Transcript w-36 mental illness - CHILD SUPPORT DIRECTORS ASSOCIATION

Mind, Body, Work: The Connection
Between Mental Illness, Stress and
Performance in the Workplace
Presenter:
Roberta Sue Buckner, J.D., M.F.C.T., Los
Angeles County Child Support Services
Department,
[email protected]
CSDA Annual Conference October 2009
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Business and Professions Code
Section 6230
“It is the intent of the Legislature that the State
Bar of California seek ways and means to
identify and rehabilitate attorneys with
impairment due to abuse of drugs or alcohol, or
due to mental illness, affecting competency so
that the attorneys so afflicted may be treated
and returned to the practice of law in a manner
that will not endanger the public health and
safety.”
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Mental Illness
Mental disorders, including disorders of thought,
mood or behavior.
Condition must result in reduced ability to function
socially, psychologically, occupationally or
interpersonally.
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Common Causes of Mental Illness
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Biological factors
Psychological factors
Environmental factors
Medications and substances
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Some Categories of Mental
Illness or Impairment
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Depression
Generalized Anxiety Disorder (GAD)
Specific Anxiety: Phobias
Panic Disorder
Bipolar Disorder
Obsessive-Compulsive Disorder (OCD)
Eating Disorders
Borderline Personality Disorder
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How Does Mental Illness Interfere
with Professional Competency?
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Screening out environmental stimuli
Sustaining concentration
Maintaining stamina
Handling time pressures and multiple
tasks
• Interacting with others
• Responding to negative feedback
• Responding to change
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Mental Illness Affects Work
Productivity: Changes in
Performance & On-the-Job Behaviors
• Decreased or inconsistent productivity
• Absenteeism, tardiness, frequent absence
from work station
• Increased errors, diminished work quality
• Procrastination, missed deadlines
• Withdrawal from co-workers
• Overly sensitive and/or emotional reactions
• Decreased interest in work
• Slowed thoughts
• Difficulty learning and remembering
• Slow movement and actions
• Frequent comments about being tired all the time
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Depression Screening Test
I am really sad most of the time.
I don’t sleep well at night and am very restless.
I don’t enjoy doing the things I’ve always enjoyed doing.
I am always tired. I find it hard to get out of bed.
I feel like eating all of the time.
I don’t feel like eating much.
I have lots of aches and pains that don’t go away.
I have little to no sexual energy.
I find it hard to focus and am very forgetful.
I am mad at everybody and everything.
I feel upset and fearful, but can’t figure out why.
I don’t feel like talking to people.
I feel like there isn’t much point to living, nothing good is
going to happen to me.
 I don’t like myself very much. I feel bad most of the time
 I think about death a lot. I even think about how I might
kill myself.
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Recognizing the Psychological
Symptoms of Depression
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Feelings of worthlessness
Excessive or inappropriate feelings of guilt
Thoughts of death or suicide
Loss of interest in or enjoyment of your
favorite activities
Trouble making decisions
Sadness throughout the day, nearly every day
Fatigue or lack of energy
Sleeping too much or too little
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Recognizing the Physical
Symptoms of Depression
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Headaches
Back Pain
Muscle aches and joint pain
Chest pain
Digestive problems
Exhaustion and fatigue
Sleeping problems
Change in appetite or weight
Dizziness or lightheadedness
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Depression and Professional
Competency
Some people will experience depression once in
awhile and will still be able to do their jobs.
For some people, depression can affect various
aspects of their lives and have a serious impact
on professional competency.
Work problems related to depression may include
tardiness or absenteeism because of chronic
health conditions, drug or alcohol dependency
or anxiety disorder.
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Depression Affects Professional
Competency in Many Ways
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Emotions
Thinking
Task Performance
Work/Professional Relationships
Physical Health
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Depression in the Workplace:
Strategies
• Pursue jobs that offer opportunity to
develop skills
• Clarify performance expectations
• Seek assistance to meet expectations
• Educate yourself about new
technologies
• Learn new skills
• Take advantage of resources
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Depression and Anxiety
• Depression and Anxiety seem like opposites
– Depression: saps you of energy; nearly
impossible to get out of bed
– Anxiety: makes you keyed up and afraid; leaves
you sleepless, pacing all night
• Depression and Anxiety often go together
– More severe symptoms, impairment, difficult to
diagnose and manage
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Generalized Anxiety
Disorder (GAD)
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Restlessness
Feeling of being keyed up or on edge
Feeling a lump in your throat/shortness of breath
Difficulty concentrating
Fatigue
Irritability
Impatience
Being easily distracted
Muscle tension
Trouble falling or staying asleep
Excessive sweating
Headache
Gastrointestinal discomfort or diarrhea
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Anxiety Disorders:
Some Common Phobias
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Agoraphobia
Claustrophobia
Acrophobia
Mysophobia
Xenophobia
Necrophobia
Brontophobia
Carcinophobia
Aviophobia
Arachnophobia
Zoophobia
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Panic Disorder and Panic
Attacks
Signs & symptoms:
- Rapid heart rate
- Sweating
- Trembling
- Shortness of breath
- Chills
- Hot flashes
- Nausea
- Abdominal cramping
- Sense of impending
death
- Chest pain
- Headache
- Dizziness
- Faintness
- Tightness in your throat
- Trouble swallowing
- Lightheadedness
- Tunnel vision
- Feeling like having a
heart attack
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Panic Disorder:
Control of Symptoms
Methods and Techniques:
• Diaphragmatic breathing or abdominal
Breathing
• Staying in the present
• Acceptance and acknowledgement
• Floating with the symptoms
• Coping statements
• Talking with a supportive person
• Taking anti-anxiety medication
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Bipolar Disorder
• Manic phase of Bipolar Disorder
- Euphoria
- Extreme optimism
- Inflated self-esteem
- Racing thoughts
- Agitation
- Risky behavior
- Poor concentration
- Drug abuse
- Tendency to be easily
distracted
- Spending sprees
- Poor judgment
- Rapid speech
- Aggressive behavior
- Increased physical
activity
- Decreased need for sleep
- Decreased sexual drive
- Increased drive to perform
or achieve goals
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Bipolar Disorder
• Depressive phase of Bipolar Disorder
- Sadness
- Guilt
- Irritability
- Sleep problems
- Appetite problems
- Loss of interest in
daily activities
- Anxiety
- Problems concentrating
- Hopelessness
- Fatigue
- Suicidal thoughts or
behavior
- Chronic pain without a
known cause
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Obsessive-Compulsive
Disorder
Obsessions (common themes)
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Fear of contamination or dirt
Having things orderly and symmetrical
Aggressive or horrific impulses
Sexual images or thoughts
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Obsessive-Compulsive
Disorder
Compulsions (common themes)
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Washing and cleaning
Counting
Checking
Demanding reassurances
Performing the same action repeatedly
Orderliness
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Eating Disorders
• Anorexia Nervosa
Relentless pursuit of thinness
Distorted body image
• Bulimia Nervosa
Binge eating and purging
Feeling a lack of control over eating
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Borderline Personality
Disorder
Signs & symptoms:
- Impulsive & risky behavior, such as risky driving,
unsafe sex, gambling sprees or taking illicit drugs
- Strong emotions that wax and wane frequently
(wide mood swings)
- Intense but short episodes of anxiety or depression
- Inappropriate anger, sometimes escalating into
physical confrontations
- Difficulty controlling emotions or impulses
- Pattern of unstable relationships
- Fear of being alone (intense fears of abandonment)
- Suicidal behavior or self-injury
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What is Stress?
Early warning signs….
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Sleep disturbances
Difficulty in concentrating
Short temper
Upset stomach
Job dissatisfaction
Low morale
Headache
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Signs of Job Stress
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Work performance
Withdrawal
Regression
Aggressive behavior
Physical signs
Other behaviors
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Causes of Stress
• Individual characteristics
• Working conditions
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Work Conditions
That Affect Job Stress
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Job Insecurity
High Demand for Performance
Technology
Workplace Culture
Personal or Family Problems
Job Stress and Women
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What are Health Effects of
Job Stress?
• Cardiovascular disease
• Musculoskeletal conditions
• Psychological disorders
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Why Should Employers Be
Concerned About Workplace Stress?
• Financial reasons
• Emotional reasons
• Safety concerns
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Workplace Stress Reduction
What can management do to
reduce stress at work and
increase levels of productivity?
• Opportunities for career development
• An organizational culture that values the
individual worker
• Management actions consistent with
organizational values
• Recognition of employees for good work
performance
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Workplace Stress Reduction
Job Conditions and Job Stress
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The design of tasks
Management style
Interpersonal relationships
Work roles
Career concerns
Environmental conditions
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Stress Management
10 practical & beneficial ways to reduce
stress:
1) Decrease or Discontinue Caffeine
2) Regular Exercise
3) Relaxation/Meditation
4) Sleep
5) Time-outs and Leisure
6) Realistic Expectations
7) Reframing
8) Belief Systems
9) Ventilation/Support System
10) Humor
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Employee Assistance
Programs (EAPs)
• Employees can learn about stress, time
management, and relaxation
• Provide counseling for employees with work or
personal problems
• Stress management training can help to rapidly
reduce stress symptoms - anxiety and sleep
disturbances
• However, benefits of stress management often shortlived; often ignore root causes of stress because
focus on the employee - not the environment
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