Mental Health Self-Management Strategies For Employees Experiencing Anxiety Or Depressive Symptoms

Anxiety and depressive symptoms can significantly impact work performance, leading to decreased productivity, increased absenteeism, and difficulties with concentration, decision-making, and interpersonal relationships.

Even when symptoms are below clinical thresholds, they can contribute to presenteeism, where employees are physically present but functioning suboptimally.

Finding effective strategies to manage these symptoms is crucial because it can help employees maintain their work performance, reduce the personal and economic costs associated with mental health issues in the workplace, and promote overall well-being.

Self-management strategies empower individuals to take an active role in their mental health, potentially complementing or reducing the need for formal interventions.

Roberge, C., Meunier, S., & Cleary, J. (2024). In action at work! Mental health self-management strategies for employees experiencing anxiety or depressive symptoms. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement, 56(1), 10–19. https://doi.org/10.1037/cbs0000346

Key Points

1. The study identified 54 self-management strategies used by workers with anxiety or depressive symptoms to promote their functioning at work.
2. Strategies were grouped into three main categories: behavioral, cognitive, and affective.
3. Behavioral strategies were most frequently reported, including task management, work-life boundaries, and seeking social support.
4. Cognitive strategies included practicing self-compassion, managing negative thoughts, and developing self-awareness.
5. Affective strategies focused on identifying and managing emotions.
6. The research provides a comprehensive inventory of strategies that can be applied during both work and non-work hours.
7. While insightful, the study has limitations such as potential sample bias towards those with milder symptoms.
8. The findings have implications for developing workplace mental health programs and tools.

Rationale

The study aimed to address a gap in the literature regarding how workers with anxiety or depressive symptoms manage their mental health while maintaining employment.

Previous research has shown that these symptoms can significantly impact work functioning, even when below clinical thresholds (Beck et al., 2014; Prater & Smith, 2011).

While some studies have explored self-management strategies for mental health in general populations (e.g., Chambers et al., 2015; Morgan et al., 2016), few have focused specifically on strategies used by workers to promote functioning in the workplace context.

The researchers identified a need to comprehensively document concrete, adaptive strategies that workers use both during and outside of work hours.

This knowledge can inform the development of workplace mental health programs and provide workers with a range of options to manage their symptoms proactively.

The study builds on previous work by Meunier et al. (2019) on workplace mental health self-management, but uses an inductive approach to capture strategies that may have been missed in prior research.

Method

The study employed a qualitative approach using semi-structured interviews based on Flanagan’s (1954) critical incident technique.

Participants were asked to recall and describe situations where they used strategies to manage their symptoms and promote work functioning. The interview guide covered behavioral, cognitive, and affective strategies used both during and outside work hours.

Interviews were recorded, transcribed, and analyzed using NVivo 12 software. A hybrid thematic analysis approach combining deductive and inductive methods was used (Fereday & Muir-Cochrane, 2006).

Initial codes were based on previous literature, with new codes added as they emerged from the data. The six-step thematic analysis process outlined by Braun and Clarke (2006) was followed.

To validate the findings, an expert committee of 13 members (4 researchers, 4 practitioners, and 5 study participants) rated the relevance of identified strategies on a 1-4 scale.

Sample

25 participants aged 20-60 (M = 35 years, SD = 12.75) from various employment sectors were interviewed. The sample included 9 males and 16 females, working between 25-90 hours per week (M = 35 hours, SD = 12.75).

Participants were recruited through social media and mental health organizations. Eligibility criteria included being 18+ years old, having at least mild-to-moderate anxiety or depressive symptoms for 6+ months, and working 21+ hours per week. Those with severe symptoms were excluded for ethical reasons.

Results

The analysis identified 54 self-management strategies across three main categories:

Behavioral Strategies

These strategies refer to concrete actions and behaviors adopted by participants to manage their symptoms and promote work functioning. They encompass 32 strategies across 8 themes:

• Managing tasks
• Managing worktime
• Managing workspace
• Managing relationships
• Managing work-life boundaries
• Using time off to recover energy
• Taking care of physical health
• Seeking social support

“What I had picked up on was mostly the expectations of me, I think I had misunderstood them. So every time I’m given a task that I’m more or less comfortable with, I just say, ‘Okay, what are your expectations? What are your deadlines?'” (Task management)

“If it’s tougher times like in the fall, then I’ll do less overtime. I’ll be more realistic with how my energy level is.” (Work time management)

Cognitive Strategies

These strategies involve mental processes and thought patterns that participants use to manage their symptoms and improve their work functioning. They include 6 themes:

• Practicing self-compassion
• Managing negative thoughts
• Adopting a positive outlook
• Accepting situations as they are
• Living in the present moment
• Developing self-awareness

“Look, we’re not doing open heart surgery. Sometimes you have to put things in perspective” or “We’re not flying a plane.” (Managing negative thoughts)

“I think to myself how lucky I am to be able to work on this project, on a project that I find so extraordinary.” (Adopting a positive outlook)

Affective Strategies

These strategies focus on recognizing and regulating emotions to better manage symptoms and enhance work functioning. They comprise 2 main themes:

• Identifying emotions
• Managing emotions

“I identify my emotion and I’m like, Okay this is it, here I can rationalize. So, instead of trying to hide all the time, and be like: ‘No, I’m not living like that, it’s stupid to live like that.’ Well, stop feeling stupid for having an emotion. Live it. After that, it’s much easier to set it aside.” (Identifying and managing emotions)

“[ … ] I am aware that sometimes there are clients who get angry at us because they don’t like what we say, because it’s just not what they want to hear. But often they come in and they’re already angry, so at that point I really try to put a wall between them and me. And I keep telling myself that: if it had been my colleague, they would have done the same.” (Managing emotions)

Insight and Depth

This study provides a comprehensive inventory of self-management strategies that workers with anxiety or depressive symptoms use to maintain their functioning.

It bridges multiple theoretical frameworks, including job crafting, work-life balance, recovery experiences, and cognitive-behavioral therapy principles.

The findings highlight the proactive role workers can play in managing their mental health, offering concrete options that can be tailored to individual preferences and work contexts.

The study also underscores the importance of considering strategies used both during and outside work hours, recognizing that off-work activities can significantly impact work functioning. This holistic approach provides a more complete picture of how workers navigate their symptoms in daily life.

Strengths

This study had several methodological strengths, including:

1. Use of qualitative methodology allowed for rich, detailed descriptions of strategies.
2. Inductive approach captured strategies that may have been missed in previous research.
3. Inclusion of expert committee to validate findings.
4. Consideration of strategies used both during and outside work hours.
5. Integration of multiple theoretical frameworks.

Limitations

This study also had several methodological limitations, including:

1. Convenience sampling may have led to underrepresentation of certain job types (e.g., manual labor, manufacturing).
2. Participants were likely those with milder symptoms and better coping skills, potentially missing strategies used by those with more severe symptoms.
3. The study was conducted in a specific cultural context (Quebec, Canada), which may limit generalizability to other cultures or work environments.
4. Reliance on self-report and retrospective recall may introduce bias.

Implications

The findings have significant implications for workplace mental health initiatives:

1. Development of comprehensive self-management tools: Organizations can create resources that offer a range of strategies for employees to experiment with and adapt to their needs.
2. Training programs: Workplace mental health programs can incorporate these strategies to equip employees with practical skills for managing symptoms.
3. Work design: Understanding the strategies employees use can inform how jobs and work environments are structured to support mental health (e.g., allowing for flexible schedules or workspaces).
4. Destigmatization: Recognizing the prevalence of these strategies may help normalize conversations about mental health in the workplace.
5. Individual empowerment: Workers can be encouraged to take an active role in managing their mental health, potentially reducing reliance on formal interventions.

However, it’s crucial to note that self-management is not a replacement for professional treatment or organizational-level interventions. The effectiveness of these strategies may vary based on symptom severity, job demands, and available resources.

Conclusion

This study provides valuable insights into how workers with anxiety or depressive symptoms actively manage their mental health to maintain work functioning.

By identifying a comprehensive range of behavioral, cognitive, and affective strategies, it offers a foundation for developing targeted interventions and resources.

However, further research is needed to validate these strategies quantitatively, examine their effectiveness across different job types and symptom severities, and explore how organizational factors influence their use.

The complexity of workplace mental health underscores the need for multi-level approaches that combine individual strategies with supportive organizational policies and cultures.

As work continues to evolve, particularly with the rise of remote and flexible arrangements, understanding and promoting effective self-management strategies will be crucial for supporting workforce mental health and productivity.

References

Primary reference

Roberge, C., Meunier, S., & Cleary, J. (2024). In action at work! Mental health self-management strategies for employees experiencing anxiety or depressive symptoms. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement, 56(1), 10–19. https://doi.org/10.1037/cbs0000346

Other references

Beck, A., Crain, L. A., Solberg, L. I., Unützer, J., Maciosek, M. V., Whitebird, R. R., & Rossom, R. C. (2014). The effect of depression treatment on work productivity. The American Journal of Managed Care, 20(8), e294-e301.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative research in psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa

Chambers, E., Cook, S., Thake, A., Foster, A., Shaw, S., Hutten, R., Parry, G., & Ricketts, T. (2015). The self-management of longer-term depression: learning from the patient, a qualitative study. BMC psychiatry, 15, 1-16. https://doi.org/10.1186/s12888-015-0550-6

Fereday, J., & Muir-Cochrane, E. (2006). Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development. International journal of qualitative methods, 5(1), 80-92. https://doi.org/10.1177/160940690600500107

Flanagan, J. C. (1954). The critical incident technique. Psychological Bulletin, 51(4), 327-358.

Meunier, S., Roberge, C., Coulombe, S., & Houle, J. (2019). Feeling better at work! Mental health self-management strategies for workers with depressive and anxiety symptoms. Journal of affective disorders, 254, 7-14. https://doi.org/10.1016/j.jad.2019.05.011

Morgan, A. J., Chittleborough, P., & Jorm, A. F. (2016). Self-help strategies for sub-threshold anxiety: A Delphi consensus study to find messages suitable for population-wide promotion. Journal of affective disorders, 206, 68-76. https://doi.org/10.1016/j.jad.2016.07.024

Prater, T., & Smith, K. (2011). Underlying factors contributing to presenteeism and absenteeism. Journal of Business & Economics Research, 9(6), 1-14.

Key learning

Suggested Socratic questions for a college class discussion:

1. How might the effectiveness of these self-management strategies vary across different industries or job types?
2. What ethical considerations should organizations keep in mind when promoting self-management strategies to employees?
3. How do societal and cultural factors potentially influence the types of strategies workers use to manage their mental health?
4. In what ways might the rise of remote work and digital technologies impact the use and effectiveness of these self-management strategies?
5. How can organizations balance promoting individual self-management strategies with addressing systemic workplace factors that contribute to anxiety and depression?
6. What role should supervisors or managers play in supporting employees’ use of these self-management strategies?
7. How might the identified strategies interact with or complement professional mental health treatments?
8. What potential unintended consequences could arise from overemphasizing individual self-management strategies in workplace mental health initiatives?