Category Archives: General

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.


Pattern Interrupts

In the business world, a pattern interrupt is anything that forces you to snap out of your automatic thinking. I believe in flashcards. They help us learn new material and remember what we have learned.

We also have adult flashcards. A picture of your dogs or children on your phone or home screen reminds you why you work. A piece of music or song reminds you of your loved one. A book on your shelf or by your bed reminds you that you have something you learned and valued. An award on your wall reminds you of your accomplishments. A shirt from a previous relationship reminds you what you don’t want to return to.

By having visual reminders in your environment, you can shake yourself out of a train of thought. Leaving positive reminders around your environment reminds your brain what you’re doing and encourages moving forward.

A Harvard University, department of psychology, study exposed a senior male group of participants to be away from routines at home and nursing facilities, to live for a week in an environment that was physically similar to where they had lived when they were younger. They discussed historical events as if they were current news, took care of their own ADLs and personal needs, and shared photos of their younger selves. A week later, they showed improvement in physical strength, manual dexterity, posture, perception, memory, cognition, taste sensitivity, hearing, and vision. They even showed improved scores on IQ testing. Visual cues within our environment serve as reminders of memories and functioning.

A pattern interrupt can change a person’s behavior patterns that are potentially detrimental to their health, mood, and potential. According to the author of the Harvard study, Dr. Ellen Langer, they may even slow down our aging process.  For additional resources see The Psychology of Nostalgia.

The Neuropsychology of Wine

Neuropsychologists already know that the brain’s memory hub, the hippocampus, is the first area to be compromised by neurodegenerative diseases such as Alzheimer’s and Parkinson’s.

Those who smell, serve, recommend, and taste wine for a living are apparently doing more than just expanding their palates. According to a study published in the journal Frontiers in Human Neuroscience, the brains of Master Sommeliers seem to be much more resistant to neurodegenerative diseases than those of the average person.

Scientists analyzed MRI scans of Master Sommeliers and compared them to those of non-wine-experts, to determine how the human brain responds when it gains a certain level of expertise. There are currently less than 250 Master Sommeliers worldwide, all of whom must pass a rigorous and in-depth exam to earn the title. The certification process can take several years and is the highest official professional distinction one can attain in the beverage service industry.

In 2016, a study on Master Sommeliers at the Cleveland Clinic for Brain Health located in Las Vegas found that the entorhinal cortex (the important area of the brain that includes the Hippocampus) was physically thicker in the wine professionals’ brains versus a control group. Results showed that sommeliers with long careers in hospitality exhibited enhanced and healthier brain tissue in the entorhinal cortex, suggesting that the specialized training of sommeliers might result in advantages in the brain, well into advanced adulthood. This is especially significant, given that the cortical regions involved are the first to be impacted by many neurodegenerative diseases. Additional research has also backed up the theory that sommeliers make excellent models to study brain health.

We know from previous research done in other fields that the brain benefits from active studying, and using the brain areas processing senses, especially smell, are responsible for memory, emotion, learning, and reward. Olfactory training, in particular, improves brain capacity which lingers in individuals, even those who have developed early stages of dementia. The research also demonstrates the importance of integrating sensory stimuli across modalities, and assigning pleasure (hedonic value) and emotional salience to stimuli. You will remember the scent of the perfume of your beloved.

Take away: experts who use ALL of their sensory knowledge for their work on a regular basis, integrating sensory stimuli across modalities, and assigning passion (hedonic value) and emotional salience (engagement) to stimuli seem to have a brain advantage.

For stats please see: Structural and Functional MRI Differences in Master Sommeliers: A Pilot Study on Expertise in the Brain in Frontiers in Human Neuroscience. 

The sun and mental health

We often hear about the risks of getting too much sun. While it’s true that sunburns and skin cancer are very real threats and that SPF is essential, there are also positive effects of sun exposure. The sun is much more than its potential pitfalls and can do plenty of good things for your body — soaking up some sunlight can do wonders for your mind, bones, and more.

When you give your skin access to a healthy dose of the sun’s rays, you are likely to experience some tangible benefits immediately. Here are five ways the sun can affect your mental and physical health.

1. Increased Vitamin D
Vitamin D has some important functions in the body. It promotes reduced inflammation and modulates cell growth. It’s also very hard to get enough from food sources alone. The sun is the best natural source of Vitamin D, and it only takes 5-15 minutes of sunlight a few times a week to notice a difference. Get outside and expose yourself to direct sun on your arms and face to soak up this necessary vitamin. Just remember to use sunscreen if you’ll be outside for more than 15 minutes.

2. Improved Mood
It turns out “sunny disposition” is more than just an expression: Researchers at BYU found more mental health distress in people during seasons with little sun exposure. On the contrary, days with plenty of sunshine were associated with better mental health — in fact, the availability of sunshine has more impact on mood than rainfall, temperature, or any other environmental factor.

Getting sun increases your serotonin and helps you stave off Seasonal Affective Disorder (SAD), and sun exposure can also help people with generalized anxiety and depression, especially in combination with other treatments, including therapy, and medical consultation, if needed.

3. More Sleep
That serotonin you soak up from the sun’s rays does more than boost your mood – it might also help you get more restful sleep at night. Working in tandem with serotonin is melatonin, a chemical in your brain that lulls you into slumber and one that sun also helps your body produce. Suffering from insomnia? Try to stick to traditionally light and dark cycles, getting sunlight during the day so you can catch some zzz’s at night.

4. Stronger Bones
Low Vitamin D has been linked to diseases like osteoporosis and rickets, and one of the most specific benefits of Vitamin D stronger bones and teeth. It will even make your nails better. How much Vitamin D do you need? For adults, a daily intake of 4,000 international units (or IUs) is recommended. While calcium intake is also crucial for bone health, getting enough sun helps your body absorb the calcium. The body does not store it.

5. Lower Blood Pressure
When sunlight hits your skin, your body releases something called nitric oxide into your blood. This compound brings down blood pressure and improves heart health. Maintaining healthy blood pressure can reduce your risks of cardiac disease and stroke. Feelings of relaxation may also naturally bring down blood pressure, so boosting your happiness by soaking up rays also aids in keeping your pressure down.

The sun can be your body’s best friend. It not only boosts your mood and can be an effective part of treatment for depression and SAD, but its rays have tangible benefits for our physical well-being. Stuck under cloudy conditions for a week or more? Consider a light therapy system, and talk to your doctor or therapist.

The primacy and recency effect

In neuropsychology experiments, research participants were asked to douse their hands in ice water for extended periods. Psychologist Dr. Daniel Kahneman called the experiment results the Peak-End rule – that our perceptions about an experience are determined by how it feels at its most intense, and how it feels at the end. The actual duration is irrelevant. It appears we don’t rationally calculate each moment of pleasure or pain using some kind of mental ledger. Instead, our memories filter how we feel about the things we’ve done and experienced, and our memories are defined more by the moments that seem most characteristic – the start, peaks, and the finish – than by how we actually felt most of the time during the experience. The theory has been applied to both positive and negative experiences, including relationships.

On Metacognition

Metacognition is thinking about your own thinking. It’s the ability to have an internal dialogue and analyze your own thought process. I have named it the personal landscape, in my work. Mediated by the frontal lobes, metacognition is a measure of executive functioning, perhaps the highest measure. People who demonstrate high metacognition talk about and analyze their own thought process. A simple example of meta behavior is: ‘I need to give myself a reminder or put this on my calendar, or I won’t hold myself accountable.’  People with high metacognition are often conscientious and successful entrepreneurs, students, and employees. They leverage self-awareness. They watch an internal movie of their personal cognition: thoughts, feelings, and observations, that’s on replay.

Another interesting example:
The tip-of-the-tongue phenomenon, which is the experience of attempting to retrieve from memory a specific name, memory, or word but not being able to do so. Usually, the name or word is eventually retrieved, but while one is trying, it seems to hover tantalizingly on the rim of consciousness. Metacognition is knowing what you know, and also knowing what you don’t know, simultaneously.

The Art of Naming: Self Testimony and Mental Health

With almost the whole world confronting changes and losses, large and small, how can people cope as they mourn their pre-pandemic lives and move forward? Language. Historically, storytelling, spoken word, and writing have been ways that humans cope with times of great grief and loss. Testimony is an account of first-hand experience, usually to create meaning and bear witness.

In my clinical work, which requires bearing witness to the stories of hundreds of people, two themes are prominent: The need to not forget and the need to process and create a sense of meaning. Sometimes, these needs can be very vague, a nameless dread or suffering. Talk therapy, journaling, and storytelling share a similar foundation; putting words to nameless feelings and memories. I call it naming.

As the work of psychologist James Pennebaker, PhD, at the University of Texas, has shown, writing about emotional upheavals can improve both physical and mental health (see Perspectives on Psychological Science, Vol. 13, No. 2, 2018). Keeping daily journals can help put words to losses and to help identify ways to move forward.

Other ways to name your experience besides journal writing:
The Debrief: Have a regular scheduled date with a trusted friend or two, virtual or IRL, to discuss your week and catch up.

Letter writing: People treasure receiving written words or cards from friends and family. Letters, on paper, are a memento of our history with the writer.

Audio diaries: Many people have access to an app where they can record their experience. Speaking aloud the words that are in your head help create meaning, clarity, and coherence.

Family meetings: In my work with families, I encourage both children and adults to set aside a time every week to speak about their experiences, air their opinions, and discuss any matters that have import in the household. Busy lives, school, work, and sports schedules often do not allow for sustained conversation for many people. Carve out a space.

(Also check out this great book: The Other Side of Sadness: what the new science of bereavement tells us about life after loss, 2019, written by the head of my doctoral committee, Dr. George Bonanno, Columbia University).

Mental Health and Pregnancy

Meghan Markle, The Duchess of Sussex, revealed that her mental health suffered significantly while she was pregnant with her son, Archie. Her internal and external environments were both highly stressful. Recently, I was interviewed for a podcast regarding mental health during pregnancy. There are several types of mental health conditions that can occur in pregnancy. The most common of these are anxiety and depression. In addition, pre-existing conditions, such as bipolar disorder, can re-emerge or become more prominent during pregnancy.

Postpartum depression is familiar to many people, but less known is the fact that women can become significantly depressed during pregnancy itself. Hormonal changes, stress, societal pressures regarding mothering, and anxiety about impending birth and parenthood can lead to a significant level of depression during the prenatal period. Up to 10% of women experience clinical levels of depression during pregnancy. Warning signs include feeling numb, feeling sad, loss of confidence, irritability, anger, sleep disturbance, eating problems, feeling isolated or that nobody understands you, difficulty coping and getting through the day, poor attention and concentration, lack of energy, and lack of interest in activities. It is important to get help because this depression may go on past the pregnancy.

The psychology behind journaling

”I am the subject I know best.” -Frida Kahlo
From a scientific standpoint, there is surprising evidence that supports cognitive, emotional, and even physical benefits from journaling. Psychologist and expressive writing expert, Dr. James Pennebaker conducted numerous studies that concluded journaling can actually strengthen immunity, decrease blood pressure, reduce stress,  diminish anxiety, lower depression, facilitate sleeping habits, and even accelerate the body’s ability to heal wounds. Also see my post on mindful writing.

There are even more benefits to the daily practice of journaling. Dr. Maud Purcell, psychotherapist and expert on journaling, concluded that writing accesses the left hemisphere of the brain, which is analytical and rational. While your left brain is occupied, your right brain is free to do what it does best, i.e. create, intuit and feel. In this way, writing removes mental blocks and allows us to use more of our inherent brainpower to better understand ourselves and the world around us. In short, journaling is intrinsically linked to the psychological process, allowing for greater insight and understanding of our self. Done on a daily basis, it clears the way for the day.

Embolden Psychology

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.

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