Dr Ellie Cannon on how a negative work situation could be making you physically or mentally ill – and why it’s time to change that …
Over my years in general practice the job-related illness I have seen has not only manifested as mental health conditions and overt stress. Many of the patients I have seen have developed physical illnesses or symptoms rather than explicitly psychological ones.
There are, of course, ailments and issues you may expect as direct consequences of the physical constraints or activities you do in your work. If you are a builder, you probably anticipate some physical aches and pains as a result of the job, just like footballers expect dodgy knees. My optician told me that after years of bending over to look closely into people’s eyes, she suffers with neck and back problems that are so significant she requires physiotherapy. But there are a whole group of people who suffer with job-related physical health problems that should not be part and parcel of their role or an expected consequence, but arise from negative work-related issues, and consequent mental health problems.
Our minds and bodies are very closely related.
Within the area of work-related ill health it has been common for me to see patients with conditions affecting all parts of the body when the cause is a negative work situation. Job-related physical illness is a hard diagnosis to make, as our automatic position is to relate physical illness to a physical or physiological problem, and it can be hard for both patient and doctor to see an alternative origin. It is made even more difficult as doctors often see patients who report physical symptoms such as insomnia or headaches, but who deny or omit to mention that they feel stressed or anxious as well.
The relationship between the mind and the physical symptoms
It can be difficult to accept that a physical issue has a psychological or emotional root cause, however this happens throughout our lives. Even from childhood we can notice the physical effects of our mind and its worries. The first day of school when your tummy was in knots, or when you were waiting to be told off by your teacher and you needed to rush to the toilet, for example. These symptoms are caused by the very close interplay of mind and body. For some people, this relationship will cause significant symptoms that warrant medical attention. Our bodies can react very strongly to our mental health and for some people the physical symptoms may be the only sign of anxiety or stress, without any psychological symptoms.
Typically patients have said to me, ‘but I don’t feel stressed’. That is because the body is feeling it rather than the mind. This is called ‘somatisation’, when our bodies develop physical signs as a result of our mental state, and some physical conditions are more common than others in this scenario.
It can be surprising how disconnected or random these physical symptoms may appear to be.
I have a young patient who is incredibly successful, well known in his field, with good self-esteem, who wakes up five or six times a night to pass water. I initiated some tests and investigations as it seemed a pretty dramatic symptom and was really disturbing his sleep, resulting in the knock-on effects of tiredness and poor performance at work. After all the tests came back clear, he asked me if I thought it could be related to anxiety. This surprised me as he is certainly not the personality type one would expect to be feeling anxious and had never disclosed any anxiety to me before. After noting in his diary the nights when it happened over two months, we could see it clearly corresponded to days when work was busy and stressful, but never happened when he was on holiday or at the weekend. A clear link to his mental state was illustrated: a physical bladder issue would not differentiate between Mondays and Saturdays, but a psychological one clearly would.
Although we don’t yet understand the root cause of the relationship between the mind and physical symptoms, there are clear pathways to treating physical conditions where there is likely a strongly emotional element. Unsurprisingly this involves addressing any physical issues and ruling out other serious physical conditions, as well as accessing the right psychological help. Getting the right help for these physical conditions will involve acknowledging the issue has emotional and physical aspects, and accepting it is related to your work.
This can be the hardest part. Many of us can cope with the idea of having headaches from sinusitis, but admitting that they are caused by job stress can be difficult, because it makes us feel weak. The stigma around mental health issues means that it is almost easier for an individual to accept a physical health issue rather than a mental health one. The correct treatment for all of these work-related physical health problems will involve the interplay of the medical treatment as well as psychological and lifestyle help. The psychological treatment may be just as effective in this setting as the pharmaceutical ones.
Is Your Job Making You Ill? How to Survive and Thrive when it Happens to You by Ellie Cannon (LittleBrown) is out now.