Managing anxiety and depression in a stressful job

February 20, 2011 5:44 AM

How do those of you with depression and anxiety manage demanding professional jobs?

I am currently being treated for depression and anxiety with both medication (Zoloft) and regular appointments with a psychologist. I’ve been in treatment for around three weeks now, and am definitely improving, though I’ve got a long way to go. The current bout of depression has been triggered by the stress of my job, although I suspect I have an underlying tendency to it.

I’ve been reading, and talking with my psychologist, about CBT and in particular the danger of negative self-talk. The problem is that I work in a very stressful job that has very high expectations. On one level I am really proud of myself for getting something done every day – a month ago I was spending whole days staring at the screen, too paralysed by anxiety to do anything. On the other hand, I know that I am not operating at nearly the level required to be effective in my job, and that lots of things are slipping between the cracks – including a couple of big, important tasks that I keep putting off because of the amount of anxiety they’re producing. It’s really hard to keep my thoughts positive when I know (from feedback from my manager as well as my own judgement) I’m not doing what’s required.

I’ve only been in the role for a few months, and am still heading up a very steep learning curve. I work long hours – an 11 or 12 hour day is fairly standard, and 15 hours is expected when we’re busy (as we will be for the next couple of weeks), so there’s little opportunity to recharge. It’s an office-based job, but in a field where one slip could put my boss on the front page of the paper, which is one source of stress. The work is constant, responsive and reactive – I’m expected to be on call constantly, and a single unproductive day seems to set me back days in terms of keeping up with the workload. I’m expected to be across every detail of every issue, and while this is clearly impossible, as I’m new I’m still developing my judgement on how to pick which things I can let drop.

My question: how do those of you who are managing anxiety and depression while working a job like this do it? How do you handle the inevitable bad days without setting yourself so far back it seems you’ll never catch up with the work?

Quitting is definitely an option that I’m considering, but this job is a major professional opportunity for me, and I don’t want to let it go until I’m pretty sure that I can’t make it work. Taking a few weeks off is probably not an option – this is the type of environment where you’re expected to be able to handle the pressure, and besides the work would just pile up while I was gone. My manager knows I am dealing with some ‘health issues’ (had to say something so I can get out to appointments) but I’m not keen to discuss it with them in any more detail.

I can be reached at [e-mail] if you’d prefer to answer in private, or want more information.

posted by anonymous to work & money (11 answers total)

There are support groups specific to some professions - I certainly know that there are support groups for doctors with mental health problems. There may be one for your profession, and they may be able to give you more tips or more specific help.
posted by Coobeastie at 6:01 AM on February 20, 2011 [1 favorite]

Is there anybody you can lean on thru this tough time? Somebody who you feel comfortable telling what's up and asking them if you can set up some checks and balances...maybe daily brief email updates where you unload how the day went, where your head is at, what you think you might need (even if it's wrong...it's about the trying) and 1-task you plan on doing for the next day (however small it is). And then they can email back and say, "got it!", give encouragement/support, and just generally be there to receive it.

It's a light volley; I find that sometimes that really helps. But you have to ask. And it's ok to say something like, "Hey friend X, I don't want to get into too much detail, but I'm having a tough time these days and was wondering if you might spot me...can you help by possibly ____?"
posted by iamkimiam at 6:06 AM on February 20, 2011 [1 favorite]

A steady diet of 11 - 15 hours days will make you less productive. Schedule physical activity during the day - visit the gym, go for a brisk walk, as long as you get out of the office and get moving. When you get raised eyebrows, just tell people it makes you able to work the long hours more productively and suggest they join you. Sunshine and exercise make a big difference to depression and anxiety.
posted by theora55 at 7:40 AM on February 20, 2011

an 11 or 12 hour day is fairly standard, and 15 hours is expected when we’re busy (as we will be for the next couple of weeks), so there’s little opportunity to recharge.

Being able to work 15 hour days is weird, not being able to is perfectly normal. Try to remember that if you ever feel like a failure or something like that.

My other advice is to quit now.
posted by The Devil Tesla at 8:25 AM on February 20, 2011 [4 favorites]

Lists. Make a list of everything and follow it slavishly. Put those big, anxiety causing tasks at the very top and don't give yourself the option of not doing them in the exact order you've written down.

Also, it might help to realize that NOBODY really thrives on 15 hour non-stop days. There may be a few who like it, but everyone will burn out or really sacrifice some other part of their life. Some are more able to withstand it than others; some will make it look easier than others. But it is not really sustainable for anyone.

What I would recommend is that you see this as a sort of time-limited bootcamp. Decide how long you are going to stay (one year?) and just brace yourself, accept the stress, and do it. You are not going to eliminate the stress - it's about learning grace under pressure.

One final caution. Make sure that with your ambitions, you aren't getting yourself into a career that's not truly suited to you (or anyone, really). Yes, your job may be a great stepping stone, but as the saying goes... sometimes a promotion is like a pie eating contest where the prize is more pie. These kinds of really influential early jobs can be really important anchors to a career, but be careful not to get so focused on the next step ip the ladder that you lose sight of what you really want.
posted by yarly at 8:32 AM on February 20, 2011 [6 favorites]

And yes, exercise, every day.
posted by yarly at 8:32 AM on February 20, 2011

Being able to work 15 hour days is weird, not being able to is perfectly normal. Try to remember that if you ever feel like a failure or something like that.

It definitely isn't for everyone but a lot of people regularly work 12 hr days in professional occupations and at times a lot more so not sure I agree it's weird to be able to do so...but yes, anything much above 12 hrs on a regular basis definitely sucks and productivity is definitely way down after 13 hrs...

So, make sure you sleep and eat properly....did I mention sleep is super important?

Try to organise your work so that you can take care of anything really complex in the earlier part of the day when you're more awake and thus hopefully better able to concentrate. Leave fairly routine tasks to the end of the day when your brain is gone to mush.

If you find that you need to lock yourself away for a few hrs to do something you really cannot have interruptions for find a way to do so - ask somebody to field your calls for a while or let your phone go to voicemail or whatever.

It also helps to remember that you're not a doctor or a pilot and therefore nobody is going to die if you make a mistake....good way to put things into perspective.
posted by koahiatamadl at 10:28 AM on February 20, 2011

For me, the answer has been finding a match. A match between my strengths and limitations on the one hand, and my work environment on the other hand. My strengths are creativity, smarts, and speed; my limitations include endurance -- I cannot regularly work 15 hour days or even 12 hour days with health and happiness. I work in a field (law) that has a substantial sector that values quantity (e.g. the billable hour). A metaphor for me, for my own thinking about my work, has been poetry -- poetry is about the right words at the right time, and in the right order, but often less is more.

Although I cannot work 60 hours a week for very long, I try to keep the poetry model in mind. Of course, the $64,000 question is how to find the employer that matches your strengths and limitations. I kept trying to find that match, and eventually I got lucky. Maybe you will, too.

As well, there are reasonable accommodations that are available. These are most effective when there is already a decent match.
posted by ClaudiaCenter at 10:36 AM on February 20, 2011

Find someone with good mental health and model off of their approach. Watch how others deal with it until you find a model that fits you. Ask others, "how do you deal with all of this?"

Open up, because the worst is when anxiety turns to shame. In particular, admit your limitations and need for help. "I have 15 'high priority' tasks on my desk, can anyone help out?" "Boss, could we think together about the most efficient ways to get this project moving?"

Deal with anxiety-producing things. Avoid avoidance. Those big important tasks you are not doing are likely creating a disproportionate amount of your stress. Yes, positive self talk helps, and you do have to start with reasonable self expectations. (Now, when you are behind on a given project, you may need to renegotiate the timeline so it is realistic.) But then you have to maintain your own respect by doing what you believe needs done. Facing the fear of a project will cure it, while giving in to the fear makes it worse. So make a list of three specific actions you absolutely want to take every day to move the project ahead. Eventually, you may discover that your overwhelm and avoidance have valid causes: "boss, pushing this issue will cause the coalition to fall apart, we cannot do the project as defined." "Boss, with our current database technology, this will take one person four solid months. We should hire some temp workers or not do the project as defined."

This job sounds so fast-paced that it might help to think of it like a speed game or assembly line. In particular, figure out whether you are striking the right balance between speed and quality. How good does your work need to be to keep the line rolling? Having a rough draft done quickly may be better than a perfect version done slowly. Can you make peace with the risks and impossibility of perfection? Some of the people in your office probably love the thrill. This is like a timed essay test. Everyone would do better work if they had twice as long.

If you want to memail me with more details about your work, I'd be happy to think it through with you, and I promise discretion.
posted by slidell at 11:37 AM on February 20, 2011

i know that it's not an option for everyone, but after i was laid off and started working for myself, things got SO MUCH BETTER. is this a field where you could be a freelancer/consultant?
posted by misanthropicsarah at 12:56 PM on February 20, 2011 [1 favorite]

I have similar issues to you - Bipolar Type I. The good news is that I can work in a good job and lead a productive life. It does take some tweaking, though.

Here is what helps me:

- Medication. Now, bipolar is something that mostly requires medication (there are exceptions), especially the type I have (type I). Some depression and anxiety issues are helped a lot by medication. It's not a panacea or a crutch, but it is legitimate help. It's not "all in your head" - for Pete's sake, your head is attached to your body! You wouldn't poo-pooh a diabetic's need for something like Metformin; some people with anxiety/depression issues function so much better with meds. Talk to your doctor. I have a GOOD psychiatrist and primary care doc and that makes a difference. Meds can take a while to work, and they have to be tweaked to find the right combo, but - it can be like night and day.

- SLEEP and FOOD. Without a good night's sleep, I can't function. Do what you need - relaxation, sleep hygiene, aromatherapy, meds (I love my Seroquel), but get the rest you need. Make sure your mattress is comfortable - a firm mattress, for instance, is not for everyone. My sleep issues are so, SO much better now that I have a nice soft squishy mattress.

Food - often small meals are better than three big ones; don't forget to eat. Boneless, skinless chicken breasts are your friends - they can be grilled with seasoning, shredded for salads, slapped into sandwiches. Snack on things like almonds that have protein and good fats in them. Don't binge on snack machine food - those are empty calories and can make your blood sugar spike and crash, and you feel crummy.

- Therapy. A good therapist is a great support.

- Exercise and fresh air - not necessarily hardcore stuff, but yoga and stretching and taking walks at lunchtime and after work, that sort of thing. You will feel better and sleep better.

- You say this is a short-term thing. This is good - very few people can successfully put in long hours day after day, year after year. If this is just a dues-paying thing, remind yourself "this too shall pass." If punishing hours are regularly demanded in your field, you might need to make some hard choices later on about your career path. That's not a weakness, that's a realization that not everyone is cut out to be a corporate lawyer/consultant/etc. For myself, I might love to have that hot-shot six-figure consulting job but I know what a price I would pay, so I elect a more low-key, less lucrative, but more healthy path (and it's still a really good one, not scraping by with crummy grunt work!).

Almost always, you don't have to choose between unemployment and 15-hour days, however. There's another path - maybe not as lucrative and prestigious, but it's there.

Good luck!
posted by Rosie M. Banks at 1:24 PM on February 20, 2011 [3 favorites]