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Amod Dalvi

Re:Cognition Health

Consultant Psychiatrist

Read more about Amod Dalvi

Talking Point: Do you know what stress looks like?

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Health and Safety Executive figures show that 10 million working days are lost in the UK each year to stress.

Each case of stress-related ill health leads to an average of 30 days off work, resulting in an annual cost to British business estimated to be in excess of £5 billion.
 
And the problem is getting worse, fuelled by the recession, lack of job security and a perceived need for key employees to be available and contactable on a 24/7 basis, even when on holiday.
 
But an overly-stressed employee presents risks. Not only will their performance inevitably drop, but they can – and an increasing number do – sue their employers for not doing anything to alleviate a situation that has led to their health being damaged. 
 
The trouble in dealing with ‘stress’, however, is that, while a bit of it can be good for stimulating performance, too much of it has the opposite effect. But it’s not always easy to judge when employees are at the tipping point between producing enough adrenalin to fuel high achievement and burning themselves out. 
 
The situation is further complicated by the view, still held by many managers, that only weaklings suffer from stress, whether that applies to themselves, colleagues or staff.
 
What is stress?
 
So what is stress anyway? While there is no agreed medical definition, it could loosely be described as something that happens to individuals when faced with circumstances that are so intense that they fear that they will be unable to cope.  
 
These circumstances generate reactions that are programmed into our DNA. For instance, the "fight or flight" response helped our ancient forbears survive dangerous situations as stress prepares the body and mind to deliver the extra speed and strength required to either escape or deal with danger.
 
If an individual is worried about the effects of stress on their life, however, they should be encouraged to seek specialist help by asking their GP for a referral to a psychiatrist or neuropsychologists. Delay in going down this route can cause the condition to become chronic, resulting in serious physical problems.
 
But there is also evidence to suggest that acute stress physically changes the brain. Cortisol, otherwise known as the ‘stress hormone’, can affect the hippocampus region of the brain, which is important for memory and learning.
 
Studying patients affected by post-traumatic stress disorder, for example, has revealed that large amounts of cortisol reduces the size of the hippocampus which, in turn, limits the brain’s ability to function effectively.
 
Another region of the brain affected by stress is the amygdala, which is located close to the hippocampus. It regulates emotions such as fear and happiness and, if the stress is extreme, can increase anxiety leading to symptoms such as nervousness, restlessness and perpetual worry. 
 
Tell-tale signs
 
Anger is another symptom and is the one most likely to be noticed by colleagues. But while frequent outbursts of anger are clearly unacceptable, it may be that medical rather than disciplinary action is required.
 
The symptoms of excessive stress almost always have a negative impact on the working environment and are damaging both to employees and employers, not least because staff are unable to work to the required standard. 
 
However, both employees and managers working their way up the career ladder often fear admitting that there is an issue in case it hinders their progress.
 
So what can be done? Recognising the signs of stress at an early stage is crucial. There is strong evidence that early diagnosis, or at least an early acceptance that there is a problem, improves the chances of successful treatment – and should minimise the damage done to the wider team.
 
As a result, HR professionals should be actively on the look-out for tell-tale signs that employees are under excessive stress. If someone starts making mistakes, falls behind or falls out with colleagues, they should move quickly to establish whether the problem is a stress-related one. 
 
But too many people simply don’t know how harmful stress is. The work culture in developed nations makes mental health issues such as stress more difficult to talk about than physical complaints like a broken leg or blocked arteries.
 
But making mental health checks part of employees’ annual health assessment could help to take away any perceived stigma and enable early detection. 
 
Fingernail sketch of a typical stress sufferer
 
A 42 year old successful management consultant recently ‘froze’ when giving a presentation. He has not been able to function at work since and is suffering from reduced concentration and poor memory. On top of this, his father was recently diagnosed with dementia and he is currently undergoing relationship difficulties.
 
Thoughts: He felt that he couldn’t cope
Feelings: Anxious and stressed out
Behaviour: Avoiding work
Neuropsychological test results and performance:
 
  • Reduced attention span but normal memory
  • Variable memory performance
  • Highly critical of himself.
 
Today’s working environment is undoubtedly stressful for a lot of people. If an employee starts to behave differently, showing anger, high levels of emotion or forgetfulness, HR professionals have a duty of care to ensure that they provide them with adequate support.
 

Amod Dalvi is consultant psychiatrist for Re:Cognition Health, which provides private healthcare services for people suffering from memory and cognitive disorders.

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Amod Dalvi

Consultant Psychiatrist

Read more from Amod Dalvi
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