3 mental health issues that need more talk and action in the workplace

23rd February 2023
 minute read

Table of contents

In recent decades we’ve seen a shift towards workplaces addressing mental health more openly, aiming to remove stigmas, and creating space for safe discussions. While this is positive, there has arguably been an over-emphasis on the more common wellbeing issues, such as stress or burnout. And while it’s crucial that these are all addressed, a number of other issues remain misunderstood and under-discussed. Here we focus on three of these issues (imposter syndrome, high-functioning addiction, and eating disorders), explaining what they are, how they show up and how to support your people with these issues at work. All three need a lot more talk and action in the modern workplace.


1-Imposter Syndrome


What is Imposter Syndrome?


Imposter syndrome is not a mental health condition, yet it can certainly affect the wellbeing of employees — as well as their career path and relationships with colleagues. Yet by its nature, it still remains hidden away. That’s because people dealing with this issue might fear that by admitting to it, they will expose their vulnerabilities — which is actually one of their greatest fears and the actual root of the issue itself.


Imposter syndrome is basically a secret feeling of “faking it” in your life and career. This can include feeling like a fraud at work — as if you have somehow “fooled” your colleagues into thinking you are more capable than you really are, or “tricked” them into giving you the job in the first place. It is the nagging sense that you haven’t really earned your accomplishments, accolades or role. However, it is important to stress that these feelings don’t necessarily have any bearing on reality — in fact, highly talented, capable, and qualified people can all experience imposter syndrome. According to The Guardian, even Einstein felt that his abilities had been over estimated.


And high-profile CEOs such as Sheryl Sandberg of Facebook and Howard Schultz of Starbucks have also admitted to feeling this way. In her book, Lean In: Women, Work, and the Will to Lead, Sandberg states that: “...many people, but especially women, feel fraudulent when they are praised for their accomplishments. Instead of feeling worthy of recognition, they feel undeserving and guilty, as if a mistake has been made. Despite being high achievers, even experts in their fields, women can't seem to shake the sense that it is only a matter of time until they are found out for who they really are — impostors with limited skills or abilities.” Yet it’s not just women who have to deal with imposter syndrome — men can grapple with it as well. In fact, according to a 2019 study published in the National Library of Medicine, up to 82% of people experience it overall.


Yet imposter syndrome isn’t always easy to spot. In fact, it can gnaw away at a person for years without anyone even knowing. That is because individuals who deal with these thoughts and feelings can often project an outward image of confidence and self-assurance. Also, they might have a first class education or qualifications, or be a recognised expert in their field. In fact, some people who wrestle with this might perform more highly than others as a result, pushing themselves harder to compensate for the feelings of inadequacy hidden inside.


In essence, people with this issue have low self-worth, as well as a powerful inner critic that berates them whenever they trip up. And this inner critic might be particularly fierce if the person had a difficult childhood, or comes from a group under-represented in their workplace or field, for example, a woman in a male-dominated tech role.


Overall, people with imposter syndrome can often develop an identity split — there is their outward, high-achieving, polished self and their inner, self-critical, vulnerable self. This split can cause a great deal of distress, as it means that they always feel the need to wear a mask at work. It also means they might feel reluctant to ask for support when stressed or overwhelmed, causing any issues to escalate.


What are the signs of imposter syndrome?


●      Excessive perfectionism.

●      Procrastination on completing projects.

●      Procrastination on making decisions.

●      Panicking when making mistakes.

●      Trying to conceal mistakes.

●      Defensiveness when receiving feedback or constructive criticism.

●      Reluctance to ask for advice, support or training.

●      Overwork leading to burnout.

●      Stress or anxiety.

●      Turning down offers of promotion for fear of not being qualified.


How can you support employees with imposter syndrome?

  1. Run an awareness workshops or webinars on the topic and encourage employees at all levels to attend. The sessions could deal with building self-esteem, learning practical techniques for silencing the inner critic and becoming aware of personal imposter syndrome triggers.
  2. Developing leaders and managers who aren’t afraid to be vulnerable through the right sessions, resources and tools from expert psychologists. In his book The Impostor Syndrome: Becoming An Authentic Leader, clinical psychologist Harold Hillman actually recommends vulnerability as an antidote to this issue. He makes a case for leaders allowing themselves to be open around their team, as removing the mask of perfection can help to reduce the isolation that leads to imposter syndrome. It can also make others feel more able to open up about their own fears and worries too. With this in mind, you could also encourage leaders and managers to give a talk to employees about their own experiences with imposter syndrome. This will help to normalise the issue by highlighting its commonness.
  3. Creating a culture of authentic recognition which enables and encourages employees to notice and feel their achievements. This could be through positive feedback sessions, sending encouraging emails, or even implementing a reward scheme. Being reminded of your gifts is a good antidote to imposter syndrome. As Sachin Gupta of Hacker Earth commented “Start by fostering a culture where anyone can say thank you to anyone else for their good work and invite people to talk about what they are doing in town halls. In creating a culture where appreciation is done publicly, managers are reminded to show appreciation to their employees and colleagues”.

2-High functioning addiction


What is high-functioning addiction?


In our society, we can still have the idea that addiction is an obvious issue — surely if an employee had this condition, everyone would know? Wouldn’t they miss work regularly, perform poorly and have a dishevelled appearance? Not so — because people with high-functioning addiction can be extremely good at concealing the problem, even (or especially) to themselves.


Put simply, high-functioning addiction means still being able to manage your day-to-day life and work despite your condition — and sometimes to a very high degree. For instance, people with this issue can be in high-pressure positions and excel in their careers. Yet behind the scenes, they might be grappling with compulsive behaviours around alcohol, drugs, gaming, gambling, sex or other issues.


According to Dr. Gabor Maté, author of In the Realm of Hungry Ghosts: Close Encounters with Addiction, an addiction is ‘any behaviour that gives you temporary relief from pain or pleasure, but has long term negative consequences.’ Addiction even changes the structure of a person’s brain to the extent that they can’t control their impulses around a particular substance or behaviour. The condition is also highly correlated with distress in childhood, and might have developed as a form of relief from the painful memories, experiences, and unresolved traumas of the past.


However, an estimated 20% of people with an addiction are of the high-functioning type. This means that the person is adept at projecting the image of “having it all together”. For instance, they could have a good career, nice home and seemingly happy relationship with their partner. Sadly, this can actually make it much harder for them to seek help — because if they are doing so well, then they might wonder why they need to.


Also, people with high-functioning addictions often have strong support networks that enable them to hide their condition — for instance, a spouse who gets them up in the morning and makes sure they look smart. Sometimes, these enablers can be present in the workplace itself — for instance, the manager who overlooks a team member’s regular over-consumption of alcohol at lunchtime, or the team member who covers for them when they forget a deadline.


It is also worth noting that while anyone can be affected by this issue, there does seem to be a link between high-functioning addiction and high pressure jobs. Also, if a person’s working environment or role normalises regular alcohol intake — for instance, frequent team socialising or entertaining of clients — this could worsen alcohol addiction. People with roles in hospitality, entertainment, or corporate account management might be particularly vulnerable to this. If heading to restaurants or bars is seen as “just part of the job” then this might make it impossible for alcohol addicted employees to stop. What’s more, high-functioning addicts can believe that their addictive behaviour is the actual reason for their career success, as it provides them with stress relief.


The trouble is that addictions usually escalate over time, meaning that the issue will eventually catch up with even high functioning individuals. At worst, it could potentially sabotage their career — or cause significant distress to colleagues, clients or customers. What’s more, people with hidden addictions are at risk of making mistakes that could seriously impact on your organisation. That is why any indicators of addiction or compulsive behaviour should never be swept beneath the carpet and always be dealt with early, no matter how awkward that might be. So it is crucial for HR professionals and people leaders to beable to spot these signs.


What are the signs of high-functioning addiction?


●      Drinking to excess during workplace social occasions or client entertaining.

●      “Blackingout” or not seeming to remember over-the-top behaviours on social occasions.

●      Taking long lunch breaks.

●      Being late regularly.

●      Seeming very tired in the morning.

●      Often complaining about being broke.

●      Frequently looking pale, tired or ill.

●      Moodswings and irritability.

●      Seeming to be “two different people” at times.

●      Having one area of life that seems “low-functioning” e.g. a rocky relationship pattern.


How can you support an employee with addiction?


  1. Talk to the person in confidence — however, it’s key not to confront them with the suggestion that they are an “addict”. This might result in defensiveness or even anger, plus you may not be qualified to assess whether someone has an addiction. Instead, focus on outlining any concerning behaviour patterns, such as lateness, mood swings, or use of gambling sites on their work computer. Aim to open up a safe, non-judgmental space for the person to talk.
  2. Set clear, compassionate boundaries — people with high-functioning addictions are often surrounded by enablers who support their behaviour. This can remove any incentive to change. So setting limits about what will and won’t be accepted atwork — for instance, angry outbursts — might help to motivate the person to seek support.
  3. Offer confidential access to the right therapy for their particular addiction (there are over 20 types of therapies so ensure you have the right option through your business provider, not only counselling). You could also direct them to other addiction resources at a local or national level. It’s also important to offer time and space for healing — people with high-functioning addiction might be afraid to take time off to enter into rehab for fear that it might impact their career. They will need reassurance that this won’t be the case and that extended, confidential leave could be an option.


3-Eating disorders


What is an eating disorder?


Beat Eating Disorders believes that around 1.25 million people in the UK have an eating disorder, with 25% being male. Yet this is also an issue that is under-discussed and misunderstood, plus eating disorders have various myths and misconceptions attached to them. However, as this condition actually causes more deaths than any other form of mental illness, it is crucial that workplaces become aware of both the signs and the impact.


As HR Zone points out: “...with little awareness of eating disorders, HR and managers are at risk of discrimination if they can’t spot the early signs. Eating disorders are psychological conditions that can last for 12 months or longer. As such they can be considered a disability under the Equality Act 2010, and therefore should be treated in the same way as any other disability in terms of employer responsibility”.


There are a number of different types of eating disorder, including anorexia (a severe fear of gaining weight that can lead to highly restrictive calorie intake), bulimia (an obsessive desire to lose weight combined with bouts of binge eating, which can be followed by vomiting or extreme exercise), avoidant restrictive food intake disorder (avoiding certain types of food and limiting diet to an extreme degree) and binge eating (eating large quantities of food in a way that feels out of control). Yet this is not a clear-cut issue either, because many individuals can show signs of more than one eating disorder.


Causes of eating disorders can be complex and there is no single explanation for why people develop this kind of condition. Yet it can have a devastating impact on an individual’s mental and physical health. And of course, it can have a huge effect on their working life and relationship with colleagues.


Overall, people with this issue might find it extremely stressful trying to navigate situations such as workplace social events, cake breaks, or even lunchtime in the staff room. This can make work feel like a minefield at times. And if it’s considered bad form to not attend events like the Christmas night out, this could also cause the person a lot of distress — and even affect their relationship with colleagues or promotional chances.


Yet while it’s easy to assume that an eating disorder is the main issue in a person’s life, it is actually always an indicator of something deeper. In fact, an eating disorder is a coping mechanism for managing underlying issues of mental or emotional distress. People with this kind of condition might also have a background of anxiety and depression, or perfectionism and obsessive-compulsive tendencies. That is why it is important not to see eating disorders as a single issue, but rather, an indicator of ongoing distress in an employee’s life.

What are the signs of an eating disorder?

As there are various types of eating disorders, not all of the signs below will apply to every condition. But here are some that you can look out for at work:


●      Sudden or regular weight changes.

●      Being excessively thin.

●      Being very self-critical about body shape.

●      Having high amounts of food stashed in desk drawers.

●      Long bathroom breaks or vomiting in the bathroom.

●      Poor health or regular sick days.

●      Unhealthy looking skin, chapped lips or a puffy face.

●      Fainting spells.

●      Withdrawal from colleagues.

●      Difficulty concentrating on work.

●      Avoiding work social events.

●      Avoiding eating with colleagues.

●      Seeming preoccupied with food, calories and nutritional content.

●      Seeming disgusted with the look or smell of food.


How do you support an employee with an eating disorder?


An eating disorder is an illness which can, in its most extreme form, be life-threatening. That is why it is important to treat it as such and deal with any warning signs that employees are displaying. HR and people teams should aim to:


  1. Talk to the person in confidence — and just like with addiction issues, it might not be helpful to tell the individual that you think they have an eating disorder. After all, this is something that would need to be medically assessed by a professional. Instead, it might be more productive to outline signs or behaviours that seem concerning, such as mood swings, regular absenteeism or looking unwell. Again, the aim is to open up a safe, non-judgemental space for conversation.
  2. Offer access to therapy and information — an eating disorder is a highly complex issue that needs specialist help. If you offer the right type of confidential therapy as part of your mental health support, you can encourage the person to seek support. You could also point them towards local or national resources for people with eating issues — but again, without trying to diagnose them.
  3. Follow up regularly — make sure that you continue to track the issue, so that the person’s wellbeing is monitored and they are given any help that they need.


In order to support employees through complex mental health needs in an increasingly high-pressure world, it’s important to avoid a one-size-fits-all approach to mental health. With at least 1 in 4 experiencing mental health issues every year, it is likely that over 25% of your workforce is likely experiencing a range of different mental health issues – including those highlighted in this article. It’s essential that the wide range of issues across the mental health spectrum are all discussed openly in businesses, and backed up by the right accessible support from leaders, managers and professional psychologists and psychotherapists whenever needed. This way, workplace issues can be dealt with earlier, employees can be supported much sooner, and people’s careers and long term wellbeing can be protected.


Want to learn more? Find out how My Therapy Assistant’s expert team can support you in developing and delivering an effective Employee Assistance Programme (EAP).

3 mental health issues that need more talk and action in the workplace
Clinical Director
Lumo Health team
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