Stress and stress-induced depression hit many knowledge workers, and yet it is still a taboo. “I am stressed” has become something we hear every day, and it has almost become prestigious to say so; it shows that we are busy, important people. On the other hand, it is a bit embarrassing to be really stressed and not being able to handle it. In this talk, I will discuss the taboo and explore why it hits knowledge workers so often, as well as come with tips and tricks to prevent it.
So I'm just gonna shortly say a little bit about me. So yes, I'm an agile coach. And a lot of what I do is working with people, I tend to work on stuff like psychological safety or communication, collaboration and retrospectives. So it's very often on the softer side of Agile coaching. I'm also a speaker, and I like to do co speaking and co workshops as well. And I have my own company called Native Wired. This is my Twitter ID, but be aware that I do tweet a lot. And of course, I am a certified unicorn and I am also a certified unicorn certifier.
The thing that I'm going to talk to you about today is mainly stress and how that also can become depression. So the thing about stress is that the way that stress shows is by very different things. So I'm going to use the very traditional agile thing, it depends. So the thing about stress is that it shows really different in different people. With some people, it's obvious to see what's going on and with other people, it is not. So what I'm going to do is I'm going to tell you my story first. And then I'm going to relate it to how you can deal with stress in general.
So when I was suffering from stress, what really happened to me was that my brain felt like the pieces didn't fit together. Like there was something missing. I remember the first time I was in between jobs, and a lot of stuff had happened a year before; my mom died, my dad had his leg amputated. I did not have good relationship with my mom. So it felt relieving that she died, but it didn't to my sister. So we kind of almost lost each other there. I had a lot of work at my then company, and then they fired me. So I had a breakdown. And one of the things that made me realise that this was really bad was that I was meeting a friend for coffee. And there was a third guy and I was like, yeah, he seems familiar, maybe I went to university with him or something. And then during the conversation, I realised that I worked with the guy for two years. So I had a lot of these small things. And at some point, actually, I had to bring a notepad with me everywhere, because my short term memory was not functioning properly, it would be totally gone. Like normally when I forget stuff, it would be like, Oh, yeah, I should have done that. But this would be like totally gone from my brain. And my emotional state was very, very dark. So a lot of what happened was that, you know, people tell give you feedback. And I don't know if you can see you in the first picture, but it says all this good stuff, and then it goes you can be a jerk sometimes. And that is kind of what stuck with me. And that that's kind of what I remembered all the time I kind of like every time I got any kind of small feedback, that would just stay with me if it was bad feedback. And all the good stuff would just disappear. Or sometimes it wouldn't even kind of enter I wouldn't notice that it was there. And I was getting in a state that became more and more dark. So if I look at how it felt for me when, before I went on sick leave, I was on a really stressful project in IBM. When anything happened, I had to report to seven levels of managers. And I was working as a scrum master, so I was doing whatever I could to protect the team. I would also be working in the evenings if anything had to be done because I was the only one without kids. So it wasn't as much an effort for me. But looking back I think the hardest part was that about you know not knowing what was going on trying to protect people having kind of so many levels of managers watching out that you were doing things right. And I recall sitting one evening in October or November and thinking if this continues, I will literally die. Of course I've always thinking it in Danish since I was mostly working in Danish at that point, but I really had this kind of like, Okay, if if this continues, I will die. And the interesting part was this didn't stop me at all, because things had to be done. And now that I look back at it, I think this is terrible, but I also see that this happens to a lot of people.
So if I look at a timeline, what happened was that in October, November of 2009, no 2008 must have been, I had this feeling if this continues, I will die. And yet, I did what had to be done, I was working on my project, we had to hand it over to a different supplier. And we managed to do it on time, and we delivered what we're supposed to, and everything was good. And then I joined a new project. Because you can't just walk around and do nothing. So I went on a new project, which, luckily for me, was cancelled. It was one of these interesting things where the client kept telling us what we will do and then we did a rough estimate and it turned out that the amount of money they had was like 100 of what they would pay for what they actually wanted us to deliver. So the good thing for me was that, well, I could go on vacation, I knew I didn't have a project but that wasen't a big problem. So during my vacation, I just became more and more tired. And since I didn't have a project, I called my manager and I said, Can I just have another week of vacation since I'm not on a project? And she said, Yes, but only on one condition, I want you to go talk to your doctor about stress. And I was like, "yeah, yeah, I'll do that" and I did not expect anything to come out of it.
So what happened when I went to the doctor is that he said, not only are you stressed, you have a severe depression, I would like you to go on sick leave. And in the beginning, I was like, yeah, I'll be on sick leave for two weeks, and then I'll be fine. What really happened was that once I was on sick leave, I kind of started letting go of everything. And at that point, you know, I was still doing and people knew I was stressed but I was taking care of everything. And that's one of the things that I have seen is that some people go like, yeah, you can always tell when people are stressed, because they start slacking off, they start not getting things done. But it wasn't this way. For me, it was like, you know, I got everything done, and I still think that if I have something I need to get done, I will keep working on this until I drop. It's like being a, well someday we won't be able to talk about this, but like being a gas car, and you definitely run on the fumes. And you know that you will continue doing this kind of like until, if you're lucky the car gets to a gas station, but it might just break down. And that's kind of where I was. And I actually didn't get back to work full time until March of 2010. So I was home for nine months. And one of the reasons I started talking about this was that so one of the things I did during this time was to kind of stay connected to the workplace, which is always a good idea. Like I would go to lunches and I went to the Christmas party. And one of the things that happens at Christmas parties is that people get a little bit drunk, which means that they lower their defences. And one of my colleagues told me that, yeah, he had had this thing where all of a sudden he started crying at work. But then he just went home for the rest of the day, and the next day, he was fine. And I found this to be really, really, really scary that we have people who just cry or work and go to work the next day. And this was not an emotional guy, he would not be anyone would be sharing emotions or naturally crying use one of these tough guys. And that's actually part of why I started talking about this.
So when I started back at work, I started with three hours a week. And when my doctor said this, I was like, yeah, sure, I could do three hours a week. But actually, that was really, really tough. And just going to work requires a few days of rest. So during this time, I talked to my doctor almost every two weeks, I did have a stress consultant, but my problem with him was that he had one set of tools and that didn't work with me and then he didn't have anything else so he just wanted me to do that more. But my own doctor helped me a lot and I ended up actually going on antidepressants. But this was the second time I went on antidepressants. The first time I got off them as fast as possible, which was a big mistake I see now, but for me, the first time it made me feel weak. Now I know that it's part of what my brain needs to actually live.
So you go, yeah, this is your story, but why should we care. And the reason I'm doing this talk, and I've done this talk a lot of times is that, I see this so much, I see people suffering from stress from depression from anxiety. And it's only grown worse after we've been working at home and we have so much unknown around us. And I kept hearing all these stories and I figured out that if I start talking about this, maybe one person will hear this qnd they will get help.
So I did this in 2018, at Craft in Budapest and one thing I do when I do this live in front of an audience, is I ask people to stand up and not sit down until I'm done. And I say if you know someone who has stress, anxiety, depression, or any kind of other mental problems, please sit down. And out of 800 people 20 people were standing. So 20 people did not know someone who had stress, depression, anxiety, anything similar. And even though I logically know the numbers before I did the talk, that was just scary. And that's one of the reasons I keep talking about this. And I keep talking about why we need to take care of our mental health. And there's a lot of scary stuff with this. There's a Japanese term called Kashi, which basically means death by work. And sometimes it will be literally working yourself to death. So working on till you drop. But the other part of that is suicide. Sadly, that's also something we see in our industry here and there, we don't tend to talk about it. There's been a bunch of that with very young people in the DevOps in the US. But we don't like to talk about these things. So what's not something that's kind of been up in the open. And when I started looking into this, one of the things I found out was that if you look at men, for instance, the main cause of death for men from 15 to 45, is suicide. And the numbers I found is from Denmark, Sweden, UK, Germany, in Scotland, I saw some papers last year that said that 75% of men under 45, who die is suicide. [So on demand, there was a big I was gonna say survey experiment. They look, I don't know what it's called in English. I'm just gonna skip that.] They looked into what's going on with these things. Why are there so many men committing suicide? What is the mental health of men in general. And when they started looking into this, they found that a lot of men still suffer under having to be strong, which then means that you don't, you don't want to show you're weak. And sometimes that even leads to suicide, but also like in lesser things that men tend to not go to the doctor. So like the, the mortality of men, for instance, with cancer is usually higher, because they go at a later point. And one of the things that stuck with me in this report was this guy saying, if I'm not feeling well, I eat in the locker room, because I don't want to lie when people ask me how I'm doing. So rather than tell his colleagues that he was not doing well, he would eat alone. And I think that having that and being in a in a very much male culture. I think this is a big problem. We need to be able to talk about these things. And suicide is terrible, but even just being stressed or depressed, and not being able to speak about this thing is equally hard. And of course, these numbers are for men. I saw some numbers last year from UK as their suicide rate is rising for women as well. And suicide is kind of the most terrible thing but it is still a terrible thing, even if you don't get to that point.
And an interesting part that I learned a few years ago While interesting, sad is that our brains shrinks. So our brain physically shrinks. If we don't do nothing, if we don't have some times where we spent nothing, our right temporal parietal junction, which is here, literally shrinks. So they did a lot of tests on this. And you can physically see that it's rings on the scannings that they make. And the thing is, we need this to collect information and processes. And we need this to be innovative. And if there's one thing we need in our industry, and in our world it is to be innovative. So basically, because we don't do nothing, [don't that, okay?] Because we do something all the time. Our brain literally shrinks. And then it's kind of like, why does this happen more and more, sometimes, I'm not sure if it happens more and more. And sometimes I am it. It's really hard to say we hear about it more and more. But I also think it's happening more and more. And these are just guesses. I am not an expert in stress, depression and mental things. I suffer from it myself, and I live with it myself in the good times. And I look into it. So my guess is is one is that we have a performance culture. So if you look around, we always have to be good. If you look at Facebook, a lot of the posts on Facebook or Instagram, and I don't even know what the young people use nowadays, are perfect. You know, oh, I just cooked this perfect meal. Or, you know, I went jogging before I baked bread for my kids in the morning. And it's like showing this that we can do, we can do, we can do. When we meet people, the first thing that we ask them is "Oh, so what do you do?" Whereas a more interesting question is kind of like, "So what makes you happy?", "What is interesting for you?" but we we are so focused on performance culture, on getting that next job on being good enough the whole time. And that's stressful for us.
And the other part is that we have way too many options., or maybe not too many, but we have a lot of options. I used to say like when I was a kid, and you went to the shop, and you would get like a hairspray, you could get cheap hairspray and expensive hairspray. That was it. Now you go there and they are like 20 different hair sprays, not to mention all the other products. And it's like that with everything. And that's also one of the things that's stressing us right now that we are so much at home is that the world is on our screens. We can literally do anything we want to do. We can attend conferences all over the world. But the problem is, it's not always good for us. And at the same time we have fear of missing out. We're so afraid to miss out on something good. We want to take part in things we want to enjoy things. So even though we can practise saying "No", it's so much easier to say no to boring stuff, but whatabout all the good stuff? And then a friend of mine, Fitz, who's a photographer said, Maybe it's because in the Western world, we value doing more than being. So when we talk about things, we often talk about doing something. Like I said, with Facebook, baking or running, when we talk about work, it's like, "Yeah, I did this talk or had that project." we very rarely value being. And I think we need to go more back to being to actually take care of ourselves. And if we look at it, knowledge workers are very affected. And maybe that's why also why we're seeing it more because more more of the work we do is knowledge work. And the thing with most knowledge work is there's always more to do than we can manage. You can have endless To Do List, endless backlogs, there's always more than we can manage. We will never ever be done. Whereas if you are making 10 chairs, as a carpenter, you're done when the 10 chairs are done. For us, there's always more to do. Not saying that carpenters can get stressed because they definitely can. And most people in the knowledge industry, in the IT industry, we are here because we like what we do. Most of us have some kind of education, some have maybe five years education. If you took a PhD even longer, which means that we chose this, we actually like what we do. And very often when we talk about stress, we talk about it as something that comes from the outside something that pushes us. But I think a lot of our stress comes from the inside. Because we truly love what we do. I just read an article about this artist, and he said he slept for hours per night, because he was so passionate about creating his art. And that passion can also be dangerous, because that means that we don't take the time to actually go in and rest. And then a lot of us suffer from imposter syndrome. And if you don't know what the imposter syndrome is, it's basically that you think you are fake, despite having evidence of the opposite. And this is something that up to 70% of the Western population suffer from at some point in their life, having the feeling that whatever they're presenting, it is fake. And our work is not tangible. So during some summers, I helped out my ex father in law in a grocery shop. And some of the really nice stuff about that was like, you know, when we would get like this pallet of groceries that needed to go into the shelves, and you would just take one cardboard box at the time, you would lift it over, you would fill up the shelves, you would fold the cardboard and put it into recycling. And you could see where you were going. And so much of what we do is not that. If you are, when I was a tester, I was sometimes like, "Oh, I wish I was a programmer," because at least programmers produce something. And a lot of what I do is I look at something and figure out if there's something wrong with it. And I find that that element is is now even harder now that I am an agile coach. Because a lot of what I do is I create a space for people, but I also plant seeds. And sometimes these seeds will grow into something and sometimes they won't. But I might not know it because it could be something that happens a year later. But even if you are a programmer, you don't see software very rarely at least. And you can sit for a full day working on something and not get any results. And there's no tangible kind of result from it. And somehow, we kind of need that we need to know where we're going, we need to know that we achieved something and then know that there is natural limits to our work.
So again, I'll use the example with a carpenter. So when a carpenter leaves his workshop, and goes home, he might think about, you know, how will I create the next chair, but most of his work will happen in the workshop. Whereas our main tool is our head. Yes, we need our, Well actually we don't need our hands I worked with
a developer who didn't have hands, but we do need to type something into a computer or speak to a computer or whatever. But all of our work takes place here. And we have our head with us always. And I think part of this is what leads us to stress. So unless we do something to take to set natural limits, we will kind of always be working. So like one of my friends who's working from home right now what she does is every morning, she opens the door, and she takes a walk and she comes back and then she is at work. And in the evening, she does the same go out, take a walk, come back, and then she's at home to kind of set those clear limit to the work that she does.
So this was a lot about why it's not good. But the good thing is we can start doing things about it. So these are some trip... [I'll just take some water.] So these are some tips. And like I said, stress is very different from person to person. Depression is very different from person to person. So you kind of need to figure out what works for you. What is the thing that helps you? So these are kind of some general tips, and I'm still learning to perfect them. So one of them is to say no. And like I said earlier, I practised this for a long time, saying no to stuff that you don't want to do is the first step. You really don't want to meet up with someone or whatever and you say no. And then the part comes where you need to say no to all the interesting stuff, to be able to have enough time for yourself. And that's when it gets hard. And what gets even harder is that sometimes you have to say no to stuff you already agreed on. So I tried this in, what was it, 2015, where I had to say no to a conference that I already agreed to speak on, because I was getting stressed again. And one of the things I do is I use my friend Tobian as one of the things, one of the things he's not a thing, I use him to give me permission. Because I am not yet not able to say no to stuff like that, like, for instance, saying no to a conference that already agreed to, even though it was two months ahead, and they had plenty of time to find a new speaker. So I talked to him about giving me permission to do this. And even though he has no ruling over me, that kind of helped me to say, okay, it's actually okay for me to say no to these things. But it is really hard. And remember to plan preparation time, I think that's something we tend to not do. Very often I hear people complaining about meetings, for instance. And yes, some meetings are horrible, but they're also a good tool for some of the things that we want to do. And very often, one of the reasons that our meetings are not good is that we don't prepare, we don't read that piece of paper that was supposed to read before we go into the meeting, or the person running the meeting, having prepared and kind of fumble around. Or, like if you're speaking at a conference, one of the things that I really struggled with, especially in 14 and 15, when a lot of people wanted me to speak was that I just looked at my calendar and saw if I had time to do this, I did not look in my calendar and say, do I actually have time to prepare my talk, or, even worse, sometimes I had to write a new talk, Do I have time to write that new talk. So plan that in and even in your daily life, just plan a bit of preparation time, block out some hours per day where you can where you could just prepare things and try to relax your brain. And this is very different for different people.
So one of the things that some people find very helpful is meditation, I find meditation very helpful, but I'm not very good at doing it. So actually getting around to doing it. And meditation is not about you sitting and thinking about nothing, but it's about sitting and letting your thoughts be. And so as you can get guided meditation, some people just like to sit and think. But that can be something to relax your brain. And [you] it doesn't need to be like meditation as in, okay, I sit now and I sit on a pillow and I put on some nice candles and everything. It can also be taking a walk in nature, or sitting and staring at water, something that helps your brain. And one of the other things you can do is more mindfulness actually starting to be aware of things that are around you, maybe if you are drinking your coffee, maybe close your eyes and actually taste what does that first sip of coffee taste like? Being aware of this try to really taste things ties to really feel things. And part of what this does is it gets it out of our head. So I talked about the stress consultant who couldn't help me before. And one thing he said to me all the time was you need to get in your body. And I was like, "What is he talking about? I am in my body". And when I was working with my doctor, what he said, Well, it's not so much about being in your body as it is getting out of your head. So he was able to explain it to me in a different way. Andone of the things he said, Well, you said for instance, you like to take a bath. One of the things you can do when you take a bath is you can move your you can move your legs, and by moving your legs and actually sensing how the water feels on your legs when you move them in water that takes the focus out of your brain and into your body. Or even just feeling it on the chair you're sitting on right now. Just feeling how does it feel against my back against my thighs. Or if you're standing up? How does the floor feel against my feet so becoming more mindful of that can help you get out of your head and into your body. And then there's exercise. And this just happens to be my friend Tobian on who helps me a lot. And running for some people is quite meditative. And research shows that exercise is really good for us. Both when we are stressed but also when it comes to depression and anxiety. And actually it can be really good to do this in nature as well, depending on where you are of course. But the thing with this is you need to be careful because if you are in a really bad state, then pushing yourself to exercise can actually, is actually not helpful. It will lead you to a place where you just feel either guilty because you didn't do your exercise, or you actually do it and then you feel more stressed because it's time that went away. But as long as you are not like at the bottom exercise is good for you, even if it's just taking a walk.
And then asking for help. And asking for help, I mean, in so many ways, like asking for like if you have something at work, where it's too much asking somebody else to help you out. And for me, that kind of help is not too difficult to ask for. If I need to ask with something physical, like putting up paintings on the wall, or putting up lamps and stuff, I can ask for that. The hard part for me to ask for is the more what's your 'social' help, like, you know, when I'm feeling bad, and I just need to blabber out, or I need someone to give me a hug and see everything is going to be fine. Or even having to ask someone to take me to the doctor, when I was really sick, that is the hardest part. And I practice this. And one of the things that helps me with this is, [talk] I've talked to some friends about this, that if you don't ask for help, because you're afraid to bother someone, you take away their option to decide if they want to help you or not, so asking for help is a good thing. And be kind to yourself. Because for us at the moment, we are all in a situation where the world is really insecure. If we look at the numbers of COVID, in most countries, it's going up and down. And it can really change within a very short moment. We don't really know what's going on. When I went came home to work in March, I was like, "yeah, we're going to work from home and in a few months, and then everything will be fine". And right now everything is just insecure. And you are, which also puts you in the sense of stress, it doesn't mean that you can't enjoy working from home. I know a lot of people who enjoy working from home, who enjoy the fact that they can actually be with their family that they don't need to commute, stuff like that. But if you are in a state of stress, and even if you're not, be kind to yourself, your feelings are always Okay, your actions might not be, but your feelings always Okay. Oh, and I would like to take Joanna who had a T shirt about being kind, because I forgot to put it on my slides. And take time off. And I don't just mean take time off work, I also mean take time off whatever else you're doing. So one of the product owners I worked with, suffers a lot from anxiety. And for him, it can sometimes be really stressful having the kids, they have two small kids at breakfast. And he actually has an agreement with his wife that if wthe kids are dressed and start on breakfast, he can go for a walk. Because that way he has more energy to help her with the rest. And then she gets time off at other points. So figuring out what is it that you need time off from and do that?
So now I talked a lot about how could you help yourself? And I'm going to talk about what can we do to help others. But first I'll tell you about what not to do. Don't say "Pull yourself together?" Because if we could we would. And very often when you are in a state of stress, depression, anxiety, what happens is you blame yourself and then somebody else says we should just pull ourselves together. We then blame ourselves for not being able to pull ourselves together. And then it just gets worse. Or "Many people are worse off than you." I know a lot of people say like "yeah, I'm really feeling terrible. But at least I get food every day. I know there are many people who don't, who don't eat every day." That's not the point. If you're feeling bad, you're feeling bad and of course there are people that are worse off than you and that you might be able to help in some way. But don't tell people that or "You have no reason to be depressed stressed have anxiety." We know that, sometimes, they found that sometimes depression and stress, while depression at least can be activated by a single incident. But most of the time it is small things that is leading to this or it is a deficiency where your brain doesn't produce produce enough Serotonin or Noradrenaline and by telling people they have no reason feel this way, they're kind of saying it's not okay for you to feel this way. Or "It's all in your head." And it's kind of "derrr, we knew that". And I think that I at least tend to blame myself a lot more for the things in my head, because it's in my head, it's just in my head. Whereas if I broke her arm, I would get cast on it. And I would take care of that, when I break my head inside, I don't take care of it the same way. And, and when it comes to it, everything is actually in our head, even the pain that we feel somewhere would come from my head. And don't ignore them. Don't just pretend that nothing is going on. because something is going on. So acknowledge that something is going on. And don't give unfunded advice, which you can say that's part of what I'm doing now. I'm not saying to do all these things, I'm telling you to actually go in and look at these things and see if it helps you. But if you tell people "Oh, if you're stressed, you just need to do that". If people are, especially if people are very stressed, the best thing you can do is actually help them go to see a doctor. So what should I do, then? Well offer your help but subtle. Going out and saying you know what, you look really stressed, how can I help you might not be the best idea. But going like, "You want to go for coffee?" And then you can chit chat about you know, if you need any help with the stuff you're working on that we know, I'm always here to talk. But don't push it on it, offer it, make it an offer. And not you have to take this. And listen. I like to say grow your ears and open your heart. People often in these situations need to talk. And they need someone to listen to them. So that's part of what you can do actually listen to them. Not to answer. But just to hear what's being said. It doesn't mean you have to agree on everything, but listen to them properly. And tell them to go to professional. So if somebody is feeling really bad, go to a professional. And sadly, there are a lot of professionals I know in a lot of countries who don't take these things serious. But there are also a lot of professionals to do. And sometimes we are not able to give that help. Even though we can help with small things, we are not able to give proper professional help on mental issues and stress. So if somebody's suffering, tell them to go to professional or maybe even offered to take them there. And respect what they feel. Because no matter what their feelings are valid. And include people. So even though people might be feeling down, make sure you include the make sure they have the option to opt in and do stuff with you. But also make sure that they have the option to opt out. And of course the Be kind, which is very essential, be kind to people, we are all struggling in different ways. And you need to be kind. And of course you need to care for people. And caring is very different. So like in this case, it's a hook. That's not something we can do with most people right now. But actually generally caring for people. People can sense if you care about them. So that can also be helpful. So the donkey is called 'Eeyore', in English, Æsel in Danish. And I have this as an example because he's basically depressed all the time he's feeling down. And yet his friends always include him. They always include him on adventures, and, and it helps him like the time when he thinks that his birthday is forgotten, and then everyone shows up. And he's this close to being happy. So I think this is a really good example of including someone on their terms. They're not required for him to be happy and joyful. They just include him just the way he is.
So to wrap this up, talk about these things, I think that's one of the best things we can do is start talking more about these things. Because it does exist everywhere. Ask for help. Whether that is you know, help with work or help to actually cope with these things. But do ask for help. And offer help. And I deliberately write offer instead of give help, because it needs to be an offer. It is very rare that people are at a point where you have to give them help. There can be people who are so far out that you need to kind of take them by the hand and take them to a doctor but this is very, very, very rare. And talk to each other. So have these discussions, talk about things, talk about your life, talk about what's going on, talk about the good things. And of course, be kind and care for people.
So that's what I had to say. I will send these slides to you and you can get access to them afterwards. And one of the things that I always talk to people about is Feel free to approach me afterwards whether I will be in Ghana town or my email, or Twitter, whatever all my information is on here, plus some link to some amazing videos, because sometimes it doesn't feel comfortable to speak about things in a big setting like this.