Learning fast. Working hard. Achieving well. Burning out. Is the sequence inevitable for anyone? The link from fatigue through stress to depressive and anxious overloads indicates a need in New Zealand workplaces for assistance in identifying workers at risk. Medical emphasis on clinical criteria delays provision of assistance, when compared to the loss of work functional effectiveness. The stigma of mental illness prevents a considerable proportion from self disclosing, and perhaps from self-identifying. Many people tend to say they are doing fine, even when they know they are not, because it is embarrassing to admit to being a mental health failure. But self-report of the sensations of fatigue on a regular basis appears to offer early indications of individual overload. Reviews of group interactions that are particularly sensitive to losses as fatigue rises appear to indicate team overload. Early intervention for all personnel (not just those ‘failing’ to meet a threshold) assists team members in supporting those most affected, with benefits for the whole team as well as the individuals most at risk. There are similar approaches possible to use the strengths of groups to support members experiencing stress, mood losses and worry.

1. FATIGUE MANAGEMENT
STRATEGIES
for high fliers and low liars
Frank O’Connor
© 2014
Working Well, Mental Health Foundation
BSSNZ Fitness for Work Services, Instep Limited

2. We are told
THE WORKPLACE MUST BE SAFE

3. … with risks mitigated or removed
Looking for workers at risk not
for risky work
o Fear of prosecution
o Ongoing liability
Risk also lies with work targets
and processes
o Functional effectiveness criteria
instead?
Drop in work or social interaction

4. Ask the right question
Am I unfit for
work?
Am I fit for
work?

5. Our fatigue is affected by:
o The kind of work we do
o The way work happens at our
place
o How engaged and supported we
feel
o Our own life circumstances and
lifestyles

6. We can choose to be in control … or not

7. Fatigue unrelieved makes stress
Excessive stress unrelieved makes burnout
Burnout feeds depressive and anxious overloads

8. Inevitable sequence?
Learning fast
Working hard
Achieving well
Burning out

9. So how do we know before
FATIGUE CHANGES THINGS
9

10. Fatigue changes thoughts
o Memory problems
o Inability to concentrate
o Poor judgment
o Seeing only the negative
o Anxious or racing thoughts
o Constant worrying
10
I think it’s
fatigue

11. Fatigue changes feelings
o Moodiness
o Irritability or short temper
o Agitation, inability to relax
o Feeling overwhelmed
o Loneliness and isolation
o General unhappiness or depression
11

12. Fatigue changes sensations
o Aches and pains
o Diarrhoea or constipation
o Nausea, dizziness
o Chest pain, rapid heartbeat
o Loss of sex drive
o Frequent colds
12

13. Fatigue changes behaviour
o Eating more or eating less
o Sleeping too much or too little
o Withdrawing from others
o Neglecting responsibilities
o Relaxing only with drink, drugs,
smokes
o Nervous habits – nail biting, pacing
13

14. Earlier indications
Use of self-report on the sensations of fatigue
o regular basis
o individual overload states
o contributing behaviours such as
resting and sleeping
eating and drinking
activity and play
Condition report: how well I am
and am likely to be?

15. How Tired Are You?
Never Sometimes Quite often Frequently
Do you fall asleep in front of the TV? 1 2 3 4
Are you irritable, at home or at work? 1 2 3 4
Do you fall asleep when you are a passenger in a
1 2 3 4
car on long journeys?
Do you sleep more on your days away from work? 1 2 3 4
Does your partner (or other family members or
friends) complain that you are not interested in
doing things on your days off?
1 2 3 4
Do you wake up feeling tired? 1 2 3 4
Do you feel tired and have difficulty concentrating
1 2 3 4
during the day?
Do you have to make an effort to do the things you
used to enjoy?
1 2 3 4
Not for reproduction
–
Used with permission
from BSSNZ

16. Asking the right question?
Am I unfit for
work?
Am I fit for
work?

17. A special interest
HIGH FLIERS

18. Destination burnout?
Something’s not right —
physical exhaustion is feeding
mental fatigue and on and on it
goes
18

19. Stress ≠ burnout?
o Stress, by and large, involves too
much demand physically and
psychologically
o It feels pressured and full and like
it matters a lot
o Stressed people often still
imagine, that if they can just get
everything under control, they’ll
feel better
“Stress drowned me in responsibilities”
o Burnout means not enough
physically and psychologically
to do what’s needed
o Burnout feels empty and
without motivation, and
beyond caring
o Burned out people often can’t
see any hope of improvement
in their situations
“Burnout dried me right out”
19

20. Deep burnout is not for wimps
Advanced burnout needs:
o Tenacity and dedication
o A sense of responsibility
o Commitment to goals
Others would have given up
sooner …
Sources of persistence
o Driven by fear of failure or of
being wrong
o Chasing (and being chased by)
ego-goals
o Rigid standards, and thinking
there's only one right way
20

21. Attention, all personnel!
Early intervention for all
o Benefits more than the individuals most at risk
o Assists persisting support for those most affected
o Reduces risk of others becoming infected
Uses the strengths of the workgroups
o To support members experiencing distress
o To strengthen compliance with standards

22. A special interest
LOW LIARS

23. Individual fatigue and wellbeing range up and
down
Hyper
Up
Blah
Zonked

24. Bad times happen, people respond
Hyper
Up
Blah
Zonked

25. How we label fatigued people
Disaffection
Distress
Dysfunction
Disorder
Weird
Anxious
Worried
Unhappy
Gloomy
Withdrawn
Depressed
Uneasy

26. What I say about my fatigue
Disaffection
Distress
Dysfunction
Disorder
This pressure is
too much
I can’t survive this
This feels
awful
I can’t do this
No-one cares
It’s not fair

27. Asking the right question?
Am I unfit for
work?
Am I fit for
work?

28. Good reason for undeclared risk
Stigma of mental illness
o Many won’t self-disclose
o Some can’t self-identify
People say they are doing fine,
even when they know they are
not
“It is embarrassing to admit to being a
mental health failure”
“The help they gave me didn’t”

29. I choose how I recover, by how I …
Hyper
Up
Blah
Zonked
Play and Be
Active
Relate and
Belong
Learn and
Accept
Eat and Drink
Rest and Sleep Think and Feel

30. A matter of process
WELLBEING IN TEAMS

31. A team is more than its members
As members struggle, so does the workgroup
o Group productivity falls faster as fatigue rises
poor load sharing
weaker joint decisions
less tolerance for differences
Team and personal overload indicators differ
o Group output indicators lag
o Group process indicators predict

32. Team wellbeing processes
Hyper
Up
Blah
Zonked
Leading and
Following
Resolving
Differences
Communicating
Aligning
and Linking

33. IN CONCLUSION

34. Mentally well people are…
o Healthier and live longer
o Better in school and work
o Happier in relationships
o Less prone to stress
o More adaptable to change
How do we get more?
34

35. More wellbeing and less fatigue at work
Blockers
• Feeling chronic stress
• Aggression intolerance
• Disengaged distant
• Unclear or no purpose
• Burnout or fatigue
• Mental illness symptoms
• Poor physical health
35
Helpers
• Positive emotions often
• Interest and involvement
• Friendly relationships
• Meaning and purpose
• Accomplishment
• Health awareness
• Good physical health

36. Good mental health is good for business
Costs if poor
• 2 x sick leave
• 2 x conflict
• 3 x cardiovascular
• 3 x back pain
• 2 - 3 x injuries
Life is more miserable!
36
Benefits if good
• 31% higher productivity
• 37% more sales
• 3 x more creativity
• Better customer satisfaction
• Reputation as a good place to
work
Sources: Harvard Business Review 2012; Robertson and Cooper 2011; Canadian
Mental Health Commission 2013