SINGING THE BLUES
I had an interesting conversation this week about mental illness and it resulted in a debate on whether people suffered more from anxiety today because of the world we live in or because we have opened a Pandora’s box on mental illness.
One not uncommon text I received said ” Depression is the pits, I swear. Today I only got out of bed because I did not have a choice. I am sitting here and my heart is aching and I’m weepy but if you asked me why I am not sure I could explain. Just that I am feeling the weight of the world on my shoulders and damn, my shoulders are definitely not made for this. I wish I could go home, pop a couple of sleeping tablets and try again tomorrow when everything does not look so grey.”
The early years of this century have witnessed a worldwide epidemic of poor mental health and related illnesses. But while depression is the condition most will associate with mental health issues, and the leading cause of disability worldwide, it is not the number one mental health concern people face. That unwanted accolade goes to anxiety.
And it is not a new disorder. You will have been living under a rock if you haven’t heard about it and, statistically, one in 5 reading this will be a sufferer. Over 40 million adults in the U.S. have it – that’s about 20% of the entire population. The amount of people that I know who suffer from it in my circle of friends, family members and community make me think it’s higher but then I’m no meta-analyst. Just this week talk of anxiety has dominated a discussion with a co-worker, colleague, friend and a coachee (and we are only 4 days in, as I write this). By dominated I mean it was the main discussion point in our interaction. The world economic forum describes it as “rampaging through society like a non-contagious cognitive plague, forming a low-level hum that hides in the corners of our collective minds”. Others may describe it less whimsically as an ever-present, uninvited guest living rent-free inside our head.
So that we are on the same page let me unpack what I am talking about. Mental illnesses are abnormalities of the mind that result in persistent behaviour patterns that can seriously affect your day-to-day function and life. Anxiety disorders, including generalised anxiety, social anxiety, panic disorders and phobias, can be experiences at varying levels of severity ranging from low-level to chronically debilitating. They all have one thing in common: persistent excessive fear or worry in situations that are not necessarily threatening.
Anxiety on a continuum at the lighter end of the scale is the feeling you get just before a job interview or an exam. It’s completely normal and not what I am referring to because these people are getting through the day. I’m referring to when anxiety jumps the line, so to speak. There is a point where it gets in the way and makes people more uncomfortable, wanting to stay at home rather than deal with the big unknown because their heart is racing and it feels like they are crawling out of their own skin, they feel sick and everything is scary – this is what is called clinically significantly anxiety.
Highly common is social anxiety which comes about from fear of being judged or criticised in social situations, I started suffering from this out of the blue a few years ago which made it almost impossible to make a presentation as my heart raced and my mouth would be so dry that it was too difficult to deliver the message effectively – never mind the personal toll feeling like that took. People often think that social anxiety is unique to our time, exacerbated by social media like Facebook and Linked In.
One recent coaching client told me he came off social media a few years ago because it made him so anxious – but it sounds remarkably like the anxiety people experienced 400 years ago. In the 17th century, Robert Burton wrote this description in The Anatomy of Melancholy (1621) referring to a patient “He dare not come into company for fear he should be misused, disgraced, overshoot himself in gestures or speeches, or be sick; he thinks every man observeth him.” The language may be different, but the sentiment will resonate with anyone who has ever experienced social anxiety – the feeling of being watched and judged and its accompanying sense of low worth and desire to shun that judgemental society.
At work we have seen significant changes to our approach to mental health. In Botswana we are seeing a surge of organisations calling for employee assistance programmes (LEA, BOMRA, FNB, in the last few months alone) to help employees cope better. While before such programmes were designed to address issues of retrenchments and layoffs and occasional counselling for stress, organisations are appreciating that with 20% of the workforce susceptible (higher than the amount of people who get flu) – and the effects of on productivity absenteeism and health costs, it cannot be ignored.
None of this of course answers the imponderables referred to above – is our society more anxiety-ridden than in the past or is the subject simply more open and openly-discussed? Certainly, even in my own lifetime, there has been a significant shift from the ‘’put on a brave face’ attitude to a more open atmosphere which encourages acknowledging ones inner fears. But it is not hard to imagine how this could easily tip over into some sort of mass mental hysteria. In all instances, whilst it’s easy to see a broken leg – it’ll have a cast on! –or a bacterial or vital infection – there’ll be a raised temperature and other external symptoms – mental illness is invisible yet in its more severe manifestations it is equally as debilitating.
The positive news is that these days help is out there, from counselling and therapy to controlling medications or a combination of both. I am also reminded of the old joke notices that were commonly hung in workplaces which read ‘You don’t have to be mad to work here but it helps!’. On a serious note any psychologist or psychiatrist will tell you there is no such state as ‘normal’ – all that is required is to reach a place where you can function and feel safe. That’s the new normal.