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Your Mental Health

Workplace mental health in the spotlight

I have written about mental health in the workplace in the past and highlighted the importance for employers to realize that mental health problems affect people in all areas of life including the workplace.

Mental illness hits companies hard every year in terms of lost productivity and disability days and now more than ever it is also costing employers in legal settlements. According to a report by the Mental Health Commission of Canada (MHCC), financial rewards for damages caused by mental injury at work increased 700 percent in recent years.

More than ever before, employers must now face their responsibilities when it comes to providing psychologically safe workplaces.

In our modern world, the workplace can be filled with pressure and excessive stress – not to mention our tendencies today to never really leave work as we bring it with us on our mobile devices everywhere we go.

All of this can lead to common mental health issues including depression, anxiety and burnout, which are increasingly being characterized as mental injury in legal settings. According to the MHCC report, Canadian courts are increasingly intolerant of workplace factors that threaten the psychological safety of employees and the courts are ordering management to change habits while imposing financial punishments for failing to do so.

An even more recent report released by the Conference Board of Canada surveyed more than 1,000 Canadian employees and found 44 percent say they have coped with a mental health problem such as extreme stress, depression, substance abuse or schizophrenia.

Twelve percent said they were currently experiencing a mental health issue and another 32 percent said they had dealt with this in the past.

These numbers are surprisingly high and definitely point to the need for employer awareness of mental health issues and how to prevent them in the workplace.

Another interesting point in this report was the extent to which managers and employees see things differently. Almost half of all managers had no training in dealing with workplace mental health issues but four fifths said they felt equipped to do so. This compared with only 30 percent of employees who agreed their management were prepared to deal with mental health issues and many feared disclosing their problems may jeopardize employment security or success.

There are a few ways in which employers can help ensure a safe and mentally healthy workplace. First, it would go a long way toward eliminating stigma if management were encouraged to openly discuss the importance of mental health – this would help employees feel more comfortable admitting if they are having difficulty.

Providing education to all management and employees about the dangers of excessive stress and the nature of some common mental illnesses would also be very helpful.

Employers can review disability claims to raise their awareness of mental health within their own companies and can then review their return to work policies, education programs and workplace attitudes about mental health.

When individuals are off work with a psychiatric disability, it is unrealistic to require them to return to work full time and 100 percent better. Often a graduated return to work is necessary to help them regain their confidence and overcome anxiety.

Finally, employers should consider implementing assistance programs for employees experiencing mental illness. These measures can help to make the workplace more productive and more compassionate.

If companies placed a true priority on mental health in the workplace, we could vastly reduce the amount of lost productivity and personal distress caused by workplace mental health issues.


Does pill colour matter?

When we pick up a prescription or over-the-counter medication, most of us feel it will simply be effective or not based on its medicinal ingredients and how they have been shown to work on the condition we’re trying to treat.

In general, this assumption is true. This is why we have such a rigorous system in place surrounding clinical trials for all medical treatments – to ensure they are medically effective and so that consumers know what they’re getting when they choose a particular product.

However, as I have discussed in several other columns over the years, the placebo effect can have a real and measurable impact on the perceived effectiveness of any medical treatment.

When we feel as though a medicine is going to work, we tend to feel better while taking it – and clinical trials repeatedly find this is true even when we take a fake or inactive medicine. When a trusted doctor or pharmacist tells us the medicine will work, we also tend to feel better after taking it.

When it comes to the placebo effect, there are many ways in which our body begins the process of feeling better simply based on the perception of treatment. It’s a phenomenon that has baffled scientists for many years and has become a very important factor when we do conduct studies on new treatments – ensuring positive effects are indeed from the medicine and not simply placebo.

A survey out of the University of Bombay in Mumbai, India has shown a few more factors that can affect our perception of any given medication and consequently our choice of which ones to take.

According to their data, the colour, shape, taste and even the name of a pill can affect how we feel about our medication.

In this study, published in the International Journal of Biotechnology, 600 people were surveyed about over-the-counter medication and how much these factors influence choice. Three quarters of participants said the colour and shape of pills act as reminders for complying to treatment. Red and pink were preferred over other colours.

Pink pills were thought to taste sweeter than red ones, yellow pills were perceived as salty, white or blue were more often thought to be bitter and orange pills were perceived as sour regardless of actual ingredients.

It’s not surprising to learn that our sensory and aesthetic biases play a role in the medicines we choose over the counter. Most people prefer one brand of pain killer over another – often due to the texture or feel of the pill or the packaging.

Our perceptions can also powerfully affect our view of the treatment’s effectiveness. A good combination of shape, texture and colour gives any medication a boost by improving outcome and even reducing side effects

Researchers in this study suggested drug manufacturers should ensure sensory elements of a medication work together to create positive perceptions that can complement medical attributes – although they seemed to feel that little attention has been paid to this aspect of pharmaceutical formulation, I think it’s already happening at the very least in the realm of the highly competitive over-the-counter market.

Although positive placebo effects can be helpful, they are usually short-lived when a patient is experiencing a chronic, serious illness. For example, those taking placebos in depression studies may experience a short improvement in their symptoms, but will probably experience another depressive episode if they are not on an effective medication. So even though a complementary relationship may be developed between sensory and medical components of a treatment, the non-medical aspect should definitely take a back seat in importance.

Dentistry fears

Does the thought of climbing into a dentist’s chair send shivers up your spine? Do you get a queasy feeling even contemplating a routine cleaning or filling?

Well, you’re not alone. Dental fear is one of the most common fears out there -- as many as 75 percent of adults experience some level of fear surrounding a visit to the dentist.

Roughly five percent of people experience a severe form of dental fear sometimes referred to as dental phobia, dentophobia or dental anxiety. In dental phobia, individuals are so fearful of dental treatment that they avoid it all together and only reluctantly seek the dentist when there is an emergency need.

Unfortunately, avoiding dental care until an invasive emergency treatment is needed often only serves to strengthen the fear.

Dental phobia seems to be most commonly caused by a negative direct experience with dental care, but can also be triggered indirectly when hearing about the experiences of others or through media portrayals or having a negative medical experience. Many people are fearful of the dentist because they feel as though they are not in control.

Whatever the cause, dental phobia can have negative consequences as good oral health is important to our overall health and quality of life.

Luckily, since it is such a common experience, there are some good techniques for helping to alleviate this condition and turn a dental visit into a tolerable if not desirable experience.

Treatment for severe dental fear usually involves a combination of behaviour therapy and medicinal assistance.

Behaviour therapy can be particularly effective and is often focused on a gradual exposure to the feared experience. This is a therapy technique employed in many different kinds of phobias and anxiety. With dental fear, therapy of this sort may often start with imagining feared objects or portions of a dental visit, leading to viewing pictures of dentists working, eventually seeing some dental tools up close and gradually making the journey to the dental chair and finally treatment.

Of course, this kind of gradual treatment can take time, but is often worth it for the long term benefit of lessening anxiety and ability to seek regular dental care as needed.

Relaxation techniques, education and building a good relationship with the dentist are also helpful in reducing fear.

Most dental offices are well-equipped and willing to help fearful patients as well. Some clinics even go so far as to cater to a sensitive clientele by offering mild sedation or even general anaesthesia to patients feeling anxious. Nitrous oxide (or laughing gas) is one of the milder forms of sedation often used by dentists to put their patients at ease. It is inhaled through a mask during a feared procedure and produces feelings of relaxation and dissociation in the patient. Oral sedatives such as benzodiazepine are also used by dentists to help in some situations.

If you experience dental phobia and are overdue for a cleaning or dental procedure, I strongly advise you to discuss this with your doctor or dentist and come up with a plan on how to proceed. Your dental health is important and there is no need to continue living in fear. Help is available.


Asthma and suicide

The association may sound like a stretch – but did you know that asthma and suicide seem to be linked somehow?

Research has shown that children with asthma have a much higher mortality rate than their peers. In addition, they have a greater than two-fold increase in completed suicide than the general population.

Several studies have found an association between asthma and suicide – but the largest was a study of more than 160,000 high school students in Taiwan who were followed up in young adulthood. Although other studies have found an association between suicide attempts and asthma, this is the first study to link asthma with completed suicide in young people.

Certainly, this correlation is concerning – asthma rates have been on the rise for the past 20 years and experts estimate the rates worldwide are rising roughly 50 percent per decade. Today in Canada there are more than three million people with asthma – it affects roughly 12 percent of children in our country. In Canada, roughly 20 children and 500 adults die as a result of asthma each year.

But why should asthma sufferers also be at increased risk for suicide?

This is not yet fully understood, but there are several theories about why asthma as well as comorbid anxiety and depression may increase the risk of subsequent suicide.

One theory says asthma could interfere with normal development in youths by making it difficult to participate in social and physical activities. Asthma could also have a negative impact on self esteem and lead to over protective parenting because of the child’s vulnerability to asthmatic episodes – causing conflict during adolescent years.

There is also a high prevalence of psychiatric conditions in people with asthma – one study found the prevalence of depression and anxiety disorders is twice as high in youths with asthma as those without – after controlling for socioeconomic status, other medical conditions, and risky behaviours. It seems that early development of respiratory symptoms is associated with a greater risk of depression and anxiety and early development of psychiatric disorders is also associated with a greater subsequent risk of asthma.

Another theory gives a cognitive and biological explanation for the correlation between suicide and asthma – essentially the experience of asthma teaches fear of symptoms and scary health situations. Repetitive experiences may sensitize the brain’s fear response and lead to depression or anxiety.

Whatever the reason, it is clear there is a marked increase in risk for psychiatric problems among those who experience asthma and parents and physicians monitoring the health of children and adolescents with asthma should be aware of the early symptoms and warning signs for anxiety and depression so they can offer help if it becomes necessary.

Read more Mental Health articles

About the author...

Paul Latimer has over 25 years experience in clinical practice, research and administration. After obtaining his medical degree from Queen's University in Kingston, Ontario, he did psychiatric training at Queen's, Oxford and Temple Universities. After his residency he did a doctorate in medical science at McMaster University where he was also a Medical Research Council of Canada Scholar. Since 1983 he has been practicing psychiatry in Kelowna, BC where he has held many administrative positions and has done numerous clinical trials. He has published many scientific papers and one book on the psychophysiology of the functional bowel disorders. He is an avid photographer, skier and outdoorsman.


The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet presents its columns "as is" and does not warrant the contents.

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