It was such a pleasure to have a GP on the Podcast talking about stress and anxiety at work. Dr. Ellie Cannon joined me for such an informative conversation.
We chat about:
- Just how common it is for GP’s to see patients with stress and anxiety
- At what point you should see your GP if you’re struggling mentally
- Taking medication for anxiety
- How to talk to your manager about how you’re feeling
- Medication for anxiety and depression
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Ep 101. Stress and Anxiety at Work with Dr Ellie Cannon
Chloe Brotheridge 00:01: Hello and welcome to the Calmer You podcast. This is your host, Chloe Brotheridge. I’m a coach, a hypnotherapist, and I’m the author of the Anxiety Solution and Brave New girl. This podcast is all about helping you to become your calmest happiest and most confident self.
If you are interested in working with me 1-2-1
I just want to let you know that I see a select number of one on one clients at the moment and have a few slots available online using a programme called zoom. It works incredibly well. It’s a powerful combination of hypnotherapy and coaching. If you want to check it out, you can head to my website, Calmer-you.com/workwithme.
You can find a load of free resources on my website to help you to become your calmest self. Head on over to calmer-you.com/free to grab those freebies now.
Meet Dr. Ellie
Today on the Calmer You podcast, I’m talking to Dr. Ellie Cannon. We met on a panel we did together and I loved everything that she was sharing. She’s not only a GP, she’s also an author. Her latest book is all about work, health and the effects that our jobs can have on our mental health. It’s called, Is Your Job Making you Ill?
She’s also columnist for The Mail on Sunday. I love her Twitter feed and approach. She’s very no-nonsense and calls all sorts of things out. I’m not a doctor so I love taking this opportunity to speak with a GP. There are lots of things that I really wanted to get her perspective on.
In this episode
We talked about how common it is for GPS to see patients with stress and anxiety. Hint, it’s an incredibly high number.
We talked about at what point we should go and see our GP if we’re struggling mentally. This has to be one of the most common questions that I get asked. People ask me, what is a normal amount of everyday worries and stress? Also, when is it something that I need to go to the doctors about? When is it a mental health condition? She really clarifies this.
We get into the topic of taking medication for anxiety, we talk about the stigma around that. She also gives us her professional opinion and her experience.
We also talked about how to talk to your manager about how you’re feeling in terms of your mental health. This is something that again, I hear a lot of people asking. Many people want guidance on this and she is the perfect person to talk about this.
She also shares just loads of other insights into work stress and how we can manage our mental health at work.
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Let’s get into the interview with Dr. Ellie Cannon.
Chloe Brotheridge 04:23: Welcome Dr. Ellie Cannon, thank you so much for joining me. Could you tell the listeners what it is that you do and how you got to where you are today?
Dr. Ellie Cannon 04:29: I’m a GP, doing really normal things in clinic that everybody would be familiar with seeing kids seeing, adults seeing, the elderly.
In general practice nowadays, we see a lot of mental health. And obviously I do a lot of writing and broadcasting. A couple of years ago when I was asked to write another book, they particularly wanted to see what sort of things I see in practice. I had a few ideas about weight loss and exercise and chronic health.
I also mentioned and that I think anybody would be quite surprised by the amount of job stress that I see or people who are really ill as a result of their job, either with anxiety or depression or stress that is caused by the job. People who’ve got chronic illness, like arthritis or they’ve already got a chronic mental health problem and it’s made worse by the job.
My publisher was really, really interested in that. I had the opportunity to write a book all about how you talk to yourself if you are unwell, and mentally really more so than physically as a result of your job. I focused on stress and anxiety and depression, how we should look after ourselves and how you can help yourself. That’s how I ended up talking so much about this.
Speaking to your doctor about mental health
Chloe Brotheridge 06:19: Amazing. Thank you and I really loved your book. It’s so kind and informative and helpful. It must help a lot of people. One thing that I hear all the time from people is that they feel nervous about going to their GP to talk about their mental health. I’ve heard from a few doctors that I’ve spoken to, I think people don’t realise just how common it is for GP to have patients talk about their mental health.
What would you say to someone that is feeling nervous about speaking to their doctor and how common is it for you to see patients for things like depression and anxiety?
Dr. Ellie Cannon 07:01: Without looking at official figures or statistics, I would say as an anecdote, probably 50% of the patients who walk through my door are going to be talking about something to do with mental health. They may actually be coming in to talk about their eczema, which is very bad at the moment because of stress. So it might not be the first thing that they come in with, but often it is.
I would say to anybody, your GP is absolutely the right place to talk about your mental health.Dr. Ellie
Men, come visit your GP
I agree with your experience that a lot of people do seem to be reluctant or nervous and worried about having that on their record, worried about sort of the stigma or even within a private GP clinic group talking about that. It’s very, very normal to start off with talking to a GP. I would particularly encourage men to come to the GP to talk about it. Not enough men come to the doctor, particularly between the ages of about 20 to 50. We know that men of that age suffer from mental health with depression and their risk of suicide is higher compared to other groups. It’s really important that people feel able to come to a GP to talk.
Chloe Brotheridge 08:26: That can be quite reassuring for people to know that actually 50% of the patients their doctor sees might be having a similar experience. They’re not the only one. Their GP is not going to be shocked by what they say or if you burst into tears. That’s quite normal, I imagine. So don’t worry too much about that.
What patients may really be coming in for
Dr. Ellie Cannon 08:47: Yeah, absolutely. It’s very, very normal, if you can’t find the words, and very normal to cry. The patient’s sort of test us out. Sometimes a patient will come in with something really minor. They might come in to talk about their back, or something really, really small. And it’s totally fine to do that. It’s totally fine to see if that’s the GP for you. GPs are not all the same with very, very different ages, interests, and personalities. So it might be that the GP who you go to to talk about your blood pressure is actually not the one who you visit to talk about your anxiety. Test it out, take someone with you if it’s better for you. There are definitely ways you can make yourself feel more comfortable.
Chloe Brotheridge 09:50: That’s such good advice. What are the common things around anxiety that you see people come for and how much do you think work is an aspect of people’s anxiety.
Dr. Ellie Cannon 10:07: It’s important to point out that anxiety obviously is a normal symptom. If you have a job interview, to feel anxious that morning, it might be a normal part of anxiety, that you feel a bit sick. You don’t feel like eating but you rush to the toilet. And that sort of normal anxiety becomes a health problem and becomes an anxiety disorder when it’s really the overriding symptom that you feel all the time.
Even on days when you don’t have a job interview, you feel sick and you feel anxious and you’ve got some overriding anxiety all the time. I think because of the way we work and the pressure on deadlines, the pressure of presenteeism, the pressure of sort of having to be doing so many things all at once and targets and hustling for work and all of this, it is hard to separate what is normal or real anxiety.
I suppose the way to test that out on yourself is to see if you can switch off on a Saturday. Can you turn your phone off? or go for a run and actually relax and calm down? Or is it still there? And I think if it’s still there, you know, then that is a concern. Can you relax? Can you make a plan with your favourite person doing your favourite thing and enjoy that without feeling nervous? If you can, it’s probably just normal stresses and strains of life. If you can not, then it could be that you have some anxiety.
When to see your doctor for anxiety
Chloe Brotheridge 11:53: A common question that I hear is at what point do I go to my Doctor. For example, if I’m feeling anxious every day is that enough to go to the doctor. How bad does it need to get? How do I know whether it’s bad enough? What do you say to people about that?
Dr. Ellie Cannon 12:15: Whether it’s mental health or whether it’s potential symptoms of cancer, it’s always best to get in there early. It might be that you go to a doctor and your doctor says to you, I think that’s normal and it is the stresses and strains of life. In order to diagnose anxiety, we do look at a lot of specific traits and situations. Can you enjoy going out with friends, how is your sleep, or do you panic? We will go through a questionnaire and a series of questions to try and unpack whether or not you do have anxiety? I would say the minute you’re asking yourself that question, should I go to the GP? That’s the right time to go to the GP.
Chloe Brotheridge 13:19: f you if you’re worried about it, that’s a sign that it probably is something to get some help for. It’s better to get help sooner rather than wait and let it get worse, potentially, maybe if it’s left untreated.
Chloe Brotheridge 13:52: In your book, you talk about workplace relationships as being a big factor in what can make us sick at work. You mentioned toxic colleagues and bosses that are not so nice. That’s such a tough one for people to deal with, because it’s almost as if there can be no escape. Sometimes you’ve got a colleague that is an absolute nightmare. If you don’t get on with your boss, it’s that inescapable kind of stress. What do you suggest to people about that sort of thing?
Dr. Ellie Cannon 14:30: I think that we all really underestimate the importance of relationships, both in terms of our personal life and our personal mental health and also our mental health at work. When I researched the book, and I looked at what was the biggest causes of mental health problems at work, the workload was the biggest cause and then the second biggest cause was relationships at work.
What we also see is that those relationships can also be what protects you at work, and what saves you at work. I think we mustn’t sort of lose sight of that. So the really simple act of having lunch every day with a colleague where both of you put your phone away for 15 minutes, so you’re actually talking and interacting. It might be that your boss is very difficult to deal with or one of your colleagues are difficult to deal with. If you’ve got strong relationships with everybody else around you, then that gives you the resilience to be able to cope with that one relationship.
Focus on the good relationships for resiliance
It’s worth building up what seems like those trivial relationships with the person you say hello to you on the door or the person who works in the next-door office. Those sorts of interactions give us the resilience to cope with what is difficult.
Now, obviously, of course, there are situations where people cannot get on with a colleague. That makes work very difficult. I’ve seen in practice, it can lead to people leaving their job and all sorts of trauma and grievances. Anything we can do to build up our resilience is going to protect us a little bit from that. It is key to focus on those good relationships at work.
Workplace relationship practices
Something simple we do at my GP surgery is have a 10-minute coffee break every morning in the middle of surgery. We didn’t used to do that, but being a GP can be quite isolating because you’re there you’re seeing patients and you’re not seeing your colleagues. We just sit down for 10 minutes. Sometimes we’re talking about what was on TV last night or a patient. We talk about all sorts of different things, it’s just that sort of human contact, it’s really brought us together. You know, you can have a laugh or let off steam, it just gives you that little boost for the rest of the day.
Chloe Brotheridge 17:29: Those relationships that we have are so important. I was talking to on the podcast with Julia Samuel, who’s a psychotherapist. She talks a lot about how our relationships are the most important things in our lives. We can get so caught up in all the other things that we have to do that we can neglect them or not make time for those things. Sometimes that can mean we isolate ourselves then there can be a bit of a vicious cycle of anxiety in depression because we’re not able to spend time with people. It’s so important. I love the idea of just having a, tea break with your colleagues arranging something, or going for lunch. It’s really the simple things that can just give you that resilience for your relationships.
The current way we work
Dr. Ellie Cannon 18:16: Unfortunately, it’s the current way we work that has, unwittingly, reduced those opportunities for those relationships. If you imagine as a workplace in the 1950s, or 60s, lunch was a very set time, everybody would have had lunch at one o’clock on their shift pattern. They’ve all sat there with their packed lunch.
It wasn’t everybody walking out to get a sandwich by themselves, checking their phone doing this doing that. Whereas now we tend to work a bit more flexibly in some ways. There may not be some where you can all sit at work. I think of those things have changed, which is why we almost have to almost artificially bring them back into our lives. When I first started working as a GP 15 years ago, it was in the clinic. The receptionist or colleague stopped at 11 o’clock and made us tea and coffee. Very sort of old fashioned really, but actually that meant that we all stopped and connected. Obviously nobody would expect that now but we need to think about how to bring back the opportunity that provided.
Chloe Brotheridge 20:09: I work for myself and quite often spend time at home. I don’t have colleagues to socialise with but I’ve got other friends who do similar work to me and sometimes we’ll go to a co-working space together. We didn’t actually get much work done. We did though get out of the routine, get away from our desk and be around other people, which is so important.
Talking to people at work about stress and anxiety
I wanted to ask you about talking to people at work about stress or anxiety This is a such a big topic and I hear this question asked a lot about how to broach the topic with managers. You mentioned a lot of different resources in your book for that. What do you suggest to your patients when they come to you about their work stress?
Dr. Ellie Cannon 21:15: I think you have to start off with a safe person or a safe group to test the water. It might be that person is a family member might be that they’re definitely not a family member because they wouldn’t understand. It might be that a friend or somebody in an online community.
Once you’ve started having that conversation with your GP, I think you then have to have a safe conversation with somebody else. Someone outside of work to see how it sounds, to test it out.
A lot of questions could come up: who do you need to talk to? Do you need to talk to somebody because you need time off? Do you need workplace adaptations? It has to be with people who you can trust and who you will not look back years later and think did that affect my career. It’s not the sort of thing you blurt out in the middle of a work meeting.
You have to remember, the person you’re speaking to. Make sure it is measured, make sure it’s planned. It might be difficult conversation for them as well. There are lots of different factors that can come into it. But it does have to be very, very planned.
A two-step process
Chloe Brotheridge 24:11: I love the idea of sending them an email beforehand and letting them know what it is that you want to discuss with them. That’s kind of a two-step process that kind of takes the pressure off. Rather than surprising them it offers a chance to prepare and think about how they can respond in a helpful way.
Dr. Ellie Cannon 24:35: I see patients every 10 minutes. Sometimes we have an idea of why people are coming in and sometimes we don’t. Sometimes we think we know why somebody is coming in. As a GP, that’s what I’m trying to deal with. Talk about somebody’s headache and then the next minute talk about a baby’s nappy rash and the next thing to talk about depression. It can be quite difficult sometimes to switch into that mode and that’s even as a trained professional.
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You touched on something earlier about eczema and the kind of the psychological things that might be at the root of that. You talk in your book about the link between stress and physical issues. What is the link there? Because some people might think, Oh, is it all in my head? You know, have I created this issue?
Dr. Ellie Cannon 27:10: No, it’s not. I think it’s really difficult for people to understand even myself as a doctor, that psychological or emotional things can cause physical symptoms. The way to think about it and to understand it is sort of like the example I gave before of a job interview.
Before a job interview, sure you feel nervous and you may feel nervous or scared or whatever you feel. You also do experience physical symptoms which might be rushing to the loo, you might feel sick, you don’t have an appetite, or like when you’re a child and you know that your mom or dad is going to tell you off and you start to get butterflies in your tummy and you feel like a tummy ache. We’ve all experienced physical symptoms from something psychological, but still, we all find it very, very hard to understand that link.
It’s probably hormonal or to do with cortisol and adrenaline. All of these different things which are triggered by the psychological side of things and then gives us physical symptoms. Definitely there’s a link and people are not imagining it. The main issue I see in the clinic is the sort of phenomenon of people who come in and say, I’m in all the time. There must be something wrong with my immune system.
Skin conditions linked with psychological conditions
I mentioned eczema, particularly because skin conditions are very closely related to psychological conditions and anybody with eczema or psoriasis, will tell you that in times of stress, their eczema is worse now because of the stress itself, but also because people don’t necessarily look after themselves when they’re stressed out or feeling unwell. Those types of conditions take a lot of personal management. Just being stressed itself makes the condition bad.
Many conditions are worse when people are psychologically stressed. Also,we know that if your pain is bad, that will make your mood worse. So it’s a backwards and forwards pattern between physical and mental health.
Chloe Brotheridge 30:52: The thing that comes to mind for me when I think about stress and physical illnesses, certainly from the clients that I see is IBS and and the link between anxiety and IBS. Is that something you see a lot of?
Dr. Ellie Cannon 31:29: Like I said your psychology is very related to our skin. It’s also very related to our tummies and our guts and everything else. People with IBS will often experience a flare-up when they are stressed out, and their toilet habits will change their tummy pain will change and increase very, very closely. That trigger could be simply stress. It’s also what you do when you are stressed or anxious or unwell. You may not be eating properly and not reaching for the right foods. If you’re not taking the time to look after yourself, and not taking the time to make yourself a lunch with foods that are not going to trigger your symptoms. All of those things can also worsen symptoms at a time of feeling unwell.
Chloe Brotheridge 32:57: It’s a bit of a vicious cycle. You have IBS because maybe you’re anxious. Having IBS can also make you anxious. It can create a bit of a vicious cycle for people. I suppose in terms of what people can do about IBS is it speak to your doctor first.
IBS – treating the condition
Dr. Ellie Cannon 33:27: With IBS we have very specific treatments that don’t treat the condition itself, they merely treat the symptoms. We have medications for bloating that are known to work quite well. Obviously, we have antispasmodic pain medication that can sort of calm down those tummy pains that people have with IBS, but we don’t have any treatment per se.
It’s part of guidelines now that we recommend for IBS that people try a probiotic supplement to increase your gut-friendly bacteria to improve your general symptoms. That can help. If you’re going to try that, then you need to use the same brand every day for a month to see if that’s having an effect on you. If IBS is something that people are suffering with, definitely do the probiotic idea but also do a food diary and get to know what your triggers are.
That’s really going to be the mainstay of your treatment. The stuff that a GP is going to give you is going to be treating the symptoms. It’s almost better if you can to try and work out what those triggers are. They might be the obvious triggers, like dairy or specific types of fruits and vegetables which can be very sort of gassy and give a lot of the bloating and the tummy pains. It might also be something that is very specific to you.
What helps a busy GP
Chloe Brotheridge 35:11: Thank you. That’s, that’s very helpful. I really wanted to ask you how you stay calm because you obviously are a GP, you know, with a busy practice, you write books, you write for the mail. What are the things that help you in your life?
Dr. Ellie Cannon 35:34: The honest answer is that I don’t really stay that calm. It’s fair to say that I definitely have anxiety and I have been through episodes in my life where I’ve needed help for that anxiety, either in medicine form or also therapy. Doctors like anybody else suffer from conditions, whether their mental health problems or physical health problems.
Relationships support my mental health
The protective factor for me is twofold. Definitely people. I’m a people person. That’s obviously why I became a doctor and became a GP. I have certain relationships that are incredibly positive in incredibly different ways. They offer pure joy and sort of love and happiness that comes from having a relationship with my kids, or my husband, but also very supportive relationships with people who are colleagues and not just friends.
I’m not a natural exercise though not a naturally sporty person. Walking and swimming or attending an exercise class help. That is definitely good for my mental health and keeps me calm. Also, I need a lot of sleep. I know that I need lots of sleep. If I do feel unwell or do feel particularly bad actually, I can look back and see that is related to a poor night’s sleep.
Chloe Brotheridge 37:52: Sleep is so important. If I’m not feeling well or feeling stressed, I’ll go to bed at 8.30pm and get about 10 hours of sleep
What’s really important to a GP
I wanted to ask you as well, because I follow you on Twitter and I love the things that you post. They are often myth-busting or holding people to account for some of the medical mistruths that go around. What can you share that you’re really passionate about at the moment in terms of what you’ve been writing about? Or what’s really important to you?
Dr. Ellie Cannon 38:31: I don’t like the notion of antidepressants being called happy pills and being shamed in any way. Unlike blood pressure tablets or diabetes medication, they seem a very easy target for headline writers and for people to think they’re unnecessary. There are all sorts of mistruths that come out about antidepressants. I find that really distasteful.
I have patients who are alive as a result of taking antidepressants. That doesn’t mean that they work for everybody. That doesn’t mean that they don’t have side effects. They do. But they are medication like a blood pressure medication and they can be essential.
They don’t make people happy. They treat depression and anxiety pretty well in a lot of cases. I don’t really like that whole narrative around medication. Celebrities who’ve had mental health problems have said they didn’t need an antidepressant they went to music classes or they took up gardening. They were drawing attention to their strength because they didn’t need that. That’s very very stigmatising for anybody else who’s needed medication.
Are we diluting true mental health issues?
I think we have to be careful. We talk about mental health so much we are in danger, very slightly of, of diluting it, to watering it down and actually not giving the voice to the people who are really suffering with their mental health. Anxiety and depressions can get so diluted by so much noise when everybody claims to have had it. We can’t check people’s claims, can we when they talk about it, and I wonder if all of this noise has made it a fashion to disclose a mental health problem. We’re in danger, a little bit of belittling what people who are really gripped by mental health problems are going through.
The privilege of celebrity who has access to treatments and access to all different things compared to people with very significant mental health problems.
Chloe Brotheridge 42:02: That’s such an important point. I hear this a lot as well about the term anxiety. A bit of discomfort isn’t really comparable to the type of anxiety where someone can’t leave their house and they’re having panic attacks every day.
Maybe we need like a new word for different types of levels of anxiety. I really liked what you said about medication and privilege. If you’re privileged enough to spend thousands of pounds having different therapies then maybe you don’t need to go on the medication route. But if you don’t have access to that, you’ll be on a waiting list for therapy.
Chloe Brotheridge 43:21
Can you share with us where people can find out more about you and your work and buy your book and that sort of thing?
Dr. Ellie Cannon 43:28: My book is Is Your Job Making You Ill? The best place to find me is probably on social media where I’m pretty active.
Chloe Brotheridge 44:18: Brilliant. Thank you so much for talking to me. It’s been really, really helpful. Thank you.
Chloe Brotheridge 44:26: Thank you so much for listening. I really hope that you gained a lot from this episode, come on over to Instagram and let me know, what are you taking from this episode? Find me at Chloe Brotheridge.
I would love it if you would leave me a review in the podcast app on iTunes, subscribe to the podcast and leave me a rating. Is there someone in your life that would really benefit from this podcast, you can let them know by sharing this podcast. I’d be so so grateful.
So I’m just wishing you a wonderful week ahead, sending you loads of love. Hopefully you’ll tune in again and I’ll see you soon.