I’ve been tracking the health consequences of the recession among my patients. The first group of victims is obvious: those suffering the anxiety and depression that follows job loss, protracted unemployment, living on savings, cutting expenses, downsizing where they live, and, of course, losing health insurance. At the very moment these folks could benefit from some therapy, they have no insurance to pay for it.
The second group consists of the “left behind” employed. Yes they still have their jobs, but when an organization lays off employees this group is going to be working in stressful surroundings. Already carrying the unspoken burden of survivor’s guilt, they’re holding their collective breath waiting for the ax to fall on them. And with employee reduction, the survivors are almost always overworked, handling multiple tasks (often with unpaid overtime), wondering if it might not be better to chuck the whole thing and take their chances with unemployment or to change jobs and start over again.
One consequence of this workplace recession is the rising tide of employee harassment, apparently on the increase in the US, Europe, and the UK. Bosses, supervisors, and “superiors” in general are sounding meaner, probably under pressure themselves and too quick to turn their own issues into hostility and disrespect for those working under them.
I’m hearing an increasing number of tales of nastiness in the workplace, with the subtext “You should be grateful to have a job” used as an excuse for employee humiliation and harassment.
Interestingly, the concept of workplace bullying/harassment has been studied more in Europe, even Eastern Europe, than in the US. There, this issue seems less recession-based and more a consequence of the huge number of foreign “guest workers” now making the European Union their home. To come across workplace harassment questionnaires in Estonian and to find the longest Wikipedia article on the subject in German was an eye-opener for me. In the US we seem more focused on workplace sexual harassment and too often the problems of a nasty boss or a psycho supervisor are quietly swept under the table.
After observing multiple patient meltdowns in my examining room as I listen to stories of harassment, I begin to wonder if sociopaths are in charge of everything. Maybe companies unconsciously seek out the cold-bloodedness of sociopathic personalities when selecting a management team. Maybe sociopaths seek management positions to hone their lack of empathy.
Exhausted, you and your adrenals
Listening to the emotional trials of workplace harassment and the physical symptoms that follow in its wake, it didn’t surprise me to learn of studies correlating workplace harassment with adrenal exhaustion. The psychological symptoms of harassment are pretty straightforward: depression (hopelessness and helplessness), anxiety, obsessive thinking, and sleep disturbances. The main physical symptom of harassment is fatigue, but frequently also headaches, muscle aches, and digestive disturbances. This is essentially the same profile as patients suffering post traumatic stress disorder (PTSD).
Using a variety of harassment questionnaires (here’s an example), Italian investigators measured salivary cortisol levels in workers throughout the day. This is the very same test we order at WholeHealth Chicago when evaluating patients with fatigue. Cortisol is a good way to track the exhaustion of the hypothalamic-pituitary-adrenal (HPA) stress response system that occurs when your fight-or-flight response is activated repeatedly.
The fight-or-flight system is an involuntary reflex that kicks in during stress. It’s designed to be a quick on-off response, for emergency use only during moments such as escaping a mugger or veering your car away from a potential crash. It was never meant to remain in the perpetually “on” position.
But this is exactly what investigators found: workplace harassment leads to a burned-out HPA stress response system. When repeatedly activated, the adrenal glands become incapable of producing anything other than low (and insufficient) levels of cortisol. The main symptom of adrenal fatigue is fatigue, sometimes with an added fatigue crash in the late afternoon, when the adrenal glands, good for one day’s work (and restored during sleep), become depleted between 3 and 5 pm instead of working as they should until bedtime.
Other symptoms of adrenal fatigue include lightheadedness, depression, brain fog, salt craving, and an increased susceptibility to whatever virus happens to be making the rounds. All this is nicely explained in the accurately titled best-selling book Adrenal Fatigue: The 21st Century Stress Syndrome, available in our apothecary.
Taking the next steps
I’m often stymied about what to suggest to victims of workplace harassment. People need jobs, especially now, but generally I ask the harassed person to view symptoms as messages from her body begging her to reconsider her current path. I ask her to meditate on the word “change.” If she can envision a different life and her body starts feeling better (muscles less tense, breathing is easier), she’s likely on to something important.
I suggest she purchase a 2012 calendar and circle a single day, the day she’ll walk out of her old job and into a new life. Whether she’s a lawyer routinely clocking a 14-hour day, a teacher fearful of turning her back on her classroom, a nurse, an office worker, or a waitperson clenching her teeth as she serves foie gras to some Wall Street honcho, she should think of that day on her calendar and put her mind into the frame of change.
In short, make a plan for getting out. Consider what life might be like with a little less money and a lot less stress. Broaden your parameters and start looking for that job.
If you believe you’re being harassed and bullied in your workplace, the very moment you say aloud, “I don’t know how I’m going to do it, but I’m out of here,” your adrenals, not known for verbal communication, will breathe an audible sigh of relief.
David Edelberg, MD