Julian Hannush: Welcome to Health Unscripted, brought to you by the Cigna Group, a podcast featuring real, raw conversations with some of the most knowledgeable experts in the healthcare industry. facing American employers, and that is the presence of anxiety in the workplace. Research by the Cigna Group found that nearly three in 10 individuals today are suffering from anxiety. We are going to be joined by Dr. Jenna Glover, the chief clinical officer at Headspace. Yeah, thanks for having me today. As we get started, could you tell us a little bit about yourself? I know you're a clinician as well. Could you tell us about your journey and how you ended up at Headspace? I've been providing clinical care in a variety of settings for over two decades. And before I got to Headspace, I was working in an academic medical center at a large hospital system delivering care. And I was there during the COVID-19 pandemic where we just saw really the mental health crisis explode. And I still have pre-vivid memories of multiple days being called down to the emergency department because we just had so many people showing up. looking for mental health support, being in a mental health crisis. And it was just like firsthand watching how broken our mental health system was. And ⁓ for me, I was like, there's gotta be a better way to get people connected to care, but be helping people before they're in crisis. And it was really that experience that led me to Headspace and really trying to do more in preventative care and making sure people have access to mental health at scale. And so from your clinical experience and your experience at Headspace, Why is anxiety so prevalent right now, particularly for American workers? If we were to zoom out, thing that we would see is that there's not really a single source of stress that a person is dealing with. What workers are really facing are what I kind of describe as multiple channels of always on stress that they're trying to navigate. And many years ago, stress tended to be a lot more episodic, and it's just not anymore. And I think a few of the areas that have really impacted the workforce, one, there is pretty persistent economic insecurity and stability for a lot of people. And we used to see really high rates of that when somebody was experiencing unemployment, but we're actually seeing really high rates of that in people who have jobs. And this is a new phenomenon that people are looking and seeing that there's been a lot of layoffs that have happened over the last several years, sectors that tended to be very stable are less stable. the technology of AI, I mean, in many fields, people are wondering what does this mean for my employment? And so people, even if they have employment, are not feeling as secure in that. I think the second component is, a lot of times work was an escape from the world, but there's a lot of instability happening in the world. we know that there's global conflicts, there's been a lot of economic uncertainty, and a lot of that is feeding directly into people feeling unsettled in the workplace. And so work isn't a place where you go to get away from those things, it's amplified almost what's happening in the world and how it's showing up in our day to day. And I think the last component is there's not a lot of boundaries between work and life anymore. So, you know, you can check your email at any time or your Slack messages. And there's, you know, often an idea that I need to always be on. And even if you do disconnect from work, if you have the intersection of being a caregiver, you know, you go home and you have those additional stressors. And so you put all this together and what I see is you've got kind of a chronic stress that's happening, amplified by ongoing uncertainty and not a lot of periods to rest or reset. And I think that's really fueling the rising ⁓ rates of anxiety that we're seeing across the workforce. I appreciate that, especially the diminishment of the space between being at work and being at home and how those things really are overlapping more. Research from the SIGNA Group uncovered that workers with anxiety are twice as likely to feel burned out. They're more likely to consider leaving their jobs for other jobs. And they also report lower levels of self-confidence. For example, 55 % of employees with anxiety feel capable in the rules versus 70%. What do you think is happening beneath the services that employers are often missing? I think there's kind of two things that employers maybe aren't thinking about as much. The first is that rising rates of anxiety and chronic stress are absolutely a business risk. We know that it impacts productivity, absenteeism, ⁓ and overall just like benefit. And so there's like a real business aspect to this. And part of that is, you know, one of the main ways that anxiety shows up is through what we call experiential avoidance, which is like, I have a strong emotion. I want to get away from it. And so I'll engage in behaviors to to try to get away from that. And a lot of times we think, ⁓ does that mean employees are going to procrastinate more or be more disengaged? Yes, for a subset of them, that's how they're going to cope with their anxiety. But another way that it shows up is people try to cope with their anxiety by overworking. So filling their schedule, doing as much as they can to try to show value to deal with that anxiety or perfectionism. So maybe not prioritizing well or taking too long on task. And a lot of times it can employers will look and be like, ⁓ I have this employee who's doing a lot, but maybe they're not being as productive as they could, or you might be burning that person out as they're attempting to deal with their anxiety. So I think that's a really important component. The second area that I think employers should be mindful of is that helping support employees with stress and anxiety is both like a bottom, it needs a bottom ups approach as well as a top down. And What I mean by that is it's great to provide benefits, mental health benefits to employees, really, really important. And that's good, but it's not enough. We really need to think about, from a structural standpoint, how is the environment engineered and what is the work environment like that's also helping support well-being? So an analogy I like to use is that if you're in manufacturing and you have machines that are performing functions, they put those machines on a schedule. and they actually have time where those machines aren't running at 100 % or they're completely shut down because you will run a machine out and it won't be able to work properly if you don't have periods of rest of maintenance. Now, I don't need to say this, but people are machines, but it's not a bad comparison that have you thought in your organization about ⁓ periods of rest for your employees or periods of turning down demands for employees to make sure that they have time for that reset. It's not activation that's the problem of stress, it's the chronicity of it and being able to make sure we can turn that down at times. In your experience ⁓ as a clinician and at Headspace, how does the anxiety impact whole person health and how does it play out in daily behaviors? A couple of things to think about. When somebody is experiencing anxiety, there are a lot of physiological aspects to that. And so the nervous system, the fight or flight system is often turned on. And so... people will experience increased heart rate, increased muscle tension. There's cortisol, adrenaline that is flooding the body. There's disruptions to digestion. All of that impacts our immune functioning. so oftentimes, not only is it degrading aspects of our mental health, but it's actually impairing our physical health in very important ways. And so I think that's the first component. And then you mentioned this, the thing that I try to call out most often in the workplace is, anxiety is significant impact on sleep. And the reason I care so much about this is I talk often that if you could improve people's sleep, would vastly improve most like physical and mental health conditions. And so when people lose sleep, their ability to regulate their emotions goes down, their cognitive sharpness goes down. And probably one of the most important things is their decision making is significantly impaired. So a research study I like to share with people is If you have one group that has got a good night's sleep and the other group that is sleep deprived and you ask them to do a variety of tasks, no surprise, the people who got good sleep do better. But the more interesting part of those studies is that they asked those groups to rate how well they did. People who got good sleep are pretty good at judging their abilities and people who had poor sleep often overestimated how well they were doing. And so sleep deprivation really impacts our ability to judge our own abilities. And so when you think about that with the workforce, like that's pretty meaningful. And so the impact to me on sleep is one that we should be really, really aware of. And so the other component of this is you don't have to do big things to change these things. It can really be, you know, little things to help build vitality. Like you don't have to completely get rid of anxiety. to improve some of your wellness. so things around sleep and thinking about sleep hygiene, like a consistent bedtime, in the mornings, making sure you get sunlight before phone light, and really thinking about what are some of the small things that you can do because so much impacts your whole person health. You don't have to get rid of your anxiety, but you can do small things to help build your wellness. For somebody dealing with anxiety, I've heard you speak about a stratified care model. getting the right care at the right time. Can you share a little bit more about that? I had mentioned that there's one of the aspects of our mental health care system that have been pretty broken for a long time. And an analogy I like to use is if you think about baking a cake and you bake the cake and you forget the salt, you can't just pour the salt on top after the cake is baked. our philosophy has really been that like the mental health care system, we need to bake a brand new cake. We can't just keep adding things on. And so what that means is that we have to change how people enter the mental health care system and are navigated through it. So stratified care is the idea that when someone enters ⁓ into the mental health system, that immediately an assessment is done to identify what are their specific needs. And then that that person is matched with the type of support that's best going to help them. And too often in mental health care, the solution has been therapy. If you have any type of mental health concern, you should go to therapy. Obviously, I believe in therapy. I'm a psychologist. I'm a therapist. Really important. But there are a lot of people who don't necessarily need therapy, but they need support. So things like mental health coaching or an empathetic AI companion or content. So as we get to the end of our time together, I wanted to go back to something that you mentioned, making very small changes, small incremental changes. And so for somebody who is suffering anxiety, who is listening to our chat today. Could you share maybe something that they could do that's small, just making a 1 % change that might make a difference in their lives? I often talk about like the power of 1%. I like people to remember that if you're trying to fly from LA to New York City, you change your flight plan by one degree, you're going to end up in Washington, DC. So a really small change over time matters. So for people who are experiencing anxiety, just a small suggestion of something you can do. Oftentimes, It's hard for us to remember that our thoughts and our feelings are just pieces of information. And oftentimes we can get swept away in those things. And so a simple practice is just providing some separation and getting some awareness of what you are thinking and feeling. So pick some anchor points in a day, like maybe every time you wash your hands, just try to think, whoa, what am I thinking about right now? How am I feeling? And then bringing a little self-compassion to it. So I might be thinking about the future, I might be thinking about the past, might be feeling overwhelmed, and then being able to say to yourself, it makes sense I'm feeling overwhelmed because. So you're getting some space, you're identifying your emotional state, and then you're showing self-compassion. This makes sense because. And those are just very small things, but it's to interrupt kind of that anxiety spiral that can happen is those small practices of just noticing thoughts and feelings. I really appreciate that and I happen to be not only a clinician and an employee, but I also happen to be an employee with anxiety as well. And I often have to remind myself that what is going on in my head that other people can't see or hear and take time to separate that out. So I really appreciate your comment there. And so I'd like to take this question and flip it for the employers, for the managers who are managing employees with anxiety. What is... one thing that they can do that might make a difference. What I would say is it's really, really critical to make sure that people do have that space for breathing and for breaks in a day. so making sure that there's those times where things can be turned down. And so maybe that's a moment of connection in a team meeting. Maybe that's strictly enforcing that you don't get to eat lunch at your desk if you are in a desk population. A fact that I share that sometimes shocks people. In France, it's actually illegal to eat lunch at your desk because it's considered an occupational hazard. There's something important about that, which is that people need periods of disconnection from always being on, especially in a work environment. So managers should really think about what are those moments and how do I reinforce them and make sure that people are taking those breaks in the day to sustain their wellbeing. again, stress isn't the problem. just never stepping away and never being able to turn it down. That's the real problem for people. Dr. Glover, this has been a pleasure to spend time with you. Thank you for joining us today. Thanks so much for having me. Thank you for listening to this episode of Health Unscripted brought to you by the Signer Group. If you enjoyed today's show, please take a moment to subscribe wherever you get your podcasts.