Category Archives: depression

12 Facts About Depression and South Asian Mental Health

South Asia is a broad region that includes close to 2 billion people. Encompassing India, Pakistan, Bangladesh, Nepal, Afghanistan, Sri Lanka, Bhutan, and the Maldives, South Asia is huge.

South Asia is a suicide-dense area but with only a handful of peer-reviewed studies assessing the relationship between depression and suicidal behavior.

South Asia represents approximately one-quarter (over 23%) of the global population. Depression affects close to 90 million people in South Asia. The World Health Organization (WHO) estimates that almost one-third of people suffering from clinical depression worldwide live in South Asia, making the region home to a large majority of the world’s depressed.

Suicide is a global public health issue (World Health Organization, 2021). WHO estimated that suicide isthe fourth-leading cause of death worldwide among 15–30- year-olds. It is the result of a complex interaction between several risk factors which may include biological, personal, social, psychological, cultural, and environmental factors, but psychiatric disorders are one of the most crucial risk factors (WHO, 2014; Arafat and Kabir, 2017). Depression numbers are probably underreported in South Asian communities because of years of stigma about mental disorders.

About 90% of people who die by suicide experience some form of psychiatric illness. Among psychiatric disorders, clinical depression is the most common risk factor for suicides.

Mental illness is taboo in many South Asian communities. Discussing mental health in South Asia has yet to be socially normalized. South Asian religious and cultural influences often do not consider mental health a medical issue, referring to it as shameful and even a “superstitious belief.”

A 2010 study by the mental health campaign Time to Change (www. time-to-change-UK.org) found that South Asians rarely discuss mental health because of the risk the subject poses to their reputation, family, and status.

South Asian languages do not have a word for depression. There is dukkha (universal suffering); pagal (derogatory word, crazy); and shikasta (broken). Many South Asians are unable to express the specific condition of depression in their language. As a result, they often downplay it as part of “life’s ups and downs.” This language limitation and difficulty describing symptoms also makes diagnoses and treatment difficult.

Depression is a major contributor to other global health problems. Medical experts have found a correlation between the symptoms of depression and the perpetuation of chronic illness, such as cardiovascular disease. Depression exacerbates other health conditions.

Postpartum depression in South Asian women is often undiagnosed and unrecognized. The gender of the baby, domestic violence, secrecy, and poverty are all factors that put new mothers at a higher risk for postpartum depression. The stigma surrounding mental health prevents new mothers from receiving mental health care or support during after pregnancy.

Bangladesh, Sri Lanka, and Indonesia are three countries who have recently emphasized mental health as a “top priority” in public health. In 2021, WHO lauded their work and the important step it takes towards normalizing and treating depression and mental illness, as illness.

Non-government organizations (NGOs) have had a positive impact on mental health care. In countries where the government is not willing or able to make mental health a priority, NGOs are providing crucial support to people suffering from mental health issues. NGOs in South Asia have expanded their community-based programs and are providing specialized mental health services. For example, in the Maldives, a number of NGOs are offering rehabilitation, life-skills training, educationsl information, and resilience-building to citizens. These efforts have begun to increase the access South Asians have to mental health care with decreased stigma.

Mental disorders are bad for work and family life. People with major depression struggle to take care of their family, complete self-care tasks, pay bills, and be productive in the work place. Although poverty rates in South Asia are declining, the region accounted for nearly half of the world’s “multidimensionally poor” in 2017. Providing mental health care to South Asians may be a major step in helping to eradicate poverty within the region.

According to the World Bank, strong mental health is a contributing factor to not only the wealth of nations but to increased quality of living and productivity for families and individuals.

Read more about this:  South Asian Mental Health

***Call 911 if you or someone you know is in immediate danger or go to the nearest emergency room.
988 Suicide & Crisis Lifeline
Call or text 988; Llame al 988 (para ayuda en español)
Use Lifeline Chat on the web.
The Lifeline provides 24-hour, confidential support to anyone in suicidal crisis or emotional distress. Call or text 988 to connect with a trained crisis counselor.
New: If you are worried about a friend’s social media updates, you can contact safety teams at the social media company. They will reach out to connect the person with the help they need.

5 Important Facts About Suicide

When I was completing my doctorate, the Clinical Director of my program committed suicide. For a bunch of psychologists committed to being healers, it was an incredibly painful experience. We yearn to lessen suffering.  It was the first large memorial service I ever attended where suicide was openly discussed. As a society, the stigma and secrecy around suicide have not been helpful.

5 Important Facts About Suicide

    1. Language matters. It is not appropriate to say that somebody committed suicide. Committed suicide is a phrase that comes from the days where it was actually considered a crime or sin. Died by or from suicide is more accurate. Some media corporations have started using more appropriate language around this topic.
    2. Talking about suicide is crucial. Asking about somebody’s suicidal thoughts will not make them suicidal. In fact the opposite is true; not giving somebody space to talk about it can be dangerous.
    3. Stop the taboo. Suicide falls within the top 10 causes of death in the United States, and in the top five within certain age ranges. We used to refer to cancer as the C word, now we have more research, treatment plans, and family support. Making suicide a taboo topic discourages individuals and their families from seeking help.
    4. Three phrases that are never helpful:
      At least their pain is over. They are in a better place. They seemed to have everything.
      Alternatively, people sometimes feel like they have nothing to say or offer, so they avoid the person and / or their family. If you want to help, be solidly present. That includes being available for 3:00 AM phone calls, helping with daily tasks, and being a loving presence. 
    5. Implying that suicide is selfish is completely inaccurate. Individuals who feel suicidal are in incredible pain

My colleague and officemate, Dr. David Jobes, one of the world’s most eminent researchers on suicidology runs the Suicide Prevention Lab, in Washington, DC. For information, see https://sites.google.com/site/cuajsplab/home

Call or text 988 to reach the 988 Lifeline.

How to get motivated when you’re not feeling it

Reasons for low motivation can include:

Avoidance of discomfort.
Sometimes a lack of motivation stems from a desire to avoid uncomfortable feelings. Discomfort could include feelings that a task is too hard, too big, too exhausting, or too complicated (task expectations that are not clearly laid out are one of the biggest motivation killers). Feelings of distress or task aversion are one of THE most common reasons for de-motivation.

Boredom.
Repetitive everyday tasks are often avoided. From doing dishes, laundry, to cleaning up after the kids, every single day feels like Groundhog Day. It feels never-ending. For students, the parallel is ‘busywork’, such as repetitive homework.

Self-doubt.
When you think you can’t do something—or just don’t know how to get it done. When you lack the tools, skills, or even the training to get it done, it can be very un-motivating.

Being over-extended.
When you are juggling a lot in life, you’ll likely feel overwhelmed. You may not even know what to tackle first and this feeling can zap your motivation.

Perfectionism.
Procrastination has a positive correlation with perfectionism. Often, perfectionists have difficulty starting or staying on task because the internalized goal of doing it perfectly feels so hard to meet.

Executive Functioning Weaknesses.
Executive function is mediated by the frontal lobe, the conductor of the brain or the Head Chef. What appears to be low motivation is sometimes a direct result of difficulties with planning, organizing, sustained effort, attention, processing speed,  prioritizing, and self monitoring. If you have a bunch of talented musicians who can’t work together in an orchestra, the result is a jarring cacophony of sound no matter the skill level. Learn more: What Is Executive Functioning?

Lack of commitment to a goal.
Agreeing to a task simply because you felt obligated, may mean your heart really isn’t in it. And you are less likely to take action when you aren’t committed to your goal.

Mental health issues.
A lack of motivation is a common symptom of depression. It can also be linked to other mental illnesses, like anxiety. So it’s important to consider whether your mental health may be affecting your motivation level. Read more on how mental health can sap your motivation.

Strategies for Motivation That Work
One Goal.
Probably the most common mistake that people make with regard to motivation: they try to take on too much, try to accomplish too many goals at once. You cannot maintain energy and focus (the two most important things in accomplishing a goal) if you are trying to do two or more goals at once. You have to choose one goal, for now, and focus on it completely.

Find inspiration.
Inspiration can come from all over: clients, mentors, friends, entrepreneurs, colleagues. Read blogs, books, magazines,  Watch movies and shows, talk to people. Write down ideas that you find inspiring. Having an inspiration journal is a boon when it feels like your mind is blank.

Ask for help.
Having trouble? Ask for help. Join an online forum. Talk to a colleague or friend you trust.  Find somebody who can coach you through the rough bits. Having an executive coach or emotion coach can get you back on your feet.

Reward Yourself.
Create small rewards for yourself that you can earn for your hard work. You might find focusing on the reward helps you stay motivated to reach your goals. For example, if you have a long paper to write for a class or a work assignment, you might tackle it in several different ways: Consider whether you are likely to be more motivated by smaller, more frequent rewards or a bigger reward for a complete job. You may want to experiment with a few different strategies until you discover an approach that works best for you.

Use the 10-Minute Rule.
When you dread doing something, like walking on the treadmill for three mile or lifting weights for 30 minutes, you may lack motivation to do it. You can reduce your feelings of dread by breaking it up into short components.  The 10-minute rule can help you get going. Give yourself permission to quit a task after 10 minutes. When you reach the 10-minute mark, ask yourself if you want to keep going or quit. Life, 10 minutes at a time.

Break it down.
I work with a lot of students, researchers, and writers. Having to write or produce a large amount of material is a daunting task for most people.  Learning how to break down a large project or paper into smaller steps, each with its own deadline, requires practice. One of the largest factors in motivation is feeling overwhelmed by the huge-ness of a task.

Ebb and Flow.
Motivation is not a constant thing that is always there for you. It comes and goes. But realize that while it may go away, it usually doesn’t do so permanently. Be patient with yourself on bad days.

Start small.
If you are having a hard time getting started, it may be because you’re thinking too big. If you want to exercise, for example, you may be thinking that you have to do these intense workouts 5 days a week. Do small, tiny, baby steps. Just do 5 minutes of exercise. Organize one cupboard or drawer.  Want to wake up early? Don’t think about waking at 5 a.m. Instead, think about waking 10 minutes earlier for a week. That’s all. Baby steps are powerful. Just think about it, a tiny human learning to walk. That’s a powerhouse.

Manage Your To-Do List.
First of all, it’s impossible to keep everything in your head. When some of my students or clients tell me it’s all up there, I just nod politely. No matter how great your memory, something will slip through the cracks. Having a list is not optional.

It’s tough to feel motivated when your to-do list is overwhelming. If you feel like there’s no hope in getting everything done, you might not try to do anything. Keep in mind that most people underestimate how long something will take them. And when they don’t get it done on time, they might view themselves as lazy or inefficient. This can backfire by causing them to lose motivation, which makes it even harder to get more things done.

Take a look at your to-do list, and determine if it’s too long. If so, get rid of tasks that aren’t essential. See if other tasks can be moved to a different day. Prioritize the most important things on the list, and move those to the top. I like keeping separate notebooks, for tasks that are essential and those that are long-term. You can further divide both categories into work deadlines, social commitments, family commitments, self-care,  and academic or educational endeavors. I actually like to use different color pens for each area. The important thing is to break your to do list down into components that are actually possible or else you will have the same long list day after day.

Mindfulness and Self-Care.
You’ll struggle with motivation as long as you aren’t caring for yourself. Sleep-deprivation, poor nutrition, stress/worry, and lack of leisure time are just a few things that can make trudging through the day more difficult than ever. Learn more about Mindfulness and Self-care.

The Pillars of Self-Care.

    • Exercise regularly.
    • Get plenty of sleep.
    • Drink water, and eat a healthy diet.
    • Make time for leisure and fun.
    • Use healthy coping skills to deal with stress.
    • Find meaningful social connection.
    • Avoid unhealthy habits, like binge eating and drinking too much alcohol.
    • Seek professional help as needed.

Get support.
It’s hard to accomplish something alone. A landmark study in 2016 (Journal of Experimental and Social Psychology) found that not feeling alone was an incredibly potent variable in motivation. Researchers gave out an impossible task, that is, it had no actual solution. The participants were split into two groups and given a complex puzzle to complete. People in one group were told they’d be working in teams, and were introduced to their teammates before being sent off to work on the puzzle alone. The other team was told they’d be working alone, and didn’t meet any teammates. While working on the puzzle, those in the team group were given handwritten notes supposedly from their teammates (they were actually from the researchers). These notes, and the process of meeting their teammates before starting the puzzle had an impact on their experience, despite the fact that they were working on the puzzle all alone, just as those in the non-team group were.

The participants who felt like they were part of a team, worked 50% longer on trying to solve the puzzle. They also reported finding the puzzle more fun and more interesting than participants who didn’t have teammates. The mere idea that one is working with a group and not alone can increase intrinsic motivation, that is, an inner drive to finish the work and increased internal satisfaction working persistently.  Read: How to Ask for Help Without Feeling Weird.

State Your Mantra.
Print out your goal in words. Make your goal just a few words long, like a mantra (“Exercise 15 mins. Daily”), and post it up on your wall or refrigerator. Post it at home and work. Put it on your computer desktop, bathroom mirror, and cell phone. You want to have real reminders about your goal, to keep your focus and keep your excitement going. Learn more about Mantras.

Pair a Dreaded Task With Something You Enjoy.
Our emotions play a major role in motivation level. If you’re sad, bored, lonely, scared, or anxious, your desire to tackle a tough challenge or complete a tedious task will suffer. Boost your mood by adding a little fun to something you’re not motivated to do. You’ll feel happier and you might even look forward to doing the task when it’s regularly paired with something fun.

Here are some examples:

  • Listen to music while you run.
  • Call a friend, and chat while you’re cleaning the house.
  • Light a scented candle while you’re working on your computer.
  • Rent a luxury vehicle when you travel for business.
  • Invite a friend to run errands with you.
  • Listen to audiobooks or interesting podcasts while commuting.
  • Turn on your favorite show while you’re folding laundry.

Give yourself a time out.
Giving yourself breaks throughout a large task can be very energizing. The average person can only sustain attention for30 to 45 minutes and often less. Get up, stretch, move, see below.

Include physical movement.
Although you might be getting ready to do something that’s not physical, like working at a desk, your schedule routine should include some movement. Exercise oxygenates your brain and can do wonders for your motivation and energy.

Get outside.
Walking or spending time in nature can be very beneficial. A 2013 study published in the British Journal of Sports Medicine found that walking half a mile through a park or working in a garden for thirty minutes reduces brain fatigue.

Write it down.
Numerous studies have shown that you are more likely to achieve your goals if you write them down. A guided day planner with a daily list of goals will give you the motivation to achieve your objectives step-by-step. When you know what steps to take to achieve your goals and you see them in writing, you’re more likely to get motivated to complete them.

Practice Self-Compassion.
You might think being hard on yourself is the key to getting motivated. But harsh self-criticism doesn’t work. Research shows that self-compassion is actually much more motivating, especially when you are struggling with adversity. For example, a 2011 study conducted by researchers at the University of California found that self-compassion increases the motivation to recover from failure. After failing a test, students spent more time studying when they spoke to themselves kindly. Additionally, they reported greater motivation to change their weaknesses when they practiced self-acceptance (a key component of self-compassion). Self-compassion may also improve mental health (which can increase motivation). Having a kind inner dialogue is a key component of avoiding discouragement, the motivation killer. Learn more about Self-Compassion

When You Are Always Tired

Sleepiness, fatigue, and depression interact and overlap a lot. We often use interchangeable terms to describe how tired we are. Far from exhaustive, there are some major differences.

Sleepiness
Sleepiness is an overwhelming desire to fall asleep. Sleepiness can look like:

  • struggling to keep eyes open
  • microbursts of sleep (the head bob)
  • low energy
  • heaviness in limbs
  • lapses in alertness
  • slower reaction time
  • difficulty making decisions
  • eyes tearing
  • ability to easily sleep when given the chance
  • feeling like you can fall asleep anywhere, on the sofa/ sitting on the toilet/at your desk 

Sleepiness can be caused by:

  • being awake for a long enough period of time
  • an underlying sleep disorder (narcolepsy, circadian rhythm disorders, etc)
  • lack of quality sleep
  • a medication side effect
  • drinking alcohol

Fatigue
Fatigue is a lack of both physical and emotional energy and motivation (tiredness, exhaustion, and low energy).

Fatigue can look like:

  • sluggishness
  • weakness
  • difficulty with concentration or memory
  • struggling to start or complete tasks
  • inability to complete regular chores
  • variable ability to fall asleep even when given the opportunity

Fatigue can be caused by:

  • physical and mental exertion
  • stress
  • depression
  • experiencing micro-aggressions
  • sleep disturbances
  • physical illness
  • medications
  • dehydration
  • poor nutrition
  • lack of physical activity
  • boredom

Fatigue is relieved by:

  • rest
  • activity reduction
  • mind-body activities (i.e. yoga, meditation, pranayama, mindfulness)
  • hydration
  • eating nutritious food
  • regular exercise

Fatigue after mental or physical exertion is normal. Ongoing fatigue for 6+ months with no known cause, that’s not improved with sleep or rest, and that worsens with physical or mental activity may indicate an underlying medical or mental health condition, such as chronic fatigue syndrome.

Depression
Depression involves persistent feelings of sadness, disappointment and hopelessness, along with other emotional, mental, and physical changes that interfere with daily activities.

Depression can look like:

  • a lack of interest and pleasure in most activities
  • restricted schedule; doing the bare minimum
  • easily irritable or frustrated (especially in children and teens)
  • feelings of worthlessness, excessive guilt, or hopelessness
  • constant low self-esteem
  • significant weight loss or gain
  • insomnia or excessive sleeping
  • lack of energy
  • inability to concentrate
  • physical problems like headache, stomachache, body aches and pains, or sexual dysfunction
  • recurrent thoughts (ideation) of death or suicide
  • diminished ADLs (not changing clothing, showering, or keeping up with daily chores)

Depression can be caused by:

  • a personal or family history of depression
  • major stressors or traumas
  • certain medications
  • specific illnesses

Depression is relieved by:

  • psychotherapy
  • medication
  • lifestyle management (regular exercise, quality sleep, a healthy diet, social support, avoiding alcohol)

We all experience sadness every now and then. When feelings of sadness continue for 2+ weeks and are felt nearly all day, nearly every day, they may indicate clinical depression. If you are experiencing symptoms of depression, it’s important to seek help from your doctor or mental health professional.

Also see my post on high functioning depression.

The Late Night Call

For many of us in psychology/mental health, when the phone rings or a text pings late night, there is an immediate frisson of worry and concern. It’s a cold shiver in your spine. Bad news is going down. I work with a lot of young people, teens through 30s, and I am readily accessible most of the time. No one abuses this. When people call you late at night, it’s usually not to say hello.

One of my mentors is a top authority in suicide research in the world. When I asked him, as a doctoral student, why he got into this painful area where he has done so much to help, he said we pursue what we fear. It might seem counterintuitive but there is no greater courage than facing the fears we have by helping others with theirs.

I started my own company several years ago after being Clinical Director elsewhere because I believe that mental health is for all. It is often excluded for many people because of financial constraints, stigma, lack of cultural competence, lack of hours to actually go see someone, and a potentially ‘authoritative’ relationship that is anathema to many.

I will tell you this.
NO doctor or therapist can do anything without their team. The team is: found or biological family or parents, other medical providers, friends and social supports of the person that you are working for and with, chosen spiritual beliefs, community, teachers (as burdened as they are are, they are very often the person that young people turn to), genuine Internet connections, ancestry/culture, companion animals, and fostering self-compassion relentlessly.

We are always so shocked and horrified to hear about someone taking their life. But when most ask people how they’re doing, they expect to hear ‘fine’.

We need to facilitate conversation where somebody can say they feel absolutely lousy. It’s been a terrible day. Right now, people at your job, your neighborhood, your home, feel absolutely lousy.  They don’t know what to do. We need dialogue about mental health so it becomes a natural thing.

It takes a village, the most trite and true statement.

The Power of Texting

Beautiful artwork, P. Cochrane

Sending a supportive text has been shown to be of significant benefit for someone struggling to cope.
What to say to a loved one:

8 Texts For Mental Health Support

  • The specific offer of help text
    Hey, I’m going to the store shortly, what are some things I can pick up for you? I’m taking the dog to the park later, can I come by and pick up yours to take with us?
  • The you are not alone text
    Why don’t we go for a walk this afternoon? Would you like to watch a movie together tonight from our own homes? Let’s FaceTime later today.
  • The checking-in text
    Just wanted to check on you, no rush to reply. I’m here.
  • The gratitude text
    I really appreciate you and having you in my life.
  • The thoughtful gift text
    I wanted to let you know I swung by and left some beer/wine/coffee and snacks at your front door.
  • The timing and dosage text
    I’m here to talk when you feel like it and as little or as much as you want to say. Or, I can come by and we can both sit quietly together.
  • The photo text
    Here’s a picture of this beautiful beach… It’s so soothing to imagine being there with you.
  • The solidarity text
    You are not alone.  I can come with you to…

When you have anxiety AND depression

Sculpture: Warriors’ Circle, National Museum of the American Indian, Washington, DC, 2019

Anxiety and depression have a complicated relationship. The chances of acquiring depression is much higher when an anxiety disorder already exists. Nearly half of those with major depression also suffer from severe anxiety. A biological vulnerability for both of these conditions is often present. Depression and anxiety are caused by a combination of genetic, biological, environmental, and psychological factors.

Symptoms that might indicate that both anxiety and depression are present:

  • Persistent worries or fears that won’t go away.
  • Physical symptoms including fatigue, headaches, gastrointestinal distress, and muscle aches and pains.
  • Difficulty relaxing.
  • Trouble going to sleep or staying asleep.
  • Intermittent eating habits- might be too much or too little.
  • Loss of interest in activities or previous pastimes.
  • Feeling overwhelmed or having a sense of losing control over things.
  • Trouble concentrating, making decisions, or remembering things.
  • Feeling irritable and cranky including about seemingly little things.
  • Constant feelings of sadness or worthlessness.

Having both anxiety and depression can mean

  • Fearing failure, but no motivation to be productive.
  • Wanting to be left alone, but not wanting to feel lonely or abandoned.
  • Avoiding social situations, but desiring close connections.
  • Being afraid and exhausted at the same time.
  • Feeling restless, but immobilized.
  • Feeling everything acutely, but feeling numb.

See also my post on how to talk to loved ones about depression and anxiety.

Depression Is:

Depression Is:
Emotional: Your baseline enjoyment of life decreases. In other words, you start constantly feeling a sense of suffering, or emotional pain, for no clear reason. Your are more negatively impacted by set-backs, and find it harder to enjoy the things that bring you pleasure and joy.

Physical : You have less energy. Just about anything feels like a tiresome undertaking, and you often feel like just lying down and doing nothing. It may seem impossible to do the smallest of tasks. Getting out of bed, taking a shower, brushing your teeth, cleaning up, or checking your email can feel like Herculean tasks.

Mental: Your thinking becomes distorted and negative. Your self esteem decreases, so that you feel worthless. Thinking and concentraing becomes harder, as if trying to see something through a fog. It’s hard to imagine things becoming better, or to form a positive idea of the future in general. You have a variety of intrusive negative thoughts; these thoughts can happen regardless of however much you believe or agree with their content.

Additional resources:

What Not to Say to Someone with Depression.

National Emergency Helpline

 

Anxiety is Bone Tiring Exhaustion

Anxiety and exhaustion go hand-in-hand.

Anxiety is a feeling of fear, dread, or apprehension. It can be brought on by a stressful event or by the way you think about an event. Sometimes people feel anxious even when there doesn’t seem to be an external trigger at all.

When you perceive a threat, your hypothalamus, pituitary, and adrenal glands release a torrent of hormones to prepare you to fight, flee, or freeze. In response, you might feel any or all of these physical symptoms:

  • shaking
  • quickened heart rate
  • fast, shallow breathing
  • dry mouth
  • muscle tension
  • dizziness
  • nausea
  • diarrhea

Reasons for Anxiety Fatigue

  • Post-Anxiety Crash
    One reason has to do with the crash you feel after your adrenaline runs out. The name for this phenomenon is adrenal fatigue. Anxiety is like being on high alert. Your body is preparing you to fight or flee; and so it is flooded with energy so that you can respond to a threat. Then, when that adrenaline runs its course, your body goes through a crash that can leave you feeling drained.
  • Muscle Tension
    Anxiety causes profound muscle tension throughout the day, and this often results in a similar drained feeling: your body feels tired. Many people who are anxious clench their jaw in their sleep, waking with headaches and facial pain.
  • Mental Tiredness
    Some of that tiredness is mental simply because your brain can run out of strength. Anxiety is linked to ongoing, stressful thoughts and an overactive brain. It taxes your cognitive capacities, leading to a drain on your ability to think and react. It also increases your emotional load, which means you can end up emotionally and mentally drained.
  • Coping
    Becoming tired is sometimes a coping mechanism that your body uses to prevent you from experiencing severe stress. Tiredness motivates you to take a break and rest rather than exposing yourself to more anxiety, which could become even more overwhelming. Fatigue is an attempt by the body to reset itself.
  • Naps
    Napping can help you overcome fatigue and reduce anxiety, making it a useful habit in many ways. But too much napping makes it harder to sleep at night, which in turn may increase your anxiety. Naps should ideally last less than 20-30 minutes to avoid sleep difficulties at night.
  • Sleep Issues
    Many people with stress and anxiety also develop serious problems sleeping, for instance, difficulty falling asleep, nocturnal waking, and reduced quality of sleep. All of this contributes to an overall lack of sleep, which causes tiredness.
  • Depression
    Finally, anxiety can cause depression. Depression is linked to a huge loss of energy; and that makes it extremely hard to stay alert throughout the day.
  • See also: Seven Subtle Signs of an Anxiety Disorder.

How to Manage Anxiety Fatigue

  • Sleep
    Protect your sleep fiercely: a cool, quiet, dark sleeping space, a regular bedtime, limited naps, and relaxation techniques are key, along with curbing your caffeine and powering down your screens an hour before bed. Even if you don’t get the ‘ideal’ amount of sleep each night, keep it consistent. Go to bed and wake up around the same time each day.
  • Get regular exercise
    Exercise reduces anxiety sensitivity and promotes healthy and restorative sleep.
  • Meditate
    Relaxation techniques like meditation and mindfulness can help quiet your mind, regulate your breathing, and lower the amount of stress hormones in your bloodstream.
  • Pacing
    Balance and allocate energy to the highest priority tasks can help cope with limited energy. Learning to pace ourselves and to manage our energy can be frustrating; it’s difficult when we don’t have the energy to do the things that we want or need to do. But it is an essential part of managing anxiety without burning out.
  • Nutrition
    Whole, unprocessed foods, such as lean proteins, fruits and veggies, legumes, nuts, seeds, and complex carbs, can give you sustained energy. Foods high in saturated fat and sugar are associated with higher anxiety levels.
  • Therapy
    A psychologist or counselor may be able to help you identify your anxiety triggers and develop coping skills that lead to less anxiety and greater relaxation.
  • Medication
    Talk to your healthcare provider or mental health counselor about whether symptoms may benefit from treatment with anti-anxiety medication.

Depression in the Workplace

Last year, I had the opportunity to teach a seminar to the upper level management of a large East Coast restaurant company, on mental health in the workplace. More and more, it has become imperative for employers to address mental health problems in the workplace. One in five adults experience depression during their lifetime. And yet, a distinct stigma still exists around the topic, especially in the workplace. Employees may be hesitant to speak up about mental health issues for fear of being unfairly judged, or worries that it may lead to a reduction in job status, loss of future opportunities or even termination.

The World Health Organization lists depression as the leading cause of disability worldwide. Calling in sick to work because of depression is a common occurrence. In fact there’s been an uptick in depression in the workplace since the pandemic. Many people are struggling to meet their deadlines, not logging on, skipping meetings, struggling with technology glitches, and the added stress of distractions and responsibilities in the household.

But beyond the negative personal impacts that stress, anxiety, or depression can cause, it can actually take a toll on the business itself. Depressed, anxious, stressed, sleep-deprived, or substance using workers can be unproductive, forgetful, and accident-prone. If it’s a service organization, they may not be able to work effectively with customers or they may call out more, which can interfere with scheduling and productivity.

Signs of Workplace Depression
Depression in the workplace can be invisible and go undetected. However, there are noticeable signs that could initiate a conversation. Perhaps you’ve noticed a colleague who’s been keeping to themselves lately, or an employee who’s been coming late to meetings or missing them entirely. Other signs include becoming easily frustrated, irritable, or overwhelmed.

Tips for Supervisors:
*Be a listener and sounding board.
Managers/supervisors should create opportunities for confidential, nonjudgmental conversations, like weekly or biweekly one-on-ones, where they can openly ask the individual what’s going on and how they can help, while assuring them it’s a safe place to chat. While some people may not open up to their supervisors for fear of judgement and job security, kindness from a manager could shift the trajectory of someone’s day.

*Maintain an open-ended conversation
Employees should feel supported by their colleagues and bosses, especially during personal hardships. These should be ongoing conversations. Offering a book, or sharing an article or mental health website are also indirect helpful ways to maintain a conversation.

*Provide effective mental health resources at work
Now’s the time to review what mental health resources are available at your company, regardless of whether you’re employed at a large corporation or a small local business.

Every organization needs to look at itself. Are there regular educational seminars or information being made available online or in pamphlets, guest speaker events or trainings, or other ways employees can get information on physical and mental health issues? This can include employee assistance programs, maintaining a list of mental health resources, and establishing connections with community services, such as mental health workers and clinics.

Sometimes one company can help shift an entire culture. If you see that your company or organization is lacking in support of those dealing with mental health issues, be the person to help change the stigma and impact your work’s environment.

The powerful first step: “Are you OK?”

Tips for Employees:
If you’re too depressed to work:
First and foremost: If you’re having trouble working during a depressive episode, don’t beat yourself up over it. This is not something you can “snap out” of with willpower. Many people become depressed or anxious about being depressed or anxious.

  • Take short breaks with a meditation app when you need them.
  • Get outside for a walk in the fresh air.
  • Go to the gym on your lunch breaks.
  • Pack or prep a nutrition-filled lunch.
  • Maintain good sleep hygiene. It will help you stay rested, regulate mood and your mental state.
  • Check in regularly with a trusted friend or colleague. I call this an emotion buddy or coach.

What to do if you can’t work
*Disability benefits are an option.
Some states offer this on a temporary basis. On a federal level, the Social Security and Supplemental Security Income disability programs will provide your retirement benefits early (including Medicare). Many companies also offer short term and long term disability possibilities. Depression and anxiety disorders are an illness, not a weakness.

*Remember that you’re not alone.
Dark thoughts can be especially heavy during this time, so reach out to family and friends for support. The Suicide Prevention Lifeline has a website and can be reached 24/7 at 800-273-8255, should you need it. Seeking professional counseling can also make a world of difference.

*If you don’t feel like your work is meaningful and/or the environment is dreadful, you’re not in a good place. It may be time to move jobs. Again, it’s important to note that depression is the leading cause of disability worldwide.

*For those returning to work, you could talk to your supervisors about working from home options to avoid some triggers.

*You can obtain a note from your treating psychologist or physician documenting your treatment. Under ADA law, companies cannot harass or terminate people for absences due to medical treatment.

For additional resources see, Wellness in the Restaurant and Bar Industry.

 

Embolden Psychology
Embolden

Embolden offers the ADOS-2, the gold standard assessment for kids on the spectrum.

Combined with psychoeducational testing, it helps provide comprehensive information and recommendations to help children and teens six and up.

Thank you for contacting us.