Britain's professionals say work is making them ill. But what's the difference between a bad day and a breakdown? URSULA KENNY reports
Last week a report from Ceridian Performance Partners and the business magazine Management Today confirmed what we have long suspected: work in the Nineties is making us ill. One in three claimed their health had suffered because of their job, while one in four admitted a lacklustre sex life. But most worryingly, over 55 per cent in the report now describe themselves as "frequently" or "very frequently" stressed at work.

While it's easy to sympathise with Nineties employment problems - longer working hours, shorter working lives, less job security - the huge numbers now claiming "stress" suggests that people could be using it as a convenient umbrella term for any number of ailments, from tiredness and annoyance to full-blown depression.

"Many people think that they're suffering from stress when actually they really mean that they're under pressure," admits psychologist Gael Lindenfield.

In which case, how can you tell if you're just having another bad day, are really "stressed" or in the middle of a breakdown? "Stress is a medical condition which usually involves the body not functioning normally," says Lindenfield, "You produce adrenalin all the time when you're stressed (ie not just when you need to); it's as if your body's emergency switch has got stuck. Signs that you're heading for a breakdown tend to be noticed by other people before you, but can involve paranoia, guilt, inability to sleep, eat, inability to function in a normal way. You might not be able to find your way home, pay bills, cook or whatever."

This all sounds very familiar to Andrew Burke. Rationally, Andrew knows that the breakdown he had last year was brought about by a sadistic and bullying boss. Still, an inner voice niggles. "I worry that it is not the whole story, that partly it was me; perhaps I'm weak. I wonder whether other people would have coped better."

Andrew, 33, says that when he took a new job in the marketing industry he knew it would be demanding and didn't expect anything less. A year later Andrew arrived at a day when he was unable to go on any longer, whether he wanted to or not. He woke to find himself literally unable to move, every muscle in his body was in spasm. It was the end of a long and painful journey.

"It was unpleasant from the start," he recalls. "My boss was a ranter and raver with no people skills whatsoever; his only motivation was money - it was his company - and the people who worked for him were just tools to be used. He never acknowledged our input in any way or recognised our efforts."

And from the word go the pressure was relentless, there was never a slack moment. "No peaks and troughs, just pressure without end. It was impossible to stop and take stock. The hours were ridiculous and it wasn't uncommon to be called back to the office from home in the evening."

Ceridian consultant Penny de Valk feels that far too many of us work with this sort of feverish intensity. "A phenomenal amount is asked of employees these days. The catch cry of the Nineties is `getting more for less'. Big companies have downsized and there are fewer people doing more work. Typically they have too many projects that they don't get time to finish properly and they feel terribly guilty about ignoring their home lives. They feel out of control everywhere."

She feels that the current increased levels of work-based stress exist because we generally feel much more insecure about work than we did five years ago. "Most people still accept insecurity at work as part of the `new deal'; that is shorter contracts and longer hours. There are indications that attitudes are changing because unemployment is down and the economy is booming, but it's early days. Largely people still feel they lack choices and are at the mercy of employers."

Eventually even Andrew's wife Lucy lived in fear of his boss and started taking on anxiety about his work. "I remember being on holiday and Andrew's mobile ringing - he always had to be available. He couldn't get a reception and I got in to as much of a state about it as him. We didn't want to face the fact that the job wasn't working because we needed the money and felt trapped. It was a dreadful time."

That went on getting progressively worse. Andrew started waking at 3am and staying awake until he got up for work. He flew off the handle about the slightest thing and felt sick all the time. "My mind was constantly whirring and my stomach was in knots so that I was unable to eat. I found myself bursting in to tears on occasion - once, towards the end, I cried for an hour solid. I hadn't understood until then how women did it."

Lucy remembers him ringing her from the car and saying that he felt like just putting his foot down and ending it all. Then one morning, having lived through months of torment, he woke up at three as usual and "my body was in spasm, my fists were gripped, everything was gripped and I literally physically couldn't move. We called the doctor and I was signed off work and put on antidepressants which didn't actually help, although they did make me think `That's it, I'm mad now, this has got to stop.' When I went back to work I handed in my notice."

Looking back now, Andrew says that bottoming out and breaking down was not actually the worst of it. "The bleakest times come earlier when you're still fighting, when you feel there's no way out, when you're convinced that it's impossible to do anything other than continue with the situation you're in. Ironically the `braver' you are, the worse it makes it. The really brave thing to do is stop and sort it out, but I couldn't."

Andrew let things go too far, partly because he had a sneaking suspicion that it was his problem, that he was weak and unable to cope where others could. And that is the rub; we find it hard to gauge when we're living with unacceptable levels of stress because what is unacceptable varies so much from person to person. What fuels performance for one can be crippling for another.

Reassuringly, stress specialist Malcolm Vandenburg says that The Positive Under Pressure programme that he runs along with psychotherapist Gael Lindenfield employs "preventive mentoring or psychiatry that can immunise you against immobilising stress. Stress management is ideally about observing the traffic lights or warning signs, instead of waiting for an ambulance to pick you up when you've crashed."

Still, if you do crash he feels that there is now less shame and stigma attached to mental health problems at work. "I genuinely think that these days you are much less likely to be greeted by judgmental and disapproving colleagues and employers when you return to your place of work. People are more sympathetic now because a lot of them have had these feelings too, from the top down. Some companies offer their own pressure management courses."

Indeed Penny de Valk's company, Ceridian, runs a helpline paid for by several large companies, so that their employees can call up for advice about counselling. "More companies are recognising the benefits of employee assistance programmes because it's in their interest to do so," she says. "Some are also genuinely appalled that their employees might be suffering and are even starting to look seriously at `time out' techniques such as meditation."

Still psychotherapist Gael Lindenfield feels that we should exercise caution, despite signs of a touchy-feely new work world. "Obviously it depends on who you work for, but if in doubt I would advise people who have time off for mental health problems to consider getting their doctor to put something else on the medical certificate. There is still a lot of prejudice around. Future employers might be put off and it may affect your life assurance application if you want a mortgage."

Lindenfield also points out that some of those who return to the work place after mental health problems have found themselves downgraded. "There's a feeling that they're not as capable and so they're treated differently."

Meanwhile Andrew Burke has a new job. "At first I was terrified that it would start all over again but it's fine; I'm doing as long hours but at least I feel appreciated."

Penny de Valk feels that because of - albeit embryonic - shifts in our work values, all employers will have to deal constructively with stress- related issues like time management or lose employees. "These days stress sufferers in the workplace tend to be in their thirties and forties, but all the signs are that the next generation of high fliers won't put up with the conditions that aggravate stress in the way that we have."

Names have been changed.

EARLY WARNING SIGNS

Dr Vandenburg says that stress symptoms fall in to three categories:

Physical:

Includes bowel-related problems like diarrhoea and constipation. Also migraines, back pain, palpitations, breathing problems, loss of libido, impotence and for women disruption of menstrual cycle.

Emotional:

Includes worrying all the time, anxiety, feeling overwhelmed, out of control, guilty, confused, trapped and unable to know what to do next.

Behavioural:

Includes mood swings, temper loss, preoccupation, inability to tolerate noise, withdrawal from `normal' life; for example stopping hobbies and exercise, inability to concentrate, using stimulants like coffee and alcohol, inability to stop moving/fidgeting.

USEFUL NUMBERS:

British Association for Counselling:

01788 578328

Positive Under Pressure:

0171 935 0113

National Work Place Bullying Advise Line:

01235 212286

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