these as part of the route back to health and wholeness – that being not so much a state that the person has once enjoyed in the past but a new state of equilibrium and meaningful life to be entered into in a new future.
Those of us who were able to make it to this new venue were glad to have been present.
Finally, if you would like to view Rob’s PowerPoint presentation, please use the icon below.
Iain Archibald
Consultant to business matters
