Those with neurodivergent conditions are at greater risk of suffering from poor mental health
Anxiety is the most common mental health disorder in the U.S., with the annual overall healthcare expenditure associated with anxiety disorders being estimated at $1,657 per person and the total direct medical expenditure estimated at approximately $33.71 billion in 2013. Adults aged 18-39 are suffering the most, and females are twice as likely to experience anxiety as men and twice as likely to be prescribed anti-anxiety or antidepressant medication.
There is no doubt about it, anxiety can be very crippling. On average, patients with generalized anxiety disorder miss more days of work per month than their colleagues who are not suffering from it. Stress, depression, or anxiety accounted for the majority of days lost due to work-related ill health in 2019/2020 in the U.K., 17.9 million in total.
Dr. Alison Smith, a neuroscientist and cofounder and Chief Scientist at Roga – a health tech startup … [+]
Dr. Alison Smith
Dr. Alison Smith, a neuroscientist and cofounder and Chief Scientist at Roga – a health tech startup developing a breakthrough anxiety treatment device using electrical brain stimulation, is very familiar with the topic of anxiety. Spending her career studying neurophysiology and the applications that can alter brain functioning, she admits she wasn’t always an anxious person: she traveled the world alone and happily pursued a successful academic career as a neuroscientist. But after suffering from a long-term chronic illness, she was left with a severe anxiety disorder that put her whole life on hold.
“I know firsthand what it’s like to be trapped by anxiety and how little help there is to break free. Anxiety can rob people of their ability to fully engage in their careers and create a life with meaning and purpose”, she shares with me.
She co-founded Roga – a medical device company developing a brain stimulation wearable to treat anxiety – because we all need better solutions beyond just medication and cognitive behavioral therapy. “We need tools that will reduce our symptoms so we can return to a full and active life. As the chief scientist of Roga, I’m on a mission to develop tools to help people move beyond the bonds of anxiety.” Roga’s revolutionary wearable device has been shown to reduce anxiety by over 50% in just 20 minutes daily, paired with an app full of helpful content to help you relax and other tools to track and improve your anxiety.
Social Media And Increased Risk Of Anxiety
Dr. Smith explains that the frequency of social media use is directly correlated with an increased risk of anxiety, especially if there is hypervigilance and a preoccupation with content that creates a high emotional connection for the viewer. Those who feel compelled to post on social media continue to stay connected out of “fear of missing out” (FOMO) and can become hypervigilant, which causes anxiety.
“The constant bombardment of information from multiple social media channels can be overwhelming, leading to elevated anxiety and the triggering of negative social comparisons, and the false belief that the lives of others are happier and more fulfilled.”
Women are twice as likely to experience an anxiety disorder than men, and even in studies where men and women both exhibit the same amount of symptoms, women are more likely than men to be diagnosed with an anxiety disorder. There are many reasons for this – women’s primary role as caregivers, multiple forms of discrimination, reduced job security, and screening tools to assess for mental illness being gender-biased and picking up female distress more readily than males.
“Ignoring the issue of mental health, especially in the workplace, can lead to the stigmatization of those who are suffering. Having people with an anxiety disorder share their lived experiences with a targeted group is one of the best strategies for reducing prejudice,” she concludes.
Toxic Workplace Behaviours Are Leading Cause Of Burnout
Let’s be honest, most of us have experienced burnout at some point in our lives. Now, how many of us are ready to admit it and talk openly about it? Not many, I’m sure. Many of us have never-ending to-do lists, and women who are also mothers tend to feel like hamsters on a wheel most of the time – there simply aren’t enough hours in a day to finish all the tasks. If we add toxic workplace culture on top of this, it’s no wonder many of us end up being chronically burned out and feeling not supported.
In Q1 of 2022, McKinsey Health Institute – an enduring, non-profit-generating global entity within McKinsey, has done a study on the drivers of employee outcomes (including burnout and employee engagement) in 15 countries, amongst ~15.000 employees and ~1.000 HR decision-makers. This study was done with a survey instrument that the Institute developed and psychometrically and cross-culturally validated.
Some of the findings from this survey are truly mind-blowing, and not in a positive way. One out of four employees experiences burnout symptoms, with the top three drivers being toxic workplace behaviors, lack of inclusivity, and lack of sustainable work. Examples of toxic workplace behavior include interpersonal behavior that leads them to feel unvalued, belittled, or unsafe, such as unfair or demeaning treatment, no inclusive behavior, sabotaging, cutthroat competition, abusive management, and unethical behavior from leaders or coworkers.
Jacqueline Brassey (Ph.D., MAfN), McKinsey’s Chief Scientist and Director of Research Science in the … [+]
Jacqueline Brassey (Ph.D., MAfN)
“In the report, we discuss the findings of a survey that sheds light on frequently overlooked workplace factors underlying employee mental health and well-being in organizations around the world. We conclude by teeing up eight questions for reflection along with recommendations on how organizations can address employee mental health and well-being challenges by taking a systemic approach focused on changing the causes rather than the symptoms of poor outcomes. While there is no well-established playbook, we suggest employers can and should respond through interventions focused on prevention rather than remediation,” explains Jacqueline Brassey (Ph.D., MAfN), McKinsey’s Chief Scientist and Director of Research Science in the area of People and Organizational Performance and an affiliated leader of the McKinsey Health Institute.
“Positive employee experiences are all influenced by a holistic, systemic approach to health and wellbeing at different levels in the organization. Helping employees build resiliency and adaptability skills is important in reducing burnout and improving performance, and it can act as a buffer to handle stress but helping leaders become better and less toxic is also hugely important – research shows that leaders’ development of self-regulation increases followers’ ratings of their effectiveness and is associated with higher team financial performance as well as a higher final team grade compared with a control group,” adds Brassey. Research has also shown that employees reporting high levels of toxic behavior at work are eight times more likely to experience burnout symptoms and those experiencing burnout symptoms are six times more likely to want to quit. No surprise.
Brassey highlights that various studies, including their own research, have found that it is even more important to the newer generation of employees that employers provide mental health resources and put health and wellbeing at the center. This drives retention but also serves as an increasingly important factor in selecting a job, especially when it comes to Gen Z, who will make up almost 30% of the global workforce by 2025 according to the WHO.
“Ultimately, if you want to create a workplace that stands for sustainable human development and performance, you need to embrace a systemic approach at three levels – organizational, team/manager, and individual,” concludes Brassey.
An Exponential Rise In Cases Of Eating Disorders
9% of the world’s population are said to be affected by an eating disorder, a significant number of whom are women, with one in seven women thought to suffer from an eating disorder in their lifetime. Eating disorders are among the deadliest mental illnesses, second only to opioid overdose. Data also indicates that children and adolescents are experiencing an increase in all mental health difficulties, this is more so true for eating disorders.
Dr. Elina (Linnie) Telford, Chartered and Registered Clinical Psychologist, was inspired to work with people with eating disorders at the age of 13, after reading a book called ‘All of Me’ by Maureen Stewart. The story outlined the experiences of a young girl who was admitted to the hospital with anorexia nervosa.
Dr. Elina (Linnie) Telford, Chartered and Registered Clinical Psychologist
Dr. Elina (Linnie) Telford
“Her story spoke to me and moved me deeply, the impact of the book was likely reinforced by my own and peers’ lived experiences of mental health difficulties at the time. The book acted to inspire both my academic and clinical career, so I started researching eating disorders all the way to the Doctoral level; lectured at University on the subject; volunteered; achieved two Doctorates, and worked therapeutically with people who have developed an eating disorder and their families,” shares Telford. She is now a Lead Clinical Psychologist for a Child and Adolescent Mental Health Service within the NHS, whilst also working in private practice.
The pandemic saw an exponential rise in cases of eating disorders. In Telford’s view, it is likely due to lockdowns significantly shifting young people’s sense of agency and experiencing an unprecedented lack of control over all areas of their life. The lockdowns also meant that for many that their normal coping strategies to manage stress and support their wellbeing were suddenly removed without warning; therefore, activities that would have kept them well and occupied, were no longer available to them.
“It is important that parents are aware of mental health issues and the stresses that their children are being exposed to both on and offline. Parents are very much part of the solution. They are well-positioned to role model appropriate and healthy expression of a range of emotions; they can also model mental and physical self-care through engaging in proportionate health and wellbeing pursuits. Also, knowing what conditions help your child communicate can also be key to exploring when things are wrong. However, some teens just don’t like talking to their parents and that’s ok. What is important is that for these kids, if parents are worried, they ask for help,” she continues.
A challenge with an eating disorder is that it is life-threatening and in some instances legal and safeguarding frameworks are utilized to enable life-saving assessment and treatment. Even within these difficult parameters, children, young people, and their families can be given a voice and choice. “It is my view that it is important to empower people throughout their treatment and to allow some aspects of control and ownership where safe to do so and where possible. Interventions which lose sight of the child and their family’s voice, or interventions that are not person-centered and/or lack evidence base are seldom helpful,” concludes Telford.
Neurodivergent Conditions And Mental Health
Lately, there has been a growing push for neurodiversity, focusing on brain differences, not deficits. It’s an undeniably complex area that, with more research and support for people, could lead to big changes in the workplace and general wellbeing. As with other mental health conditions, neurodiversity is still not as widely recognized and there are often long waiting times for assessments to be completed as a result of this people are seeking assessments privately.
Those with neurodivergent conditions are at greater risk of suffering from poor mental health because of a lack of support and constantly feeling the need to ‘mask’ their symptoms from others to fit in with societal norms, according to Jenny Okolo, Wellbeing Centre Manager and Lead Occupational Therapist at NHS, and founder of SASA – a career platform set up to inspire young women to become what they want to be, regardless of their background.
Jenny Okolo, Lead Occupational Therapist at NHS and founder of SASA – a career platform set up to … [+]
“Our aim is to promote diversity in all factors and encourage young women to overcome the glass ceiling that is currently being presented by society. We also aim to elevate the work of emerging women, by providing an open platform where their voices can be heard,” she shares with me.
As an experienced occupational therapist and an award-nominated mental health advocate with extensive experience within the psychiatric and criminal justice sectors, Okolo has come across patients with mild to severe mental illnesses such as schizophrenia, psychosis, bipolar, and personality disorder. “The brain is such a complex organ and for the most part, is an area that still has so many gaps. One of the favorite projects that I worked on is supporting patients with integration into the community via positive risk-taking and enablement into vocational services.”
Depression and anxiety are the most common mental health problems among people with neurodiversity as they are associated to have lower life satisfaction, social difficulties, insomnia, and loneliness which can have negative consequences. According to the National Institute for Health and Care Excellence (NICE), 2018 guidance relating to suicide prevention recognizes that autistic people are among those at high risk. Another common reason why mental health is so prevalent in neurodiverse people is that there is a significant lack of resources in this area to help with confirming the diagnosis and accessing the right support.
Working in an inpatient psychiatric hospital and prison has provided Okolo with insight into how race, social background, economics, and pure lack of support and oversight at pivotal stages in one’s life can become the breeding ground for creating some of the most unwell and dangerous people.
“Studies have shown that U.K. prisons are disproportionately made up of people with various psychotic and neurological conditions such as schizophrenia, personality disorder, brain injury, ADHD, autism spectrum disorder ad learning disabilities, indicating a need for greater awareness of mental health and neurodiversity within the criminal justice system. Those who have had any involvement with the criminal justice system often face scrutiny and judgment based on their crimes only, which is why more than likely mental health support isn’t as accessible to them. Fortunately, a lot of prisons have started taking notice and have placed mental health in-reach teams to support inmates with mental ill-health,” she adds.
Women And ADHD
According to a 2016 study from the Centers for Disease Control and Prevention, more than six million children in the U.S. between ages 2 to 17 are estimated to have been diagnosed with attention deficit hyperactivity disorder (ADHD). The latest NHS figures show that number of men who were diagnosed with ADHD in 2019-20 was three times higher than the number of women who received the same diagnosis. Similar to many other areas of our health, the diagnostic standards set to diagnose ADHD were developed in studies of boys and men – who tend to show symptoms such as hyperactivity, as opposed to the introverted and inattentive presentations more common in women and girls.
“ADHD has always been spoken about in terms of myths and stigma. It has long been regarded as a “naughty boys” disorder, an excuse for bad behavior and within the public and healthcare often not seen as a valid condition. This is despite the highly extensive and high-quality scientific research about the condition dating back now 30 years and which continues to be one of the highest research medical conditions,” shares Dr. Rob Baskind, Independent Adult Psychiatrist, specialist, trainer, and educator in ADHD.
Dr. Rob Baskind, Independent Adult Psychiatrist, specialist, trainer, and educator in ADHD
In 2021, the gymnast Simone Biles has spoken publicly about her diagnosis and her use of medication, tweeting “it’s nothing to be ashamed of”; as well as famous swimming champion Michael Phelps who was diagnosed aged nine.
Over the last five to 10 years, there has been a significant increase in media articles and awareness, and the acceptance and identification of the difficulties those with ADHD experience, as well as the strengths they manifest, is increasing massively, demonstrated by the increase in NHS and other services and support for persons with ADHD.
Baskind qualified as a doctor in 2001 and trained to be a psychiatrist, Baskind then worked in prisons for eight years and subsequently developed and became the clinical lead of the first NHS service for adults with ADHD in Leeds, increasing awareness and accessibility for assessment and treatment for adults living in Leeds that previously didn’t exist. “The rates actually in our clinics were almost equal between men and women, and this demonstrates that the prevalence rates are similar, whilst also it is clear many women got “missed” as children and adolescents, for lots of reasons, such as often being more likely to mask symptoms and present as anxious or having low mood, usually as a consequence of unidentified underlying ADHD, and so ADHD is not picked up until much later,” he explains.
According to him, it’s important to hear positive stories and experiences of people with ADHD, especially women, but also the positive aspects of medication for ADHD as that also is often stigmatized and can lead to discrimination. The reality is that medicines are in the main very safe and hugely effective treatments, but at the same time, they are only one tool of strategies and interventions that help manage ADHD.
Seeing ADHD cases being dismissed by colleagues in mental health, and by other psychiatrists, can be really disappointing for someone so passionate about helping disadvantaged patients with mental health issues, such as Baskind. He agrees that this is mainly due to a lack of knowledge and stigma, within the profession, and has led to patients being ignored and to inappropriate treatments.
“There are some fantastic organizations now who are out there lobbying and raising awareness about neurodiversity and I am really confident that the services and support, and appropriate adjustments within industries and education will continue to increase and be seen as the norm, rather than exceptions,” he concludes.
Democratizing Access To Mental Health Support Through Telehealth
If a pandemic has brought us any good, then it’s more awareness of how we need to take better care of our mental health. And although some might say that getting good support is expensive and thus not available to everyone, innovative startups tackling this issue are booming more than ever. One of those companies is Sesh, a platform providing digital support groups facilitated by board-certified and licensed therapists.
“We aim to close the accessibility gap for those seeking mental health support. Our session offerings are both unique and interesting for a broad array of audiences and the cost of our service is unbelievably low compared to traditional therapy offerings,” shares Lauren Sumrell, Vice President of Clinical Operations at Sesh. For Sumrell and her team, it is imperative not to discriminate by age, sex, ethnicity, location, or socioeconomic class, when it comes to their offering.
Lauren Sumrell, Vice President of Clinical Operations at Sesh
In England, It is estimated that around 10 million people with mental health problems cannot get specialist help because they are not considered sick enough to qualify, as revealed last year, in addition to the official waiting list for NHS mental health care, which stands at 1.6 million people, including 374,000 under-18s.
“Our diverse sessions and our diverse facilitator network create lots of crossover interest and engagement from our user base. Originally, our offering was heavier on the D2C side, but in 2022 we’ve had a huge growth in our B2B sales and partnership affiliations. It’s so encouraging to see employers investing in Sesh services to support their employees’ well-being, they’re really interested in reducing stress and burnout while increasing retention through our group support model. We’ve definitely seen momentum continue post-pandemic surges, ultimately the pandemic put a spotlight on both the importance of mental health and also the ease of accessing those services virtually,” she adds. And indeed, addressing wellbeing at work increases productivity by as much as 12%, research has shown.
Sesh’s facilitator network has grown by 25% in 2021, so it is truly encouraging to see so much professional interest in this business model given the climate of competition for therapy talent right now. Additionally, they took it upon themselves to make the service fully available via the web whereas they initially started out as mobile-only.
“We still see mobile-first as the primary engagement for reserving sessions but the web access has seen some early success. It is imperative that as we expand, our work continues to be deeply rooted in credibly supporting people,” concludes Sumrell.