Women and workplace mental health

Several scientific studies in recent decades have affirmed that there are more similarities than differences between men and women. True, we are born with the physical characteristics of the male or female sex, but in gender terms we are not born masculine or feminine, but become masculinised or feminised through a range of intersecting factors, among them cultural and familial influences. These findings, together with widespread discrimination against members of LGBTQ+ communities, are fuelling a movement in liberal societies to embrace a non-binary approach to gender, one that avoids confining people to a strict segregation and definition of roles, whether in terms of clothing options and public washrooms or parenting rights and gendered pronouns. 

As attractive as gender fluidity or even the eradication of gender as a social construct may sound, there are nonetheless still very real physical and social differences in the experiences of men and women and boys and girls, as well as those outside this binary. In the case of women and girls, many of these differences are unfortunately better described as challenges and barriers, meaning that handling women’s mental health as a separate topic is a necessity. Biological differences – among them the reproductive system and certain brain chemistry – mean women may have different mental health struggles and/or symptoms to deal with as well. On top of this come a range of social factors which can adversely impact mental health from a young age. This is true even in the most economically developed and socially progressive countries. As long as there is widespread gender inequality and suppression of women, underscored by the terrible statistic that one in three women worldwide will experience physical or sexual violence at least once in her lifetime, the topic of women’s mental health demands special focus – on International Women’s Day as well as every other day of the year.

What issues might the women in your office be dealing with? What should you, as an HR leader, be aware of and what processes would it be wise to have in place to ensure that mental health topics more likely to be impacting your female colleagues are taken into account? To answer these questions, this piece is divided into two sections: Part 1, “Understanding the issues”, looks at the mental health topics currently critically affecting women; Part 2, “Supporting women in the workplace”, gives you expert advice on addressing each of these issues, plus suggestions for far-reaching policies and procedures to ensure your efforts to create a mental health-friendly workplace for women are robust and in place for the long term.

Part 1: Understanding the issues

Women at higher risk for burnout

Until recently, burnout was labelled a stress syndrome. However, in 2019, the WHO updated its definition to a “syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed”. While factors beyond one’s professional life can certainly contribute to burnout, this definition is helpful in that it highlights the role that employers must play in ensuring employees’ workloads are manageable and that their life-work balance and overall well-being is proactively supported. The revised definition will hopefully also help change the misbelief that burnout is “nothing serious”.

Manifesting as intense physical, mental, and emotional exhaustion, people with burnout feel confronted with “unmeetable expectations and unceasing demands”. If left untreated, the syndrome can lead to other serious physical and psychological illnesses, such as depression, heart disease and diabetes.

Since the start of the pandemic, women are considered at higher risk for burnout, with women leaders who manage teams especially likely to be burnt out and one in three considering downshifting their career or leaving the workforce entirely in what’s being called the “Great Resignation”.

Putting others’ needs before their own

According to a new study, “time stress” is what’s causing women to burn out faster than men. “Women are less likely to ask for more time to complete their tasks because they hold stronger beliefs that they will be penalised for these requests and worry more about burdening others,” concludes the report by researchers from the Harvard Business School. Fear of being penalised can be traced to women’s sense of not fully belonging in the historically male, often male-dominated workplace (more on this in the “Imposter Syndrome” section). Interestingly, the researchers also found that women are more in tune with others’ emotions than men, making them “more likely to prioritise the feelings of others instead of their own”. This, combined with the finding that women’s “relationships with their employers also come above all else, including career aspirations,” helps illuminate why so many women literally work themselves sick. 

The rise of burnout among women is not only harmful to those impacted, but to employers, the overall economy and the next generation of working women, who will lose valuable female role models, mentors and colleagues if this distressing trend continues.

The long shadow of trauma

Given the widespread violence against women, the ways in which the psychological effects of these experiences can manifest and affect women’s mental health is something we should all be aware of – not only in the workplace, but really in every part of society. 

In the case of sexual trauma, as our Head of Psychology, Dr. Eva Elisa Schneider, explains: 

“Certain physical contact or statements can be extremely triggering, thus it’s incredibly important that you have formal and informal structures in place to defuse a situation in which someone has been triggered.” There’s an aspect of this that can make it tricky: “Often people who have been traumatised are unable to react to the specific situation – they become paralysed, realising only afterwards that it negatively affected them.”

As an HR leader therefore, you must work to be observant and intervene when you sense emotions are running high, without assuming you know the full story. Discreetly ask affected parties what they need and listen carefully, in the awareness that such situations may take time and space to be fully processed and/or resolved.

Here’s an example from real life that may help convey how difficult it can be to read or respond to a situation where someone has been triggered: 

Trauma in the workplace – a real example

A young woman was in her office kitchen preparing her lunch when a male colleague she felt comfortable with – they even occasionally socialised in a group outside the workplace – came in to make coffee. When he needed a mug from a cupboard she was standing in front of, instead of asking her to move, in a gesture he considered playful, he put his hands on her shoulders and steered her to the side, so he could reach the cupboard. He then made his coffee and left, the two colleagues exchanging cheerful farewells. Within moments of him leaving, the woman began to shake uncontrollably and hyperventilate. She went to the bathroom where she cried for several minutes, before returning to her workday without sharing the experience with anyone. Only when reflecting on the incident on her way home, did the woman realise that the sensation of her male colleague’s controlling hands on her shoulders had triggered her sexual abuse trauma. Not surprisingly, those memories were not top of mind and, after years of keeping her trauma a secret, it felt perfectly normal for her to process it by herself, then dry her tears and get back to business as usual.

In this case, the woman was alone in the kitchen, she knew her colleague had meant no harm and HR did not become involved, but what if someone had come across her during her panic attack or if her colleague’s gesture had triggered anger instead of feelings of helplessness? The situation might have gone in a completely different direction. “Strive for a workplace where there’s an appreciation and understanding of a range of mental health topics,” urges Dr. Schneider. Only in this way, can awareness grow amongst employees that there may be a lot going on below the surface with colleagues. Ideally, their compassion and willingness to be attuned to each other’s needs and express support will be awakened. 

Is Imposter Syndrome the real imposter?

Imposter Syndrome is not a diagnosis or a mental health condition, rather a pattern of thinking. A person with impostor syndrome typically has:

  • a sense of being a fraud
  • a fear of their “inadequacy” being discovered
  • difficulty internalising their success

This ongoing pattern of thinking can trigger a range of other mental health issues, among them:

  • anxiety
  • depression – a condition which women suffer from disproportionately, it affecting one in every four women
  • frustration
  • lack of self-confidence
  • shame

Both men and women in any type of work can suffer from feeling like an impostor. It’s been estimated that nearly 70% of individuals will experience signs and symptoms of impostor syndrome at least once in their lifetime – and it might be triggered by something as common as a new academic or professional setting. High achieving women have been identified as being particularly susceptible to imposter syndrome, but overall there is inconclusive data on whether women suffer more than men from it. 

Lack of role models for women and LGBTQ+

Brian Daniel Norton, a psychotherapist and executive coach in New York suggests that “women of colour, especially black women, as well as the LGBTQ community are most at risk”. He explains: “When you experience systemic oppression or are directly or indirectly told your whole life that you are less-than or undeserving of success and you begin to achieve things in a way that goes against a long-standing narrative in the mind, imposter syndrome will occur.” Not seeing others like you in similar roles is also a central contributor, say Jodi-Ann Burey and Ruchika Tulshyan, the authors of the article “Stop Telling Women They Have Imposter Syndrome”, asserting: “Many of us [women of colour] across the world are implicitly, if not explicitly, told we don’t belong in white- and male-dominated workplaces.” 

Burey and Tulshyan even question the helpfulness of the concept imposter syndrome itself, defined in the late 1970s when an understanding of “the impact of systemic racism, classism, xenophobia, and other biases was categorically absent”. The authors argue that by pathologising “a fairly universal feeling of discomfort” and putting the responsibility on women themselves, “without accounting for the historical and cultural contexts that are foundational to how it manifests”, imposter syndrome encourages “fixing women at work instead of fixing the places where women work.” 

Put another way: imposter syndrome has spared employers the hard work of looking in the mirror at how the deeply ingrained norms and attitudes of their workplaces might be negatively impacting women’s mental health. 

Tiptoeing around reproductive health

Many mental health topics specific to women relate to areas of life that are taboo or stigmatised in our culture. Menstruation, fertility and menopause are subjects that women often feel most comfortable talking about with their nearest and dearest – and those of the same sex. Yet each of these can impact women’s working lives and mental well-being to an extent that it’s extremely valuable for both male and female HR leaders to have an understanding of them.

PMS and PMDD

Let’s start with the topic of menstruation. Firstly, it’s important to know that not only can hormonal and physical health changes during the menstrual cycle affect mental health, but, vice versa, mental health conditions have also been found to impact the menstrual cycle. Depression and anxiety disorders, for example, increase the likelihood of premenstrual problems. Over 90% of people who get periods report experiencing symptoms of premenstrual syndrome (PMS) one or even two weeks before their periods begin.

PMS may manifest in feelings of irritability, nervousness and/or anxiety. A further three to eight percent of people who get periods suffer more severely with a condition called premenstrual dysphoric disorder (PMDD), a frequently debilitating form of PMS that manifests through both physical and emotional symptoms. Our Head of Psychology Dr. Eva Schneider points out that:

“pronounced irritability and emotional lability can cause considerable suffering – particularly when accompanied by the feeling or even the experience of losing control. Various other symptoms: depression, anxiety, tension, reduced self-esteem, lack of energy, tiredness, changes in sleep rhythms (often with an increased need for sleep and feelings of tiredness during the day), changes in appetite (frequently with carbohydrate cravings and/or bingeing), difficulty concentrating, and somatic symptoms – among them: water retention, weight gain, abdominal pain, back and joint pain, swollen and/or tender breasts, the sensation of being bloated) – can considerably impact the subjective well-being of those affected.”

Endometriosis

Approximately ten percent of women worldwide have endometriosis, an often painful disorder in which tissue similar to the tissue that normally lines the inside of the uterus grows outside the uterus. Pain can extend beyond the pelvic area to the legs, back, shoulders and neck, sometimes also making intercourse painful. Endometriosis pain can vary from day to day and it’s different for everyone: some feel pain constantly, whereas others may only be in pain around the time of their period. Menstruation may also occur irregularly, making it difficult to assess whether any symptoms arising are a result of endometriosis or another ailment. Getting taken seriously by a doctor and/or getting a proper diagnosis can be problematic, due to prevailing beliefs that pain during menstruation is normal. The condition can also negatively impact fertility, adding a further psychological burden to the stress of physical pain.

Infertility

Calling it a “global public health issue”, the WHO estimates that over 10% of women worldwide suffer from infertility – including in that figure only women who have “remained in a stable relationship for five years or more”. 

The emotional and hormonal rollercoaster and financial stress of fertility treatments, combined with the very inflexible and often last-minute scheduling needed for procedures can place a lot of pressure on professional women. They may fear being overlooked for raises or promotions or worry about being treated differently by their team if it’s known they are trying to become mothers. The double whammy of such feelings of uncertainty and apprehension paired with the stressful fertility treatments themselves can create massive inner disunity in women, making it extremely difficult for them to determine whether it is wise to bring up this very private topic in the workplace or not.

Abortions and miscarriages

These are both intense, often highly emotional, experiences that many women undergo, with one in ten women worldwide miscarrying during their lifetime, according to a 2021 study. While getting an official medical leave is common and can help with the physical healing and emotional processing, it can be stressful for affected women to answer questions about where they’ve been, or – if a miscarried pregnancy or one that had to be terminated for medical reasons was already announced and/or visible – to brave the well-meaning glances and condolences of colleagues. Having already done the work of creating a workplace that’s mental health-friendly can go a long way towards making this experience less uncomfortable.

Menopause

Perhaps the most taboo topic of all, menopause – a natural biological process – is loaded with aspects of life we all fear on a deep level: ageing and death. Making matters worse, we usually only hear vague and unpleasant stories of night sweats, hot flashes and mood swings.

As an HR leader, it’s important for you to know that for some menopause can be truly debilitating, with the symptoms above as well as others de-railing sleep patterns and affecting performance, not to mention causing embarrassment – for example, if an intense hot flash occurs during a meeting. Here as well, a woman may understandably choose to keep her health status private. Once more, having a thriving mental health-friendly culture in place can help enormously to ease anxieties and self-consciousness.

Thankfully, in recent years many women have not only taken this topic out of the shadows with books and articles – they’ve taken it to the courts, in some cases getting compensation for unfair workplace dismissals when they were undergoing menopause. 

Silence should not mean suffering

What can HR and leadership do to help the women and transgender men potentially struggling with these issues in silence? Simply being aware of these topics will help keep you from jumping to conclusions if someone suddenly has a lot more appointments outside the office, has to go home suddenly or cancels meetings at the last minute they previously agreed to attend. In any case, don’t be hesitant about gently reaching out to these individuals. You can simply ask how they’re doing in general and focus on assessing their overall attitude towards their work and colleagues rather than asking about specific behaviour. 

Should a colleague opt to share any reproductive health issues with you, be ready to respond empathetically and professionally. Thank them for their trust, discuss how you and/or the team (if appropriate) can support – for example by offering days off, creating a more flexible workday, helping with communicating the topic to the team, etc. – and, naturally, keep the disclosure confidential unless the affected employee requests otherwise. 

Part 2: Supporting women in the workplace

Before we look at what you can do to ensure women’s mental health needs are accommodated and accounted for in your workplace, it’s important to understand the overarching status quo.Even in 2022, the majority of offices around the world are still patriarchal by default with certain masculine behavioural characteristics unconsciously celebrated and encouraged, such as individualism and dominance. Sexual harassment and microaggressions impact women’s mental health on a daily basis with 35% of women in full-time corporate sector jobs reporting having experienced sexual harassment and 64% saying they faced microaggressions at work (compared to about 50% of men).

The glass ceiling still very much exists. As journalist Barbara Bry wrote in 2021, women are “dramatically underrepresented in the ranks of business executives. In 2020, only 7.4 percent of Fortune 500 companies were run by women. And this was an all-time high”. Bry asserts that “women generally attain leadership positions by threading the thinnest of needles – managing the trade-off between competence and likeability”.

Germany ranks well below the U.S. on the “Glass-ceiling index”, which evaluates the environment for working women worldwide through data on higher education, labour-force participation, pay, child-care costs, maternity and paternity rights, business-school applications and representation in senior jobs. 

STEP 1: Raise awareness

Building a culture that’s understanding and accepting of women-specific mental health topics means first and foremost raising everyone’s awareness – including women’s – of the unique challenges and barriers women and girls are confronted with, naturally without painting them as enduring victims. Consider using some of the statistics quoted in this article in a statement announcing the company’s intentions topromote women’s workplace mental health as well as gender equality on all fronts. 

If you’re located in Germany, your organisation could also consider signing the Ad Girls Manifesto, as digital communication agency la red did. Of their decision, la red’s PR Manager Samira Großhennig says:

“It’s important to us that every person feel comfortable working with us and is encouraged to share their individual background, ideas and potential. By signing the manifesto, we are not only publicly committing to a clear stance but, above all, we see it as an obligation to our colleagues to demonstrate that we are now actively tackling the issues in the industry. Simultaneously, we hope that through exchange with the other agencies participating in the initiative, we can share both experiences and powerful incentives and solutions. We have already developed guidelines for gender-appropriate language and are currently in talks with experts who will support us in tackling related topics correctly, sustainably and in collaboration with our colleagues.”

If you’re not in advertising, you can create your own manifesto for your industry and/or list of actions focused on establishing gender equality, such as this one from Münster-based social media agency Social Match

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STEP 2: Educate

Start a deeper conversation in the workplace by holding workshops on different mental health topics, not just those primarily impacting women. Teach employees about the prevalence and symptoms so they are aware of topics those around them may be struggling with – and, ideally, better able to have empathy for them and offer support when needed.

As Dr. Schneider explains, “the goal is to build a culture where caring behaviours and interactions arise spontaneously, so that if a colleague observes that someone obviously felt uncomfortable in a given situation, they know they can approach that person afterwards to ask if they’re ok and wish to talk about anything”.

Draw on the findings of academic Brené Brown as you strive to “dispel the myth that vulnerability is a weakness” and “foster a culture of belonging where people can bring their authentic selves to work”.

Trauma

When discussing trauma, you might supply employees with best practises for what to do when a colleague is triggered, explaining that – as in the example given at the beginning of this piece – one person’s harmless comment or touch can be another person’s trigger. While everyone is different, educating people about what trauma is, its widespread nature and its potential impact is a good place to start. Another workshop or discussion could look at understanding boundaries and physical contact – a topic that could not only cover gender but address cultural and religious differences as well. 

Imposter syndrome

The authors of “Stop telling women they have Imposter Syndrome” conclude that:

“the answer to overcoming imposter syndrome is not to fix individuals but to create an environment that fosters a variety of leadership styles and in which diverse racial, ethnic, and gender identities are seen as just as professional as the current […] ‘Eurocentric, masculine, and heteronormative [model].’” 

This raises the question about whether quotas should be introduced to address diversity, given that some studies demonstrate that “if we continue at the current pace, it would take more than 100 years for leadership positions to be equally distributed,” as Dr. Schneider explains. She believes that quotas can help build a culture of true diversity, equity and inclusion, but advises that whether or not quotas are in place, teams should learn to “communicate very precisely where they see a person’s skills and strengths. These qualities should be decoupled from characteristics such as gender, identity or cultural or class background. It should be made clear that an individual’s presence has nothing to do with luck, coincidence or external circumstances.”

Reproductive health

Dr. Schneider proposes that the topic of menstrual health should not be shied away from in the workplace.

“It’s simply a natural part of us, affecting at least half the world’s population. The stresses that can arise from it can influence personal work rhythms and should therefore also be discussed in the work environment.” 

Government legislation for period leave exists in several countries – including Japan, South Korea, India, Zambia and Taiwan. Until the day when such measures are perhaps more widely in place, one way to support colleagues who have severe menstruation, menopause or endometriosis symptoms is to set up a process ‘safety net’ for them, in case they need to step away from their work at short notice. This might be something as simple as having an agreed-upon emoji they post in the team chat that signals to the group what’s happening so that fallback processes are activated. 

As always, the first step is to be aware of and take seriously the wide range of reproductive health topics that can impact women and trans men, both physically and psychologically. Consider establishing procedures that enable everyone impacted to seamlessly handle any stressors or emergencies that arise while simultaneously sending women the signal they are understood and supported. 

Burnout

McKinsey and Lean In’s 2021 Women in the Workplace Report advises that “across all of their efforts to combat burnout, companies would benefit from embracing experimentation […] [and] make strides by listening closely to employees, exploring creative solutions, and trying something different if a new norm or program falls flat.” Some things you might consider in addition to project management tools and daily check-in meetings are meditation or mindfulness classes, or providing access to mental health resources, such as counselling.

The Harvard Business Review study which revealed that women’s feeling of “time stress” is causing them to burn out faster than men recommends that workplaces “implement clear protocols about raises and extension requests through official channels, which would encourage women to ask for help without being penalised”.

The charity Mental Health UK also suggests giving employees regular stress risk assessments – introducing them to it during onboarding so they’re mindful of their experience from the start and can monitor any triggers.You can download sample templates here.

STEP 3: Transform

Now let’s look at some more far-reaching policies and procedures you can adopt to ensure your efforts to build a women’s mental health-friendly workplace are durable for the long-term:

  • If you aren’t doing so already, offer parents greater flexibility in working hours and location; consider offering childcare support or benefits
  • Adopt a Sexual Harassment Policy, such as this one 
  • Implement anonymous reporting structures for harassment and discrimination
  • Empower female employees to form mental health employee resource groups (ERGs) and other affinity groups and start peer listening initiatives
  • Launch a male allyship programme – a recent study published in the journal “Psychology of Men and Masculinities” found that “having men as allies in male-dominated workplaces seems to help women feel like they belong, and this helps them function enthusiastically with their male colleagues on the job.” Furthermore, as Barbara Bry writes, “men are essential to the success of women […] In positions of power, authority and influence, they can sidestep some of the backlash that women receive, and their efforts to combat sexism are seen as more legitimate and more favourable.”
  • Support employees in using nilo.health tools as an ongoing self-help and empowerment resource

We hope you’ve found this piece informative and a helpful starting point for updating or transforming your culture to be more optimally supportive of women’s mental health. As you move forward, keep in mind that no group wants to be singled out as disadvantaged or needing special attention.

Today’s professional women are impatient to propel themselves into the future with their heads held high – letting yesterday’s obstacles shatter and fall below them in tiny, sparkling glass shards.

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