Nancy M. Valentine

Have you ever wondered about your mental state or your co-workers'? Some studies suggest that more than half of those in the U.S. with psychiatric problems never get treatment, and that may end up affecting you in the workplace.

According to Harvard scientists from the School of Public Health, depression and other psychiatric illnesses will be very close behind heart disease as the No.1 health threat around the globe by 2020. Nancy M. Valentine, RN, Ph.D, MPH, FAAN, is online today to answer your questions about how this could affect you or a colleague, and how to deal with it.

Below is today's transcript.

Nancy M. Valentine: Thanks for joining us today. Dealing with problems in the workplace can be as challenging as any we encounter as part of day to day life-so learning how to deal effectively with yourself and co-workers poses particular challenges! Even in the worse situations, there are opportunities to learn and grow-so don't get discouraged and start each day wondering if you should be looking for another job. Often even the most difficult situation can be turned around if you use your head more and your emotions less. Let's get started.

Anywhere, USA: Thanks for coming back for another discussion. I hope you can help me with this.

I've got a well-paying job that I really like, but is highly stressful. My position may be eliminated in a corporate merger, but no one knows anything.

Should I jump ship now, and risk losing a good job? Or how can I tough it out when morale is low and others are leaving. It's getting harder and harder to do my job, which I used to love.

Thanks for your help.

Nancy M. Valentine: Not knowing what may happen is always more stressful than having a firm answer, but what you are having to cope with is precisely not knowing what the outcome may be. Weigh your options carefully. Take a blank piece of paper and draw a line down the middle. List the reasons to stay and on the opposite side, the reasons to leave now versus later.And see how these tally up. Often if you can keep your vision clear and not get involved in everyone else's low morale, you may come out the winner in a corporate shake-up, but of course there are no guarantees. If there are options in the area of your specialty outside, you may want to start interviewing for these now and just see what is out there without making any commitments to leave your current job. good Luck!

NYC: I am in a situation for the first time in my working life where, in order to do my job, I have to depend on a number of people to do things for me-people on others' staffs. Dealing with them all is tough enough, but inevitably someone drops the ball. It's keeping me up at night with worry. Should I get out or do you have advice on how to deal with this? Thank you.

Nancy M. Valentine: You have moved from being a staffer to being a front-line manager and this is an entirely different job and you need to develop the skills to get maximum performance out of your TEAM! There are walls full of books in any good bookstore on how to get these skills. Go browse and see what appeals to you and then get reading instead of losing sleep. There are also workshops on this topic. See if your employer will invest in sending you to one. It is very gratifying to be a team leader where you get the work done through others. Give yourself 90-180 days to learn the basics and I guarantee that if you start today-you will learn to love your job.

Washington, DC: I'm really glad you're calling attention to mental health issues in the workplace and hope at some point in the discussion you'll call attention to the benefits of having an employee assistance program (EAP) professional in the workplace to facilitate assessment, referral and short-term counseling for persons experiencing personal problems that are having a negative impact at work. It's what we do.

(Sorry for the commercial, but I'm a strong believer in the program, it works!)

Nancy M. Valentine: EAP is a life saver for employees, their families and the employer. Even small employers can benefit from contracting for these services since even one problem can cost a lot if there are no support systems in the workplace. Thanks for bringing this up! Sounds like you are very invested in your work! We need you.

CA: I work for the state at a public Univ. and am coming to the harsh realization that should I remain, I will never achieve the kind of salary that I want. I value the work, but not enough to feel undervalued. It is beginning to upset me and lowering my energy on the job.

I'm up for my annual review (which always goes very well) and am wondering whether I should speak with my supervisor about my dissatisfaction. We are in the midst of "boosting" me up a notch for a bit more $$, but still, I'm afraid, far less than I can make elsewhere.

Is it okay to express my dissatisfaction? But where can the conversation go from there? She can only do so much, considering salaries are predetermined. Should she be made aware that I may be on my way out, or is it best to simply stay quiet, find other work, and then explain why. I'm not quiet sure where to go with this.

I work in the IT field in Education, and many are leaving for the very same reason. It wouldn't be a shocker to anyone. Thanks.

Nancy M. Valentine: Love your work-disappointed with the pay? You sound like most nurses. It is such a personal decision and living in California only makes it harder since your peers are probably dot.com millionaires. We have less of a problem with that from where I come from.....But you do like your work and I would suggest that you talk openly with your supervisor and find out what is the max you can get and if there are any plans to increase these salaries overall because of the marketplace issues for IT experts? You may find that it will improve in the longer term. Weigh all factors such as work environment and other satisfiers before jumping ship. A university has a lot of interesting things going on and your stress level may be a lot less than in private industry.

Falls Church, VA: Dr. Valentine-
I have a friend and colleague who lost her husband tragically last year (she was 34 at the time). Many of her friends have supported her, but it has at times been difficult to determine what is normal grief after such a loss and what is depression that needs treatment. Can you offer insight?
Thanks!

Nancy M. Valentine: It takes alot of time and a lot of support to get over such a loss and it sounds like she is working with good folks like you. But part of grieving is getting help and if she has not gotten any counseling or seen a treater, it may be time to do so. Perhaps you or someone else who she trusts can explore this with her. She may be angry at first, but it is real caring to explore such an issue with a co-worker who you think is having a real hard time. Keep emphasizing that it is because people care, that you are bringing this up to her.

Wilmington,Delaware: My boss just lost her husband and is having trouble keeping a good morale among myself and coworkers at work. It's been a few months now and we have all expressed our sincere condolences but we don't know what else to do. It's beginning to affect everyone's work.

Nancy M. Valentine: This one is a challenge simply because it is your boss and you all are in a subordinate position. Often when the phrase is used..."it is lonely at the top", this is a good example of that. As much as your boss is allowed to have feelings, it is also important that the work not erode, so here are some suggestions. Invite your boss out to lunch-with a few of you and get around to the topic of her loss and then move beyond the condolences since there is no more that can be said on that topic. Ask her what she is doing to cope? If there is someone in the group that has gone through such an event, have that person talk about how they got through it. etc. share tips. Maybe give her a book on the topic of bereavement and how to move on...By discussing this in a more informal setting such as a quiet lunch spot, you are moving out of the structured relationships at work and communicating your assistance as more of a "community of employees" of which she is an important member. Even give her a few gentle examples of how difficult it has been to know how to approach her over the past few months. She should get the message and I would suspect will be grateful for the advice and assistance.

Bowie, MD: I am currently at a job where I have zero to do. The organization is poorly managed and without direction, but the issues we deal with are those that I am interested in and want to build the rest of my career around. It looks like the head of the firm - the one who is responsible for the lack of direction and management skills - may be retiring within the year. In that case, things will pick up and I will most undoubtedly have more to do. However, until then, I am not exaggerating when I say that I have nothing to do. It is ridiculous for me to even come into work. (And I've tried and tried and tried to create or get involved in projects) Anyway, I recently got a job offer that will be a step up in pay and responsibility in an office that really hums. However, I'm not interested in their line of work and it would take me out of my career path. Should I wait it out or go to this new job or keep looking?

Nancy M. Valentine: Wow-you could use a crystal ball, but I don't have one! One question is if you went to the new job, could you not leave in a year and come back to this one when the management changes? The other option is to look for alternatives in your field where there is meaningful work to be done? You may be able to create more options for your self than the either or that you have today. Staying in the present job sounds stultifying and you are not getting the experience you need. The only thing I can suggest you do if you do decide to stay, is use the time to design how the company should work if there were clear management-sort of along the lines of "How to Succeed in Business Without Really Trying". Have you seen the play? It's great! When new management comes along, you will have the blueprints ready and if they are smart, you will get promoted to vice president. Use the time to learn as much as you can. But above all-get busy! Idleness is really a downer.

Arlington, VA: Hi Nancy,

I have been treated for depression in the past, happy to say that's under control and my personal life is great. Work, though, still depresses me, because I am a terrible procrastinator and never have been much interested in what I do. I can't leave this type of job, though, because I have so many student loans to pay off, and the type of job I would love to do would not pay nearly as much. Any suggestions on how to be more motivated?

Nancy M. Valentine: Unfortunately there are no pills for this one! You need to get some career counseling and find out how you can broaden your options. You are staying in this field in a "make-do" arrangement and this is not good over either the short and especially the long run. You may pay off the loans, but you will be the employment equivalent of brain dead-NOT GOOD. What you like to do may have some career building possibilities and it is important to check this out. Don't write it off so soon. Another way to look at this is to put a strict time limit on how long you do this job. By setting a time limit and tearing up your credit cards, you can get out of jail-perhaps in 3-5 years and not spend a lifetime trying to convince yourself that this is your only option. Be strict with your self and you will see your procrastination change. Make up a list of key points and guidelines for yourself and past on the inside of your front door so you read and remember to follow these rules everyday

washington, dc: i enjoy my job when i'm busy but when i'm not i almost hate it. i'm thinking about looking for a new job but i'm not sure if i should do this right away because i just started this job. my workload is not challengeing enough or keeps me busy enough. i've talked to my boss on several occasions about this and she doesn't do anything about it. she rarely deals with any problems within the department and she is also very unorganized. i'm just starting my career and it doesn't seem to be getting off to a good start. i don't like being bored at work. doing nothing all day has an impact on me mentally but it seems like i can't and don't know how to handle this problem.

Nancy M. Valentine: Is this your first job? Sounds like part of the problem is just getting adjusted to work in general. A good employee is a self starter. That means you look around and figure out what needs to be done and then take the initiative to do it. Or each day when you finish your assigned duties, you ask your boss what else she needs done today. Most bosses will come up with more to do than there are hours in the day to do it. This way both YOU and the boss are working together to bring value to the company. Try to stay in this job for a year and make it work for you. Job hopping never looks good. But work to turn this around and learn as much as you can. If you put your focus on how to make this a good job for you and to please your boss each day, you will have a good year. After that, start looking around for that promotional opportunity.

DC: My boyfriend and I just broke up and I'm so depressed I can't even think about work!! I've even thought of quitting. What should I do?

Nancy M. Valentine: Any loss take 6-8 weeks to begin to get over, so hold your horses until then. Take a few days off and go out with friends and do something good for yourself that you have always wanted to do. How about a massage? Treat yourself and when you come back to work you will feel refreshed. Even if he was a good boyfriends-men come and men go, but your job is always there and many women go to work just to keep their sanity, especially in a crisis. Hold on and I guarantee you will feel better no later than the first of June if you get started working on resolution today.

Washington, DC: Good afternoon,

I know you are flooded. I really dislike my job and I have been depressed (gained 30 lbs) since moving back to an unnurturing area.

This entire place in unnurturing. I have tried repeatedly to seek new assignments, only to be turned away. Guess what? I went to get a certificate in Event Management only to get patronized by management. You would think that they would want to utilize their investment since my employer paid for the program. I am looking, volunteering in the field, only to be turned down job interview after job interview. This also makes me extremely depressed at times? Thanks for listening.

Nancy M. Valentine: You are depressed and also angry. Do you need to deal with your own issues first totally independent of the workplace. You can change even if they cannot-so concentrate on yourself. Make an appointment with your doctor and get an evaluation of both your physical and mental status and find out if you need any medication.Then get into an exercise program and lose the weight. set a three month goal for yourself to lose at least 20 of the 30 lbs. Maybe join a weight reduction program. Do they have one at work? You will feel better about yourself and that will start to slowly change what is going on at work. But for now, tune them out and just focus on yourself. The new job opportunities in the fields that interest you are there and can be explored as you start to feel better. Work environments rarely nurtures us, we have to learn to love and nurture ourselves and then we are not dependent on the workplace for support that they may not be able to provide.

Philadelphia, PA: We have a senior staff member who has worked for our company for many years. This person is very difficult for everyone to work with. She is always extremely negative, talks down to people, and makes them feel inadequate--everyone's afraid to do anything. This has created a horrendous working environment. People have left her department, complained about her behavior, even other staff members have noted her bad behavior, yet nothing is done. What can be done to deal with this person?

Nancy M. Valentine: Take her on. Stop being afraid of her. You can all be assertive without being aggressive, but everyone is hoping for miracles-which rarely happen in such circumstances. When she is rude, let her know that you do not respond to such behavior or language. I once had an instructor who made every student feel stupid. We would quake just thinking about going into her office for a conference which happened weekly while we were in her clinical rotation. One day she started in on me with her usual berating way and I just looked her in the eye and said, "I am here because I am the student and your are the teacher-isn't it always the case, that I am here to learn because I don't know what you do?" She immediately became much nicer and that was the last time there was any friction. I cannot guarantee you will have instant results, but if you all practice your lines of positive and direct comebacks to her behavior, you should see a change. There are more of you to her as one person, so go to it and start practicing. Stop wimping out!

Colesville, Maryland: I have had to stay away from my job due many renovations being done at my workplace. However, one of the managers there is harassing me to come in even though I provided a doctors notice advising me not to come in for a specified amount of time. What do you think of this? And if I quit, is my job allowed to say anything against me to prevent me from getting another job? Please advise. Thank you!!

Nancy M. Valentine: Your health may need to come first. I do not know what you do, but is there any possibility you could do a lot of it from home? Then you could compromise. Keep in touch with the doctor and determine when and under what circumstances you can return. If you tell your employer that you are getting bi-weekly consultation from your doctor, this may decrease the concern that you are using health as an excuse to get out of work. Try to work it out and compromise-you should not have to leave over this. Keep the communication open.

Langhorne, PA: I feel like I'm working very hard at my job, and have even taken on more responsibilities, however I am not being recognized for all of my efforts. I already asked for a promotion and was promised something would be done. A co-worker also asked for a promotion and quickly received hers, but I didn't. Even though I like my job, I feel like I will have to move on soon unless someone recognizes my work. I'm feeling depressed because I'm unable to make a decision whether to move on or approach the subject again.

Nancy M. Valentine: If you were promised, then there needs to be a time limit assigned to when it will happen. Don't let it drift. Assert yourself with your boss and explore what the plans are and when you could look forward to the promotion.
That alone will make you feel better and if you can get an answer, you then can make plans to stay or explore other options. Definitely finish the conversation before thinking about moving on!

DC: I am a case for getting help when you really need it, as soon as you need it (perhaps with EAPs!) Five years ago, I went through a bout of severe depression (I found out about severe sexual abuse in my family, and had my own memories brought up) which led to my leaving a job as an attorney, moving away and trying to start life anew. I left under bad circumstances--incomplete projects, had almost zero productivity for six months prior--and basically knew that I would lose my job if I had stayed. It was a small firm, and my bosses did not know what was going on with me personally, though they suspected. I have not had direct contact with my prior employers since, but I want some form of closure on this. I was lucky to get new jobs without having to ask for references from them. I am not working as an attorney (my ultimate goal anyway) anymore, and have never been happier or more successful, but I feel that when it's time to move on, this will come back to haunt me--I could use job references, at least neutral from them. (If it helps, prior to that, I did a good job!) Help!

Nancy M. Valentine: You are right in wanting to finish up this piece of business in your life. I would suggest that if you could to go back and have a face to face meeting with the previous employer(s). Tell then as much as you feel you can-be open and honest and tell them that you are doing this for both personal and business reasons. Apologize for leaving them in the lurch. I would suspect that they will be both forgiving and forthcoming. It is a learning experience for all-including them. Alternatively, write and long and clear letter. but if you can do it personally, it is much better.

Arlington, VA: Hi Nancy, I know someone who is in a bad position at work. He just gave notice and has experienced some hostility from his boss. Part of his job entails going through his boss's e-mails everyday. Recently, he found a letter written to a co-worker about him and his work. The things in that letter were demeaning and outright lies. What do you think he should do? His last day of work is in 2 weeks.

Nancy M. Valentine: He should immediately go to his boss and show him a printout of the e-mail and discuss it openly. There is no excuse for such behavior. Ask his boss if he prefers, he could leave early with the 2 weeks pay as severance. I would be sure to have a letter of reference in hand before leaving from the person above his boss. If the boss is uncooperative, go to the person the boss reports to.

Morrisville, PA: How can I deal with working with co-workers who have bad work ethics such as taking long lunches, coming in late, not doing their share of work, etc. I feel like I try to ignore their behavior, but it's making me angry and I have a hard time dealing with it. I sometimes don't even want to come into work.

Nancy M. Valentine: You need to go to the supervisor and get this worked out. You cannot do it alone. Explain the morale issues and the business issues and keep it focused on non-emotional topics such as work flow etc. Good luck!

Washington, DC: I am worried about my sister- she is bipolar and has spent the last eight years of her life battling severe episodes of depression and has obviously not been able to keep many jobs or finish school as a result of her illness. Now, she is finally on a good combination of medication and seeing a wonderful psychologist- but the past eight years have put her at an extreme disadvantage to move forward in her life. Now, it seems that her lack of the time to learn how to live in the real world (she is 27- her illness has consumed her entire adult life)is really becoming a problem for her. She lacks the life skills to thrive. Do you have any advice as to how we as her family can help her- aside from financially- to help her get back on track and find a life path (socially and career-wise). Thanks for your advice- I worry about her constantly!

Nancy M. Valentine: You worry because you are a good sister. She could benefit from some kind of half-way house experience where she could live there for about 6 months and get back on track with what she has lagged in. See if the psychologist can assist in locating such a resource. It is private pay, but may be well worth the investment. It is a community of people with similar issues and they can learn from one another and such programs are run by professionals

help for an artist: I am an artist who has always worked full-time jobs and pushed my passion into evening and weekend hours. Needless to say, I'm tired of it. I'm an excellent employee, but really want the chance to pursue my dream without ending up in the poorhouse. I'd love to find a part-to-3/4 time job that would offer at least partial health coverage and a salary that will pay my rent. Is this possible? My day jobs have usually involved the legal field (secretary, paralegal, communications, etc.) It seems as though DC employers want the total, full time plus commitment. Thanks!

Nancy M. Valentine: You may have to do a lot of cold calling for this. Call employers who are in the field you want to pursue and start networking. Find out what there needs are now and into the future. Follow-up with a letter and resume. Ask them for the names of others who they know might be able to meet your requirements. A lot of people I have met do their art on the side and then exhibit in craft shows. this is how they make the ir jobs pay without running a full-time business in some cases. Good Luck!

Nancy M. Valentine: Lots of good questions-Time is up! Talk with you again!