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How to know when you need a mental health break and ways to make the most of it

Naomi Osaka recently announced her decision to withdraw from the French Open, citing concerns about her mental health.
Naomi Osaka recently announced her decision to withdraw from the French Open, citing concerns about her mental health. (Clive Brunskill/Getty Images)
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Tennis phenom Naomi Osaka’s decision to withdraw from the French Open, citing concerns about her mental health, has been heralded as a “wake-up call” by many in the world of elite athletic competition. But mental health experts hope that discussion of Osaka’s actions transcends the professional sports industry and encourages more Americans to take time off when they need it — and more workplaces to make that possible.

“This just shows us that it is possible and there is a way to prioritize your mental health over anything else in your life,” said Akua Boateng, a licensed psychotherapist in Philadelphia. Osaka, she added, “is changing the culture around what’s important.”

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In the statement announcing her withdrawal, Osaka, 23, revealed that she has “suffered long bouts of depression” in recent years and highlighted some of the unique pressures of being a high-profile athlete — including being expected to field myriad questions from the media. While some of the challenges Osaka faces are specific to her, many Americans also experience overwhelming work demands.

“American society has a lot of pressure or expectation about job performance,” said Theresa Nguyen, a licensed clinical social worker and chief program officer of Mental Health America. “We’re at a turning point. More people are understanding what it feels like to work to the point of breaking, which is far beyond when we should be thinking about taking a mental health break.”

The concept of workers using paid leave to care for their mental health — as they do to recover from physical ailments — is still gaining acceptance. People who take mental health days often “feel really guilty about it,” said Natalie Dattilo, a clinical health psychologist with Brigham and Women’s Hospital in Boston. “They’ll worry all day about having taken their mental health day and basically undermine their chance to refresh themselves and actually take the time that they need.”

Furthermore, not all workers have the option. In March 2020, only 78 percent of civilian workers, which combines those in private industry and in state and local governments, had access to paid sick leave benefits, according to the U.S. Bureau of Labor Statistics. And some data has suggested that many Americans tend not to take sick days, even if they have them, or use all of their allotted vacation time. As of 2018, the U.S. Travel Association reported, 55 percent of Americans were still not using all their paid time off.

But Nguyen and the other experts say it’s important to be able to identify when you need a break, and to make the most of it. Here are their tips.

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Learn to differentiate between good and bad stress

Certain situations, such as starting a new job or giving a big presentation, are naturally going to cause some stress and anxiety. “That doesn’t necessarily mean you are clinically diagnosed with generalized anxiety disorder,” said Sean Baker, a licensed clinical professional counselor based in Maryland and a partner of the Black Mental Health Alliance. “That just means you’re human and you have feelings.”

In some cases, feeling stressed or anxious can even be helpful, Boateng said. “Good stress really is just our body rising to the challenge of whatever is in front of us.”

And, Dattilo added, it’s important not to avoid anxiety-inducing activities. Such behavior, she said, may only serve to reinforce the negative feelings.

Experts emphasized that you need to pay attention to the duration and severity of these feelings. For example, after you’ve settled into your job or the presentation is over, that stress and anxiety should subside. If it doesn’t and instead starts to overwhelm you and affect your ability to function, that’s a problem.

“Everyone has a bad day here or there . . . I think that’s to be expected,” said Vivian Pender, president of the American Psychiatric Association and a clinical professor of psychiatry at Weill Cornell Medical College. But when you experience a “persistent feeling that keeps going on day after day after day” and you no longer feel capable of taking care of your responsibilities, “then you have to you have to do something,” Pender said. “You have to take it seriously.”

In a given year, nearly 1 in 5 U.S. adults experience some type of mental health condition, according to the American Psychiatric Association. More than half of that population doesn’t get treatment, Pender said, in part “because of those outside pressures to kind of power through no matter what.”

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Identify red flags

People tolerate and respond to stress differently, but there are mental and physical symptoms that may indicate it’s time for a mental health break.

One of the clear signs is feeling a sense of dread about situations, Nguyen said. Also concerning are persistent thoughts related to your work or home life that may prompt a mixture of sadness or depression, anxiety, and hatred for yourself or others, she said.

Feeling burned out, exhausted or overwhelmed will probably begin to have noticeable impacts on three areas of your life, Dattilo said: Commitment, concentration and connection.

You may find it harder to set goals and stick with them as well as to be productive and meet demands at work or home, she said. There could also be changes in your ability to focus and retain information. On top of that, your frustration tolerance decreases when you’re not doing well, she said, and it can become difficult to nurture relationships.

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Stress can also exact a bodily toll, experts said, affecting sleep and appetite and causing other symptoms such as stomach discomfort, headaches and pain.

Pender recommended checking in with yourself daily, or even multiple times a day, if necessary, to see how you’re feeling and doing.

Normalize taking care of your mental health

Experts encouraged companies and people in leadership positions to have open conversations about mental health and help increase employees’ awareness of resources that may be available to them.

“Companies have to do a better job of letting their staff know if you’re not abusing your time off and you have the time, definitely use it. That’s what it’s there for,” Baker said. “It has to be normalized that it’s okay to take time for yourself.”

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One solution is to schedule occasional office closures, Nguyen said. It can ensure people are taking time off and lessen the chance that they will feel pressure to work while on vacation.

It might also be beneficial to designate a certain number of available sick days as optional wellness or self-care days that can be taken without needing a doctor’s note or explanation, Boateng said. By taking that step, she said, companies can send a message to employees that “we’re actually thinking about how to keep people well, not just to take care of them when they’re sick.”

But any real change will require more than a patchwork of mental health supports, Nguyen said. “The issues are systemic and it isn’t fair for us as fellow society members to put the entire onus of self-care and time off on the worker alone,” she said. “We have to evaluate the way that our policies and our drive toward productivity is carried on the back of our workforce.”

Give yourself permission to rest

If you have decided that you need a break and are employed by a workplace that makes that possible, how you use the time matters, experts said.

For those who take a day off and end up feeling bad that they did, “is that really restful time or is it just ruminating in anxiety and guilt?” Nguyen said.

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Consider approaching your time off with a plan. Baker suggested creating a mental tool kit of enjoyable, healthy activities that can address various needs. And whatever you choose to do should be very different from your work, Pender said.

But perhaps most importantly, give yourself permission to focus on your well-being and recognize that it’s necessary. “We’ve made rest a reward instead of a requirement,” Dattilo said. “Our primary objective is to be productive, and once you’ve been productive enough, then you can rest, then you can relax.”

The problem, she continued, is that the “finish line keeps getting moved. It’s set up so that you can always be more productive.” If workers are able to prioritize rest and self-care without guilt, she said, they’ll be better able to contribute at work or at home.

There is, however, a limit to what self-care can remedy, experts said. If your situation is affecting “your outlook on life, your desire to live, those are serious red flags,” Dattilo said. If you’re asking yourself questions such as “What’s the point?” and “What am I doing here?” or you’re feeling hopeless and helpless, that, she said, may be “indicative of a pretty serious mood disorder for which treatment could be helpful.”

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