All of us have personal struggles, some of them serious, and when we do, it can be hard to keep them from affecting our performance at work. Take health issues: In an article in The Chronicle of Higher Education, a chair of an academic department estimated that in a group of 50 professors and five office staff, serious illness affects at least three or four of them -- in addition to close friends and relatives -- during a given month. And then there's depression: A large study reported in Academic Medicine found that one out of five medical students and residents suffer from mild to severe depression, and one out of 17 reported suicidal thoughts.

Not covered by either study are a variety of other problems -- with children, relationships, aging parents, financial issues, substance abuse, the death of a loved one, and so on. The possibilities are too numerous to list.1 And experiencing one crisis isn't insurance against another; sometimes we're hit with several problems at once.

What is true for us is also true for our co-workers. And that, not our own problems, is the subject of this Mind Matters column. When a colleague is struggling noticeably due to personal problems, what should you do? It's a hard question, because many times colleagues aren't close friends. Intervention could lead to resentments and damage reputations and delicate work relationships -- but doing nothing can also have serious consequences.

Signs of distress

Much of the literature on dealing with distressed co-workers is focused on physicians and other mental health professionals. Yet the lessons learned can be applied to professionals in other scientific settings.

"At first, outward signs of distress can look like ordinary behavior, and individuals who interact infrequently with the distressed professional may not see the symptoms and signals," write Richard Kilburg, Florence Kaslow, and Gary VandenBos in an article in Hospital and Community Psychiatry.2 "The work setting is often the last place the problem appears. Inappropriate work behavior is usually treated as an isolated incident." This is especially true in a setting like a university, where eccentricity is often tolerated and accepted -- as long as the individual remains productive.

The box below lists some of the signs that may signal an emerging mental disorder or substance abuse problem. Sudden changes in behavior, in particular, may suggest a need for professional help.

Problem behaviors that may suggest a troubled colleague (adapted, in part, from Kilburg)

Boredom or loss of interest in work

Fatigue

Inability to concentrate or remember

Declines in work performance

Missed deadlines, canceled or forgotten appointments or meetings

Irregular work hours or excessive use of sick leave

Highly critical, abrasive, or hostile behavior leading to conflicts with others

Having a quick fuse, frequent emotional outbursts

Inappropriate drinking or use of drugs

Sloppy dress or changes in hygiene or appearance

Sexual misconduct

Overuse of prescribed medications for sleep, anxiety

Withdrawal from people

Despondency

Odd or unusual behaviors

Overtalkativeness

Grandiosity

Suspiciousness

Threats of violence or self-harm

Sara

Sara* was a foreign postdoc, far from home. She split her time between two labs, each with a different supervisor, and she couldn't get along with either. Sara was preoccupied by the issue of intellectual property. Certain that her ideas were being stolen, she cautiously approached one of the co-chairs of the postdoc association at her university -- let's call him Mark -- to solicit his advice on how to protect her rights.

"She wasn't overly demanding of my time, but she was insistent when we spoke," Mark says. He made a few suggestions and provided the names of university officials who could assess her situation knowledgeably and impartially.

"While Sara seemed pleasant and rather docile, she became explosive and argumentative with folks that she perceived as stealing her ideas and working against her," Mark says. "I don't know if this was due to some underlying problem or if it was simply that she was overwhelmed by stress, but either way it was clear that she wasn't coping."

Mark wasn't a close colleague or a friend. His involvement with Sara was in an official capacity. His role was limited. He wished he could do more and struggled to strike the right balance between compassion on the one hand and professional distance on the other. He chose to stay within his professional role.

Sara's situation got worse, and one day she was asked to leave and escorted out of the building. Several weeks later, she returned to her home country.

"She didn't have a strong support system in this country that I'm aware of," Mark says. "She spoke of her faith and her church on occasion but never of other friends. One of the things that upset me most was that when she left, there was no one to see her off or say goodbye."

Although the outcome was unfortunate, we can hope that Sara was able to receive help and support at home. This wasn't necessarily a bad outcome. Mark's approach was reasonable given the circumstances.

Fools rush in?

When a relative or close friend is in emotional distress, few would hesitate to provide comfort and support. When a colleague appears to be choking or appears short of breath, you would offer assistance and call for help. But when it comes to mental or emotional problems in the workplace, deciding whether to intervene, and how to intervene, is more complicated.

One of the factors adding to the complexity is that although we interact with colleagues on a daily basis, our relationships with co-workers range in intimacy, from distant acquaintances to close friends. Considering this, are we our colleagues' keeper? Or should we ignore what some might say is none of our business and stay focused on our own work? Are we bound to confidentiality, or should we mention what we think, see, or know to a supervisor, another colleague, or someone else? What are the risks of acting on a hunch that turns out to be totally off base?

What you CAN do

The decision whether to intervene is personal. Before making your decision, consider talking to a friend or confidante, confidentially. Meanwhile, here are some general guidelines to help guide your approach to a colleague who seems to be having trouble:

1) If you have a close relationship with a troubled colleague and he seems oblivious to his own behaviors, let him know he's acting differently. "Frame your concerns within the context that you might be mistaken and/or the person might not be ready to talk about it with you," suggests Linda Rosenberg, CEO of the National Council for Community Behavioral Healthcare in Washington, D.C. Provide concrete examples to demonstrate the behavior you're concerned about. "If the person doesn't want to speak now, let your offer to speak in the future stand," Rosenberg says. Don't hesitate to suggest professional help.

2) Even if the troubled co-worker is a friend, set limits. Don't pry or ask for too much information. Try to empathize and understand your friend's point of view. Sometimes just talking about a problem enables the person to realize they need more help. "Just remember that you cannot solve this person's problems. You aren't being paid to be a social worker, and you probably have a job to do," says Kathi Elster, a management consultant and co-author of Working With You is Killing Me: Freeing Yourself from Emotional Traps at Work.

3) When you're listening, you don't have to agree with everything a troubled colleague tells you or complains about. Don't provoke an argument, but don't hesitate to be critical in a gentle and good-natured way. A reality check can sometimes help defuse a tense situation.

4) If a colleague you're not close to is telling you things that make you uncomfortable, make it clear that your relationship is professional, not personal. Explain that although you care, you aren't a therapist and are at work to do your own job. Say you have to get back to your work and advise your colleague to talk to someone who is trained to listen.

5) If you don't have the time or inclination to help someone directly, find out what resources are available in your organization. Is there a postdoc association? A supervisor to whom you can address your concerns in confidence? But be cautious about whom you talk to, because talking too openly could undermine your colleague's credibility in the workplace.

6) If you sense that your colleague is deeply depressed or at risk of harming himself, you, or someone else, act quickly. Notify a supervisor, the campus security office, or someone else who's in a position to intervene. Even if you are overreacting, it transfers the responsibility -- and the decision -- to someone with more experience.

Of course, there are no one-size-fits-all solutions to any difficult situation. The decent and appropriate response to a colleague in distress depends on a variety of factors: the individuals involved, your role in the organization, the nature of the aberrant behavior, the relationship between you and your co-workers, and the type of work setting and institutional supports available to you.

1Several other Mind Matters columns have addressed the career challenges and unique stressors affecting young scientists.

2Richard R. Kilburg, Florence W. Kaslow, and Gary R. VandenBos, Professionals in Distress. Hospital and Community Psychiatry 39, 723 (1988).

Resources:

The University of California, San Francisco, Office of Postdoctoral Affairs has developed an excellent guide called Postdoc Guide: Caring for Yourself and Your Colleagues.

Irene S. Levine is a freelance journalist whose work has appeared in many of America's leading newspapers and magazines. Trained as a psychologist, she works part time as a research scientist at the Nathan S. Kline Institute for Psychiatric Research in Orangeburg, New York, and she holds a faculty appointment as a professor of psychiatry at the New York University School of Medicine. She resides in Chappaqua, New York.

Irene S. Levine is a freelance journalist whose work has appeared in many of America's leading newspapers and magazines. Trained as a psychologist, she works part time as a research scientist at the Nathan S. Kline Institute for Psychiatric Research in Orangeburg, New York, and she holds a faculty appointment as a professor of psychiatry at the New York University School of Medicine. She resides in Chappaqua, New York.
10.1126/science.caredit.a1100022