What Do You Do if Mindfulness Does Not Reduce Your Symptoms of Anxiety or Depression?

I was approached recently by a young man who was experiencing severe anxiety.  He was able to cope well with his work but had all kinds of difficulties coping at home, including endless self-doubts, negative self-stories and an inability to relax or concentrate.  He indicated that he had “tried everything’ – meditation, mindfulness practices and reflection. 

He found, for example, that “reflection” only resulted in his entertaining negative thoughts about himself and re-visiting his destructive self-stories.  So, reflection for him resulted in a downward spiral rather than a release from self-deprecation.

What does “tried everything” mean?

The first consideration is how did he approach these attempts to develop mindfulness and reduce his symptoms?  Given the young man’s level of agitation, it was likely that his efforts were somewhat frantic and unfocussed.  One could question whether he engaged in a sustained meditation practice in a focused way, e.g. working on his self-stories with the aid of a meditation teacher or meditation group.

One of the issues is that there are so many different forms of meditation that it is tempting to “try them all” and flit from one form to another, without addressing your specific needs or the causal factors of your depression or anxiety.  This is where a professional psychologist or dedicated professional group could help.  Organisations like Beyond Blue and the Black Dog Institute can help by providing knowledge, resources, group support, access to programs and advice in identifying a suitable medical practitioner, psychologist or psychiatrist.  Other specialist carer support groups can assist people who are experiencing anxiety or depression as a result of caring for someone who has a long-term need for care and support.

The Mental Health Care Plan

You may need medication and/or the aid of an allied health professional to overcome depression and/or anxiety. In Australia, there is a specialist form of help that can be accessed through your local medical practitioner, the Mental Health Care Plan.   You explain your symptoms and needs to a doctor who develops a mental health treatment plan with you.  This may include medication, referral to an allied health professional such as a psychologist and/or other forms of activity designed to address your specific mental health condition.  Medicare will provide rebates for visits to an authorised health care professional where the visits have been the subject of referral by a medical practitioner as part of a Mental Health Care Plan.  The number of visits covered by Medicare rebate is 10 (subject to a confirming review by the doctor after the first six visits).

Advancing our understanding of the causes of depression and anxiety

Johann Hari, in his book Lost Connections, highlights recent research undertaken worldwide that shows that anti-depression medication can be effective in the short term to reduce symptoms but that, in the medium to long term, it typically has to be increased and can reduce in effectiveness over time.  In his book, Johann focuses on the social factors contributing to the global rise in depression and anxiety and proposes solutions that support rather than replace medication treatments, although some people are able to give up their medication after a period of successful use of one or more of these alternative approaches.

Johann identifies seven social factors that contribute to the rise in depression and anxiety, all relating to a loss of connection.  He describes them as “disconnection from”:

Johann acknowledges the research that shows that in some instances a person experiences depression and/or anxiety because of their genes or a brain change brought on by some life experience (pp. 143-155).

Reconnection: alternative anti-depressant treatments

Johann describes several ways to reconnect to overcome depression and anxiety.  These include reconnecting with others, with meaningful work, with nature and/or meaningful values. He also includes chapters on finding “sympathetic joy” while overcoming self-obsession (Chapter 20), and a compelling chapter on acknowledging and overcoming childhood trauma (Chapter 21).

What I found particularly intriguing, as well as very practical, was a chapter on “social prescribing” (Chapter 17).  In this chapter, Johann highlights the work of the Bromley-by-Bow Center which combines a medication approach (where deemed necessary) with hundreds of social programs.  This medical centre is very different to most doctor’s clinics that you would normally visit, both in terms of the orientation of the medical practitioner and the physical environment.  The emphasis is on listening, not medication prescription, and treatment is strongly oriented to “reconnection” strategies such as a walking group, employment skills group, start-up support to establish your own business and a casual group focused on “Create Your Future”.

What further intrigued me was the effectiveness of one project described by Johann through the experience of Lisa, who was experiencing severe depression.  The project was the brainchild of Dr. Sam Everington who was concerned about the over-reliance on anti-depression medication.  Basically, he assigned some of his patients to a community project focused on beautifying a strip of bushland that had become overgrown and neglected but was a popular walk-through. 

The group of people experiencing depression, who had difficulty interacting with anyone and typically kept to themselves, eventually started having conversations, sharing their life histories and their personal mental health challenges as well as plans to beautify the bushland strip.  They had to learn about the seasons, plants and their nutrition needs and how to plant and cultivate different kinds of plants.  They took pride in their project and started to gain confidence and competence.  A moving story was that of a person who had initially presented as very angry and aggressive who went out of his way to help two people who experienced learning difficulties.  Eventually, the members of the group decided to do a Certificate in Horticulture.

Johann pointed out that this creative project addressed two major reconnection needs – reconnection with others and with nature.  It can also be seen that each of these reconnections reinforces the other.

As we grow in mindfulness, we can be open to new ways of dealing with depression and anxiety.  We can learn to reconnect with key elements in our life that induce mentally healthy living, including mindful connection to others, spending time in nature, being grateful for what we have (rather than suffer “status anxiety”) and being willing to show compassion towards others.

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Image by Henning Westerkamp from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Mental Illness in the Workplace

There are two compounding trends that, in concert, are beginning to increase the issues associated with mental illness in the workplace.  They are the incidence of narcissistic managers and the growth in the number of people in the workforce who have a mental illness.  I will deal with each of these trends in turn and link the issues to the offsetting influence of mindfulness.

The Incidence of Narcissistic Managers

Many significant publications such as Psychology Today, Harvard Business Review, Inc.com, Health.com and Time.com, have recently discussed the incidence of narcissistic bosses and ways to self-manage in the workplace to protect yourself from psychological damage caused by these bosses.  It is suggested that most people will encounter at least one narcissistic manager in their working life – I have experienced three that I can recall.

What are the characteristics of narcissistic managers that contribute to mental illness in the workplace?  Well the characteristics of these managers have been summarised by the underlying philosophy of “me, myself, I” – that is  I “first and foremost”.

Characteristics of Narcissistic Managers

There are many characteristics of narcissistic managers described in the articles and in research. Some of the more common traits described (and confirmed by my own experience) are:

  • Self-aggrandisement – believe they are more capable, competent or efficient than they actually are (believe they create high performance teams when the reverse is true)
  • Obsession with self advancement – their careers come before anything or anybody else
  • Over-concern with visibility and being seen in a good light
  • Blame others when mistakes occur (to deflect blame from themselves) – always looking for a “scapegoat”
  • Will lie to save their projected image
  • Take credit for other’s work if it advances their own positive visibility
  • Insensitive to the needs of others, especially their own staff
  • Will constantly change priorities depending on what advantages them, without regard for the impact of such constant change on others
  • Will have an in-group, but any member can become part of the out-group at anytime if they cause embarrassment
  • Create unrealistic time pressures for staff to try to show that their area is highly productive
  • Will publically criticise their own managers in front of the manager’s own staff
  •  Will micromanage to try to ensure that mistakes do not occur and that what they want to occur will actually happen.

The Impact of Narcissistic Managers on Mental Health

The reality is that these managers do not achieve control. In fact, their situation becomes progressively out of control  and they experience high levels of stress as a result, on top of their self-induced stress caused by self-obsession.  They may gain compliance through fear, but lose commitment because people physically or psychologically withdraw to protect themselves – no longer caring about the work, unwilling to offer suggestions for improvement, avoiding contact with the manager or engaging in covert sabotage (to get back at the narcissistic manager). They also lose confidence and begin to question their own competence.

The narcissistic manager, then, not only creates an environment conducive to the development of mental illness in staff, they also potentially aggravate  the condition of staff who already have a mental illness before joining the narcissistic manager’s workgroup.  The compounding issue is that the narcissistic manager lacks the insight to see how they contribute to the conditions creating, or aggravating, mental illness; nor are they overly concerned about the individuals negatively impacted by the highly stressful workplaces they create.

People in the Workplace with a Mental Illness

Beyond Blue, an organisation dedicated to improving the mental health of all Australians, estimates that there are 3 million people in Australia suffering from anxiety or depression and eight people die each day from suicide.  This suggests that anxiety and depression are an issue in the workplace.  Beyond Blue funds an extensive research program covering anxiety and suicide for all categories, including young people, women, men, aged people and the LGBT community.

The Black  Dog Institute also supports the development of mental health in the community.   They draw extensively on research to support their role.  From this research, they are able to maintain that:

Mental illness is very common. One in five (20%) Australians age 16-65 experience a mental illness in any year.  The most common mental illnesses are depressive, anxiety and substance  use disorders.

What is particularly concerning is that they report that suicide “is the leading cause of death for Australians aged 25-44 and second leading cause of death for young people aged 15-24”.

This means that suicide is potentially prevalent among people who are in early-career or mid-career as well as those entering or about to enter the workforce.

The role of Mindfulness 

The narcissistic manager exhibits the characteristics that are the opposite of the mindful manager.  They particularly lack self-awareness and hence self-management. They are by nature lacking in empathy and compassion and are unable to communicate with insight as they are blinded by their own emotions and selfish-obsession.  Their only motivation is to advance themselves – they have no source of motivation beyond themselves and  are thus unable to engage committed individuals.

As we mentioned in recent posts, emotional intelligence skills can be learned through mindfulness.  The challenge is finding ways to engage narcissistic managers in mindfulness training when they have a “keep busy” mindset.  Offering mindfulness training as a means of stress reduction may provide the motivation for them to be involved – because it focuses on “where they are hurting”.

Hence, mindfulness has the potential to help narcissistic managers to manage their stress levels, change their management style and assist other individuals experiencing mental illness.

Jon Kabat-Zinn has demonstrated over more than 30 years that his Mindfulness Based Stress Reduction (MBSR) training has very substantial benefits for people suffering different levels of stress and forms of mental illness.  His findings through his practice have been confirmed by neuroscience research.

As individuals in either group grow in mindfulness, they will experience the benefits, and contribute to the development of a more humane workplace.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: courtesy of Maialisa on Pixabay