January 19, 2007 9:57

Let's Not Shrink From Tackling Stress on the Job

A couple of months ago, I saw a shrink.

I was just beginning to recover from a nasty bout of a chronic illness that doctors think might be triggered by stress. Although I've lived with the illness for 15 years, the prolonged hospital stay scared me into making a resolution: I would do whatever it takes to avoid ever facing two weeks of pureed peas again.

I'd never in my life considered therapy, because therapy is for crazy people and I am a productive, resourceful, highly functioning member of society. I juggle a demanding job, a household and a large family with--okay, not with grace, but with decent proficiency. I don't drop a lot of balls. Okay, I do, but I pick them up with style.

Me and stress, we're old friends. Not friends exactly. More like frienemies. Okay, I hate stress, that pushy pest. Like many people I know, I'm stressed most by my work, even though--or maybe because--I love it so. I could quit my job and move my family to a trailer park in Lodi, N.J. But if I did, I'd probably find myself hanging out at the nearby D.M.V. just to breathe in other people's anxiety.

The logical thing, I thought, would be to take whatever steps necessary to reduce stress on the job. First I exercised my said resourcefulness by researching the accommodations offered by my employer. One of those accommodations is a doctor-recommended arrangement to work temporarily from home. Another is an employer-subsidized gym membership, through which I can kickbox my way to serenity. Then I remembered getting a brochure on something called the Employee Assistance Program.

When I called and explained my mission, the nice lady referred me to a list of therapists. She told me sessions would be covered by insurance, which made me far more open to the idea (aside from being stressed, I am extremely cheap). I called a few in my area and settled on one with a nice phone voice whose practice happened to be next door to my kid's daycare.

This therapist was nothing like Dr. Melfi on The Sopranos, which is a good thing because I find Lorraine Bracco intensely annoying. We discussed some things I found stressful, and she made some useful suggestions. I'm not sure when I'll seek her out again (with layoffs looming, right about now is probably a good idea). Still, knowing I can add her to my arsenal of ways to deal with stress is comforting.

I share all this because a) I am apparently getting way too comfortable with my audience and b) I've been reading a just-published book titled The Mark of Shame: Stigma of Mental Illness and an Agenda for Change. Okay, not so much reading it as staring at the creepy cover art of some medieval shrink slicing into a conscious subject's brain.

In the book, Stephen P. Hinshaw, professor and chair of the department of psychology at the University of California, Berkeley, discusses the ways that society stigmatizes people with mental disorders, the effects of that stigma, and how to change it. Among the most important battlegrounds for his campaign is the workplace. (He has much more to say on this subject, so I'll follow up with a Q. & A. from our interview.)

Stress, it turns out, is a widespread workplace affliction that can very often lead to or exacerbate truly debilitating mental disorders. "Much of work and much of life involves stress," says Hinshaw. While many major forms of mental illness have some genetic predisposition, "in none of them is a genetic cause sufficient" as the only explanation. "And so if one has a genetic liability, it may well be that life stress and work stress pushes one over the threshold into a range of mental illness." When that happens, workers often miss work or even quit jobs.

In that sense, stressed-out workers can have an enormous effect on employers' bottom line. By Hinshaw's measure,

• about one in five Americans will suffer from a mental disorder in the course of a year.

• Depression is the leading cause of disability worldwide, according to the World Health Organization.

• Untreated mental illness costs $105 billion in lost productivity each year with U.S. employers footing up to $44 billion of the bill, according to the national mental health association.

Yet employers have a history of ignoring or even discriminating against mental illness among its workers. The Americans with Disabilities Act of 1990 forbids them to fire workers with mental illnesses. And the Mental Health Parity Act of 1996 was, says Hinshaw, "a first step toward guaranteeing equal coverage for mental disorders on a par with physical disorders." Another bill awaits Congress that closes many of the loopholes in the 1996 act.

Still, secrecy still shrouds mental illness in the workplace, reinforcing the shame of society at large. I don't know if we're ready for a day when coworkers hang out at the coffee machine jibing each other about their bipolar disorders; after all, even physical illnesses untainted by shame are often taboo topics in the workplace. But we can start by treating mental ill health with the same respect and dignity we give, say, cancer.

To begin with, let's stop treating stress as a minor side effect of work. Employers should offer help coping with job-induced stress, and workers should accept it. Employers' support and employees' trust could result in a "win-win," as Hinshaw puts it. Say Tony Soprano urged it and Christopher got help. Who benefits? The organization at large.