Depresión y Trabajo

aquí no hay duda de que el cambio completo que se ha venido dando en las instituciones laborales, que se centra en la competitividad y la eficiencia económica, ha dado lugar a nuevos tipos de sufrimiento y de nuevas patologías de un orden mental y emocional, y que, como una consecuencia del estrés y el mobbing, mental problemas de salud en el trabajo se han convertido en la razón principal detrás del aumento de la ausentismo profesional.

Estrés en el trabajo En el año 2000, casi un tercio de todos los europeos los trabajadores (41 millones) dijeron que estaban afectados por el estrés. Es el segundo mayor problema de salud en el trabajo después musculoesqueléticos trastornos. La evolución actual la organización del trabajo por completo cambiado las condiciones de trabajo en todos los niveles jerárquicos. Horario de trabajo puede haber mejorado, pero la presión sobre a los cambios en las tasas de producción, trabajos urgentes llevadas a cabo bajo la directa presión de los clientes, y una mayor énfasis en la autonomía, iniciativa y la responsabilidad puede llevar a los empleados dudar de su capacidad y se creen incapaz de cumplir con las exigencias que se realizan sobre ellos. Estrés profesional surge cuando relacionado con el trabajo demandas o exigencias que sobrepasan la empleado los recursos. Sin embargo, hay no link1 directa entre la carga de trabajo, es decir, las demandas del empleador, y enfermedades relacionadas con el estrés. Se sabe que el riesgo de enfermedad mental o física, en particular depresión, es mucho mayor en los empleados que están sujetos a una alta nivel de presión, pero que, en otros aspectos, tienen poca autonomía y poco posibilidad de expresarse o reaccionar. El riesgo es mucho mayor si los en cuestión no son apoyados por sus entorno profesional. Frente a la sobreestimulación, el ser humano primer cuerpo trata de adaptarse con el fin de responder a la situación. En un principio, es el organismo que reacciona: tensión muscular, problemas digestivos, lumbalgias, migrañas, y la fatiga. Los síntomas psicológicos primera son nerviosismo, irritabilidad, ansiedad, y trastornos del sueño. Si la situación persiste, estos son seguidos por la pérdida de la motivación, la anorexia, apragmatism, y ansiedad severa, poco a poco hacia las principales depresión. La siguiente etapa es el agotamiento, que se produce cuando una persona está completamente agotado por trabajo. Corresponde a la aparición de un estado de desilusión y frustración en relación con las demandas profesionales en una persona que ha dedicado mucho tiempo y energía en el trabajo. La persona a continuación, pierde todo interés en el trabajo y sus colegas y se vuelve más y más irritable, incluso agresivo y cínico, hasta que el total depresión finalmente establece pulg Mobbing Mientras que el estrés sólo se vuelve destructiva cuando es excesiva, el mobbing es destructivo por nature.2 Numerosos estudios demuestran la prevalencia de un colapso emocional una respuesta a mobbing.3 A diferencia de otros tipos de violencia en el lugar de trabajo, el mobbing es una insidiosa, a largo plazo proceso. En un principio, la víctima no entiende lo que está sucediendo y toma mucho tiempo para reaccionar. Si la agresión viene de los superiores o colegas, compuesto por pequeñas y repetidas ataques, a menudo sin testigos, a veces no verbal, a menudo ambiguo, porque se puede interpretar de de diferentes maneras. Estos ataques consisten en críticas injustificadas, comentarios humillantes, y búsqueda de fallas. En la cara de estos solapada ataques, las víctimas de el acoso tratan en vano de adaptarse y probar su inocencia, y terminan agotado y en un estado emocional de colapso. Cuando el mobbing se detecta temprano, y las víctimas han sido capaces de hablar de en el tiempo, o si todavía tiene la posibilidad de tomar represalias o encontrar una solución, la los síntomas son bastante similares a los de estrés. La ansiedad incrementa con su multitud de los síntomas somáticos: digestivo problemas, dolores en el pecho, una sensación de constricción en la garganta, anorexia, náuseas, dolores de cabeza, dolor muscular, y así sucesivamente. Pero si la situación persiste, las víctimas poco a poco se encuentran con discapacidad psíquica. Sus procesos de pensamiento son perturbados y pueden pensar en nada más. En esta etapa, además de su síntomas de ansiedad, la depresión comienza a El conjunto pulg víctimas entristecemos y perder el interés en la vida, tienen a corto plazo pérdida de memoria, disminución de la concentración, y una sensación de impotencia y falta de valor que se esconden de sus médico, porque se sienten culpables por no cumplir con las expectativas de sus superiores, y de su familia, porque tienen miedo de ser pensamiento débil. Antes de la depresión en los conjuntos, es el real proceso de mobbing en el trabajo que hace que las personas tienen sentimientos de inutilidad, la duda y la culpa, porque se les hace creer que que son responsables de lo que está sucediendo a ellos. Hostigadores empezar a aislar a sus futuras víctimas, criticando su trabajo sin razón, menospreciarlos, desacreditando a los ojos de sus superiores, atacando su reputación, y la prevención ellos hagan su trabajo correctamente. Su trabajo se utiliza como un pretexto para cuestionar el víctimas en su vida privada, lo que hace que se sientan avergonzados y humillados, y pierden su dignidad. Hostigadores sutilmente perfeccionar en la vulnerabilidad de las víctimas, tan bien que el hostigamiento a menudo parece ser una eco de temas fuera del lugar de trabajo, ansiedad revivir el pasado, lo que puede caído en el olvido, y la reducción psicológica defensas. Ninguna de las estrategias establecido por las víctimas son efectivos, nadie cree o entiende que, de manera que se retiran poco a poco y aislar propios más. Así pues, en qué momento puede la depresión mayor tal como se define en el DSM IV se diagnostica y los antidepresivos prescritos? El diagnóstico se basará en el grado de de la persona trastornos del sueño, ansiedad, la culpa y la morbosidad, así como el tiempo del día en que los trastornos se producen, principalmente en la mañana. Sin embargo, es obvio que una respuesta terapéutica no ser plenamente eficaz si se basa únicamente en medicamento. La persona tiene que estar separados desde el acosador se le da licencia por enfermedad, y luego puso en contacto con un organización que puede prestar asistencia jurídica y ayuda práctica. Por tanto, es aconsejable en contacto con el doctor de la compañía con el fin de examinar las posibilidades de un cambio de trabajo o incluso de adquirir la condición de discapacidad. Pero en primer lugar, se debe ayudar a recuperar su capacidad crítica para que valerse por sí mismos. Suicidio Un empleado que es víctima de mobbing tendrá a menudo dañada autoestima, creer que la situación es sin esperanza y las perspectivas de empleo sombrío, la muerte deseos son frecuentes y pueden llegar a ser suicida. 4 suicidios correlacionado con el mobbing probablemente subestimada, porque sólo los suicidios o intentos de suicidio que se registran son los que ocurren en el lugar de trabajo, por lo que califican legalmente como profesionales, o aquellos para los que la persona ha dejado un documento escrito indicando claramente las obligaciones del empleador, o de un acosador en el workplace.5 Como se mencionó anteriormente, las víctimas la experiencia de mobbing culpabilidad y vergüenza, y no siempre hablan de forma voluntaria su sufrimiento en el trabajo. La dimensión de la impulsividad y la ansiedad que a menudo precede el suicidio, y que es particularmente presente en el mobbing, en caso de no pasar por alto. Los procedimientos perversos empleados en este tipo de agresión tienden para paralizar a la víctima y conducir a autodestrucción. Además, en un contexto en el que la víctima es cosificado, el suicidio puede ser una víctima mensaje al acosador, así como un intento de transferir los sentimientos de la víctima de culpa al agresor. Conclusión Es importante destacar la enorme carácter destructivo de este tipo de situación. Desafortunadamente, aunque el repercusiones de la disfunción profesional en la salud de un paciente puede ser tratado, un médico no puede hacer nada para combatir la la dinámica interna de las empresas que permiten este tipo de situaciones.

Depression and work

there is no doubt that the
complete change in work
organization, which focuses
on competitiveness and
economic efficiency, has led to new types
of suffering and new pathologies of a
mental and emotional order, and that as
a result of stress and mobbing, mental
health problems at work have become
the main reason behind the increase in
professional absenteeism.
Stress at work
In 2000, nearly one-third of all European
workers (41 million) said they were
affected by stress. It is the second largest
health problem at work after musculoskeletal
disorders. Current developments
in work organization have completely
changed working conditions at
every hierarchical level. Working hours
may have improved, but pressure relating
to changes in production rates,
urgent work carried out under direct
pressure from customers, and greater
emphasis on autonomy, initiative, and
responsibility can lead employees to
doubt their capacities and believe themselves
incapable of meeting the demands
that are made on them.
Professional stress arises when work-related
demands or requirements exceed the
employee’s resources. However, there is
no direct link1 between the work load,
that is, the employer’s demands, and
stress-related diseases. It is known that
the risk of mental or physical illness, particularly
depression, is much higher in
employees who are subjected to a high
level of pressure, but who, in other
respects, have little autonomy and little
possibility of expressing themselves or
reacting. The risk is much higher if those
concerned are not supported by their
professional environment.
Faced with overstimulation, the human
body first tries to adapt in order to
respond to the situation. Initially, it is the
body which reacts: muscular tension,
digestive problems, lumbago, migraines,
and fatigue. The first psychological symptoms
are fidgetiness, irritability, anxiety,
and sleep disorders. If the situation
persists, these are followed by loss of
motivation, anorexia, apragmatism, and
severe anxiety, gradually leading to major
depression.
The next stage is burnout, which occurs
when a person is completely worn out by
work. It corresponds to the appearance
of a state of disillusionment and frustration
in relation to professional demands
in a person who has put a lot of time and
energy into the job. The person then
loses all interest in work and colleagues
and becomes more and more irritable,
even aggressive and cynical, until total
depression eventually sets in.
Mobbing
While stress only becomes destructive
when it is excessive, mobbing is destructive
by nature.2 Numerous studies show
the prevalence of emotional collapse as
a response to mobbing.3 Unlike other
types of violence in the workplace,
mobbing is an insidious, long-term
process. In the beginning, the victim
does not understand what is happening
and takes a long time to react. Whether
the aggression comes from superiors or
colleagues, it consists of small, repeated
attacks, often without witnesses,
sometimes not verbal, often ambiguous,
because they can be interpreted in
different ways. Such attacks consist of
unjustified criticism, humiliating remarks,
and faultfinding. In the face of these
underhand attacks, the victims of
harassment try in vain to adapt and to
prove their innocence, and end up
exhausted and in a state of emotional
collapse.
When mobbing is detected early on, and
the victims have been able to talk about
it in time, or still have the possibility of
retaliating or finding a solution, the
symptoms are fairly similar to those of
stress. Anxiety increases with its multitude
of somatic symptoms: digestive
problems, chest pains, a feeling of constriction
in the throat, anorexia, nausea,
headaches, muscular pain, and so on.
But if the situation persists, victims gradually
find themselves psychologically disabled.
Their thought processes are disturbed
and they can think of nothing
else. At this stage, in addition to their
symptoms of anxiety, depression starts to
set in. The victims become dejected and
lose interest in life; they have short-term
memory loss, decreased concentration,
and a feeling of powerlessness and
worthlessness that they hide from their
doctor, because they feel guilty about
not meeting the expectations of their
superiors, and from their family, because
they are afraid of being thought weak.
Before depression sets in, it is the actual
process of mobbing in the workplace
which causes people to have feelings
of worthlessness, self-doubt, and guilt,
because they are made to believe that
they are responsible for what is happening
to them. Harassers begin by isolating
T
2
WPA Bulletin on Depression. Vol. 11 – N° 32, 2006
Depression and work
Marie-France Hirigoyen
Psychiatrist, psychoanalyst,
and family psychotherapist,
specialist in psychological violence
Paris, France
hirigomf@club-internet.fr
3
their future victims, criticizing their work
without reason, belittling them, discrediting
them in the eyes of their superiors,
attacking their reputation, and preventing
them from doing their job properly.
Their job is used as a pretext to undermine
victims in their private lives, making
them feel ashamed and humiliated, and
lose their dignity. Harassers subtly hone
in on victims’ vulnerability, so well that
the harassment often seems to be an
echo of issues outside the workplace,
reviving past anxiety, which may have
been forgotten, and lowering psychological
defenses. None of the strategies
set up by victims are effective; no one
believes or understands them, so that
they gradually withdraw and isolate
themselves further.
So, at what moment can major depression
as defined in DSM IV be diagnosed
and antidepressants prescribed? The
diagnosis will be based on the extent of
the person’s sleep disorders, anxiety,
guilt, and morbidness, as well as the time
of day at which the disorders occur,
mainly in the morning. However, it is
obvious that a therapeutic response will
not be fully effective if it is only based on
medication. The person needs to be separated
from the harasser by being given
sick leave, and then put in touch with an
organization that can provide legal and
practical help. It is therefore advisable to
contact the company doctor in order to
examine the possibilities of a change of
job or even of acquiring disability status.
But first, people must be helped to recover
their critical capacities so that they
stand up for themselves.
Suicide
An employee who is the victim of mobbing
will often have damaged selfesteem,
believing that the situation is
hopeless and job prospects grim; death
wishes are frequent and can become suicidal.
4 Suicides correlated with mobbing
are probably underestimated, because
the only suicides or attempted suicides
that are recorded are those that occur
in the workplace and therefore qualify
legally as occupational, or those for
which the person has left a written document
clearly indicating the responsibility
of the employer, or of a harasser in the
workplace.5 As mentioned earlier, victims
of mobbing experience guilt and shame,
and do not always voluntarily talk about
their suffering in the workplace.
The dimension of impulsivity and anxiety
that often precedes suicide, and which is
particularly present in mobbing, should
not be ignored. The perverse procedures
employed in this sort of aggression tend
to paralyze the victim and lead to selfdestruction.
Also, in a context in which
the victim is reified, suicide can be a victim’s
message to the harasser, as well as
an attempt to transfer the victim’s feelings
of guilt to the aggressor.
Conclusion
It is important to emphasize the enormously
destructive nature of this type of
situation. Unfortunately, although the
repercussions of professional dysfunction
on a patient’s health can be treated, a
physician is powerless to combat the
internal dynamics of companies that permit
this type of situation.
Further Readings
1. Legeron P. (2005): Le stress au travail. Paris, Odile Jacob
2. Hirigoyen, M-F. (2001): Malaise dans le travail, harcèlement moral, démêler le vrai du faux. Paris, Syros.
3. Soares A. (2002): Quand le travail devient indécent: le harcèlement psychologique au travail. Rapport de recherche, Montréal, UQAM.
4. Prigent Y. Compréhension et évaluation du risque suicidaire dans les cas de harcèlement moral. Communication lors des Journées internationales francophones et latines pour la prévention du
suicide. February 2002.
5. Leymann

here is no doubt that thecomplete change in workorganization, which focuseson competitiveness andeconomic efficiency, has led to new typesof suffering and new pathologies of amental and emotional order, and that asa result of stress and mobbing, mentalhealth problems at work have becomethe main reason behind the increase inprofessional absenteeism.Stress at workIn 2000, nearly one-third of all Europeanworkers (41 million) said they wereaffected by stress. It is the second largesthealth problem at work after musculoskeletaldisorders. Current developmentsin work organization have completelychanged working conditions atevery hierarchical level. Working hoursmay have improved, but pressure relatingto changes in production rates,urgent work carried out under directpressure from customers, and greateremphasis on autonomy, initiative, andresponsibility can lead employees todoubt their capacities and believe themselvesincapable of meeting the demandsthat are made on them.Professional stress arises when work-relateddemands or requirements exceed theemployee’s resources. However, there isno direct link1 between the work load,that is, the employer’s demands, andstress-related diseases. It is known thatthe risk of mental or physical illness, particularlydepression, is much higher inemployees who are subjected to a highlevel of pressure, but who, in otherrespects, have little autonomy and littlepossibility of expressing themselves orreacting. The risk is much higher if thoseconcerned are not supported by theirprofessional environment.Faced with overstimulation, the humanbody first tries to adapt in order torespond to the situation. Initially, it is thebody which reacts: muscular tension,digestive problems, lumbago, migraines,and fatigue. The first psychological symptomsare fidgetiness, irritability, anxiety,and sleep disorders. If the situationpersists, these are followed by loss ofmotivation, anorexia, apragmatism, andsevere anxiety, gradually leading to majordepression.The next stage is burnout, which occurswhen a person is completely worn out bywork. It corresponds to the appearanceof a state of disillusionment and frustrationin relation to professional demandsin a person who has put a lot of time andenergy into the job. The person thenloses all interest in work and colleaguesand becomes more and more irritable,even aggressive and cynical, until totaldepression eventually sets in.MobbingWhile stress only becomes destructivewhen it is excessive, mobbing is destructiveby nature.2 Numerous studies showthe prevalence of emotional collapse asa response to mobbing.3 Unlike othertypes of violence in the workplace,mobbing is an insidious, long-termprocess. In the beginning, the victimdoes not understand what is happeningand takes a long time to react. Whetherthe aggression comes from superiors orcolleagues, it consists of small, repeatedattacks, often without witnesses,sometimes not verbal, often ambiguous,because they can be interpreted indifferent ways. Such attacks consist ofunjustified criticism, humiliating remarks,and faultfinding. In the face of theseunderhand attacks, the victims ofharassment try in vain to adapt and toprove their innocence, and end upexhausted and in a state of emotionalcollapse.When mobbing is detected early on, andthe victims have been able to talk aboutit in time, or still have the possibility ofretaliating or finding a solution, thesymptoms are fairly similar to those ofstress. Anxiety increases with its multitudeof somatic symptoms: digestiveproblems, chest pains, a feeling of constrictionin the throat, anorexia, nausea,headaches, muscular pain, and so on.But if the situation persists, victims graduallyfind themselves psychologically disabled.Their thought processes are disturbedand they can think of nothingelse. At this stage, in addition to theirsymptoms of anxiety, depression starts toset in. The victims become dejected andlose interest in life; they have short-termmemory loss, decreased concentration,and a feeling of powerlessness andworthlessness that they hide from theirdoctor, because they feel guilty aboutnot meeting the expectations of theirsuperiors, and from their family, becausethey are afraid of being thought weak.Before depression sets in, it is the actualprocess of mobbing in the workplacewhich causes people to have feelingsof worthlessness, self-doubt, and guilt,because they are made to believe thatthey are responsible for what is happeningto them. Harassers begin by isolatingT2WPA Bulletin on Depression. Vol. 11 – N° 32, 2006Depression and workMarie-France HirigoyenPsychiatrist, psychoanalyst,and family psychotherapist,specialist in psychological violenceParis, Francehirigomf@club-internet.fr3their future victims, criticizing their workwithout reason, belittling them, discreditingthem in the eyes of their superiors,attacking their reputation, and preventingthem from doing their job properly.Their job is used as a pretext to underminevictims in their private lives, makingthem feel ashamed and humiliated, andlose their dignity. Harassers subtly honein on victims’ vulnerability, so well thatthe harassment often seems to be anecho of issues outside the workplace,reviving past anxiety, which may havebeen forgotten, and lowering psychologicaldefenses. None of the strategiesset up by victims are effective; no onebelieves or understands them, so thatthey gradually withdraw and isolatethemselves further.So, at what moment can major depressionas defined in DSM IV be diagnosedand antidepressants prescribed? Thediagnosis will be based on the extent ofthe person’s sleep disorders, anxiety,guilt, and morbidness, as well as the timeof day at which the disorders occur,mainly in the morning. However, it isobvious that a therapeutic response willnot be fully effective if it is only based onmedication. The person needs to be separatedfrom the harasser by being givensick leave, and then put in touch with anorganization that can provide legal andpractical help. It is therefore advisable tocontact the company doctor in order toexamine the possibilities of a change ofjob or even of acquiring disability status.But first, people must be helped to recovertheir critical capacities so that theystand up for themselves.SuicideAn employee who is the victim of mobbingwill often have damaged selfesteem,believing that the situation ishopeless and job prospects grim; deathwishes are frequent and can become suicidal.4 Suicides correlated with mobbingare probably underestimated, becausethe only suicides or attempted suicidesthat are recorded are those that occurin the workplace and therefore qualifylegally as occupational, or those forwhich the person has left a written documentclearly indicating the responsibilityof the employer, or of a harasser in theworkplace.5 As mentioned earlier, victimsof mobbing experience guilt and shame,and do not always voluntarily talk abouttheir suffering in the workplace.The dimension of impulsivity and anxietythat often precedes suicide, and which isparticularly present in mobbing, shouldnot be ignored. The perverse proceduresemployed in this sort of aggression tendto paralyze the victim and lead to selfdestruction.Also, in a context in whichthe victim is reified, suicide can be a victim’smessage to the harasser, as well asan attempt to transfer the victim’s feelingsof guilt to the aggressor.ConclusionIt is important to emphasize the enormouslydestructive nature of this type ofsituation. Unfortunately, although therepercussions of professional dysfunctionon a patient’s health can be treated, aphysician is powerless to combat theinternal dynamics of companies that permitthis type of situation.Further Readings1. Legeron P. (2005): Le stress au travail. Paris, Odile Jacob2. Hirigoyen, M-F. (2001): Malaise dans le travail, harcèlement moral, démêler le vrai du faux. Paris, Syros.3. Soares A. (2002): Quand le travail devient indécent: le harcèlement psychologique au travail. Rapport de recherche, Montréal, UQAM.4. Prigent Y. Compréhension et évaluation du risque suicidaire dans les cas de harcèlement moral. Communication lors des Journées internationales francophones et latines pour la prévention dusuicide. February 2002.5. Leymannt

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Marie-France Hirigoyen Psiquiatra, psicoanalista, psicoterapeuta y la familia, especialista en violencia psicológica París, Francia

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