The pressures of modern social work have caused anxiety and depression among some staff. But there are many ways to help overcome this, writes Julie Griffiths
1 How to spot the signs of depression and anxiety
Geraldine*, a social worker in adult services, knew her anxiety was serious when she experienced behavioural and physical changes.
“I cried a lot and I didn’t want to socialise with anyone,” she says. “I had pain – a tightness – in my chest and I felt physically sick before going to work. I also started having panic attacks.”
Any changes that last for more than two weeks could indicate a problem, says Dr Deenesh Khoosal, a consultant psychiatrist and spokesperson for the Royal College of Psychiatrists.
Watch out for increased smoking or drinking alcohol, which serve as mood stabilisers, and a loss of interest in the things that usually bring pleasure, including sex.
Tell-tale signs can be irritability, an inability to concentrate and problems in finishing tasks.
Use your feelings as a guide, says Dr Khoosal: “You might have a low mood, feel like a failure and your self-esteem goes down. You might worry about everything – sometimes worrying about worry itself.”
2 What can be done to help yourself?
Cut down on tea and coffee and ensure you get sufficient sleep and relaxation. Forcing yourself to take regular exercise can also help.
If you are worried about the level of anxiety and depression, self-assessment can be a helpful first step. Consultant psychiatrist and RCPsych member Dr Trevor Turner suggests the Beck inventory scales – there is one for depression and another for anxiety – which are available on the internet.
There are also online tools that can help those who want to try self-help.
“FearFighter and Beating the Blues may help,” says Dr Turner. “These are cognitive behavioural therapy (CBT) based programmes that you can do yourself.”
Trying to work out the root of the problem can also help because then you can begin to address it. But people need not struggle alone. Help is available from the GP or a counsellor.
Dr Turner also has advice for people, such as the social workers surveyed by Unison, who have turned to medication to fight depression.
“It’s something that can benefit you like hormone replacement or folic acid if you’re trying to get pregnant. If you think about it, depression is an illness like flue or arthritis. It’s very common,” he says.
People on antidepressants need to give the medication time to work, though. “People think that it’s like a course of antibiotics, but it takes a few weeks to get into the system and you need to stay on them for a good three to six months,” he says.
He describes it as “one of the great myths” that people become dependent on anti-depressants. “That belief needs to be shot down,” says Dr Turner. “You can become dependent on alcohol, but not antidepressants.”
3 How to deal with depression at work
Taking time off is not necessarily the answer, says Dr Turner, who suggests solving the problem in the workplace is preferable. “Don’t take a holiday when you feel unwell because you’ll return to the same situation. It is much better to talk to your manager,” he says.
But sometimes the problem cannot be addressed even by a supportive manager, says Peter Beresford, professor of social policy at Brunel University. The system can be enormously frustrating for social workers, he says, because they are stuck between the people they support and those holding the purse-strings.
“Social workers have to battle against a system that tends to put budgets before needs and they’re working for organisations that are constantly cash-strapped,” he says.
Ruth Cartwright, professional officer for England at the British Association of Social Workers, says this can lead to a sense of powerlessness.
4 What external help is there?
If the root problem is one that cannot be resolved, the key is finding a way to live with it. Talking about feelings and options can help to achieve this.
Many public sector organisations have employee assistance programmes (EAP) which offer a limited number of counselling sessions to staff. They are free and a confidential way to get support.
Social workers can also visit their GP. The government-backed Improving Access to Psychological Therapies (IAPT) programme is providing £173m over three years to offer more talking therapies to those with depression and anxiety.
Phillip Hodson, a fellow of the British Association for Counselling and Psychotherapy (BACP), says those willing to pay for support could seek recommendations from their GP or search the BACP website for a qualified therapist.
5 Keeping yourself well
Geraldine* returned to her post after nine months off work with acute anxiety. Now back a year, she has found techniques to help her keep stress at bay. For example, she and a colleague make time to talk to one another.
“If things are bad, we take five minutes out and support each other. I also make sure I take my lunch breaks and I try to only work the hours that I’m paid for,” she says.
Finding ways to prevent mental health problems recurring is important.
Hodson says that making time for outside interests helps to counteract the stress of work. He says it is particularly important to pursue hobbies when work pressure mounts because this is the time it is most needed.
Sleep is also important. If there is a tendency for work to play on your mind when you get to bed then take measures to combat it, he says.
“If it helps, write things down so they don’t bother you as you go to sleep and think to yourself that you’ll address them tomorrow morning,” he says.
*Not her real name
ADVICE FOR MANAGERS
Research from the Chartered Institute of Personnel and Development (CIPD) this month (November) shows the extent of poor mental health in the working population.
More than a quarter of 2,000 UK employees surveyed described their mental health as moderate or poor, while more than 90% of those suffering from poor mental health said it affected their work performance.
How managers can help
CIPD adviser Ben Willmott says managers need to be on the look-out for changes in behaviour, such as over-sensitivity to criticism or getting into conflict with colleagues.
The manifestation of depression or anxiety will vary from person to person, he says.
“It could be that there are attendance issues with one person and somebody else might be working excessive hours. Everyone will respond in a different way.”
Managers can handle it in a number of ways, says Willmott. Good managers may choose to have an informal conversation, which may verge on counselling. This can be effective in the early stages of a mental health problem.
They can also flag up other sources of support such as an employee assistance programme (EAP) or refer staff to occupational health.
To show support, managers ought to be as flexible as possible about workload or hours.
Adopting a coaching-style of management is helpful, says Willmott.
What to avoid
Responses that managers should avoid include a style of management in which employees feel they have no control over their work.
“Managers who put excessive workloads on staff or have a bullying management style are likely to create or exacerbate mental health problems at work,” says Willmott.
He says that managers who do nothing risk seeing increasing absence levels and poor performance from staff.
The CIPD research shows that 41% of respondents thought poor mental health interfered with their ability to make decisions and 46% said they had less patience with clients.
● One-third of council social workers in south east England are on antidepressants or other medication, according to Unison.
● 9% of adults in the UK have mixed anxiety and depression (ONS 2000 survey)
● 11.4 million working days lost due to stress, depression or anxiety in a year (HSE 2008-9)
Sources of help
➔ Saneline 0845 767 8000
➔ Mindinfoline 0845 766 0163