In a <a href="https://link.chtbl.com/lfa7XKjB">podcast from June 2022</a>, Adam Grant, American author and professor of organizational psychology explains the 4 deadly sins of work culture. 
At Siffi we talk a lot about the importance of creating a well being culture in companies. 
But before we even start focusing on deep health related topics, it is essential to recognize the impact other behaviors that may, at first, seem unrelated to mental health, have on the overall well being of a team. 
According to Grant, there are 4 traits that, if demonstrated by the management, will destroy any effort a company makes to create a positive and health culture in the workplace. 

<h3>1. Toxicity</h3>

We observe toxicity when a company chose to value results over everything else, and at all cost. 
As long as KPIs are met, the way people are treated or treat each other does not matter. If people bring results, they will advanced. 
According to <a href="https://www.mckinsey.com/featured-insights/sustainable-inclusive-growth/chart-of-the-day/toxic-exodus">a 2022 survey by McKinsey</a> on Toxicity in the workplace, more than 60% of negative workplace outcomes (burnout symptoms, intent to leave) are due to toxic workplace behaviors. 
Some “obvious” toxicity behaviours are yelling, bullying or belittling. Others are more sly like omitting to invite someone to a meeting that impacts them, withholding important information, micromanagement or encouraging gossips… 
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<h3>2. Mediocracy</h3>

We see mediocracy in companies which, on the contrary, are only valuing personal relationships over results and will advantage someone who is more liked rather over someone who deliver better work. 
 Management that avoids confrontation, are always going with “the way it’s always been done” and favour team members they have relationships with, tend to create a culture of mediocracy in which people stay because of the comfort rather than the inspiration, healthy challenge or opportunity to thrive. 

<h3>3. Bureaucracy</h3>

 Ever got an idea killed by the amount of paperwork you had to fill in to put it in motion? 
 That is the sin of bureaucracy. When there are so many rules that creativity is nipped in the bud. 
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<h3>4. Anarchy</h3>

Of course, without any rules… it is chaos. 
Some company are all about “freedom” and lack the structure that will make people feel safe. Without restrictions, guidelines or even common values, a culture of anarchy can quickly kill any sense of belonging or team spirit and cultivate an ‘all for themselves’ mindset.
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Do you recognize any of these traits in your team? 
Check out our piece on <a href="https://www.siffi.com/blog/building-a-mental-well-being-company-culture">how to build a strong company culture</a> and hopefully avoid those sins!

The 4 Deadly sins of work culture

If there is one thing to keep in mind it is that a company always has a culture. Whether it is one that was carefully curated or one that was born out of the absence of care for the topic, a culture will appear. Probably not a great one though.
It may seem a bit flimsy at first to worry about culture in the workplace. But history has shown us repeatedly how powerful culture can be.
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<h3>What Do We Mean By Work Culture?</h3>
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Culture in general is defined as the way of life, the general customs and beliefs of a particular group of people at a particular time. 
When we apply it to the business world, the group of people is usually the employees of a company or a specific team within a large company which can each have their own culture.
Work culture can include the way people communicate, what is celebrated and how, how people feedback …
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<h3>What Do We Mean By Well Being Culture?</h3>
Many of those decisions, on how things are done, will impact employees’ well being.
The World health Organization breaks down Well being into four sections: 
&#8211; Emotional 
&#8211; Social 
&#8211; Financial 
&#8211; Physical 
All of these are in a small or big way affected by the work place. 
Implementing a well being culture is acknowledging that how work is done and how teams interact have an impact on people’s general mental health, as much as their physical health.
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<h3>How Do You Create a Culture?</h3>
&nbsp;
As we mentioned above, Culture will create itself if you do not spend time on it. 
That is why it is something to start working on from day one. In order to avoid bad habits from taking roots.
Some of our favorite pointers are:
1. Assess how things currently are. What is the culture like today? Observe but also talk to your team. 
2. Set (realistic) goals &#8211; What Culture do you wish your company to have? What do you want your employees to feel like? Make sure those are achievable and can easily be followed by everyone 
3. Remember Culture is a conversation, not a monologue. Include your team in the change. Listen. Act upon feedback 
4. Make space for it &#8211; Accept change &#8211; Be open to try new ways 
5. Plan training &#8211; Make Managers lead by example 
6. Assess progress &#8211; Plan milestones 
7. Be patient. Iterate.
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<h3>And finally, how do you create a culture of well being?</h3>
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Make even more space, for well being this time.
Mental health and well being is a constant work in progress. Make sure to include those topics as integral parts of your company DNA. Make well being part of the conversation: include it in the regular agenda, introduce it as a KPI…
Acknowledge your team is made of individuals with their talents and challenges. One size cannot fit all and it is important to embrace everyone’s individuality to best nurture their very own skills and creativity.
A healthy team is one in which everyone feels free and safe to engage and participate. Make sure to hold space for all team members to speak up, bring ideas and suggest solutions.
When people feel safe they dare more. To create that safety, show that trial and errors are celebrated just like wins. Remember to always praise in public and criticize in private. 
This will encourage more thinking outside the box, creativity and engagement.
Finally, always welcome feedback and make sure to act upon them, even if it is to say that it will not work.
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The best leaders are those who recognize their teams talents and nurture a culture of authenticity, communication, collaboration and growth.
Knowing how to do just that is not necessarily something that we’re born with, but it is something we can learn along the way and definitely something that can be facilitated through the use of tools and platforms such as Siffi’s.

Building a Mental Well-being Company Culture

In a 2019 article titled “<a href="https://hcp.hms.harvard.edu/news/mental-illnesses-are-common-care-lacking">Mental illnesses are Common, but Care is Lacking</a>” published in Harvard Medical School, author Lauren Jett shares impressive numbers: 
“Nearly 60% of people with mental illnesses did not seek treatment last year” [2018] and “ 25% of adults in developed countries experience significant mental health problems each year”. 
There are many reasons why so few people actually get support and more importantly, get the right kind of support. 

<h3>Not being able to identify it ourselves</h3>

The first reason can simply be that we do not know ourselves well enough to recognise that we are struggling mentally. We might assume it is just another tiring day, and find many other reasons for why we are feeling poorly. Unlike physical ailments, when the protocol of getting help (i.e. turning to GP) is well understood and routine, for mental wellbeing there’s no such habit or user experience. 
Often because we do not know any better, but often also because we are afraid of what other might think of us if we shared how we really feel. 

<h3>Not knowing what it involves</h3>

It seems quite a demanding thing to meet a professional and structure and convey your thoughts in a manner which condenses the issue at hand and leads to a smooth solution. It feels like a fuzzy thing and it is hard to talk to a stranger about it. Also, we might not know exactly what a professional can do about it, so it maybe conveys initial scepticism. So, awareness, peer support and describing how the process works, who does what (like we have done here) may help to overcome this.

<h3>Harder to recognise even for professionals</h3>

Because mental health symptoms may manifest different conditions and there’s no clear cut to distinct these, the actual understanding of the underlying problem may come after few sessions only. Medical advances in these area have been slower than the ones in physical illnesses, as symptoms and cures have taken many different forms depending on the patient. 
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<h3>Stigma</h3>

Mental health issue is sadly still very often associated with old cliches and stereotypes ideas associating it with weakness, lack of self control or even madness and insanity. There is still shame in admitting mental problems that give an image of fragility. A kind of vulnerability that is still seen negatively in our modern Society promoting resilience, growth and productivity at (almost) all cost as the pinnacle of success, leaving no space for self doubt and anxiety. Again, awareness raising is something that can have a very positive impact and encourage people to undertake this very needed path.
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<h3>Lack of knowledge about the different offerings</h3>
 
Even when the condition is determined, it is not easy to keep track of all the possible services and support available and accessible to that particular case. There are loads of self-help materials on the internet, there are apps and there are professionals online these days, but it takes so much effort to run them all through and determine what is the best. Employer led programs take that pain away, as they have often done the selection of the provider and this also comes with professional solutions that one can access and benefit from.

<h3>Cost</h3>

Last but absolutely not least, sadly access to mental health professional such as psychologist and psychiatrist can be expensive and are not always covered by basic insurance. 
People willing to seek support might be discouraged by the budget sometimes needed, and feel even more guilty to add a “unnecessary cost” to the household. 
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All of these reasons, and probably more, are why we believe it is essential that we play our part in talking about mental health in the workplace more freely and offer a safe space for individuals to address those issues without fear of stigma or worry about costs.

Barriers to accessing mental health support

Most people will agree with the importance of well-being and mental health in the workplace. 
When it comes to actually investing in tools and processes that will help create a mental health culture, though, some companies are still slightly reluctant.
It is easy to miss the big picture and focus on yet another expense. After all, well-being and mental health are not easy things to precisely measure, and we live in a world that loves numbers and KPIs.
So if you find yourself feeling like you are fighting an uphill battle to try and implement more mental health offerings, here are our most heard pushbacks and favorite comebacks:
<h3>PUSHBACK 1: IT IS NOT A PRIORITY RIGHT NOW</h3>
IF NOT NOW, WHEN?
Usually? When it is too late. We tend to fix the problem rather than try and prevent it.
Employees are in grave need of renewed faith in their companies and their purposes. 
Most surveys and researches show that building trust, showing care, building a strong culture, and focusing on well-being, are some of <a href="https://www.workhuman.com/blog/hr-trends/">the main priorities in the workplace for 2023</a>.
We have just faced a global pandemic that deeply impacted the way we worked, thousands of workers are now working online or in a new hybrid way, and we have seen surges of resignations as employees questioned their goals and values … 
People in general and younger generations in particular, such as Gen Z entering the workforce in the last few years, are showing some of the lowest rates of satisfaction and loyalty towards their employers <a href="https://www.metlife.com/content/dam/metlifecom/us/noindex/pdf/ebts-2023/MetLife_EBTS_2023.pdf">over the last 20 years</a>. (see graph below)
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Also, even if one may seemingly have a “benefit” like health insurance, let&#8217;s keep in mind that this instrument works for already advanced mental health issues a person has. The barrage of steps to take to end up meeting a psychologist, including waiting times, etc make an effective instrument for those who are already suffering. But it does matter to pay attention early enough, which will save both organization and the employee from the escalation of mental health problems, and hence absenteeism and presenteeism-related costs to a company.
<h3>PUSHBACK 2: IT IS TOO EXPENSIVE!</h3>
BUT CAN YOU AFFORD NOT TO CARE?
Of course, there is a cost to taking good care of people. But a lot of it is also behavioral and small but powerful changes in communication, that are completely free.
Companies’ biggest expense is labor. Your staff is your main source of cost but also part of your essentials. Why spend so much money on hiring talents, if you are not going to make sure they do the work to the best of their potential? 
If your employees are happy they will be more productive and more creative science, (and common sense), show. They will also talk positively about the company which is great word of mouth, PR, and marketing in general.
In today’s world, many companies are cutting down on rent, going hybrid or fully remote. Why not re-invest parts of that budget into building a strong mental health culture within the company?
It is essential to make sure that whatever money the company invests in culture and well-being is well spent. And for that, it is important to understand the particular needs and expectations of your employees and teams rather than fall for <a href="https://www.siffi.com/blog/avoid-well-being-washing">well-being washing</a> measures that will not be used and make no difference.
Multiple evidence also shows a very high ROI from making these investments &#8211; after all, the money you spend on mitigating mental health-related productivity cuts has a lot of leverage. Any day missed from work or work without the ability to concentrate on your tasks will scale quickly into large figures.
For instance, <a href="https://www.mentalhealth.org.uk/explore-mental-health/mental-health-statistics/mental-health-work-statistics">One UK study</a> found that a company with 500 employees would see a net return of £347,722 in savings after an initial investment of £40,000 into workplace mental health interventions due to decreased absenteeism and presenteeism. https://www.frankie.health/blog/roi-of-employee-mental-health
<h3>PUSHBACK 3: BUT WE ALREADY HAVE PROGRAMS IN PLACE</h3>
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Alright, that sounds good. Some companies indeed have a holistic and well-designed mental health program in place. Others often say that they have mental well-being months and workshops, or they allow people to bring in checks from psychological counseling.
Addressing the mental health environment in an organization is quite a challenge. It is a holistic topic that spans across ease of access to a specialist, the right level of assistance (preventative, clinical?), activation and awareness raising, coaching of mid-level management and team leaders, the general attitude of the company, and conveying it in a supportive manner to employees.
So, there is a complex of measures that need to be applied to make it really efficient. A few pieces of the puzzle alone will not suffice, as this will not address the friction that is usually associated with the usage of the service. Low engagement in turn will mean that most of the costs related to mental well-being are internalized by the organization.
<h3>PUSHBACK 4: IT IS NOT WORTH IT</h3>
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RESULTS TALK FOR THEMSELVES
Have a look at that what is easily measured currently in your company:
&#8211; absenteeism 
&#8211; sick days 
&#8211; conflicts in the workplace
When people feel good and motivated at work they don’t call in sick as much. It is as simple as that.
Mental health, stress, and well-being remain some of the main reasons for employees to miss work for short to long periods. As we can see in the data below from a 2021 report by The Chartered Institute of Personnel and Development in the UK.
source <a href="https://www.cipd.co.uk/Images/health-wellbeing-work-report-2021_tcm18-93541.pdf">https://www.cipd.co.uk/Images/health-wellbeing-work-report-2021_tcm18-93541.pdf</a>
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A recent study by Deloitte shows that for every 1$ invested, the company gets a return of 4$. Also, this number is further proven by an analysis conducted by NSC and NORC at the University of Chicago, which reveals organizations that support mental health see a return of $4 for every dollar invested.
<h3>PUSHBACK 5: IT IS NOT OUR ROLE</h3>
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WHAT KIND OF LEADER DO YOU WANT TO BE? 
This goes down to the kind of company you wish to be in and the values that you have decided to work and live by. 
Of course, no one expects the company to fix each trauma and stress of their employees but facilitating access to support and a healthier work-life balance is part of the job of a good employer.
In their 2023 report, the insurance company MetLife shares the data below showing that employees expect to feel cared for by their company.
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REMEMBER WHAT IS AT STAKE 
Indeed, the return on investment of a well-being culture in the workplace is not as easily calculated as in other areas of the company.
Just as the workplace is changing, employers’ measuring tools need to evolve as well. 
The future of work: productivity and innovation, is at stake after all.
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Return-On-Investment from creating a mental health culture in your organisation

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<h3></h3>
<h3>roses will be red…</h3>
For hundreds of years 14th of February has been the day to celebrate love. Usually love for a romantic partner. Between Christmas traditionally celebrating family and New Year usually spent with friends… when is the time to care for the individual? For oneself?
Whether we like it or not, roses will be red, heart shape chocolates will be displayed and cheesy movies will be watched. It is hard to avoid this highly commercialised holiday.
<h4>How About Taking Care of Your Most Important Relationship?</h4>
What can be done though is turning it around on its head and make it a day to celebrate oneself. 
Show love and compassion to oneself for once.
&#8211; Ask yourself, how am I, really? 
&#8211; What is it that I need most right now? 
&#8211; What is my biggest challenge? 
&#8211; How can I show myself love today?
<h4>Caring for All Kind Of Relationships</h4>
As an employer it is also an opportunity to show extra care. 
After all, the relationships one has with their employer, workplace and colleagues a revery important one and they need to be taken care of.
Relationships are complex. At Siffi we provide support to employers and employees to navigate the self within the context of the constantly evolving workspace. <a href="https://www.siffi.com/">www.siffi.com</a>

Will You Be Your Valentine?

‘The future of work’ is already here. Today a lot of people can work from anywhere and many teams only meet a few times a year face to face. As technology allows us to explore these new ways of working, it is essential for companies to adapt the way they care for their employees. 
The ‘nice to have’ perks are long gone.
If COVID has taught us anything it is that we need to take mental health and well-being seriously and it is not something that is only the responsibility of the private realm.
Now the shift that needs to happen, is for companies to understand and fully embrace that investing in your employees’ mental health and well-being actually means future-proofing their business. 
Studies across the world give compelling estimations of how much money is being wasted or lost due to employees’ poor mental health.
In the US alone, companies could lose up to 300 000 billion dollars a year because of employees&#8217; poor mental health <a href="https://apnews.com/article/return-to-office-mental-health-f4877db797e9cccb14e68af2b0b90f29">according to the National Alliance on Mental Illness</a>.
<a href="https://www2.deloitte.com/uk/en/pages/consulting/articles/mental-health-and-employers-refreshing-the-case-for-investment.html">Deloitte’s report on Investing in Mental Health in the UK</a> presented £42 billion of losses due to absenteeism (£7 billion), turnover (£9 billion), and presenteeism (£28 billion) created by mental health issues, especially in industries like finance, insurance, real estate, and communication.
Employee well-being encompasses a lot of areas such as personal health of course but also workspace &amp; environment, work relationships, career growth opportunities… 
When employees feel trust and belonging within their team, when they feel safe and supported and share an alignment on common goals and values, that is when great things can start to happen:
&#8211; Increased productivity ( <a href="https://www.silvercloudhealth.com/us/blog/the-effect-of-employee-mental-health-on-productivity">Studies show that people with depression symptoms can be up to 35% less productive</a>) 
&#8211; Increased engagement 
&#8211; Greater collaboration &amp; innovation 
&#8211; <a href="https://www.newstatesman.com/spotlight/healthcare/2021/10/workplace-wellbeing-employers-invest-mental-health">Higher chance to attract and retain talents &#8211; A 2019 Harvard Business review</a> shows that 50% of Millennials and 75% of Gen Zers had left positions for mental health reasons.
However these things are rarely achieved solely through gift cards and gym memberships but through establishing good practices, clear communication, and offering safe forums for employees’ voices to be heard and championed or supported. Such good practices need to be set up and structured through careful and proper investments in finding the right people, tools, and services. And what might seem like a lot of money right now is really an investment toward a stronger company with happier employees. Indeed, the same Deloitte report estimates that <a href="https://www2.deloitte.com/uk/en/pages/press-releases/articles/poor-mental-health-costs-uk-employers-up-to-pound-45-billion-a-year.html">every £1 spent towards your employee’s well-being and mental health gives a £5 return</a> thanks to the impact listed above.
There are many reasons to invest in your employees&#8217; well-being but these alone should convince any leaders to bring this topic to the forefront of the priority list in 2023 in order to create more resilient teams in which talents want to stay and thrive together.

What does it really cost you, not to spend on your employees’ mental health?

We have all heard of Greenwashing. This concept refers to brands and companies claiming to act for the environment to retain and gain customers all the while not acting on these claims, or worst, actually actively damaging the environment through their actions. 
It is called washing because it refers to the first time this term was coined. Back in 1986, Jay Westerveld wrote about Hotel chains asking their customers to keep their towels to avoid washing them unnecessarily under the pretense of saving water when it was in fact, a way to save money first. 
If going Green is all about our planet&#8217;s health, similar toxic patterns can be observed when it comes to our health and well-being. 
FROM GOOD TO HAVE, TO TOP PRIORITY
Up until recently, to care about the well-being of your employees and actively implement actions and activities to enhance that well-being was something considered ‘good to have’. 
Very often, most of these actions had actually been ‘reactions’. Only when facing a problem, would the company act and figure out a solution. More often than not, it was on the individual to do most of the work to ‘get better’ and come back to work ‘fixed’. 
Another approach was ‘health perks’ such as discounted or free gym memberships for employees who often barely had the time to eat lunch at their desks… 
When Covid hit and everyone from top to bottom of the organization chart was faced with their own well-being crisis (stuck at home, no more routines, no one to talk to, no boundaries…) mental health went from bottom to top of the priority list for everyone. 
What used to be perks is turning into a competitive advantage more and more employees are looking into when applying for positions. 
JUMPING ON THE TREND TRAIN
When something starts to become ‘trendy’ there is of course the pressure from Society (be it the media or the market) to keep up and if not set the trend, at the very least follow closely. 
That pressure is often what leads to some slightly less scrupulous businesses to cut corners, i.e, focusing on symptoms rather than the roots of the issues (offering organizational coaching when what is needed is to diminish the workload); putting the responsibility on the employee rather than reflecting on the role of the management or assuming everything is fine because no one dares to speak up about personal issues! 
ONLY WHAT IS MEASURED IS ACTED UPON
Not every poor ‘well-being policy’ stems from careless corporate management. Very often it simply comes from the novelty of it all, the lack of knowledge around the topic and not knowing where to start or what to focus on first. It is important to train HR professionals and supports them in figuring out the best tools at their disposal and KPIs to look at for their specific teams. 
It is only by being able to measure the impact of its policies and actions that the company will truly make a difference in the long term. 
SIMPLE STEPS TO START WALKING THE TALK
Research shows (source) there are 5 pillars of well-being to experience daily:
&#8211; Connecting (with people) 
&#8211; Be physically active 
&#8211; Learn new skills 
&#8211; Give to others 
&#8211; Pay attention (to the present moment) 
These can really inspire easy steps to implement and measure (encourage more one on ones, organize walks at lunch break, create opportunities for training and skill sharing, learn from one another, celebrate each others’ wins…) 
In line with these recommendations we would advise starting by connecting with your people: Actually, talk and try to figure out, together, or with representatives depending on the size of your business, what are the main issues. 
Start small, review, and iterate!

Avoid Well-Being Washing

<a href="https://www.hrgrapevine.com/content/article/2022-12-15-1-in-3-workers-wont-switch-off-this-christmas-will-2023-begin-with-more-burnout?utm_source=template-pardot-partner-2210&amp;utm_medium=email&amp;utm_campaign=hr-20-12-22&amp;pid=&amp;utm_content=employee-experience&amp;utm_term=Festive+fatigue">A recent study in the UK</a> shows that employees feel a lot of pressure on being responsive and available even on holidays and days off &#8211; &#8220;3 in 5 (53%) of those .. are available to work despite having time off.&#8221;
Does this just mean employees are devoted body and soul to their work? Or that they need to get better at creating and respecting boundaries in 2023?
<h3>The tools that make us available at all times</h3>
Being passionate about one&#8217;s work and being driven is to be applauded. We tend to believe though, that these are not the sole reason employees decide to stay available on their days off. 
It&#8217;s nothing new that we are in a world of constant notifications. And not only are we constantly notified, but both our private and professional worlds tend to collide. Even more now that many of us work or have worked from home. We receive our work email on our phones, have access to our files through the cloud on our laptop in the bedroom, and check our work messages together with our family texts first thing in the morning. 
Even with the best determination in the world, it is very difficult to stay &#8216;offline&#8217; as that would mean cutting ourselves off completely.
The vicious circle
And once you receive the notification, the email, or the message, it takes the greatest willpower not to check it and act on it. We tell ourselves it will only take a minute, which might be true in terms of action but our minds will wind up in work mode for several hours after that email was sent. 
On top of that, there is the very real fear of anticipating going back to work and being swamped with emails and tasks from day one. In order to avoid that, many people prefer to keep an eye on what is going on at the office while they are away. 
And that is how, even if it is not expected of us from management, we will receive that extra pressure to stay alert, no matter what.
Boundaries 101
In their book &#8216; <a href="https://maketime.blog/">Make time. How to focus on what matters every day</a> &#8216; authors Jake Knapp and John Zeratsky address the disturbance of endless notifications. They explain how these steal our time and attention away from our well-deserved time off. 
There is a tendency to believe that being constantly available makes us better at our jobs. To a certain extent maybe, but it is quite impossible to sustain such behavior in the long run. 
By allowing offline periods you are able to truly rest your mind. It will slowly disconnect from the work mode and allow for other thoughts, and creativity to come in. 
That usually means you will come back to work more refreshed and more productive.
Simple but essential tips:
<li>Turn off all work notifications. It might take a few minutes, but it will be beneficial.</li>
<li>Have an &#8216;Out Of Office&#8217; automated message. Be clear in your OOO message about how long you will be away and how much access you will have to your messages.</li>
<li>Delegate. If anything urgent were to come up during your break, have a trusted coworker in copy of your automated email to make sure not to come back to more stress.</li>

Creating and respecting boundaries in 2023

New buzzword or self-evident, re-recruitment is a term we hear more and more within Human Resources departments. Before going all in, what if we focused on employee well-being?
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<h2>What is re-recruitment and why is it important right now</h2>
The concept of re-recruitment could be seen as the idea of ​​​​​​​​​​​bringing the romance back. When they started working for the company, the employee was most probably excited and full of good intentions, aligned with the values ​​of the company.
The company had shown itself in its best light while onboarding the new employee. Like with any relationship, as time passes, routines settle, habits (good or bad) take on and the shine can slowly crackle. After several years, sometimes even without noticing it, the passion on both sides slowly dies out.
The idea behind re-recruitment is to revive the flame. It is about reminding the employee why they started working here in the first place as well as reassuring them of their value within the company. Re-recruitment encompasses some of the workplace routines that would re-establish the bond between the employee and the company.
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Here are some best practices to take to re-recruit and retain.
Facilitate targeted retention conversations with follow-up actions. 
Provide personalized recognition, including investing in skills and career development. 
Provide stretch assignments for employees that will inspire and challenge them, while helping them plan a targeted career road map.
Identify and remove obstacles that an employee may encounter. What can empower them to best contribute to the organization?
The key role of employee well-being in re-recruitment
A long-lasting relationship is a healthy and trusting one. That is why we believe in the importance of well-being in employee re-recruitment.
Beyond the goodie bags, discounts, and cinema tickets, what truly makes a difference in people&#8217;s day to day is that their company cares about the work-life balance of their employees, their mental health, and their ability to seek help if or when needed . Indeed, the workplace can be the source of several issues experienced by any number of coworkers
It is not simply about &#8216;the benefits&#8217; anymore. It is about living a full life. &#8216; Work&#8217; is only one of the components.
Companies that truly understand the importance of well-being in retaining talents will implement long-lasting changes. Changes that will positively impact behaviors and habits rather than focusing on short terms and quick easy fixes such as gifts, vouchers, and parties.
Ideas to rekindle the working relationship in a post-pandemic world 
Those changes do not have to be expensive or complicated. They need to become new habits. They might start small at first. It is when the habits truly stick and the employees trust that the changes are real and here to stay, that it can do wonders in the long-term internal culture of the company. 
We call these first four simple steps LEAD:
Listen &#8211; by creating a forum for employees to speak/be heard the company not only improves the feeling of trust it also welcomes new and potentially brilliant ideas that will improve creativity and productivity. 
Empower &#8211; your team. Delegating and trusting your employees with new and important tasks is a simple way to show trust and respect. 
Adapt &#8211; to new trends. Accepting that your way can be challenged and being open to changing things is a great way to make employees feel heard and valued 
Deepen &#8211; the relationship. Pay attention to your employee beyond the tasks at hand and get to know the person beyond the desk or screen.
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The importance of well-being in re-recruitment

&#8217;it&#8217;s the most wonderful time of the year&#8230;&#8217; says the 1963 Andy Williams song.
And for many it is. For others though, the Holiday period can be simply dreadful. 
There are a lot of resurfacing &#8216;traumas&#8217; around the holiday season that seem to be magnified by the twinkling lights: loneliness, social anxiety, high workload, comparison, financial stress, and family feuds.
The injunction to be festive even extends to the workplace with the traditional Christmas party, themed zoom calls, mulled wine after work, secret Santas, and ugly sweaters competition. 
Again, some people might go through the motion without giving it too much attention while others will struggle to put on a brave face. How can the workplace (at the office or at home) support its team through the holiday period?
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<h2>SAD is real.</h2>
First it is important to be aware of the real impact the winter season can have on some people. <a href="https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651">Seasonal Affective Disorder </a>is a depression-like feeling (tiredness, lack of engagement, moodiness, difficulty concentrating, hopelessness&#8230;) that appears in the fall and usually goes away around the beginning of the spring. As the weather becomes colder and gloomier, as the temperatures drop, people start feeling sad and it is not something they can shake off easily.
When prone to SAD the holidays might not be a source of joy as it is for many. it can increase the anxiety and feeling of hopelessness triggered by the numerous societal expectations attached to these festivities.
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<h2>The workload remains the same.</h2>
Every year the Christmas decorations seem to appear out of nowhere earlier and earlier in our stores, offices, and homes. This means many of us spend the whole month of Christmas, willingly or not, listening to Christmas carols, surrounded by colorful lights and gingerbread men.
However, the palpable excitement does not mean that the workload diminishes. On the contrary. Not only do many projects often get pressured to &#8216;be finished before the new year&#8217;, but there is the added workload of buying presents (for the family and at times, colleagues) and planning the celebration which is expected to be &#8216;perfect&#8217; of course.
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<h2>Jolly vs. anxiety</h2>
Because the Holiday season is supposed to be &#8216;the happiest time&#8217; of the year there is a strong expectation from Society in general, for everyone to be &#8216;jolly&#8217;. This makes it even more difficult for people who regularly struggle with mental health issues, stress, anxiety, and depression, to find space to express their feelings or simply space to breathe and recharge.
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<h2>Simple tips for a smooth Christmas at the office</h2>
Before rushing ahead and planning the classic Christmas party for your staff. As yourself, and ask them, what do they really want/need for Christmas? What could be the best way to truly make a positive impact on their well-being this season?
<h3>Co-creating the celebration:</h3>
This does not mean turning Grinch and canceling it all. It means being attentive and thoughtful rather than &#8217;do as we&#8217;ve always done&#8217;. 
Encouraging the team to co-create a celebration or event that will be their own and will respect everyone&#8217;s beliefs and energy levels can be an exciting challenge and a beautiful team-building exercise.
<h3>Respecting boundaries:</h3>
As much as we want it to be an inclusive time for festivities it is essential to respect people&#8217;s boundaries. Forcing someone into a celebration will not make them any happier. Let some people appreciate the JOMO (Joy of Missing Out), they will be grateful.
<h3>Finding the right gift:</h3>
Anxiety around Christmas and the Holidays can be felt at work as well. It is supposed to be a time to relax and enjoy. However, a lot of people find it to be a time of high stress and anxiety-conducive expectations. Sometimes what is needed is the space to express these issues or simply to know they are not alone. Creating a safe forum or offering self-care/mental health support to your team might well be the best gift you could give this time of year.
If it is tradition in your company to give gifts to your employees, it might be an idea to gift something that can truly make a difference in 2023. 
We like to think that <a href="http://www.siffi.com">Siffi</a> is a gift that keeps on giving! It can be used anytime and all year round through the holidays or other &#8216;mental health&#8217; more challenging periods. 
It&#8217;s a wonderful way to show that you care while respecting your employees, privacy and boundaries.
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Fighting Christmas stress and S.A.D at the office

There are a variety of different types of mental health professionals out there and it can be confusing to at times to know who provides what kind of support. 
This article aims to give you an overview of some of the different mental health professions and what they are best suited for. 
Psychologist 
A psychologist is a specialist who has a relevant psychology degree from an accredited curriculum at a university. 
Through their sessions psychologists’ main aim is to provide advice to the person regarding any psychological issues, for example self-esteem problems, analyzing relationships, dealing with assertiveness, etc. Psychologists can deal with mental health disorders, stress and anxiety. 
A psychologist is not a medical doctor and does not prescribe medication.
Psychiatrist 
A psychiatrist is a doctor who, in addition to basic medical training, has passed the relevant psychiatric residency. 
Their main aim is to determine if a mental disorder is present, diagnose it and treat it with medication if the situation requires it. In order to do so, they usually conduct a clinical interview to get the patient&#8217;s medical history and may ask for tests to be conducted to determine the level of specific symptoms. Additionally, they deal with rehabilitation and prevention.
Psychotherapists 
Psychotherapists usually have finished their education in psychology or psychiatry, and have additionally completed a comprehensive specialized training in their respective field of therapy for example cognitive behavioral therapy, family psychotherapy, psychodynamic therapy, etc. 
In selecting a psychotherapist, it&#8217;s recommended to know their specialty to understand how and with what they could help.
Clinical psychologist 
A clinical psychologist has a relevant psychology degree and additional training in clinical psychology, which includes making a diagnosis and putting together a treatment plan with a medical doctor. 
This specialist mainly deals with helping medical doctors in assessing, mitigating, treating and preventing mental and behavioural disorders, disability and at risk behaviours. This specialist is suited to identify if a person is suffering under mental illness by overseeing relevant tests and studies. 
The term ‘clinical’ in this specialist&#8217;s name refers to the fact that the psychologist mostly deals with patients who have been diagnosed with a disorder. Patients need a referral from a psychiatrist to see a clinical psychologist. 
A clinical psychologist is not a doctor with a medical degree, so they don’t have a licence to prescribe medications.
Counsellor 
A counsellor in a work environment is someone who has an educational background as a psychologist, psychiatrist, psychotherapist, social worker or similar, that gives the specialist skills for professional counselling. In general, counselling is a short term process that is focusing on a specific question or problem.
Supervisors 
Supervisors assist their clients in reviewing and reflecting on work that has already been done, to better learn from the past so as to achieve more success in the future. Real-life cases are used during supervision to analyse and see how things could be played out. Supervision can be, depending on the need and situation, an individual effort or group work &#8211; even including a whole team. Supervision service is used mainly by managers and specialists who work in areas such as, but not limited to, social work, schools, mental health, law enforcement, etc.
Coach 
A coach is most suited to help you unravel your professional or personal potential and guides you in dealing with setting goals and the motivation to reach them. Coaches don’t provide you with ready made solutions, instead, they assist you in finding out what the right path might be for you. 
HOW TO PICK THE RIGHT PROFESSIONAL? 
Reading the different descriptions, you might rightly get the impression that multiple specialists can be approached for similar issues.
If you have already selected a specialist, it doesn’t mean you have to exclude other professions. Mental health is a comprehensive system. Whilst visiting a psychologist to deal with problems related to the past, you can at the same consult with a workplace counsellor about a specific issue or approach a coach to discuss future goals.
Try to openly share your thoughts and questions while talking with a professional &#8211; if they aren’t the right person to assist you, then they can direct you to a more suitable specialist.

Mental Health Specialists: Who does what?

It is important to understand the different symptoms to best apprehend mental health issues. Many of us tend to use ‘generic’ terms like ‘being stressed’ to actually describe a wide range of issues we are struggling with such as tiredness or irritability but not everyone who is stressed will feel the same way. Being able to put a name to each of these symptoms will make it easier to find the right way to deal with the situation.
In this piece, we are giving you a brief description of the most recurring symptoms people are suffering from in the workplace based on our 2022 data.
Worry and Anxiety
Worry and doubt are a part of life and all people are doing it. It is normal to worry from time to time, but worrying can be persistent and become a permanent and uncontrollable part of life. People who worry excessively can constantly think of worst-case scenarios and &#8220;what ifs&#8221;. It is also typical to expect the worst and prepare for it. Constant worry can also be a symptom of anxiety disorder.
Anxiety is defined as apprehension over an anticipated problem. It involves worrying, feelings of insecurity, and fear of losing control. Fear is a reaction to immediate danger, whereas anxiety is about a future threat. People who suffer from anxiety start looking for threats in the environment and are very receptive to each stimulus that may represent them. An inner value conflict or trauma can also cause anxiety. 
Anxiety can also cause uncomfortable bodily sensations due to the fight-and-flight reaction being activated. For example, symptoms of anxiety can be (but are not limited to) restlessness, tension, breathing difficulties, heart beating, and sweating. It is important to know and keep in mind that when we experience anxiety the above-mentioned sensations aren&#8217;t dangerous to our health.
In the workplace, constant worry and anxiety can have various manifestations. But some of the common problems anxiety can cause, for example, are being worried about one&#8217;s competence and fearing losing the job even if there is no apparent reason to feel this way. In case of anxiety, one might start making faulty judgments about their performance and productivity. Also, being worried about making mistakes, and having difficulties switching off work-related thoughts in free time are common.
<a href="https://www.minudoc.ee/problem-description/anxiety">Read more here</a> and <a href="https://www.minudoc.ee/problem-description/worrying">here</a>.
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Trouble concentrating
Having trouble with recalling recent events or remembering where things are placed, lack of focus and difficulties maintaining attention on tasks, and not being able to think clearly may indicate problems with concentration. Having difficulties finishing everyday tasks and being restless may also happen. It is also common to struggle with decision-making and lack of energy. Trouble concentrating affects people in various ways. Some may experience problems with concentration at work or when studying, while others experience it during their private time. 
Concentration difficulties can be a symptom of something more serious such as burnout, anxiety, or mood problems.
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Tiredness
Tiredness can be caused by poor sleep but it can also happen if one is suffering from long-term stress or physical or mental health issues. It is important to note that stress is not only caused by negatively perceived events but can also be caused by positive life events and this can also be tiring for the body. Tiredness can be caused by intense times at work but it can also be related to personal life matters. There is no need to worry about short-term tiredness, we all feel tired from time to time and it can be caused by various things, but persistent long-term tiredness can be an indicator of something else going on in one&#8217;s life that might need attention.
Loss of interest
Loss of interest is a common symptom of depression, but it can also be caused by some other mental health issues. It&#8217;s commonly expressed through not feeling joy in things that used to give positive emotions. It can be difficult to engage with everyday tasks and one can lose motivation to do anything. Pastimes that used to be relaxing and time spent with loved ones don&#8217;t give positive emotions and one can start avoiding social events and engaging in hobbies. This can lead to a downward spiral. At the workplace, one can experience losing interest and motivation in work that they used to enjoy before and it’s difficult to find meaning in one&#8217;s job.
Irritability 
With irritability comes various behavioral patterns and feelings such as disappointment and aversion (reluctance), trouble concentrating, struggle to accommodate other people&#8217;s wishes, or when changing plans &#8211; tiredness, sensitivity, and tension. 
An easily irritable person may feel fine at one moment and then suddenly overreact to the slightest issue. This builds even more tension in that person&#8217;s life, creating a snowball effect of more sensitivity and stress. 
Irritability can be an indication of multiple mental health problems like anxiety, depression but also addiction.
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Sadness 
Sadness is an emotional state which leads to crying, social withdrawal and slowing down all activities. Sometimes people also experience emotional pain and feelings of loneliness. 
The goal of sadness is to facilitate the process of loss &#8211; for example, the end of a friendship or a romantic relationship or also losing resources or status. Interestingly, it has been found that sadness helps to improve attention to capture details, be less biased by prejudice, maintain orientation to goals and encourage generosity towards others. 
<a href="https://www.minudoc.ee/problem-description/sadness">Read more here</a>.
Relationship problems 
Some of the most common relationship problems include jealousy, economic problems; sexual performance issues, children, infidelity, violence, and many other reasons. 
<a href="https://www.minudoc.ee/problem-description/relationship">Read more here</a>.
Sleeping problems 
Most people experience temporary and short-term sleeping problems. This kind of short-term insomnia is one of the ways to respond to challenging life events. 
Insomnia can easily reappear and last for longer periods of time. It can be exhausting to the person and disturb everyday life, culminating with a lack of energy for socialising, participation in hobbies or other activities. 
<a href="https://www.minudoc.ee/problem-description/sleeping">Read more here</a>.
Self-esteem 
Self-esteem is a person&#8217;s subjective opinion of themselves and their value. It shows how much a person likes themselves regardless of the situation they are in at the moment. Self-esteem also indicates how much a person thinks they can cope with everyday challenges and whether they think they deserve to be happy. 
In case of low self-esteem, a person doubts their abilities and makes decisions based on these limiting beliefs. A person may not dare to accept new challenges because they do not believe that they can handle them. People who have low self-esteem often feel that everyone else is better than them. 
Problems can also arise in relationships because one&#8217;s needs are not met. People with low self-esteem don&#8217;t dare to talk about their needs and the needs of others are considered more important than one&#8217;s own.
In the workplace, someone with low self-esteem may not seek or accept new challenges because they think they are not worthy or will not succeed. People who have low self-esteem don’t want to draw attention and often try to keep a low profile. They tend to be pessimistic, point out their mistakes, and don’t pay attention to their accomplishments. People with low self-esteem often think that they don’t contribute enough and they might start overworking to compensate. Working while sick and not taking sick leave is also common. 
<a href="https://www.minudoc.ee/problem-description/self-esteem">Read more here</a>.
By learning and talking more openly about all of these feelings we make it easier to identify deep mental health issues and to seek the right kind of help. That is what we aspire to do through our services.

Understanding The Most Common Mental Health Issues In The Workplace

The term burnout was first used in the 1970s for specific work fields. As the issue grew, it was added to the <a href="https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases">World Health Organization</a> International Classification of Diseases as an occupational phenomenon in 2019. 
Here we explore how the employer can take a role in avoiding employee burnout.
More than half of employees feel burned out 
In 2018, <a href="https://www.gallup.com/workplace/237059/employee-burnout-part-main-causes.aspx">Gallup published the results of a survey</a> they completed among 7,500 full-time employees. Despite the research being conducted pre-COVID, the causes of burnout are pretty much the same today. In this survey, 23% of employees reported feeling burned out very often or often. An additional 44% of employees reported feeling burnt out sometimes. Adding those numbers together, it turns out that 2/3 of employees are facing the feeling of burnout in their work. Take a moment and think about your colleagues &#8211; that is a large portion of us, who could really be struggling.
A burned-out employee is not productive 
For the employer, there is a big difference in terms of cost, whether their employees are in a good mental health state or they are burned out. The employees dealing with burnout are 63% more likely to need and use sick days. Also, it is 2.6 times more likely that they are actively looking for a new job to get out of a situation they attribute to their work environment. Even if these people do not change their jobs, their worries and struggles make their work performance significantly worse than their happier colleagues. 
Burnout leads to diminished productivity, decreased focus, frustration, and tiredness. 
This affects both the individual and the organization.
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The main 5 reasons for burnout
These are the main factors employers should focus on when trying to reduce the risk of burnout
1. Unfair treatment at work 
If people feel that they are treated unfairly compared to other employees, their risk of burnout more than doubles immediately. Sensing unfair treatment can come from different factors. For example, unfairness can mean that managers have clear favorites. They may be biased in their decisions or the employees are compensated differently for the same work tasks. 
The employee must be able to trust their employer. Attitudes will change when they feel they are not in a similar position to others. They may feel defiant against their employers or start being neglectful towards their work tasks. 
In light of this, the manager should always look at their team as a whole. Understand that there is no room for unfairness in the workplace. This can quickly backfire in terms of employees&#8217; mental health and productivity.
2. Unmanageable workload 
If you give an employee more work than they could ever complete in the time they have, they may look at it as a challenge at first. It turns into a problem when they understand that no matter the effort that they put in, managing the workload is not possible. Even a very productive employee will lose their optimism when given so many tasks that it is impossible to complete them. 
The role of the leader in such a situation is to help their employees figure out what the optimal workload is for them. If the workload is too big, the employee needs to notify their manager right away. It&#8217;s very important that the manager is open to discussions around this topic. The employee should not be afraid to tell the manager if it&#8217;s getting to be too much and they should work together to find a solution.
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3. Lack of role clarity 
Gallup&#8217;s study showed that only 60% of employees find that they know what is expected of them in the workplace. If there are no clear directions and expectations, it will make it very difficult for the employees to keep up with their tasks. This leads to confusion and frustration. 
In regular practice, people have job descriptions that state their work tasks. If those work tasks start building up and growing over time, it may lead to ambiguity in the role of the employee. If the tasks get too complicated or too scattered, the employee must acknowledge the issue and talk to their employer about it. The employer should be responsible for taking the time to regularly sit down at a meeting with their employees, discuss the tasks that they have been given, and talk about expectations and the results thus far. This will give the employees confidence in their work, both in their past achievements and for the future.
4. Lack of communication and support from the manager 
If the employee is left alone in their tasks, with their worries, and even their accomplishments, they lose contact with their manager. Even a very motivated employee can realize over time that no one is paying attention to what they are doing and feel the lack of support. Why would they then do their best? The employee loses interest in their work and ends up doing the bare minimum. 
Constant discussions and communication with the manager make the employee feel that they are supported. Employees who feel they have the support of their manager are 70% less likely to be a victim of burnout.
5. Unreasonable time pressure 
If the employees feel like they never have enough time to complete their tasks, they are at a very high risk for burnout. When a manager gives an employee a task, they must be able to come up with a realistic and sensible time limit for completing it. 
Oftentimes people set up work tasks without thinking through how much time this task is going to take. If the employee is unable to complete the task in the given time and they have multiple tasks waiting for them, all of the work will start piling up. 
The employee has to stand up for themselves and notify their manager when they are not able to complete a task within the time limit and they are falling behind. The role of the manager in such a situation is in communicating and setting realistic expectations. In situations where there is no precedent for timing a task, the manager and the employee should try to come to a reasonable and flexible time limit together. This way, the likelihood of getting a reasonable time plan is the greatest and the employee feels that they are being listened to.
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Burnout is not solely the burden of the employee, the employee has to do their part as well. 
Burnout can definitely be avoided, prevented, and foreseen. When a leader focuses on communication, equal treatment, and realistic well-thought-through tasks in their managing strategies, they are in a much better position. If employees are in a difficult situation, a good and attentive manager will make a difference. Tired and burned-out employees affect the organizational culture, customer service, and development. Managers should do their best to avoid such issues.
Other important factors can lead to employee burnout, but if you want to start from somewhere, the list above is a great start you can focus on. 
<a href="https://www.siffi.com/problem-description/burnout">Read more what our psychologists have to say about burnout.</a>

How employers can help prevent burnout

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The Estonian software testing company Testlio has employees from over 30 different countries, making the company truly a multicultural place to be. Maintaining a satisfied staff with such a multicultural and diverse profile brings new challenges, but also experiences that expand one&#8217;s world view.
Siffi interviewed Evert Kraav, Testlio&#8217;s director of experiences, inclusion and reward, to see behind the scenes of their HR. Testlio has offered Siffi services to its employees since April 2022.
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&#8220;Our goal is to keep our people engaged and through that we keep them with us,&#8221; Evert starts by explaining Testlio&#8217;s HR department core values. &#8220;It is important for us that our coworkers feel that they are noticed,&#8221; he ads.
Evert is responsible for promoting diversity in Testlio&#8217;s multicultural work environment. This means that on a daily basis he thinks about how to manage and promote the well-being of employees from more than 30 different countries. In addition to multiculturalism, Testlio mostly operates through remote working.
&#8220;From several countries we have only one or two employees, but we still take under consideration their unique needs and values,&#8221; he says, pointing out that every employee is important. Because of that, a large part of Evert&#8217;s work is spent on understanding different work cultures and habits. &#8220;Some are from South America, some from Africa, some from Asia &#8211; it&#8217;s difficult when there are many different regions,&#8221; pointing out the challenges of everyday work. &#8220;Unfortunately, we can’t tailor every person&#8217;s experience, but we can try to find things that more or less suit everyone.&#8221;
Retention versus engagement
Evert points out that overall, Testlio probably has the same things in the employee benefits package than most companies &#8211; different subsidies and hopefully also good management. &#8220;We offer a health day, sports support, remote work support, you can choose where to spend your self-development credit and much more. For those who have been working at Testlio for five years, we provide an additional month of vacation per year,&#8221; he gives examples of some of the things that Testlio employees have access to.
&#8220;We are working to ensure that it’s good to be at Testlio on a daily basis,&#8221; explains Evert, why besides the common retention package, the focus is on keeping employees involved. &#8220;In such an international company, from time to time something important is overlooked. We expect that people themselves will say if something should be changed.&#8221;
Evert has plenty of examples of how in different countries things are done differently or small nuances that you have to consider. Most of them you can&#8217;t figure out yourself, even though in retrospect, they seem elementary. &#8220;For example, in some countries working days are from Sunday to Thursday. In some countries people are used to receiving lunch vouchers. When we get together, at parties, you should play music from every region. At these moments, we expect the employees themselves to pay attention and point them out to us. There are some things we don&#8217;t do, but we try to find a common ground.&#8221;
<img decoding="async" loading="lazy" class="aligncenter wp-image-3306" src="https://blog.minudoc.ee/wp-content/uploads/2022/11/Screenshot-2022-11-24-at-12.07.06.png" alt="" width="223" height="200" />
Working remotely can make people lonely
&#8220;We’ve realised that loneliness can be the hardest thing for a person when working from home. It&#8217;s worse when that person also lives alone. Their only interaction during most days might be with their colleagues,&#8221; Evert points out a usual daily life of a person working at home office. &#8220;So we&#8217;re trying to put an emphasis on finding ways to come together, even if it&#8217;s just on Zoom.&#8221;
The decision to take Testlio to a fully remote working format was made in October 2020, in the middle of the COVID-19 pandemic. At the beginning of the same year, Testlio mostly had employees only in Estonia and the USA. There were a total of three offices in two countries &#8211; Tallinn, Tartu and San Francisco. In the United States, several employees already worked from home because they lived in different states.
Slowly, the staff started to expand with people from various other countries. With this, the need to maintain offices gradually disappeared because employees simply were not located near each other.
At the moment, Testlio has only one office that works on an open door policy &#8211; everyone is welcomed to come to the Tallinn office. This includes team members from abroad. The office aims to be a place where people can come together, meet each other, something like a coworking space.
Mental health support must be from person to person
&#8220;In 2021, when I was preparing for mental health month in October, I was looking to bring more attention to the topic. We can share articles and things like that, but they might not be read. We paid monthly fees for different apps like Calm and Headspace, but the usage wasn’t that good,” Evert explains how he looked for appropriate ways to provide health support to employees.
&#8220;For several months I was looking for a service that would allow me to provide support from person to person. Reading is not as effective. The problem was that we needed to cover all 30 countries. I can’t get one service provider for Estonia, another in the USA, and then a third provider for all the other countries. It would be difficult to manage,&#8221; he explains.
<img decoding="async" loading="lazy" class="aligncenter size-full wp-image-3273" src="https://blog.minudoc.ee/wp-content/uploads/2022/11/Testlio-artikli-sees.png" alt="" width="1200" height="200" />
There is no substitute for meeting in real life
At the beginning of August 2022, all Testlio employees were together in Estonia. People from all over the world came here to spend time together, work, listen to presentations and reviews. People said they got to know each other more.
Similar events are also planned regionally, so that teams can meet at least once in the middle of the year.
&#8220;Unfortunately, we see that there is no substitute for meeting a person face to face. It creates a better relationship,&#8221; admits Evert. At the same time, you have to make the best of the situation, which is why Testlio organises various virtual gatherings.
Virtual meetings are not just for work
&#8220;We do a lot of events on Zoom and Slack where people can come together. During themed months, we share stories about our employees, organise games, we&#8217;ve even made a virtual escape room. It&#8217;s fun, it works,&#8221; he shares.
&#8220;We haven’t developed specific formats. We experiment with what works. We try to encourage teams themselves to do something on their own,&#8221; says Evert, adding that those who are together in the same country can still see each other live.
When organising virtual events of an international company, the same event has to be done two or three times. &#8220;Time zones must be taken into account &#8211; one event in the European and African time zones, another for the Americas, the third suitable to Asia,&#8221; lists Evert.
&#8220;We have written down ideas that teams could do virtually. In the future, we want to train and help people more in remote working related issues,&#8221; mentions Evert about future plans.
<img decoding="async" loading="lazy" class="aligncenter wp-image-3286" src="https://blog.minudoc.ee/wp-content/uploads/2022/11/Screenshot-2022-11-24-at-09.46.19.png" alt="Testlio" width="700" height="239" />

Siffi helps Testlio to focus on employee engagement

What mental health problems troubled employees in 2022?

In this article, we look at 5 simple ways to prevent stress and anxiety in the office from the point of view of the manager. <a href="https://www.siffi.com/blog/four-simple-tips-to-prevent-stress-at-the-office-for-the-employee">You can also read our tips for the employee.</a>
Humans are designed quite efficiently. Few functions or features are superfluous. Even stress is an emotion that serves a purpose: detecting threats and sensing danger or change, vital skills in a cavemen (and women) world. To be fair those skills are still very valuable today. The problem is that we haven&#8217;t evolved as fast as our society has progressed and we are unable to adapt our stress reaction to the different kinds of stress we are faced with today: from being late for work, having to speak in front of a crowd (unpleasant but not life-threatening) to avoid being hit by a car.
That inability to make sense of what is survival and what is actually bringing us down is the real problem in today&#8217;s society and workplace. One of the manager&#8217;s tasks, which can sometimes be overlooked, is to create a good and healthy working environment for the team. This can be done through:
<h2>Listen</h2>
Feeling heard and listened to, and having a space to voice opinions, hopes and concerns can be a real game changer in a team. As a manager, it is essential to build a working culture within which everyone feels safe to share and speak up. These forums, whether they are off or online, or both, need to be clearly identified and easy to use for all.
<img decoding="async" loading="lazy" class="aligncenter size-full wp-image-3234" src="https://blog.minudoc.ee/wp-content/uploads/2022/03/Screenshot-2022-10-19-120927.png" alt="2 coworkers on a couch one talking and the other deep listening taking notes" width="1400" height="910" />
<h2>Act</h2>
It is not enough to allow people to speak their minds. As a manager, it is important to acknowledge those thoughts and concerns. To address them. To find solutions when possible and when not, to explain why. Employees need clarity on what is happening to them, what they do, and why.
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<h2>Communicate</h2>
The communication should be a dialogue. It is essential that the manager express their ideas and expectations clearly so that everyone is on the same page: what is a rule and what is a guideline, what can be challenged and what cannot. In addition, regular face to face check-ins and feedback sessions ahead of big deadlines foster a continuous and healthy communication loop.
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<img decoding="async" loading="lazy" class="aligncenter wp-image-3233 size-full" src="https://blog.minudoc.ee/wp-content/uploads/2022/03/Screenshot-2022-10-19-121003.png" alt="three colleagues having a check in" width="1417" height="837" />
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<h2>Encourage</h2>
Be your employee&#8217;s best supporter. Celebrate them, give them attention and thank them for their work. Encourage them to do the same towards each other.
<img decoding="async" loading="lazy" class="aligncenter size-full wp-image-3236" src="https://blog.minudoc.ee/wp-content/uploads/2022/03/leah-hetteberg-tl6kEtP6nn8-unsplash.jpg" alt="4 cheerleaders smiling" width="1920" height="1440" />
<h2>Adapt &amp; Learn</h2>
One of the best ways to prevent stress and anxiety at the office is to be transparent. Accept that change is constant and not everyone will react the same way to your management style. Accept that we are constantly learning: from past mistakes, from each other. It is ok not to have all the answers and to admit it to your team. It will bring you closer together to find solutions as a group!

5 simple tips to prevent stress at the office for the manager

4 simple tips to prevent stress at the office for the employee

Author: Mirjam Varik, psychologist
Hybrid and remote work is here to stay. Inevitably, however, it has both positive and negative aspects, which both employers and employees should keep in mind. In any case, this means a transformation of existing work habits.
But what could be the potential dangers of remote work and what could be done about them? In this article, we talk about the main positive and negative effects and what new habits need to be established in the context of remote and hybrid work.
<hr />
In the article we take a closer look at:
1. Increased autonomy increases job satisfaction
2. Flexibility can compromise work-life balance
3. Promote healthy habits
4. Promote contact with colleagues virtually
<hr />
&nbsp;
<h3>1. Increased autonomy increases job satisfaction</h3>
Depending on the nature of the work and the employer, hybrid and remote work can increase the perceived autonomy of the employee. Autonomy is related to greater job satisfaction and, in turn, to reducing the effects of work stress.
But what is perceived autonomy in the work context?
Autonomy is the ability to influence one&#8217;s own work. How the employee perceives autonomy tells to what extent he thinks he has control and freedom of choice over his work tasks. This includes, for example, the ability to influence your schedule, the order of work, make independent decisions, choose the most suitable way to do work, and much more.
Autonomy can significantly reduce the negative effects of work stress, especially in mentally demanding jobs. Examples of such positions are managerial positions and jobs that involve emotionally demanding tasks.
Consequently, it is logical that autonomy is also related to greater job satisfaction. However, low job satisfaction can contribute to the development of burnout, anxiety disorders and depression. Chronic (work) stress increases the risk of developing depression, burnout, chronic fatigue syndrome and also cardiovascular diseases.
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<h3>2. Flexibility can jeopardize work-life balance</h3>
When working in a home office, it is necessary to pay special attention to work-life balance, as both work and home life take place in the same environment. By doing work from home, time and resource consumption is reduced, as doing work does not require leaving home, and flexibility increases, as activities take place in the same environment.
Flexibility allows, on the one hand, to fit other activities into working time, such as household duties, sports and others. On the other hand, the line between work and free time can become blurred.
For example, if an employee has normally worked from nine to five, now he is also doing tasks outside of the scheduled working hours. This is a higher risk point if the workload in the corresponding position is usually high. If when going home from the office you can draw some kind of mental border between environments and try to distance yourself from unfinished work tasks, it is more difficult in the home office, where work tools are a few metres away.
The use of virtual communication tools in a new way also creates a situation where there is often a pressure to be available to colleagues or superiors all day. This is especially so in the context of teams crossing time zones.
However, all of the above contribute to overwork. It has been found that a high workload is associated with an increase in absenteeism, burnout, depression and anxiety disorders, and various complaints related to physical health. Also, in the form of excessive work volume or pace, it is a psychosocial risk factor, for which the employer is obliged to implement appropriate measures to prevent related health damage.
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DEFINITION: PSYCHOSOCIAL RISK FACTORS 
Work-related health risks can be divided into two &#8211; some affect our physical health, others affect our mental health. Mental health is affected by psychosocial risk factors, the health effects of which are manifested through the stress reaction. However, the stress reaction can lead to both physical and mental health problems. The existence of the problem is proven by several studies. 
Read: <a style="color: #808080;" href="https://www.siffi.com/blog/overworking-doesnt-necessarily-mean-working-overtime" target="_blank" rel="noopener">Overworking does not necessarily mean working overtime</a>
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In order to avoid possible health risks, rules regarding working hours could also be established for employees in the home office. This does not preclude flexibility, which is one of the significant positive aspects of telecommuting, but allows the employee to step away from work tasks without guilt.
If absolutely necessary, in some cases it would be worthwhile, for example, to restrict access to work-related programs. Also, a separate room or table could be set aside for work at home, if possible. When you finish work and leave your office or desk, you can mentally draw a line for the working day, so to speak.
If difficulties with switching from work life and integrating work into home life can increase the level of work stress of people working full-time in a home office, then a hybrid work format could be preferred.
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<hr />
Pay attention to:
&#8211; Establish rules regarding working hours for employees in the home office as well.
&#8211; In some cases, it is worth limiting access to work-related programs.
&#8211; A separate room, table, etc. could be set aside for work at home.
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<h3>3. Promote healthy habits</h3>
The employee may also need additional support in terms of healthy habits. Working on a computer late at night can negatively affect sleep and result in the inability to fully recover from the day&#8217;s work. Clearer rules for working hours can also be helpful here.
Taking breaks as needed (important both in the context of risks related to working with a screen and in the context of preventing work stress), changing work positions (working while standing and sitting at the computer) and healthy eating and exercise habits could also be promoted.
It is also important here for the employee to be informed about why the above-mentioned aspects are important in the context of maintaining working capacity.
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<hr />
Pay attention to:
&#8211; Working on the computer late at night can negatively affect sleep.
&#8211; Promote and inform why taking breaks, changing work positions and healthy eating and exercise habits are important.
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<h3>4. Promote contact with colleagues virtually</h3>
In the case of remote and hybrid work, it is more difficult to create, so to speak, coffee corner situations where co-workers continuously talk about private life topics as well as work-related wild thoughts. In remote work, a situation often arises where all contact is strictly about work and there is no place to create social connections. To avoid isolation, new virtual habits must be introduced.
During breaks, it is also possible to establish contact with colleagues in a virtual rest corner, which can be, for example, a zoom video call with your favourite colleague. Such short, impromptu contacts help prevent mental health risks resulting from social isolation and support the employee&#8217;s subjective well-being.
Before hybrid and telecommuting became popular, the psychosocial risk factor of working alone was more associated with on-call, cleaning and other after-hours jobs. Now the average office worker is also exposed to this risk factor.
In addition to informal contact with colleagues, the efficiency of information flow and the perceived ability to get help or support when needed also require special attention. If the possibility of direct contact can promote the flow of information and the feeling of involvement when working in an office, it may be necessary to introduce new habits when working remotely. For example, hold separate meetings for employee suggestions and feedback, have regular one-on-one conversations with the manager, and the like.
Virtual meetings can also encourage greater involvement of employees who are unable to speak up due to the anxiety associated with social situations.
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<hr />
Pay attention to:
&#8211; Create a virtual relaxation corner
&#8211; The efficiency of information movement
&#8211; There is a chance to get help
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Considering the events taking place in the world, all employees, regardless of the work format, should have the opportunity to consult a mental health specialist if necessary. The company&#8217;s culture could emphasise the comprehensive well-being of employees and prioritise the necessary steps to support employees&#8217; work ability.
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Author: Miriam Varik, psychologist
An occupational psychologist who has completed the competence training of an interdisciplinary occupational health specialist. In my daily work, I help support the working capacity of employees both in individual receptions and as part of risk analysis by mapping psychosocial risk factors in the work environment and advising employers.
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What to consider with remote and hybrid work?

Author: Kaire Viil, development partner of Eesti Energia, management coach 

Talented people know their worth, and companies are constantly on the hunt for them. Work and professional development play an important role in an adult&#8217;s life. How well do you know what motivates your employees and makes them shine? Salary is important to an employee, but there is always someone who offers more.
Team tends to stay with you if you have the following:
&#8211; pleasant environment,
&#8211; opportunity for development,
&#8211; recognition,
&#8211; flexibility,
&#8211; good relations.
People come for the values, but many leave because of the management culture.
<h3>The Five Why exercise helps to create clarity</h3>
Recently, job crafting, i.e. creating meaning at work, has been a fashionable topic in articles on work happiness. How often do you think with your team about why the organisation exists and why your talent works here. By doing this exercise, the employee gets to think about the meaning of his work. In addition, you can remind the organisation&#8217;s values ​​and discuss the role of each employee in realising the company&#8217;s vision. In this way, the person gets clarity in his role and confirmation that they are valuable to the company. Go even deeper and do the Five Why exercise together. Ask this five times and you&#8217;ll get to the root causes that will bring clarity and perhaps will surprise. If necessary, a neutral moderator will guide this workshop.
<h3>How can employees keep in mind the vision and values ​​of the organisation?</h3>
Do you know the classic example when Apple&#8217;s cleaner told Steve Jobs that he was helping to produce the best computers in the world, not just walking around with a cloth? The NASA cleaner also told the company&#8217;s high-ranking guest at the reception desk that thanks to his work, people will reach the moon. A hotel room cleaner can also set himself up as a creator of a pleasant experience for tourists, not just a sheet changer. After all, a chef&#8217;s assistant is actually a provider of culinary experiences, an artist, a valuer of food products and a developer of the country&#8217;s tourism sector. For the employee, their status and recognition are important. If you help them see the meaning of their work, you increase commitment. Adults spend more than half of their waking hours at work. That&#8217;s about 13 years of their life.
<h3>How can you find out what the employees really want and can do?</h3>
The employees wants their efforts to be noticed and for them to bear fruit. Have career interviews with your employees more often than once a year. Especially for younger employees, it is important to know what their development opportunities are in half a year. You can also schedule 1:1 conversations on career development topics. Feel free to ask what else the employee knows and wants to do or what skill he has not been able to apply.
<h3>Highlight long term employees</h3>
Don&#8217;t forget your long-time employees, either. They also need confirmation that they are the organisation&#8217;s most valuable asset. They can share their expertise as a mentor to a new employee or a career changer, thus becoming a development partner. By the way, teaching others is the most effective way to learn. Employees with long experience should be remembered when important milestones are reached, and each one should be thanked individually and their strengths should be highlighted.
<h3>Value employees&#8217; families</h3>
A rather vulnerable target group are those with children, especially parents with small children. They are often faced with the dilemma of how to maintain work-life balance. Are they good enough, committed both to the team and to their children? Constantly let parents of young children know that you value them as employees and their family. Your actions are more important than national family-friendly employer labels. Celebrate holidays like Christmas or Easter. Memories or joint activities are remembered for a long time, and caring about the employee is what keeps a person in the organisation.
What step will you take today to create a pleasant environment for your team, develop good relationships and recognize everyone? This is how you confirm that you care and retain your team.

How to retain employees?

Author: Kaire Viil, development partner of Eesti Energia, coach, mentor, trainer
Remote work is considered to be a more flexible and convenient way of working for many, but it can also increase isolation, silos and feelings of loneliness. A sense of belonging is a basic need in Maslow&#8217;s pyramid of needs and is important in maintaining motivation amongst your team.
If employee participation is low, then the person
&#8211; quickly becomes alienated from the team,
&#8211; are working below their capabilities,
&#8211; is at a higher risk of burnout.
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<h3>Prevention is more effective than recovery</h3>
Engaging a lonely employee is much more difficult than creating a sense of belonging in a new employee during the onboarding period. The feeling of isolation is accompanied by stress, and the reintegration of that employee requires consistent action by the manager.
A high sense of belonging increases up to 30% of employees:
&#8211; motivation,
&#8211; performance,
&#8211; productivity and
&#8211; feeling of well-being.
A feeeling of being part of the team and sharing the organisation&#8217;s values ​​can reduce absenteeism and leave given for illness by up to 30%.
<h3>A magical question to ask from an employee</h3>
You can engage every employee by showing them you value their input with asking what they think and listen to their thoughts without interruption. This increases the employee&#8217;s self-esteem. At regular meetings, about 30% of the participants speak, and you don&#8217;t know the position of 70% of the people. Don&#8217;t assume you know what they actually think.
<h3>How can you increase the self-confidence of a remote worker?</h3>
Many (remote) workers feel constant anxiety. As a leader or manager you can reduce this with the following:
&#8211; You articulate expectations clearly and simply. Let the employee reflect on how he interprets the next steps and the desired end result.
&#8211; Employees are often haunted by the thought of whether their work is enough. Give the employee constant feedback on how they are doing.
&#8211; Ask feedback for yourself. Practice this skill and the courage to do it constantly.
&#8211; If possible, acknowledge the employee and keep in mind that it’s always possible.
&#8211; Ask advice from an employee. This is how you increase their self-confidence and value their competence.
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<h3>One picture speaks more than thousand words</h3>
In virtual meetings, monitor the employee body language. It is often more eloquent than the words spoken. In remote work, alienation and a feeling of isolation arise faster and start to snowball if the team doesn’t notice it. You can create an organisational culture based on company values ​​in a virtual office.
Simple ways to create virtual traditions:
&#8211; celebrate progress and highlights of the month;
&#8211; celebrate each employee&#8217;s birthday in a slightly different way, so they won&#8217;t become routine for the manager either;
&#8211; surprise the team with a handwritten thank you card and a small memento;
&#8211; order and deliver a refreshing meal to a sick employee and flowers upon returning to work.
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<h3>Diversity enriches</h3>
Meet with your employees every week &#8211; both as a team and individually. Use different channels, as each employee has their own preferences – video or phone calls, messages, emails. It is worth meeting a new employee every day during the first weeks. Also encourage team cooperation and mentoring. In any case, always keep your virtual door open for employees. Your employees&#8217; courage is their greatest wisdom in staying engaged.

How to increase employee participation while working remotely?

<img decoding="async" loading="lazy" class="aligncenter size-full wp-image-2987" src="https://blog.minudoc.ee/wp-content/uploads/2022/03/Blog-suhtlus-1200x200-1.png" alt="Suhtlus juhi ja töötaja vahel" width="1200" height="200" />
In this three-part article series we’re looking into how to clarify concerns between employee and manager. First, we discuss why communication can be difficult. Then we describe a way the <a href="https://www.siffi.com/blog/communication-between-employee-and-manager-part-2-how-to-express-your-needs-as-an-employee" target="_blank" rel="noopener">employee could explain his or her worries or needs to the supervisor</a>. Finally, we look at <a href="https://www.siffi.com/blog/communication-between-employee-and-manager-part-3-how-to-converse-as-a-manager" target="_blank" rel="noopener">how the manager could build up communication with the employee</a>.
Communication between employee and supervisor is often the main solution in reducing tension. Here, it&#8217;s important to note that a daily dialogue is what keeps tension at bay, before serious problems arise.
In this series, we take a look at one way to improve communication in a team.
Keep in mind that any advice taken into consideration should have a personal approach. Recommendations that are meant to work for everyone hardly work for anyone in real life.
<h3>Communication is a skill that can be developed</h3>
Certain techniques aid in expressing your needs and thoughts. The model we describe here is one way out of multiple different methods to give you an idea of how you might want to proceed.
Advice that is tailored specifically for your unique situation can be provided by a mental health professional.
Fortunately, communication skills are something that can be developed through training and practice. Simple directions of ‘do this and then you will find the courage to successfully communicate’, don’t exist. The ability to communicate is closely tied to the person&#8217;s self esteem. This is something that can be worked with, even though it’s a long-term process.
<h3>Why is communication difficult?</h3>
Discussions between manager and employee are sometimes made difficult by suggesting ‘I can’t manage’. A solution here is to word the issue differently.
Start by not saying ‘I can’t manage’. Firstly, with this mentality you express a sense of incompetence. Secondly, it&#8217;s as if you would assign your supervisor to solve your personal issues.
<h3>Communication has to be a dialogue</h3>
There are numerous different solutions of how to build up a conversation between manager and employee. Here, we are looking at a situation where a problem has already accumulated. That&#8217;s why we mainly concentrate on identifying the needs of the worker.
A mutual daily dialogue on important and relevant topics is essential for maintaining a healthy work environment. For the manager, it&#8217;s a tool to communicate information and requirements. For the employee, it’s a way to receive the particulars that are needed in order to successfully execute tasks.
The byproduct is a more relaxed working environment.
Advice that is tailored specifically for your unique situation can be provided by a mental health professional.

Communication between employee and manager, Part 1: Why is it hard?

<img decoding="async" loading="lazy" class="aligncenter size-full wp-image-2987" src="https://blog.minudoc.ee/wp-content/uploads/2022/03/Blog-suhtlus-1200x200-1.png" alt="Suhtlus juhi ja töötaja vahel" width="1200" height="200" />
In this three-part article series we’re looking into how to clarify concerns between employee and manager. First, we discuss <a href="https://www.siffi.com/blog/communication-between-employee-and-manager-part-1-why-is-it-hard" target="_blank" rel="noopener">why communication can be difficult</a>. Then we describe a way how the employee could explain his or her worries or needs to the supervisor. Finally, we look at <a href="https://www.siffi.com/blog/communication-between-employee-and-manager-part-3-how-to-converse-as-a-manager" target="_blank" rel="noopener">how the manager could build up communication with the employee</a>.
Next, we will specify what steps you could take to build up a conversation with the manager, if you are in a situation where you already are in a situation where you have trouble managing your work.
<h3>1. Instead of judging yourself, describe the situation</h3>
A more astute way to start the talk with ‘I am concerned’. With this you open up to your supervisor in a sort of a dance, where both of you together will start to find out if the problem can be solved, and how.
If at all possible, try to describe your thoughts and feelings in a stable, calm and self-assertive manner. For example, speak of ‘I feel that lately this is too much for me’. Don’t give judgments about your ability to cope.
Directly describe the situation by bringing examples such as, you don’t have enough time to complete the tasks, the assignment is unclear, or you lack something else to complete the job in a timely and successful way.
Bring out how this has influenced you. For example, you are more tired, irritable, not as productive and you see it’s not sustainable.
<h3>2. Explain a possible solution for the situation</h3>
Describe how you believe the circumstances could be improved. For example, longer deadlines or a chance to discuss the assignment with someone. After that, ask the manager for their opinion.
By building up the conversation in this manner, you enter the negotiations in a position where you don’t judge your abilities or express your inadequacy. Instead, you are describing what is happening to you in a specific situation and what your needs are.
<h3>3. Include the supervisor in finding a resolution</h3>
Invite the manager to discuss ways to improve the state of affairs. Here, your supervisor can contribute by thinking along or describing their needs. This is a suitable spot to find satisfactory solutions together.
Overall, keep in mind that suitable advice matching your specific situation should be given by a mental health professional. As luck would have it, communication is a skill that can be improved by training and practice.
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Communication between employee and manager, Part 2: How to express your needs as an employee?

In this three-part article series we’re looking into how to clarify concerns between employee and manager. First, we discuss <a href="https://www.siffi.com/blog/communication-between-employee-and-manager-part-1-why-is-it-hard" target="_blank" rel="noopener">why communication can be difficult</a>. Then we describe a way how the <a href="https://www.siffi.com/blog/communication-between-employee-and-manager-part-2-how-to-express-your-needs-as-an-employee" target="_blank" rel="noopener">employee could explain his or her worries or needs</a> to the supervisor. Finally, we look at how the manager could build up communication with the employee.
<h3>Communication is a two way street.</h3>
The previous article in the series concentrated on how an employee can discuss what they need to complete their tasks, or to share information that the manager might lack in a troubling situation.
The other side of the coin is how a supervisor could respond to what is worrying their employee.
<h3>1. Concentrate on listening</h3>
The first thing as a manager is to listen without giving any judgments. Besides that, keep in mind that it’s not your place to immediately start offering solutions. Concentrate on actively listening and asking questions to get additional information on the situation.
Although we are concentrating on a situation where a problem has already become apparent, listening should be a daily rule of thumb. In everyday discussions ask your staff about what is going on with them; what their opinions and requirements are.
<h3>2. Find a solution together</h3>
The employee might approach the manager when the problem has already grown out of proportion. In that case, often the employee is holding on to the last straw and will express it accordingly.
You’ll hear how the staff member is burnt out, too tired and overall can’t handle anything anymore. When you happen to stumble on that kind of an extreme conversation you might think you need to jump in and immediately solve the damaging situation. But perhaps you don’t have to?
Before offering solutions, ask what the employee needs. Answer ‘ok, I see that this situation is very difficult for you, what do you need?’. Give the employee a space to think about it and only start thinking about possible solutions when they really don’t know how to go on.
Most often, the employee will have suggestions. That&#8217;s half of the job already done! From there on, start a discussion if and how you can meet your staff member&#8217;s requirements. Perhaps together you will find new alternative solutions that suit both parties.
Overall, keep in mind that suitable advice matching your specific situation should be given by a mental health professional. As luck would have it, communication is a skill that can be improved by training and practice.

Communication between employee and manager, Part 3: How to converse as a manager?

In this guide, we provide strategies that will help you and your workforce to stay resilient and functional in a time of crisis, such as the one we are now witnessing in Europe.
We’re engulfed in events that few of us could have predicted. As the pandemic now seems to be subsiding, we’re now witnessing a brutal war in the middle of Europe. This affects all of us.
Here at Siffi, we’ve experienced the invasion of Ukraine first-hand. Some of our coworkers are Ukrainian and reside in cities that are now torn by the war. Their plight is our plight. We immediately made our internal crisis support team available for them and their families. Now several of our therapists have stepped forward and are providing free crisis support for any Ukrainian.
Taking care of mental health is now more important than ever. In fact, every employer should now take action on this. So what can organizations do to secure and build the mental health of their employees?
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Let’s begin with a description of the situation.
<h3>What affects our mental wellbeing right now:</h3>

1. We’re barraged by bad news. For the past two years, we were all glued to pandemic news and now a humanitarian tragedy is unfolding. A new word, doomscrolling (the tendency to continue to surf or scroll through bad news) is now a part of our vocabulary. In a remote working environment, we don’t have a good way to share the anguish. We’re often alone with our screens.
2. Due to remote work, the number of rich interactions, conversations and genuine human contact has been cut down. This becomes even more evident in a time of crisis: social tools have mechanisms for showing positive emotions and support (thumbs up, hearts etc.) but are very poor mediums for listening or sharing difficult feelings such as fear.
3. Work and distractions to work are omnipresent. Like a shadow, work follows us wherever we go; the supermarket, the gym or to our parents’ house. Achieving harmony between work and otheractivities is difficult.
Other pressures have not gone away: rising costs of living, work stress and relationship issues. It’s almost impossible not to feel overwhelmed.
<img decoding="async" loading="lazy" class="aligncenter wp-image-3084" src="https://blog.minudoc.ee/wp-content/uploads/2022/03/Screenshot-2022-03-23-at-07.23.31.png" alt="" width="500" height="172" />
<h3>Ease-of-Use Matters. Especially in Employee Wellbeing.</h3>

So many questions are on the workers’ minds: Whom should I talk with? Who will know that I need help? What is the first step? Can I change the therapist if I’m not happy?
Siffi’s digital service addresses these topics one by one and takes away all the doubts. When traditional Employee Assistance Programmes (EAP) typically see 2-3% annual engagement, we see an average of 15% of the workforce using Siffi. That’s a fivefold increase or more! Despite high usage, Siffi’s fixed subscription price keeps your costs down and makes budgeting easy.
<img decoding="async" loading="lazy" class="aligncenter size-full wp-image-3085" src="https://blog.minudoc.ee/wp-content/uploads/2022/03/Screenshot-2022-03-23-at-07.24.43.png" alt="" width="1417" height="651" />
<h3>Now What?</h3>

How should HR professionals and leaders react? We suggest four lines of action.
1. 
Show your values. Employees shouldn’t feel uncertain about where their employer stands in asevere conflict. Stating your values clearly is now more important than ever. If you can, present and commend a coworker who is taking action. Put out clear statements and put your money where your mouth is. Your workforce should feel proud of their employer.
2. 
Take ownership. In Siffi’s experience, the first failure of employee wellbeing is a failure of communication. This is particularly true of organizations with international teams. Workers are simply unaware of how the topic of mental health is perceived in the organization. So raise the flag of mental health and let it fly.
Everybody has mental health. Make sure your workforce knows that there is zero shame in needing support. Show genuine empathy.
3. 
Build awareness. We all need to strengthen our understanding of what mental wellbeing means.
What is crisis support and when should I seek it? What does good mental health consist of? What’s the difference between (positive) stress and burn- out? What are coping strategies and how do they apply to me?
We recommend that you seek out mental health professionals (such as Siffi or our peers). They will help you to prepare the right materials and arrange webinars.
4. 
Provide access and think about the cultural context. Your workers should have access to mental health professionals who understand their own language and culture. Remember that the lack of genuine human contact is quite often at the root of the problem.
According to studies, giving employees access to emotional support and therapy provides a 300% return on investment.
<img decoding="async" loading="lazy" class="aligncenter wp-image-3086" src="https://blog.minudoc.ee/wp-content/uploads/2022/03/Screenshot-2022-03-23-at-07.27.52.png" alt="" width="500" height="180" />
What if most of my workers are remote or reside in several locations?
Siffi set out to solve this problem by building an international network of top-rated coaches and therapists and making them available for appointments and on-demand chats at the click of a button.
“Enlab’s employees reside in a growing number of countries. So it didn’t make sense for us to start finding the right mental wellbeing partner in each location. Instead, we decided to go for a subscription with Siffi who already had the rightmix of professionals in place internationally” says Maria Gendelevitch, HR Director of Enlabs.
<h3>Everyone Onboard in Days</h3>

A well-known fact: HR departments spend so much on onboarding and in explaining how benefits work. The HR Lead at game company Creative Mobile had a very different experience onboarding people to Siffi: “Instead of months and months of research and talking with local providers, we were able to onboard all of our workers within one week of deciding to provide Siffi to everyone. My desk was cleared for the things I really need to do: to talk, interact and help our workers”
<h3>Speak the Language of Your Heart</h3>

We may mostly work in English, but our minds mostly still work in our native languages. This becomes more pronounced in a crisis &#8211; we seek shelter in the language and culture of our hearts.
Siffi makes sure that you can share your thoughts and solve your problems in your native language and with someone who understands your cultural context. Siffi is a mental wellbeing benefit that works for international teams. To learn more visit <a href="https://www.siffi.com" target="_blank" rel="noopener">siffi.com</a>.

Ukraine and Employee Mental Health

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There are a variety of different types of mental health professionals than can help you with diverse issues or help you advance in life. These different specialists have been taught to use numerous tools that help with certain issues that are related to our past, present or future.
This article aims to give you an overview of some of the different mental health professions and what they are best suited for. See below for an explanation for the following professions:
&#8211; Psychologist
&#8211; Psychiatrist
&#8211; Psychotherapist
&#8211; Clinical psychologist
&#8211; Counsellor
&#8211; Supervisor
&#8211; Coach
<h3></h3>
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<h3>Psychologist</h3>
A psychologist is a specialist who has a relevant psychological degree from an accredited curriculum at a university.
The main aim in sessions is to provide advice to the person regarding any psychological issues, for example self-esteem problems, analysing relationships, dealing with assertiveness, etc. Psychologists can deal with mental health disorders, stress and anxiety.
A psychologist is not a medical doctor and does not prescribe medication.
<h3>Psychiatrist</h3>
A psychiatrist is a doctor who, in addition to basic medical training, has passed the relevant psychiatric residency.
Their main aim is to determine if a mental disorder is present, diagnose it and treat it with medication if the situation requires it. In order to do so, they usually conduct a clinical interview to get the patient’s medical history and may ask for a battery of tests to be conducted to determine the level of specific symptoms. Additionally, they deal with rehabilitation and prevention.
In compliance with the symptoms and diagnosis, the psychiatrist usually recommends psychotherapeutic intervention and/or prescribes relevant medication.
<h3>Psychotherapists</h3>
Psychotherapists have usually (but not always, depending on the therapy) finished their education in psychology or psychiatry, and have additionally completed a comprehensive specialised training in their respective field of therapy for example cognitive behavioural therapy, family psychotherapy, psychodynamic therapy, etc.
In selecting a psychotherapist, it&#8217;s recommended to know their specialty to understand how and with what they could help with.
<h3>Clinical psychologist</h3>
A clinical psychologist has a relevant psychological degree and additional training in clinical psychology, which includes making a diagnosis and putting together a treatment plan with a medical doctor.
This specialist mainly deals with helping medical doctors in assessing, mitigating, treating and preventing mental and behavioural disorders, disability and at risk behaviours. This specialist is suited to identify if a person is suffering under mental illness by overseeing relevant tests and studies.
The term ‘clinical’ in this specialist&#8217;s name refers to the fact that the psychologist mostly deals with patients who have been diagnosed with a disorder. Patients need a referral from a psychiatrist to see a clinical psychologist.
A clinical psychologist is not a doctor with a medical degree, so they don’t have a licence to prescribe medications.
<h3>Counsellor</h3>
A counsellor in a work environment is someone who has an educational background as a psychologist, psychiatrist, psychotherapist, social worker or something similar, that gives the specialist skills for professional counselling. In general, counselling is a short term process that is focusing on  a specific question or a problem in the past, present or future.
<h3>Supervisors</h3>
Supervisors assist their clients in reviewing and reflecting work that has already been done, to better learn from the past so as to achieve more success in the future. Real-life cases are used during supervision to analyse and see how things could be played out. Supervision can be, depending on the need and situation, an individual effort or group work &#8211; even including the whole team. Supervision service is used mainly by managers and specialists who work in areas such as, but not limited to, social work, schools, mental health, law enforcement, etc.
<h3>Coach</h3>
A coach is most suited to help you unravel your professional or personal potential and guides you in dealing with setting goals and the motivation to reach them. Coaches don’t provide you with ready made solutions, instead, they assist you in finding out what the right path might be for you. A coach always looks toward the future.
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<h2></h2>
<h2>Points of contacts and similarities</h2>
Reading the different descriptions, you might rightly get the impression that with some issues you could approach multiple specialists.
If you have already selected a specialist, it doesn’t mean you have to exclude other professions. Mental health is a comprehensive system. Whilst visiting a psychologist to deal with problems related to the past, you can at the same consult with a workplace counsellor about a specific issue or approach a coach to discuss future goals.
Try to openly share your thoughts and questions while talking with a professional &#8211; if they aren’t the right person to assist you, then they can direct you to a more suitable specialist.
Note that in mental health issues, medication can be prescribed only by doctors who have a medical degree. As an example, that can be a psychiatrist or your general practitioner. In any case, the treatment plan with medications should be accompanied by psychological support, whether it be from a psychiatrist or another suitable mental health professional to manage the patient&#8217;s thoughts, feelings, environment, etc.
In many cases, taking care of your mental health can prevent more serious issues so try to think of it as a hygiene issue. Take regular time out to sort things out, address your thoughts and take a step back to see how your lifestyle is supporting your wellbeing.

Mental health specialists: who does what?

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To give teams and organisations interested in promoting mental health wellbeing amongst their staff a sense of what might be going on in their coworkers’ heads, we decided to publish last year&#8217;s numbers on which mental health issues people in the workplace say they have experienced.
This analysis was collected from people who have contacted a mental health professional at Siffi via their employer. All of the information is gathered anonymously and discreetly. Find out more about how and where the information was collected at the end of this article.
The top four main mental health issues in 2021 – anxiety, worrying, trouble concentrating, tiredness – do not come as a surprise to our psychologists. With some changes from month to month, these mental health issues are often at the top. Such fluctuations mostly appear during holidays, including summer months and Christmas time.
Let it be said that these numbers are quite average across the board, meaning that these indicate a “decent” to “good” place to work at. After all, these are answers from employees who work in establishments that care for their employees’ mental wellbeing.
See below the full list of mental health issues and their weight in 2021 by people who have opted to talk to a mental health professional.
<img decoding="async" loading="lazy" class="aligncenter wp-image-2997" src="https://blog.minudoc.ee/wp-content/uploads/2022/03/chart.png" alt="employee mental health 2021 " width="500" height="550" />
All emotions and issues, that are mentioned in the table above, are normal in everyday life. They become a problem when they persist for a long time and start to negatively affect our everyday life.
The top issues in 2021 were anxiety (54% of employees) and worrying (44% of employees). These issues quite often go hand in hand, though not always. For example, you can often be in a state of worry without being anxious, but extreme worrying may induce anxiety.
Whatever the case, if we feel anxious, worried, or both due to constantly being on guard, our performance is challenged. This can lead to trouble concentrating (42% of employees) and feeling tired (39% of employees).
When you think about being constantly concerned with topics that affect you due to anxiety or worry, it makes sense that there is limited space to concentrate on the task at hand. The mind just keeps drifting back to the things that bother you, and thinking of distressful topics around the clock is frankly tiresome.
Next, we will explain some of the main mental health issues a bit more thoroughly.
&nbsp;
Anxiety
Anxiety is defined as apprehension over an anticipated problem. It involves worrying, feelings of insecurity and fear of losing control. Fear is a reaction to immediate danger, whereas anxiety is about a future threat.
People who suffer from anxiety start looking for threats in the environment and are very receptive to each stimulus that may represent them. Anxiety can also be caused by an inner value conflict or trauma.
<a href="https://www.minudoc.ee/problem-description/anxiety" target="_blank" rel="noopener">Read more here.</a>
We will add more statistics and information about anxiety in 2021 soon.
&nbsp;
Worrying
It&#8217;s normal to worry from time to time, but worrying can be persistent and become a permanent and uncontrollable part of life. People who worry excessively can constantly think of worst-case scenarios and „what ifs&#8221;. It is also typical to wait for the worst and prepare for it.
<a href="https://www.minudoc.ee/problem-description/worrying" target="_blank" rel="noopener">Read more here.</a>
We will add more statistics and information about worrying in 2021 soon.
&nbsp;
Trouble concentrating
Trouble concentrating affects people in a variety of ways. Some may experience problems with concentration at work or while studying, while others have trouble during their leisure time.
If a person has difficulties with finishing everyday tasks or is restless, it may indicate trouble in concentrating. The person might also strain to recollect recent events or remember where things are placed. It is also common that the person struggles to make decisions and has a constant lack of energy.
Trouble concentrating is often accompanied by stress, anxiety and loss of control.
We will add more statistics and information about trouble concentrating in 2021 soon.
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Tiredness
If long term fatigue isn’t due to sleeping problems, then it is reasonable to look more deeply at what parts of people’s lives are exhausting. This can be related to a person&#8217;s work-life or may have something to do with personal issues, such as problems with family life. Tiredness can also be caused by life events like grief or breakdown in a relationship. Tiredness is often influenced by lifestyle.
Psychologically, tiredness is a natural conclusion when a person has experienced long term stress, anxiety or worrying. Tiredness is not influenced only by negative stress, but also positive, as in moving home or getting married.
We will add more statistics and information about tiredness in 2021 soon.
&nbsp;
Loss of interest
Loss of interest is a deeper symptom of something that has been mentally very difficult in the person&#8217;s life for a long time. It&#8217;s commonly expressed through not feeling joy in things that used to give positive emotions. If pastimes that used to be relaxing or time spent with loved ones don’t give positive emotions anymore, it can lead to sadness.
We will add more statistics and information about loss of interest in 2021 soon.
&nbsp;
Irritability
With irritability comes various behavioural patterns and feelings such as disappointment and aversion (reluctance), trouble concentrating, struggle to accommodate other people&#8217;s wishes, or when changing plans &#8211; tiredness, over sensitivity and tension.
An easily irritable person may feel fine at one moment and then suddenly overreact to the slightest issue. This creates even more tension in that person&#8217;s life, creating a snowball effect of more sensitivity and stress.
Irritability can be an indication of multiple mental health problems like stress, depression or addiction.
We will add more statistics and information about irritability in 2021 soon.
&nbsp;
Sadness
Sadness is an emotional state which leads to crying, social withdrawal and slowing down all activities. Sometimes people also experience emotional pain and feelings of loneliness.
The goal of sadness is to facilitate the process of loss &#8211; for example, the ending of a friendship or a romantic relationship or also losing resources or status. It has been found that sadness helps to improve attention to capture details, be less biased by prejudice, maintain orientation to goals and encourage generosity towards others.
<a href="https://www.minudoc.ee/problem-description/sadness" target="_blank" rel="noopener">Read more here.</a>
We will add more statistics and information about sadness in 2021 soon.
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Relationship problems
Some of the most common relationship problems include jealousy, economical problems; related to sexuality, children, infidelity, violence, and many other reasons.
<a href="https://www.minudoc.ee/problem-description/relationship" target="_blank" rel="noopener">Read more here.</a>
We will add more statistics and information about relationship problems in 2021 soon.
&nbsp;
Sleeping problems
Most people experience temporary and short-term sleeping problems. This kind of short-term insomnia is one of the ways to respond to challenging life events.
Insomnia can easily reappear and last for longer periods of time. It can be exhausting to the person and disturb everyday life, culminating with a lack of energy for socialising, participation in hobbies or other activities.
<a href="https://www.minudoc.ee/problem-description/sleeping" target="_blank" rel="noopener">Read more here.</a>
We will add more statistics and information about sleeping problems in 2021 soon.
&nbsp;
Self-esteem
Self-esteem is a person&#8217;s subjective opinion of himself and his value. It shows how much a person likes himself regardless of the situation he is in at the moment. Self-esteem also indicates how much a person thinks he can cope with everyday challenges and whether he thinks he deserves to be happy.
In case of low self-esteem, a person doubts his abilities and makes decisions based on these limiting beliefs. A person may not dare to accept new challenges because he does not believe that he can cope with them. People who have low self-esteem often feel that everyone else is better than them.
Problems can also arise in relationships because one’s needs are not met. People with low self-esteem don’t dare to talk about their needs and the needs of others are considered more important than one&#8217;s own.
<a href="https://www.minudoc.ee/problem-description/self-esteem" target="_blank" rel="noopener">Read more here.</a>
We will add more statistics and information about self-esteem in 2021 soon.
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<h3>How the information was gathered</h3>
This information is gathered through organisations that have selected to provide their employees with professional mental health support through Siffi. All of the information abides strictly to discretion and anonymity. We take the trust that has been given to us seriously.
The aforementioned 21 keywords are used as the first step in a consultation to give the mental health professional a head start. Any person contacting a healthcare professional selects relevant keywords to indicate the topics they want to discuss. There is no restriction (minimum, maximum or otherwise) in selecting suitable keywords for a consultation.
For the mental health professional, these keywords indicate if the person contacting them has a specific problem or has a wide range of issues that, when combined, can present a set of symptoms, which in turn can give cause to a deeper concern.
For example, tiredness, loss of interest and trouble concentrating might indicate stress or mood disorders. Feeling tired and sleeping problems can go hand in hand, but not necessarily, and it is insightful if a person indicates tiredness without having any trouble sleeping, because that might mean they are experiencing mental exhaustion.
Just for kicks and number buffs, here’s a table that shows how many keywords people selected when answering.
<img decoding="async" loading="lazy" class="aligncenter wp-image-2998" src="https://blog.minudoc.ee/wp-content/uploads/2022/03/Number-of-keywords-selected-for-a-consultation.png" alt="Number of keywords selected for a consultation" width="430" height="266" />

What mental health problems troubled employees in 2021?

Designing a mental health support system in a workplace

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To give teams and organisations interested in promoting mental health wellbeing amongst their staff a sense of what might be going on in their coworkers&#8217; heads, we decided to publish last month&#8217;s numbers on which mental health issues people in the workplace say they have experienced.
This analysis was collected from people who have contacted a mental health professional through their employer. All of the information is gathered anonymously and discreetly. Find out more about how and where the information was collected at the end of this article.
The top four main mental health issues in November &#8211; anxiety, worrying, trouble concentrating, tiredness &#8211; do not come as a surprise to our psychologists. With some changes from month to month, these mental health issues are often at the top. Such fluctuations mostly appear during holidays, including summer months and Christmas time.
Let it be said that these numbers are quite average across the board, meaning that these indicate a “decent” to “good” place to work at. After all, these are answers from employees who work in establishments that care for their employees’ mental wellbeing.  
&nbsp;
<h2>Main issues in the workplace</h2>
&nbsp;
The top issues in November were anxiety (65% of employees) and worrying (53% of employees). These issues quite often go hand in hand, though not always. For example, you can often be in a state of worry without being anxious. But extreme worrying may induce anxiety. 
Whatever the case, if we feel anxious, worried, or both due to constantly being on guard, our performance is challenged. This can lead to trouble concentrating (47% of employees) and feeling tired (43% of employees).
When you think about how when being constantly concerned with topics that affect you due to anxiety or worry, it makes sense that there is limited space to concentrate on the task at hand. The mind just keeps drifting back to the things that bother you, and thinking of distressful topics around the clock is frankly tiresome.
See below the full list of mental health issues and their weight in November 2021 by people who have opted to talk to a mental health professional. 
<img decoding="async" loading="lazy" class="aligncenter wp-image-2831" src="https://blog.minudoc.ee/wp-content/uploads/2021/12/Screenshot-2021-12-17-at-12.38.26.png" alt="Workplace mental health issues in November 2021" width="600" height="622" />
&nbsp;
<h2>Issues that present together</h2>
&nbsp;
The 21 mental health issues listed above, or lets say keywords for simplicity, have varying degrees of correlation between themselves. As discussed before, anxiety and worrying quite often go hand in hand. For example, 81% of people who have indicated that they feel constant worry, also say they feel anxious. 
Here is a list of keywords that people have indicated in November that have a 100% of correlation. This means that when they have selected a specific issue, it always accompanies another matter.
&#8211; Those who said they feel irritation, also said they are anxious.
&#8211; Fear always comes with a sense of worry.
&#8211; Loneliness is accompanied by worrying and sadness.
&#8211; If a person indicates a loss of control, they also have trouble concentrating and are in constant state of worry.
We will post more information on the interdependence of keywords and other correlations starting from January.
&nbsp;
<h2>How the information was gathered</h2>
&nbsp;
This information is gathered through organisations that have selected to provide their employees with professional mental health support through <a href="https://www.siffi.com">Siffi</a>. All of the information abides strictly to discretion and anonymity. We take the trust that has been given to us seriously. 
The aforementioned 21 keywords are used as the first step in a consultation to give the mental health professional a head start. Any person contacting a healthcare professional selects relevant keywords to indicate the topics they want to discuss. There is no restriction (minimum, maximum or otherwise) in selecting suitable keywords for a consultation. On average, in November people selected 5.5 keywords. 
For the mental health professional, these keywords indicate if the person contacting them has a specific problem or has a wide range of issues that, when combined, can present a set of symptoms, which in turn can give cause to a deeper concern.
For example, tiredness, loss of interest and trouble concentrating might indicate stress or mood disorders. Feeling tired and sleeping problems can go hand in hand, but not necessarily, and it is insightful if a person indicates tiredness without having any trouble sleeping, because that might mean they are experiencing mental exhaustion. 
Just for kicks and number buffs, here’s a table that shows how many keywords people selected when answering. 
<img decoding="async" loading="lazy" class="aligncenter wp-image-2832" src="https://blog.minudoc.ee/wp-content/uploads/2021/12/Screenshot-2021-12-17-at-12.39.56.png" alt="" width="491" height="400" />

What worries do people have in the workplace?

Sirli Loorits
Counselling psychologist
I believe the mental health area should be thought through on a corporate level and a proper plan should be made to improve this area at workplaces.  Mental health problems are becoming more and more common and most people seek help only when they have developed quite serious symptoms. Organizations can foresee this and get great results with systematic prevention techniques.
&nbsp;
<h3>People need to start “turning off”</h3>
&nbsp;
Burnout, stress, and imbalance in work and home life are becoming more frequent in our society. Due to modern technology, people are becoming reachable at any time and any place. Oftentimes people don’t turn off their work emails or notifications when they are supposed to finish their work. Instead, they still react to work-related matters after work as well.
While this might seem like a good thing from the employer’s perspective at first, it actually isn’t and will backfire sooner or later. Of course, the work-home imbalance is not the only reason why people get stressed at work. Reasons probably vary, but continuing stress and burnout still have the same consequences for the organizations: decreased productivity, more mistakes, sick leaves, and even employees leaving their job.
Of course, people are different and due to individual differences some will encounter burnout sooner, some later, and some not at all. In general, stress and burnout at work are a big problem and not only for the employees but also for employers. Eventually, constant stress can lead to serious health problems, both physical and mental, such as depression and anxiety.
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<h3>Mental health problems are becoming increasingly common</h3>
&nbsp;
Depression and anxiety disorders are the most common mental health problems and are huge contributors to the overall disease burden in the world. People, who turn towards professional help, oftentimes do it only when their suffering has become unbearable. They look for help when they already have severe depression or anxiety, sometimes both. The longer people wait before they do something about their symptoms, the more difficult it will be to treat them.
There might be different reasons why people don’t seek help sooner, starting from poor knowledge or false shame about mental health problems and ending with long waiting times or high prices. Employers have a great opportunity to meet people halfway here. I guess it’s really important to start educating people about mental health problems and also increase the possibilities to get help sooner. That’s a great way for employers to show they care.
I believe many cases of serious depression and anxiety disorder can be prevented by taking the right action sooner. 
Big problems can start with small and seemingly unimportant issues. When those „small“ and „unimportant“ problems will be addressed at the right time and with the right kind of attention, then there is a big possibility that they do not turn into serious mental health issues. This is a big win not only for individuals but also for organizations.
&nbsp;
<h3>Organizations can take care of their employees through systematic work</h3>
&nbsp;
Organizations that will engage in preventing mental health problems can decrease sick leaves and employee turnover, and increase their employee’s productivity instead. To accomplish that, a systematic approach to improving mental health should be taken on the corporate level.  The beginning could be educating the employees about mental health and different possibilities to support it, starting to talk about it openly, bringing in professionals to talk about specific techniques, etc. A big leap forward would also be offering employees the possibility of counseling sessions. We need to start putting a lot more effort into addressing mental health challenges.

Why do employees need counseling?

Recognising if your co-worker is burned out or at risk, helps to keep an eye on the wellbeing of the whole work environment. To understand this topic better, we will also take a look at the stages of getting to be burned out and take a look at what causes it.
Burnout is the result of the work environment of recent decades. In the 1970s, Herbert Freudenberger, an American psychologist, started using this term to describe the effect of increased stress and tension in the fields of work, where people were helping others (for example doctors, nurses). In the current times, this term is used more and more, as the issue has spread to other fields as well.
In 2018, the World Health Organization (WHO) added the term burnout to their<a href="https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases#:~:text=%E2%80%9CBurn%2Dout%20is%20a%20syndrome,related%20to%20one's%20job%3B%20and" target="_blank" rel="noopener"> International Classification of Diseases</a>. It is described as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed”.
<h3>Defining who is burned out</h3>
Based on WHO classification, a person is burned out when there are:
&#8211; feelings of energy depletion or exhaustion; 
&#8211; increased mental distance from one’s job, or feelings of negativism or cynicism related to one&#8217;s job; and 
&#8211; reduced professional efficacy.
The World Health Organization ties the burnout term specifically to the context of the work environment and advises that this term should not be used to describe other fields of life.
<img decoding="async" loading="lazy" class="aligncenter wp-image-2388" src="https://blog.minudoc.ee/wp-content/uploads/2021/03/burnout-phases_minudoc.jpg" alt="" width="223" height="148" />
<h3>12 steps to burnout</h3>
Here, we&#8217;re using Herbert Freudenberger&#8217;s work, that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3230825/" target="_blank" rel="noopener">divides burnout into 12 phases</a>.
<h4 style="padding-left: 40px;">1. Compulsion to prove oneself (excessive ambition).</h4>
When we wish to show the best of ourselves and maybe get a promotion or a raise, we wish to prove ourselves. Generally speaking, it can be very positive, that we wish to be good at what we do, but there are limits to it as well.
<h4 style="padding-left: 40px;">2. Working harder. </h4>
This often goes hand in hand with the wishes behind the previous point. We wish to maximize our work time and may put in some overtime, even, if we could avoid it.
<h4 style="padding-left: 40px;">3. Neglecting own needs. </h4>
How many times have you skipped your lunch break, because there is so much work to do?
<h4 style="padding-left: 40px;">4. Displacement of conflicts and needs. </h4>
There are changes to the way we see our work tasks, understanding our own needs, prioritizing.
<h4 style="padding-left: 40px;">5. No longer any time for non-work-related needs. </h4>
You should be taking care of your health, see a doctor or something of that sort, and you don’t, because that would mean missing time off work? Maybe your family is waiting for you to come home after your workday has ended, but you keep thinking that you need to finish x amount of tasks and keep staying late at work?
<h4 style="padding-left: 40px;">6. Increasing denial of the problem, decreasing flexibility of thought/behavior. </h4>
You do not have a real understanding of how much you keep thinking about work when your workday has ended, or how your personal life is suffering.
<h4 style="padding-left: 40px;">7. Withdrawal, lack of direction, cynicism. </h4>
Confusion sets in, you cannot understand anymore, why are you struggling with work, work is creating negative emotions.
<h4 style="padding-left: 40px;">8. Behavioral changes/psychological reactions. </h4>
Anxiety, high-stress levels, etc. You may be acting unpleasantly towards others as they cannot understand the situation you are in.
<h4 style="padding-left: 40px;">9. Depersonalization: loss of contact with self and own needs. </h4>
You are not really taking care of yourself anymore. If you may have thought about canceling some things before, then now it has become automatic.
<h4 style="padding-left: 40px;">10. Inner emptiness, anxiety, addictive behavior. </h4>
Mental health problems are increasing.
<h4 style="padding-left: 40px;">11. Increasing feeling of meaninglessness and lack of interest. </h4>
This phase is pretty self-explanatory as was the last one. Mental health is definitely at a low and the issue may show on a physical level already.
<h4 style="padding-left: 40px;">12. Physical exhaustion that can be life-threatening. </h4>
In addition to mental health issues and exhaustion, there is also physical fatigue and the feeling that you are unable to do anything, work-related nor anything else.
When you read this list of phases, you may analyze where in this scale you see yourself and where you see the people around you. The issue keeps getting greater at each phase, but you can keep taking steps back, when taking appropriate action – the process of burnout is not one-way and it can be stopped.
<img decoding="async" loading="lazy" class="aligncenter wp-image-2390" src="https://blog.minudoc.ee/wp-content/uploads/2021/03/work-assignments_minudoc.jpg" alt="" width="231" height="154" />
<h3>What creates burnout at work?</h3>
There can be multiple different sources of stress at work that could lead to the feeling of burnout. The main reasons are often brought out to be unequal treatment, unrealistic workload, the ambiguity of roles, communication issues, and too much time pressure.
Negative stress at work can also be caused by conflicts with colleagues, uncertainty towards the future, lack of required skills, etc. The stressors are not always external. People can add additional stress and burnout risk through internal pressuring. Internal, self-caused stress can be caused by fears, repetitive thought patterns, worrying about the future, or setting unrealistic expectations for themselves.
<h3>How to recognise when your colleague may be burned out?</h3>
An important symptom of burnout is physical and emotional exhaustion. This type of exhaustion can show in different ways. You may notice that your colleague always looks tired, they are mentally not there, their under-eyes are dark or they always seem like they have not slept. This constant exhaustion can also cause physical issues with health. Meaning that the person is sick more often and misses work. When the physical exhaustion is making someone feel bad as it is, then every small added health issue is automatically much greater for them.
Burnout can also be accompanied by depression, anxiety, insomnia, and loss of appetite. These issues will lead to both physical and emotional difficulties. It is hard to function and complete daily tasks when you have not slept or eaten. Being productive at work seems like a tall order in that situation. 

You might notice that your colleague often starts their workday late. Or it seems that they can never wait for the workday to end. Those might be signs of burnout. When burnout is developing, the employee may start to have less interest in their work tasks. This issue has the potential to grow into trying to avoid work altogether. The employee can also be more and more pessimistic and frustrated about their work and surroundings. They may wish to isolate themselves (refusing lunch, group tasks, etc). They may start increasingly avoiding and missing work, saying that they have health issues.
What you may not initially tie to burnout, but is also a sign of it, is when an employee does not want to discuss future plans or work performance. When an employee is already negatively minded about work and not able to be productive, they are usually thinking negative thoughts about their future in their job.
<h3>How to move forward?</h3>
There are many things that someone facing burnout can do to help themselves. The issue must be first acknowledged and analyzed, then the next step is to find support and decrease stress levels. The first recommendations to start taking care of your mental health is usually physical movement and sleep.
For employers, we would advise starting to make changes by working on the <a href="https://www.siffi.com/blog/burnout-is-caused-mainly-by-employers-not-employees-themselves" target="_blank" rel="noopener">5 main reasons for burnout</a> in the workplace.
<a href="https://www.siffi.com/problem-description/burnout" target="_blank" rel="noopener">Read more what our psychologists have to say about burnout.</a>

How to recognise who is burned out?

It would be quite difficult to find someone today, who could truly state, that the COVID crisis has not had any effect on them. We all live in a world that is changing constantly. The information about the virus is constantly changing. The restrictions imposed on us are constantly changing. An <a href="https://www.mckinsey.com/business-functions/risk/our-insights/when-nothing-is-normal-managing-in-extreme-uncertainty?cid=other-eml-alt-mip-mck&amp;hdpid=945e4631-e58b-4382-b32b-b65f36c77939&amp;hctky=12300454&amp;hlkid=b77ca6c108474c89821a727bd1e1d181" target="_blank" rel="noopener">article by McKinsey</a> states that the current crisis is causing as much pressure on peoples’ mental health, as living in a war zone would.
When this new normality started to unfold and the initial quarantine and restrictions were introduced in March 2020, no one could guess what dimensions this situation would take on the world in the next year. The virus and the devastation caused by it have not gone anywhere. All of it has a very clear effect on peoples’ mental health on many levels, both in the work and home realms.
<h4>Quarantine went from holiday-like to worrying</h4>
In the light of the initial quarantine, some people may have thought that this is a short-term sabbatical from work. As time passed, it became clear, that we are far from that. The job environments started changing, a lot of people started working from their homes. There were also a lot of organizations and businesses, for which the markets and clients disappeared all of a sudden. People had to manage with decreased wages, some with redundancies. These kind of changes create worry and anxiety for almost all of us.
<img decoding="async" loading="lazy" class="aligncenter wp-image-2383" src="https://blog.minudoc.ee/wp-content/uploads/2021/03/work-home-stress_minudoc.jpg" alt="" width="244" height="162" />
<h4>Extreme uncertainty creates tension</h4>
The biggest role in causing such anxiety is the uncertainty that is becoming extreme. Companies are unable to predict, what will happen to markets in this crisis. Organisations are used to long-term planning, for years or longer periods. When the COVID crisis started to be accompanied by national restrictions, it started creating more and more uncertainty around the world.
In the past there have been crises that have affected large groups of people or large areas and have been broadcast worldwide by the media. A global crisis with an impact as COVID cannot be found in our past. In the McKinsey article the COVID crisis is compared to living in a war zone and also to the 2008-2009 economic crisis. This article also states that the current uncertainty is creating higher levels of anxiety and stress than the economic crisis ever did.
The uncertainty tied to the COVID crisis is especially high in the work environment, as a lot of companies and organizations are unable to plan and be sustainable in this sort of uncertainty. Plans which were made in January, were unreal by March. The plans made in March were too optimistic, hoping that the crisis will end by the end of summer. By now it is clear, that nothing is for certain anymore.
<h4>The mental health of employees is a growing concern for employers</h4>
The mental health of employees is becoming an increasing concern in the work environment. McKinsey conducted a 1,000-company-based <a href="https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/national-employer-survey-reveals-behavioral-health-in-a-covid-19-era-as-a-major-concern" target="_blank" rel="noopener">study of behavioral health during the COVID crisis</a>, focusing mainly on mental health and substance use.
Their study showed that nine organizations out of ten feel that mental health is the largest issue for employers when thinking about their employees. 80% of employers were concerned (approx. 60% very concerned) that their employees may abuse substances. 77% of employers were concerned (approx. 38% very concerned) about their employees’ mental health.
Seven out of ten organizations were planning to take steps to help with the mental health of their employees. The main measures they planned to invest in were ambulatory treatment, digitalized treatment, and stationary treatment.
<h4>We are grieving the way we lived in the past but should be looking forward – even in a crisis</h4>
Uncertainty and change are having an increasing effect on peoples’ mental health. Everyone has lost something in this crisis – whether it has been loved ones, jobs, sense of freedom, etc. We keep grieving the freedom we had before, to travel, to work in our offices with our colleagues, to go where we wish. None of us have any idea what our workplace will be like when we truly can go back there. Our employers cannot really make any promises either, because they are also uncertain about the future.
Maybe a step forward would be that employers should stop telling their employees, what they will do when everything “goes back to normal”. Maybe nothing will be the same as it was before, not our work or lives. Because of that, it would probably be time to face the reality as it is now and support the employees in the situation that we find ourselves in.
Each and every one of us has the right to miss things or situations. It&#8217;s not worth it to wait for things to go back to the way they were before. Instead, we should try to look towards our future. It is important to help the people around us to look forward, whichever way we can do that. In the work environment and communication with our colleagues there has most likely never before been something like this crisis. This ties us together and makes us think of a common topic. It affects us all and therefore the work environment and our interactions at work need the same type of humane understanding and empathy as our personal lives.
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<h4>A leader in crisis needs to be more humane and empathic than before</h4>
<a href="https://www.mckinsey.com/business-functions/organization/our-insights/tuning-in-turning-outward-cultivating-compassionate-leadership-in-a-crisis">Another McKinsey article on leadership in crisis</a> brings out four main characteristics for leaders. To help employees and restore businesses, you need awareness, vulnerability, empathy, and compassion. Leaders have never had to be as humane as they need to be in the current world and environment.
Within the worrying and anxiety, the leader needs to ask their employees how they are feeling. It is not just about asking, but also listening to them, openly discussing issues, being compassionate. This kind of humane attitude brings people together, helps foster loyalty, ties together teams, and helps be more uniform. It is important that leaders understand their own internal lives and fears, then turn their gazes outward, to see what is happening around them and how they could come out of it with their people.
In conclusion, we would like to say that it is important to turn more attention to our mental health, and the mental health of people around us. The uncertainty that is constantly around us during this COVID crisis, especially in the work environment, is a fertile ground for stress, anxiety, and burnout. People have to be attentive and present for themselves, but also for their colleagues and employees. That is the only way we can take care of our people.

COVID crisis is comparable to being in a war zone

With the current pace of life, it&#8217;s becoming more noticeable that people have more stress and tension than ever before. This sort of growing pressure in the workplace can very quickly lead to employee burnout. Burnout is not always something that people cause to themselves. This issue is more often caused by the work environment. The 2018 year Gallup study shows that employers play a huge role in employee burnout.
The term burnout was first used in the 1970s for specific work fields. Because the issue started growing, it was added to the <a href="https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases"> World Health Organization</a> International Classification of Diseases as an occupational phenomenon in 2019. The employer is responsible for environmental factors. Therefore it is the responsibility of the employer to see the danger signs and to take steps to try to avoid employee burnout.
<h3>More than half of employees feel burned out</h3>
In 2018, <a href="https://www.gallup.com/workplace/237059/employee-burnout-part-main-causes.aspx">Gallup published the results of a survey</a> they completed amongst 7500 full-time employees. In this survey, 23% of employees reported feeling burned out very often or often. An additional 44% of employees reported feeling burned out sometimes. Adding those numbers together, it turns out that 2/3 of employees are facing the feeling of burnout in their work. Take a moment and think about your colleagues &#8211; that is a large portion of us, who could really be struggling!
<h3>A burned-out employee is not productive</h3>
For the employer, there is a big difference in terms of cost, whether their employees are in a good mental health state or they are burned out. The employees dealing with burnout are 63% more likely to need and use sick days. Also, it is 2,6 times likelier that they are actively seeking for a new job to get out of this situation. Even if these people do not change their jobs, their worries and struggles make their work performance significantly worse than their happy colleagues.
Burnout leads to diminished productiveness, a decrease in being able to focus, visible frustration, and constant tiredness. If there is a person or maybe a few with these issues in a team, this may mean a significant decrease in work abilities. This affects both individual and organisational results.
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<h3>The main 5 reasons for burnout</h3>
These are the main factors employers should focus on when trying to decrease the risk of burnout
<h4>1. Unfair treatment at work</h4>
If people feel that they are treated unfairly compared to other employees, their risk of burnout more than doubles immediately. Sensing unfair treatment can come from different factors. For example, unfairness can mean that managers have clear favourites. They may be biased in their decisions or the employees are compensated differently for the same work tasks.
The employee must be able to trust their employer. Attitudes will change, when they sense they aren&#8217;t in a similar position to others. They may feel defiant against their employers or start being neglectful towards their work tasks.
In the light of this, the manager should always look at their team as a whole. Understand that there is no room for unfairness in the workplace. This can quickly backfire in terms of employees’ mental health and productivity.
<h4>2. Unmanageable workload</h4>
If you give an employee more work than they ever could complete in the time that they have, they may look at it as a challenge at first. It turns into a problem when they understand that no matter the effort that they put in, managing this workload is not possible. Even a very productive employee will lose their optimism when given so many tasks that it is impossible to complete them.
The role of the leader in such a situation is to give their employees an optimal workload. The role of the employee is to take care of themselves. If the workload is too big, they need to notify their manager right away. It&#8217;s very important that the manager is open for discussions. The employee should not be afraid to tell the manager if it&#8217;s getting to be too much.
<img decoding="async" loading="lazy" class="aligncenter wp-image-2378" src="https://blog.minudoc.ee/wp-content/uploads/2021/03/workload_minudoc.jpg" alt="" width="242" height="161" />
<h4>3. Lack of role clarity</h4>
Gallup’s study showed that only 60% of employees find that they know what is expected of them in the workplace. If there are no clear directions and expectations, it will make it very difficult for the employees to keep up with their tasks. This leads to confusion and frustration.
In regular practice, people have job descriptions that state their work tasks. If those work tasks start building up and growing over time, it may lead to unclarity in the role of the employee. If the tasks get too complicated or too scattered, the employee must acknowledge the issue and talk to their employer about it. The employer should be responsible for taking the time to regularly sit down at a meeting with their employees, discuss the tasks that they have been given, talk about expectations and the results thus far. This will give the employees confidence in their work, both in the past and future.
<h4>4. Lack of communication and support from the manager</h4>
If the employee is left alone in their tasks, worries, and even their accomplishments, they lose contact with their manager. Even a very motivated employee can realize over time that no one is paying attention to what they are doing. They feel the lack of support. Why would they then do their best? The employee loses interest in their work and ends up doing the bare minimum.
Constant discussions and communication with the manager make the employee feel that they can turn to their manager. The employees that feel they have the support of their manager are 70% less likely to be a victim of burnout.
<h4>5. Unreasonable time pressure</h4>
If the employees feel like they never have enough time to complete their tasks, they are at very high risk for burnout. When a manager gives an employee a task, they must be able to analyze and come up with a realistic and sensible time limit for completing it.
Oftentimes people set up work tasks without thinking through how much time this task is going to take. If the employee is unable to complete the task in the given time and they have multiple tasks waiting for them, all of the work will start piling up.
The employee has to stand up for themselves and notify their manager when they are not able to complete a task in the time limit and they are falling behind. The role of the manager in such a situation is in communicating and setting realistic expectations. In situations where there is no precedent for timing a task, the manager and the employee should try to come to a reasonable and flexible time limit together. This way, the likelihood of getting a reasonable time plan is the greatest and the employee feels that they are being listened to.
<img decoding="async" loading="lazy" class="aligncenter wp-image-2379" src="https://blog.minudoc.ee/wp-content/uploads/2021/03/happy-employees_minudoc.jpg" alt="" width="259" height="172" />
<h3>An employee meditating at home is not zen all of a sudden, the employee has to do their part as well.</h3>
Burnout can definitely be avoided, prevented, and foreseen. When the leader focuses on communication, equal treatment, and realistic well-thought-through tasks in their managing strategies, they are in a much better position. If employees are in a situation in which their fuel is almost finished, a good and attentive manager will make a difference. Tired and burned-out employees affect the organisational culture, customer service, and development. Managers should do their best to avoid such issues.
Other important factors can lead to employee burnout, but if you want to start from somewhere, the list above is what you should focus on.
<a href="https://www.siffi.com/problem-description/burnout">Read more what our psychologists have to say about burnout.</a>

Burnout is caused mainly by employers

This is a Anette&#8217;s personal account of feeling anxiety during Christmas. In trying to understand why she was feeling anxious during the holidays, she asked her peers about their thoughts.  
During Christmas period I started feeling constant anxiety with physical symptoms. In the moment when I felt better, I tried to analyse why and look for the cause.
During an anxiety attack, it&#8217;s very difficult to understand the exact cause. Also, trying to analyse your worries during the attack does not really help with getting it to end. Therefore, I used my clearer moments to think about the reasons and causes. I realised there were many different components leading to anxiety. Some of them I could actively work at, some need to wait for calmer moments.
In the anxiety bubble, I ended up talking to a few people about it. Some of them stated honestly that they also struggle with anxiety and it goes as far as getting strong physical symptoms and deeply struggling every day.
This caught my attention. How many people around me are struggling with anxiety? Who is acknowledging it? What is the cause?
I decided to start a survey on my personal social media accounts and got over 70 replies.
<h4>Anxiety is a common issue</h4>
<img decoding="async" loading="lazy" class="aligncenter size-full wp-image-2973" src="https://blog.minudoc.ee/wp-content/uploads/2021/07/Surface-Book-1.png" alt="" width="1350" height="860" />
I have realised that peoples’ mental health has had a decline in the last year due to COVID. The feelings of isolation, uncertainty regarding work, all sort of restrictions play a role in this decline.
We see anxiety and mental health issues in ourselves a lot clearer than in the people around us. These days the topic is talked about more, but maybe not all of us have acknowledged we might be struggling due to anxiety.
A lot of people don&#8217;t dare to admit that they need professional help. Therefore they do not turn to it. Other reasons for not seeing a specialist are long wait times to see a specialist, cost of visits and prejudices.
<img decoding="async" loading="lazy" class="aligncenter wp-image-2372" src="https://blog.minudoc.ee/wp-content/uploads/2021/03/what-makes-anxious_minudoc.jpg" alt="" width="252" height="157" />
<h3>What makes us anxious?</h3>
The below list express the the thoughts of more than 20 people. Most of the respondents were young women (mainly aged 25-35). It&#8217;s visible, that our issues and what causes us anxiety can vary.
&#8211; Health-related issues 
&#8211; Too much worrying about loved ones 
&#8211; Work piling up 
&#8211; New people and company 
&#8211; Mess at home 
&#8211; Children not sleeping well 
&#8211; Parental benefits ending 
&#8211; Doing nothing 
&#8211; Short deadlines 
&#8211; Unexpected/fast decisions 
&#8211; Expectations set by other and outselves 
&#8211; Work instability 
&#8211; Starting something (vacation, work week) 
&#8211; Tension, feeling tired 
&#8211; Studying with children 
&#8211; Lack of support 
&#8211; Crowded places (shopping, public transportation) 
&#8211; Activities that cannot be finished 
&#8211; Giving birth 
&#8211; Having no proper plans
<h3>How do people deal with anxiety?</h3>
The same people also answered what are their tips and remedies to mitigate the emotional and physical effects of anxiety.
&#8211; Haven&#8217;t found a solution 
&#8211; Moving in fresh air 
&#8211; Breathing exercises 
&#8211; Making to-do lists 
&#8211; Actively working on solutions for issues 
&#8211; Listening to music and resting 
&#8211; Sleeping 
&#8211; forcing yourself to move forward 
&#8211; Doing exercises taught by a psychologist 
&#8211; Prioritising 
&#8211; Meditating 
&#8211; Doing other things while ignoring anxiety 
&#8211; Taking time for yourself 
&#8211; Telling yourself that everything is actually fine 
&#8211; Accepting anxiety, then letting go of it
<img decoding="async" loading="lazy" class="aligncenter wp-image-2373" src="https://blog.minudoc.ee/wp-content/uploads/2021/03/talking-helps_minudoc.jpg" alt="" width="261" height="175" />
<h3>What else was pointed out?</h3>
You have to think about yourself first, however selfish that might seem. Anxiety is caused by different reasons for different people, but when we do not take care of ourselves and not deal with our issues, then nothing will change. You have to fill your cup. There are many ways and activities for that. Something that might work for your friend might not work for you.
When you get stuck, it is important to ask for help. Asking for help doesn’t make you weak, it’s more the other way around. Issues need to be talked about. Talk to your partner, parents, friends or whomever else you can open up to. If none of those options are available or help, it really could be beneficial to turn to a professional. Psychologists and other mental health professionals can give us the tools to help ourselves.
In conclusion, ask yourself how you are really doing. Be honest with yourself. When your own mental health state is good, ask the same from your loved ones too. A lot of the time people around us need someone to listen to them, but they may not dare to ask for it.
<a href="https://www.siffi.com/problem-description/anxiety" target="_blank" rel="noopener">Read more about what our psychologists say about anxiety.</a>
Author: Anette Villberg, written in December 2020

A quick survey on anxiety

It’s no secret that we are living in an era that is most defined by technology and its opportunities. Being able to reach out and have access to our tasks remotely not only makes the job more flexible but it also tempts some people to work even after working hours. Although it’s good to be passionate about a job, it’s also important to know when it’s going too far and could start to affect one’s life. Psychologist Lucia Riet de Mahhov reveals the essence of overworking, and it’s not only about the hours.
<h4>How to recognise overworking?</h4>
Overworking tends to go hand in hand with a hectic lifestyle. The person either has no personal time off because of working and taking care of the family, or the person chooses to fill days with work and work only. Once the person starts to feel like they can’t find time for anything else and yet they are still always behind, it turns into a problem. Feeling like they are not managing makes them anxious because they even start to spend the time off thinking about work and everything that needs to be done.
“For example, even when they are in the cinema, they can’t stop thinking about their task which still needs to be done and what has not been done to their satisfaction. This person gets into a very anxious state, it can even turn into depression, because the person is completely exhausted,” explains Lucia.
Lucia also says that the symptoms of overworking are very similar to anxiety and depression. “They are feeling really low, constantly in a sad mood. This is followed by lack of energy and symptoms of anxiety like heart pounding, high blood pressure, low blood sugar.”
One key symptom is sleep deprivation. Person who is suffering from overworking has trouble falling asleep or tends to wake up multiple times at night. “Studies show that it is a very specific time when these people wake up and it is usually between 3am and 4:30am.”
<h4>Who are more torn to overworking?</h4>
Lucia explains that people with certain characteristics are more likely to suffer from overworking. “For example, someone who thinks they should do everything right all the time &#8211; a perfectionist. “I should, I should, I should…” This person has a clear picture of who they want to be. They have expectations for themselves and they don’t want to be disappointed with themselves.” These people are also usually afraid of letting other people down. They feel that everybody is depending on them and they need to do better all the time.
Another key factor is overthinking with a twist of self-criticism. This means analyzing everything they do and say and criticizing everything about themselves. “Usually this person already has a low self-esteem and for this they feel the need to be on guard at any time. This is the bottom of all the issues. Not only are they pushing themselves down, they are not giving their mind and body time to rest from the day and reboot. A machine that is working non-stop day and night will explode at one point.”
There are people who can manage this way and as long as they are achieving their own goals and expectations, it gives a good feeling and also strength. “The risk is that when a person is facing multiple factors at the same time, and one of them backfires, the whole systems breaks down and the person collapses. And this is the problem.”
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<h4>When to address overworking?</h4>
Some people can manage on their own and they don’t need to seek help. However, this is only thanks to acknowledging and admitting having a problem. Once this happens, they realize that it is necessary to take some time off or just slow down.
In Lucia’s experience, people turn to a specialist only when things have got serious and the anxious state has started to affect health. “Once people come in, they are already really crushed &#8211; there is lack of prevention. People should come in as soon as they start to see the first symptoms. For example, when they can’t sleep so well for a significant period of time.”
<h4>What can be the long term impacts?</h4>
Suffering from overworking for a longer period of time may even cause panic attacks. Once these episodes start to happen more often, they can become chronic and this is something that could be prevented by seeing a doctor before it gets too severe. Lucia explains that it is much more difficult to treat a patient and the recovery is also longer if the symptoms have become chronic.
And then there is much talk about the higher risk of heart diseases and having a stroke. “Most people try to react before the stress level reaches a breaking point. People who get to the bottom line, sometimes actually get a physical disease because they have completely drained their body.”
“People who are in a chronic state have modifications in their brain. The thing is, we are body and mind, and we can’t separate one from the other. One is influencing and modifying the other,” says Lucia. “Our thoughts can make changes to the physical body and the other way around. It’s scary what you can do to yourself with bad thoughts.”
<h4>How overworking effects coworkers, family and friends?</h4>
In addition to making changes in the brain, overworking can also start to affect family and friends. The person suffering from overworking sometimes becomes very easily irritable and experiences regular mood swings. “It has been proved statistically that women can get extremely sad suddenly. Men on the other hand get aggressive, and one’s close ones get hurt or attacked mentally, sometimes it gets physical. Once the person realizes that, they start to feel even worse.”
Lucia urges people to keep their eyes open and stay alert. Pay attention to friends and family and have the courage to talk to the person who may be getting close to their breaking point. Prevention has a very important role. Reaching out for help already in an early stage can save lives.

Overworking does not necessarily mean working overtime

Anxiety is body’s natural response to stress. It is common to occur before an important meeting, performing in front of a crowd or prior to a trip abroad. It becomes a disorder when it starts to occur on everyday bases and is disturbing ones everyday life. Therefore most routine activities, such as going grocery shopping, using public transportation, or taking phone calls can be a struggle.
Up to 30% people experience anxiety at least once in their life, women are affected by the disorder twice as much as men. Anxiety has usually developed by the age of 25, however, it is most common among 15-35 year old people.
Anxiety in its origin is body’s way of preparing itself for a dangerous situation, it is part of the so-called fight or flight instinct which was necessary for survival back in the days. Common symptoms are heart pounding, high blood pressure, sweating and shaking. Nowadays, this kind of survival mechanism can cause trouble instead.
Not every case of anxiety has so obvious symptoms. Some forms of anxiety mean persistent worry thoughts that come from rational reasons such as money, relationships, and career, or from irrational reasons. Being constantly worried causes sleep disturbance, fatigue and loss of ability to work. Although scientist have not been able to find the exact cause for this disorder, both heredity and surrounding environment have its part.
<h4>Treatment</h4>
As there are different forms, so is anxiety also treated differently. The nature and cause of the disorder is diagnosed by a family physician who then can determine the treatment plan. This can mean seeing a psychologist or going to a cognitive behavioral therapy. In some cases, therapist prescribe antidepressants, sedatives, or sleeping pills.
Although it’s not often possible to be cured from anxiety disorder, it is possible to learn how to live with the disorder and be able raise the quality of life with the help of good specialists.
<a href="https://www.siffi.com/problem-description/anxiety" target="_blank" rel="noopener">Read more what our psychologists have to say about anxiety.</a>
<a href="https://www.nhs.uk/mental-health/conditions/anxiety/" target="_blank" rel="noopener">Read more about what NHS has to say about anxiety types, symptoms, treatment, and more.</a>

Anxiety: what is it and how to treat it?

Many people have problematic skin and often do not know exactly what it might be and how to fix it. How do different skin problems start and what can be done to treat them?
<h3>What is acne?</h3>
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Acne is a skin condition that occurs when dead skin cells and sebaceous gland’s secretions clog hair, hair follicles and pores. The resulting corks aka comedones are divided into: open comedones (blackheads), closed comedones (white comedones) and &#8220;ready&#8221; purulent pustules (pustules). Pimples usually occur on the face, forehead, chest, back, and shoulders, as these areas have the most sebaceous glands. Acne is most common among teens.
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There are effective treatments available, but acne can be persistent and respond poorly to treatment.
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<h3>What are the causes of acne?</h3>
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If cosmetic products don&#8217;t bring you significant improvements, then it is the right time to consult your general practitioner. A family doctor is competent enough to deal with the causes of acne and begin treatment. If necessary, the GP will refer the patient to the dermatologist.
For women, acne may flare up about a week before menstruation. This type of acne is successfully treated with birth control pills.
In older adults, the onset of sudden severe acne may be a disease that will certainly require additional research.
Acne is caused by four main factors: excess sebaceous gland function, clogging of hair follicles and pores by sebum and dead skin cells, bacteria on the skin, and over-activity of androgens.
There are many different contributing factors to acne. It can be triggered or exacerbated by changes in hormone levels, the use of medicines containing androgens or their production, and also people&#8217;s choices for what&#8217;s on the table play a big role. Various studies show that certain foods, such as milk and carbohydrate foods, may contribute to acne. Stress can also contribute to the progression of acne.
It is often believed that acne can be caused by eating fatty foods, poor hygiene, or using inappropriate cosmetics. This is not true. For example, the condition of the skin may worsen by cleaning too often.
Many different risk factors also play a role in acne. The first is definitely age &#8211; acne is the most common problem among teens. Second is hormonal changes. The third risk factor is genetics; if both parents had acne, then their child will most likely suffer. Rubbing and constant pressure on the skin can also cause acne. For example, cell phones or the constant wearing of a helmet or a backpack. Lastly, stress, which does not cause acne, but often contributes to the progression of the problem.
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<h3>When to see a doctor?</h3>
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In addition to skincare with conventional cosmetics, your doctor may prescribe a prescription drug. Usually, the desired effects occur after four to eight weeks, but in more severe cases, it can take up to a year or even longer. The most common prescription drugs for acne are retinoids and retinoid-like drugs.
These are also creams, gels and lotions. Retinoids are derived from vitamin A and may contain tretinoin and adapalene. Antibiotics are still used to treat acne. Antibiotics are often combined with benzoyl peroxide to reduce the likelihood of antibiotic resistance. Salicylic acid and azelaic acid are also important in the treatment of acne. As mentioned before, birth control pills are often prescribed for acne treatment. In more severe cases, isotretinoin is prescribed, which is very effective, but has many different side effects.
In some cases, other treatments such as photodynamic therapy,laser therapy, and chemical peeling may be tried. Some alternative methods to try include probiotics, beer yeast, fish oil, and oral zinc.
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Doctor explains: why does acne occur and how do you treat it?

Allergies are the natural defense response of the immune system to an invader, called an allergen. The allergen triggers defense mechanisms in the body that cause mild symptoms such as runny nose, itching, sneezing or more severe symptoms such as swelling of the throat and difficulty breathing. Some foods contain bioactive histamine or factors that promote its production, inducing symptoms of an allergy.
According to <a href="https://www.minudoc.ee/doctors/family-physician-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergei%20saadi">Sergey Saadi</a>, family doctor at <a href="https://www.minudoc.ee/?utm_source=blogi&amp;utm_medium=minudoc">Minudoc.ee</a>, allergies have several subspecies, the most common being food allergy, allergic skin reaction and inhalation allergy. Depending on the form of the allergy, different symptoms may develop.
“The most common symptoms of a food allergy start in the mouth.The mouth becomes numb, the nose, lips and mouth become swollen, with burning or itching. If the redness and swelling develops in the esophagus and neck, it can be a life-threatening situation,” <a href="https://www.minudoc.ee/doctors/family-physician-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergei%20saadi">Saadi</a> says, adding that “allergies can cause stomach pain, nausea and vomiting. &#8220;In other cases, only skin inflammation and itching occur after eating the food, either in certain areas such as the face, neck and limbs, or throughout the body. The most common food allergens are seafood, crustaceans, nuts, eggs, cow&#8217;s milk, wheat, soy products, honey and citrus.&#8221;
One of the most certain ways to identify allergens at home is to change your diet. 
“The effect is quickly noticeable and the symptoms should go away the same day or at least 2-3 weeks after the food is excluded. For some of the substances, it takes a little more time to get out of the body,” says <a href="https://www.minudoc.ee/doctors/family-physician-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergei%20saadi">Saadi</a>. “When allergy symptoms disappear, you can add different foods back to your menu, but you should do it step by step. Children should not engage in &#8220;self-diagnostics&#8221; for more than a month, as this can lead to unreasonable menu restrictions and malnutrition, which children are particularly sensitive to.&#8221;
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In case of an allergic skin reaction called contact dermatitis, the symptoms appear immediately or 1-2 days after contact with the allergen. 
“Only those areas of the skin that were in direct contact with the allergen will suffer. There appears a red and itchy spot or rash, and the skin will flake. In more serious cases, blisters or swelling of the subcutaneous tissue, which can be life-threatening if it occurs in the neck or face area” <a href="https://www.minudoc.ee/doctors/family-physician-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergei%20saadi">Saadi</a> explains. 
The most common allergens in this case are perfumes, cosmetics, metals, latex, dyes, and herbs. According to<a href="https://www.minudoc.ee/doctors/family-physician-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergei%20saadi"> Dr. Saadi</a>, it is important to keep in mind that an allergic skin reaction can also occur with substances that you have previously used for years without any problems.
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Inhaled allergens cause symptoms of &#8220;classic allergy&#8221;: dry cough, difficulty breathing, sneezing, runny nose, nasal congestion, runny eyes, and itchy face. Symptoms usually appear immediately after exposure to an allergen.
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The most common allergens are household dust (containing dust mite particles and their droppings), mold spores, pollen, animal hair, dander and saliva.
It is thought that allergies are more common to develop in children or adults who have experienced allergic reactions in the past &#8211; in fact, this is not quite the case. 
“Asthmatics, people suffering from chronic intestinal inflammation and people with atopic dermatitis or chronic skin inflammation are also at risk. An allergic reaction is not dependent on the amount of allergen and can recur upon exposure even with minimal amounts,” says <a href="https://www.minudoc.ee/doctors/family-physician-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergei%20saadi">Dr. Saadi.</a>
“If you suspect you or your child have allergies, I recommend that you consult a family doctor who knows your medical history, can conduct additional tests (skin tests or blood tests) and is able to assess the severity of your allergic reaction. If necessary, your GP will also refer you to a dermatologist or allergist,” says <a href="https://www.minudoc.ee/doctors/family-physician-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergei%20saadi">Saadi.</a>
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When to suspect an allergy

It’s not an unusual thing for a mom-to-be to worry about the child’s health and be overly cautious. One of the biggest concerns during summer is the sun and all the health risks it causes. Is it true that sunbathing can be dangerous to the fetus or is it just another myth? Minudoc.ee family physician clears it up.
<a href="https://www.minudoc.ee/arstid/perearst-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergey%20saadi">Saadi</a> admits that it is absolutely okay to spend a reasonable amount of time outside, in the sun during summer. “No study has shown that sunbathing could cause any damage to an evolving fetus. UV rays can’t get through the skin and tissue that are protecting the fetus,” says <a href="https://www.minudoc.ee/arstid/perearst-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergey%20saadi">Saadi.</a> “However, it is necessary to be aware of the impact of UV rays as they have positive but also negative effects on the mother’s health.”
There are three kinds of UV rays &#8211; UVA, UVB and UVC rays. “UVA rays have a positive effect on blood circulation, metabolism and immune system. On the other hand, UVA rays cause skin aging and wrinkling (photoaging) and increase the risk of skin cancer. UVB rays increase the level of vitamin D and help to strengthen your immune system. As a negative side UVB causes sunburn, increases the risk of melanoma, and in some cases damages eyesight. It is not possible to get in contact with UVC rays in natural conditions, however, it is possible to get an overdose from sunbeds.”
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<h3>Sun and pregnancy</h3>
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During pregnancy women may experience some changes in pigmentation. This can be noticed on nipples, on the area around nipples, on the white line and on external genital organs. “Pigmentation may change as well on the face during pregnancy and sunbathing may help for these changes to happen.” Due to hormonal changes pregnant women tend to have more sensitive skin and therefore it is much easier to get a sunburn.
According to <a href="https://www.minudoc.ee/arstid/perearst-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergey%20saadi">Saadi</a> the safest way to enjoy the sun during summer is walking. “There is a high risk of dehydration and sunstroke when lying in the sun and sunbathing. Both of these are harmful to the person and the fetus. It’s important not to forget that the fetus starts to react more to the daylight the closer the birth gets. It is highly recommended to cover up the belly when being in the sun,” says family physician.
UV rays are the strongest at midday &#8211; try to avoid being exposed to the sun at this time of the day. Apply sunblock regularly when outside and always have water with you to avoid dehydration. Return to the indoors once you start to feel dizzy, nauseous, weak, experience heart pounding or headache.
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<h2 style="text-align: center;">Download MinuDoc app</h2>
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Family physician explains: Is sunbathing dangerous to pregnancy?

The current healthcare system in Estonia is supporting people to go to a family physician or a family nurse at a medical center &#8211; home visits are not exactly common. However, in some cases it is the best and sometimes only solution. When is it most reasonable to use home visit services? 
<a href="https://www.minudoc.ee/?utm_source=blogi&amp;utm_medium=minudoc">Minudoc.ee</a> family nurse <a href="https://www.minudoc.ee/doctors/medical-nurse-lilli-gross-45?utm_source=blogi&amp;utm_medium=lilli%20gross">Lilli Gross</a> agrees that sometimes all the patient needs is a standard check up and brief medical advice. On rare occasions the health issue turns out to be more serious and needs additional attention from a family physician or even hospitalization. The need for a nurse’s home visit may also be caused by time limitations, for example evenings, weekends or public holidays when family physicians are not available. Instead of overloading emergency rooms with non urgent cases the more reasonable alternative is calling a nurse for a home visit. 
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<h3>What to do if your child has been ill for days?</h3>
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Nurse’s home visit is justified if examination and quick blood or urine tests are enough to evaluate the patient’s health, give a proper diagnosis and come up with a treatment plan, if necessary in corporation with a family physician.
“One example would be a child who has been ill for a few days and needs to be examined in order to proceed with the right treatment. Sometimes it is not possible to go to a doctor yourself, whether the doctor is far away, not taking in patients at the moment, or transportation is just not possible. Instead of turning to the emergency room you can get help from a home visit,” explains<a href="https://www.minudoc.ee/doctors/medical-nurse-lilli-gross-45?utm_source=blogi&amp;utm_medium=lilli%20gross"> Gross.</a>
“During a home visit we conduct a health examination and take necessary tests in order to detect inflammation or other complications. It really depends on the patient’s complaints.” <a href="https://www.minudoc.ee/doctors/medical-nurse-lilli-gross-45?utm_source=blogi&amp;utm_medium=lilli%20gross">Gross</a> adds that when it comes to children, for example, they also provide additional advice for future reference. 
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<h3>Feeling extremely bad, lighter injuries</h3>
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“Especially during the summer, but all year round as well, people tend to experience falls, cuts, lighter injuries at home, with which the person may need some assistance. A lot of such occasions do not need emergency care &#8211; no need to go to the emergency room and wait for hours to get a simple bandage. If the person doesn’t have the necessary items at home or lacks knowledge of what to do with the injury a nurse’s home visit can help with that,” adds <a href="https://www.minudoc.ee/doctors/medical-nurse-lilli-gross-45?utm_source=blogi&amp;utm_medium=lilli%20gross">Gross</a>.
All these examples are common everyday situation that can be resolved at a primary care medical center, if that is not possible the best alternative is nurse’s home visit. The wait times in emergency rooms are already long and they are over-crowded. Having another alternative may end up easing the workload in emergency rooms as well. “Every patient is the best experts of their health and how they are feeling &#8211; if going to a medical center to see a doctor doesn’t seem like an option, it is good to know alternatives and take responsibility for their health.”
Healthcare in Estonia is very digitized, meaning that all the necessary information is available in databases and every home visit and the outcome of it can be recorder to be visible for a personal family physician as well. 
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<h3>Family physicians are available for additional help</h3>
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It may happen that the nurse conducting the home visit needs assistance from a family physician. In such cases the nurse can easily consult with a family physician over a phone call or a video consultation on the spot. 
mFamily physician <a href="https://www.minudoc.ee/arstid/perearst-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergey%20saadi">Sergey Saadi</a> who works in the same institution as family nurse <a href="https://www.minudoc.ee/doctors/medical-nurse-lilli-gross-45?utm_source=blogi&amp;utm_medium=lilli%20gross">Lilli Gross</a> says that in most cases people turn to private health care with acute illnesses and seasonal complaints &#8211; cold, allergies, rashes. But, in addition to that, people also come looking for second opinions, explanation to different test results, etc.
“Many people have understood that their issue has not been urgent enough to turn to an emergency room but due to lack of alternatives they have been forced to do so for example on weekends or evenings,” says <a href="https://www.minudoc.ee/arstid/perearst-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergey%20saadi">Saadi.</a> “And this is where the new service seeks to help out.”
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When is it most reasonable to use the home visit service?

The month of October has been declared Mental Health Awareness month with the objective of not only educating the public about mental health but also to reduce the stigma and discrimination that people with mental illness are often subjected to.
However, mental illness affects everyone directly or indirectly through family, friends or coworkers. Here are the stories of some foreigners who have moved to Estonia about their personal battles with mental issues. 
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I&#8217;ve been suffering from depression for just under four years, and depression has a way of replacing your confidence with pure anxiety and self-hatred. 
The scariest thing I found about suffering from a mental illness is the effect it has on every aspect of your life; it’s not just what’s inside your head. For me, suffering from depression became debilitating as I couldn&#8217;t find happiness in the little things I used to enjoy doing. More often than not, depression would cause me to sit in my room and cry, usually for no reason at all.
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It&#8217;s been two years since my very first dealing with depression and anxiety, also since I moved to Tallinn.
I remember the day when I first hit a low point in life and it&#8217;s not a nice memory to have. I didn&#8217;t know how to deal with such a strong mental health issue, so I hid my problems away from family and friends which made my issues worse.
I didn&#8217;t want to get out of bed, I didn&#8217;t want to socialise with friends.
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There came a time when I questioned my existence in life: was I a burden? Was I even worth having around? What did I bring to life in general?
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Today, any of my friends would tell you that I am more than happy to talk about mental health openly and without shame. In fact, it&#8217;s one of my favourite topics of conversation, and I think sometimes people might wish I would give it a rest. But I refuse to stop talking about it, because I know exactly how much impact a single conversation can have, and what it feels like to struggle alone in silence.
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I was diagnosed with depression during my final year of medical school. Since then it’s been a struggle of relapses and recovery. 
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Sharing my story makes things easier. If I tell you my experience it’s easier for you to share yours.
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I remember I wrote a sort of suicide note when I was 12. At that age I self-harmed as well. I didn’t speak to anyone about how I was feeling. What was I going to say? 
That was the first time I started feeling something wasn’t right, but I didn’t know what it was. Even at medical school, I still couldn’t figure it out.
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As a man with mental health problems myself, when the topic of men’s mental health comes up I often feel guilty. There are so many women suffering not just from mental health problems but also from a wide range of societal problems that can make it harder to cope with them. 
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Who are we as men to complain about the stigma we face? But the more I think about it the more I realise that the guilt I feel is only a reflection of the problem as a whole &#8211; that we struggle to face up to the reality of our so called “weaknesses”.”
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I was diagnosed with pre and postnatal depression after the birth of my second baby. I kept quiet throughout my pregnancy until I was 32 weeks pregnant and then the Dr said he couldn&#8217;t give me anything because I was too far gone. 
I then stayed quiet for 14 weeks until something inside switched and I knew I needed to seek help. I was given six sessions of cognitive behavioural therapy, but could only make it to three because of childcare issues. It&#8217;s still haunting me today.
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I have anxiety and depression. I also suffer from panic attacks. It makes life so hard on a daily basis, everything I seem to worry and panic about, literally everything. Going out and socialising, I can&#8217;t do much because of my anxiety. It sucks having both of them because most of the times they just come together and make your day even worse. 
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I used to be very much high functioning, but for some reason that I&#8217;ve not found out yet, I just all of a sudden dropped, and the high functioning person I used to be had just disappeared.
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What happens if your friend stops texting you back? No longer seems interested when you suggest a night out? It’s so easy to automatically assume that perhaps they’re losing interest in your friendship. 
Sometimes, the reality can be that they are facing a daily battle with their own mind. Mental illness comes in different forms but no matter the problem, it can become awfully debilitating for those suffering. 
Getting out of bed, if achieved at all, can feel like an uphill battle. Everyday tasks which are usually done without batting an eyelid become more and more difficult to manage.
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At the age of twenty-two, after four years of my first identified episode of depression, I sit here with the realisation that although I haven&#8217;t sank, I have merely been bobbing along through life – similar to a rubber duck on water. I’ve been staying afloat, and on the surface I am fine.
But like the water in a storm, things can quickly change with an unexpected trigger. Negative thought patterns occur, feelings blur and in consequence emotions become uncontrollable.
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I’ve always found it a strange concept how physical and mental health are viewed differently.
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I mean, when I had tonsillitis I received grapes, get well wishes, plenty of hugs and often my friends would throw a few jokes at my expense due to my lack of voice. When I’ve had a relapse with my mental health however things were different which is strange, after all the brain can get sick like any other part of the body?
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Expats and depression: it&#8217;s like being a rubber duck on water

Dehydration can be a serious health risk especially during summer time. Toddlers and elderly people are in higher risk. What causes dehydration and what should you do when you suspect dehydration? <a href="https://www.minudoc.ee/?utm_source=blogi&amp;utm_medium=minudoc">Minudoc.ee</a> family physician  <a href="https://www.minudoc.ee/arstid/perearst-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergey%20saadi">Sergey Saadi</a> explains the issue.
While grown ups need to drink 28-25 ml per weight kg in a day, children, depending on their age need to drink 40-150 ml per kg. The younger the child the higher water consumption. Dehydration is caused by losing more fluids than taking in, therefore it is necessary to make sure to consume plenty of water.
Causes of losing more fluids in the body than taking in may be different. “When it comes to children, most common causes are diarrhea and vomiting, more rarely sweating.” Adult’s body contains less water than a child&#8217;s body and its fluid levels are more sensitive to drugs and medication. In addition, older people tend to drink less water as they don’t get the feeling of thirst as easily as children do. “Even minor illnesses, for example bladder infection or bronchitis can cause serious dehydration. Diabetes and kidney diseases among others may also be the causes of dehydration,” says <a href="https://www.minudoc.ee/arstid/perearst-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergey%20saadi">Saadi.</a>
Tendency towards dehydration doesn’t come from the age only. “Jobs that require physical activity or are mentally stressful, consuming too much caffeine drinks, fast metabolism, breathing difficulties caused by nose issues (chronic cold, nasal septum deviation, snoring, etc.), hyperthyroidism, diabetes, etc. may all cause dehydration. You can treat a minor dehydration by drinking water or other fluids, most severe cases require medical treatment.”
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<img decoding="async" loading="lazy" class="aligncenter wp-image-2682" src="https://blog.minudoc.ee/wp-content/uploads/2019/07/water_minudoc.jpg" alt="" width="175" height="112" />
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<h3>What are the symptoms?</h3>
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It is important to note that small children do not know how to recognize dehydration or health issues. Only way to know is to observe the child and notice the symptoms of dehydration. “First symptoms of dehydration in babies or toddlers are mouth dryness, dry lips and tongue,  sunken cheeks. It is also time to suspect dehydration if the baby hasn’t peed in 3-4 hours or the baby is crying without tears. Drowsiness or irritability may also suggest dehydration.
It is much easier with grown ups as it takes less time for the symptoms to show. “In most cases, the first symptom is the feeling of thirst. Fatigue, tiredness, dizziness or disorientation may also refer to a dehydration. In case of dehydration there is less of a need to pee and the color of urine turns darker.
“Dehydration can be treated only by consuming fluids. This can be done by drinking water, clear broths, frozen water or ice pops, or sports drinks. Some dehydration patients, however, will require intravenous fluids in order to rehydrate,” says <a href="https://www.minudoc.ee/arstid/perearst-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergey%20saadi">Saadi</a>. “It is necessary to turn to a doctor if diarrhea or vomiting has been going on for more than 24 hours or if it starting to show blood in excrement or vomit.” Medical treatment is also required if the person is sleeping more than usual and is showing a severe lack of energy and delirium. “If you are suspecting dehydration in a child younger than 2 years old, turn to a doctor straight away.”
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<h2 style="text-align: center;">Download MinuDoc app</h2>
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Family physician explains: How to recognize dehydration?

It may come as a surprise but the sun in Estonia can sometimes be pretty mean. You may end up with a sunburn when you least expect it. Prevention is definitely better than treatment &#8211; apply sunscreen even when you’re just taking a long walk in a park or doing some gardening. Although there are different after sun products available in stores and pharmacies, what to do when you can’t find any of that?
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<h3>Cool down and moisturize the damaged area</h3>
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The temperature of sunburned skin is really high and in order to get the burn down it is essential to first cool down the skin. Take a cool shower or a bath, regularly if necessary, to cool down the area. Be careful not to get the water too cold as this on the other hand my cause a cold damage. Dry your skin with a towel by gently patting your skin but leave a few water drops here and there.
Sunburned skin is not only very warm but it also gets really dry. Use a moisturizer that contains aloe vera or soy to help soothe sunburned skin. Apply moisturizing creams containing hydrocortisone to areas which feel especially dry or uncomfortable. However, avoid using oil-based creams before your skin has cooled down as these may irritate the skin instead of soothing it. In addition, should the burned area start to blister, don’t pop the blisters and let them heal on their own as to avoid the risk of infection.
In addition to treating your skin from the outside, you can also take aspirin or ibuprofen to soothe the pain and infection. It takes a lot of fluid to cool down your skin. Therefore, it is extremely important to drink plenty of water to avoid dehydration.
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<h3>Sun protection is everything</h3>
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Needless to say, sun protection is an important part of everyday skin care routine, but it is even more so while healing from a sunburn. Make sure to apply sunblock regularly and try to cover up burned areas with clothes. Although it may seem like a temporary condition, sunburn can cause long-lasting damage to the skin.
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<h2 style="text-align: center;">Download MinuDoc app</h2>
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How to treat a sunburn without after sun lotion?

Overworking and avoiding taking sick days will probably turn against you in no time. Should employers start to put more emphasis on their employees’ mental health and how to prevent mental health problems?
Pressure and stress may have a short-term positive effect as it motivates us to work harder and be more productive. However, long-term stress may lead to permanent health damage and incapacity of work. This is how young people come to have heart attacks, strokes or mental breakdowns
Although women seem to be getting more aware of the symptoms caused by obvious overworking, it is still not a common practice to deal with anxiety, panic attacks and mental healthcare at work places. Nonetheless, it is becoming more important to pay attention to these issues and support mental health at work in order to keep employees committed and motivated.
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<h3>Health days come to help</h3>
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Health day is a paid day off when an employee gets to slow down for a day in order to take care of health or to recover. Excellent solution when encountering work stress symptoms, such as tiredness, anxiety, panic attacks, etc. Note that giving employees paid health days is not an obligation set by the law, rather a right or benefit given by the employer.
How many paid health days an employer has, how they are compensated and how the system works overall is set by the employer.
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<img decoding="async" loading="lazy" class="aligncenter wp-image-2674" src="https://blog.minudoc.ee/wp-content/uploads/2019/07/sick-leave-health-day_minudoc.jpg" alt="" width="125" height="127" />
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<h3>Sick leave in case of work stress?</h3>
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Giving employees health days is not widely common yet. If it is not possible to get one, according to family physician <a href="https://www.minudoc.ee/arstid/perearst-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergey%20saadi">Sergey Saadi</a> there is also the option of asking for a sick leave. “Family physicians are qualified to assess employee’s mental health condition and if necessary give the person a sick leave. This can be done if the doctor finds that the health issue in question may have long term impacts,” explains family physician <a href="https://www.minudoc.ee/arstid/perearst-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergey%20saadi">Sergey Saadi.</a>
“Let’s say a person has no visible injuries nor physical illnesses. It doesn’t necessarily mean that the person doesn’t have incapability to work. In addition, untreated work stress may cause severe physical complaints, such as weakness, high blood pressure, blood disorders (which may lead to a heart attack or a stroke), skin problems, etc. Therefore, it is important to pay attention to prevention and avoid further complications.”
Overall it is best to acknowledge possible work stress or overworking before it gets to the point of temporary incapacity of work. “Instead, let your employer know, take a short vacation, ask for health days &#8211; there is always an option.”
As first three sick leave days are not paid for, people rather prefer to go to work or work from home instead of taking a sick leave. In most cases this is only because the person does not want to lose their income. I should be in employers&#8217; benefit to support giving paid health days when needed. The result is  healthy and motivated employees which is every company&#8217;s dream. Making people choose between their income and their health should be out of question.
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<h3>It is time for a cultural change</h3>
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It should be the leader’s obligation to be a good example. A good leader should show what the attitude towards coming to work sick and over working should be. Employers should be encouraged to stay home and rest and then return to work full power. In addition, the leader should be attentive to employees’ working hours and notice when someone has been doing too much. If necessary, advise them to take a few days off or turn to a specialist.
“Family physicians usually don’t deal with chronic stress, but still is the first specialist who should be able to notice the issue, suggest a treatment plant and refer to the right specialist,” says <a href="https://www.minudoc.ee/arstid/perearst-sergey-saadi-46?utm_source=blogi&amp;utm_medium=sergey%20saadi">Saadi.</a>
Considerate attitude and letting employees know of different options will make them feel more involved and valued making the whole working environment healthier.
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How to request a leave in case of work stress?

Dizziness is actually just one word to describe many different symptoms, for example vertigo, sudden feeling of weakness, pre-fainting feeling, also feeling of being lightheaded, woozy, or unbalanced. Minudoc.ee family physician Sergey Saadi explains different forms of dizziness and why they occur.
Vertigo is a feeling of lightheadedness when everything seems to be going in circles. Vertigo is not a sickness nor diagnose, but it is more of a sensation. Vertigo may be accompanied with nausea, vomiting, feeling unbalanced, sometimes abnormal or jerking <a href="https://www.webmd.com/eye-health/picture-of-the-eyes">eye</a> movements. The person experiencing vertigo multiple times may always have the same side symptoms or they may differ from episode to episode.
Dizziness and issues caused by it may be inconvenient, because frequent dizziness episodes may lead to  incapacity to work with moving vehicles or machines and work in heights. Nausea and vomiting make the episodes even worse. Although, dizziness may occur at any age, it is most common among people older than 40, the statistics being that 40% of over 40-year-olds experience dizziness.
Dizziness may be temporary or chronic. Dizziness lasting for more than a month is considered chronic. One episode may last from just a few seconds to an hour. In the worst case  it can last up to a few months or even a year. Light and medium dizziness usually doesn’t need treatment and will pass on its own.
Most common causes of dizziness are inner ear diseases, sudden movements, labyrinthitis (<a href="https://www.healthline.com/human-body-maps/vestibulocochlear-nerve">vestibular nerve</a> infection), too low or too high blood pressure, and migraines. Dizziness is also a common side effect to different medications.
<h3>How to treat dizziness?</h3>
There are multiple ways to relieve the symptoms or decrease the number of episodes. One trick is to go to a dark and cool room while having an episode. Find a place to sit down as soon as the episode starts and avoid rapid head movements.
Once you are ready to stand up, do it slowly and carefully. Try to relax as anxiety and tension may promote episodes. In case the episodes as more severe and frequent, use a walking stick to keep your balance. Using a higher pillow for sleeping may also help.
In order to stop episodes from happening, it is recommended to avoid certain movements. Such movements may be bowing down and picking things up from the floor, also try to avoid reaching for things from above.
<h3>When is it time to go to a doctor or an  emergency room?</h3>
It is necessary to turn to a family physician if dizziness is not passing on its own or there are additional symptoms, such as weakness, headache, nausea, or vomiting. It is time to call an ambulance or turn to an emergency room if you are feeling extreme weakness, repetitive vomiting, severe headache, numbness in limbs, vision or hearing disorder, fever. Let your family know of the issue straight away so someone can come and get you help.
Treatment depends on the cause. If it is an infection causing these symptoms, it is usually treated with antibiotics. In some cases treatment consists of different exercises, or physiotherapy. If the cause is inner ear diseases the treatment is targeted to improve the blood flow in certain parts of the brain and the ear, etc.
It is important to note that dizziness may be extremely dangerous while driving. Needless to say, make sure to temporarily avoid driving while having an episode of dizziness.
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All about dizziness

It’s again time for a holiday! Midsummer is not just another public holiday, but it’s second greatest feast of the year &#8211; it is quite difficult to top Christmas. Great feasts often include greasy food, a lot of meat and mixed drinks. All the temptations may make it too easy to overeat and end up feeling sick or heavy. Here are some pointers to avoid that situation and still get to enjoy all the delicious food.
It’s not necessary to restrict yourself, you can eat everything just in reasonable amounts. The worst you can do is to skip meals during the day in order to have more room for food in the evening. It is much harder to control the amount of food you consume while your hungry, which means you may end up eating way more than you actually should.
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<h3>What to keep in mind behind a rich dinner table?</h3>
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There are certain foods that don’t really go together and will cause an uncomfortable feeling in your stomach. This will also upset digestive processes, which may result in nausea, stomachache, gases and fatigue. In order to avoid such complaints it is recommended to avoid mixing foods which are high in protein &#8211; cheese, meat, eggs. It is also wise to avoid combining fats with protein &#8211; nuts with oils or eggs with meat etc.
Neither is it a good idea to have fruits for dessert straight after the main course as fruits contain fructose which will start to ferment and cause digestive problems.
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<img decoding="async" loading="lazy" class="aligncenter wp-image-2669" src="https://blog.minudoc.ee/wp-content/uploads/2019/06/barbecue-food-feast_minudoc.jpg" alt="" width="223" height="124" />
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<h3>What to drink during and after dinner?</h3>
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Midsummer and alcohol tend to go hand in hand. Having a few drinks is not forbidden, just not too much. It’s important to remember that stronger spirits also contain more calories and sugar &#8211; cocktails, liquors, etc. Try to prefer drinks containing less sugar, for example wine. Most importantly, don’t forget to drink plenty of water to avoid dehydration and secretly decrease alcohol consumption.
Hint &#8211; drinking water before a meal can help to prevent you from eating too much.
In addition, while having a cup of coffee straight after dinner is a standard routine, it is wiser to wait for an hour before brewing a cup. This is because drinking coffee straight after dinner will only slow down your metabolism.
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<h3>How to make yourself feel better?</h3>
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Once your stomach is full of all the good stuff, it is time to go for a walk. Slight physical activity helps to boost your metabolism and make you feel better. In case you still feel too heavy, you can opt for over-the-counter medications. For example, you can take drugs to reduce the level of acids which may cause an uncomfortable feeling.
If you’re suffering from bloating, take medication that contain simethicone &#8211; it helps to reduce bloating, discomfort or pain caused by excessive gas. There are also pills you can take to boost your metabolism while eating. Take one when you’re feeling heavy or have any discomfort in your stomach.
Hint &#8211; there are also various natural ingredient based drops and pills that will help to  boost your metabolism and prevent digestive problems.
Take probiotics in case of diarrhea to restore natural microflora.
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How to survive Midsummer festivities without digestive problems

Home visit is the best fit for customers who require a physical check up, or a high quality health advice privately for yourself or your child for various non-emergency disorders. An experienced nurse can check the lungs or carry out an examination of the throat or ear, assess the nature of the rash that has occurred and the need for treatment, take a blood or urine test to determine the level of inflammation, check the wound or recommend binding, measure blood pressure or blood sugar, whenever appropriate give dietary recommendations.
Home visit service is addressing those customers who want to access a high-quality and prompt health advice by an experienced practicing nurse without leaving the house. The nurse may consult during the visit with an experienced family physician represented on MinuDoc platform and they can decide on a necessary treatment approach together.
In addition, visits are conducted under medical supervision and in close cooperation with the doctor. The consultation is also documented in patient&#8217;s digital health record so that it can be accessed by both the client and the client&#8217;s family doctor.
<h3>Choose home visit when you or your child have:</h3>
<ol>
<li>Respiratory and ear-nose-throat problems: sore throat, cough, runny nose, ear pain, cold disease</li>
<li>Gastrointestinal disorders: Nausea, vomiting, constipation or diarrhea, abdominal pain, bloating, heartburn.</li>
<li>Acute or prolonged tolerable and mild back pain, pain in extremities, headache, other pain</li>
<li>Urinary disorders and other urinary problems</li>
<li>Skin problems &#8211; rash, inflammation of the skin</li>
<li>Fever</li>
<li>Eye inflammation</li>
<li>Symptoms of Allergy</li>
<li>Previously diagnosed chronic diseases &#8211; for example, hypertension, diabetes, asthma, thyroid dysfunction, if necessary counseling, treatment adjustment</li>
<li>Desire for advice on the use of over-the-counter and prescription drugs etc.</li>
</ol>
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<h3>How do I order a home visit?</h3>
You can book a home visit from the <a href="https://www.minudoc.ee/?category=HOME_VISITS">Minudoc web</a>. For this, please choose a nurse from <a href="https://www.minudoc.ee/?category=HOME_VISITS">Home Visit</a> section and select a suitable time. In order to do this, please proceed to the nurse&#8217;s profile, select the suitable time and authorize yourself via your mobile-ID, Smart-ID or ID card. Please enter your home address, describe the problem briefly, and pay the fee for your visit.
Your booking is transferred in real time to the nurse, who has to accept it. Once the nurse has accepted your booking, you will receive an email notification. You will also receive an invoice for the service you have paid for. If the booking is not accepted, we will refund you the money.
Please be home at the agreed time. A nurse will either call you or ring the doorbell and introduce herself. For security reasons the nurse is required to present an identity document if requested.
If you are not home at the agreed time and do not respond to phone calls, we will consider the service provided.  As the time spent on commute will be lost for the medical consultant, the payment will still be charged.
The typical length of a visit on site is 20-30 minutes, but may be longer or shorter depending on the case.
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When to choose a home visit service?

It is completely normal and very common to feel more stressed or tensed up before an exam. But it is important to be able to manage the stress to keep focused on the studying. Getting started with the studying process sooner rather than later will not only get you more prepared but will also help to lower the stress level, says <a href="https://www.minudoc.ee/?utm_source=blog&amp;utm_campaign=minudoc">Minudoc.ee</a> psychologist <a href="https://www.minudoc.ee/doctors/psychologist-tiina-liina-martsoo-19?utm_source=blog&amp;utm_campaign=Tiina-Liina%20Martsoo">Tiina-Liina Märtsoo.</a>
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<h3>Here are some tips and tricks to help you handle pre-exam stress and anxiety:</h3>
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<ol>
<li>Plan ahead. It is reasonable to first go through all the study material and make a plan to cover all of it in chunks. For example, if you need to study 30 topics or questions, divide them over multiple days and leave the last day before the exam for revising only. Last day should be focused on relaxing and focusing. Let your mind rest for a moment and get a good night sleep!</li>
</ol>
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<ol start="2">
<li>Take notes. Write down your own notes while going through the material. Later use the same notes for revising. Writing down and reading your own notes helps your memory to save all the information. Don’t forget to take a break every once in a while and let all that new knowledge sink in. Trying to process a lot of information at the same time will only leave your brain even more confused and tired.</li>
</ol>
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<img decoding="async" loading="lazy" class="aligncenter wp-image-2665" src="https://blog.minudoc.ee/wp-content/uploads/2019/05/exam-stess-reading-notes-support_minudoc.jpg" alt="" width="166" height="115" />
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<ol start="3">
<li>Stay active. While you’re taking a study break go outside, take a walk or go cycling. Physical activity helps to lower stress and lets your mind rest for a moment. Make sure to eat healthy nutritious food to feed your brain as well, and get enough sleep!</li>
</ol>
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<ol start="4">
<li>Find support from family. While you are busy studying and planning and just trying to remember the material, you may forget the most basic needs. Your family can remind you and make sure you get enough sleep and eat well between study sessions. Encouraging words from close ones can give the last push you need to pass the exam with flying colours.</li>
</ol>
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<ol start="5">
<li>Read through. Once you get your exam questions, read them all through. While you are writing down the answer to the first question, your brain is already searching for answers to other questions. Start with the easiest questions as the feeling of knowing the answers can be empowering. At the same time, don’t leave the most difficult ones to be answered last, try to do them between.</li>
</ol>
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Good luck!
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5 tips to beat exam stress

There are a lot of questions about eggs and there are just as many myths about eggs. Some say that eggs are not good for our health, some say that we need to eat one egg a day. Minudoc family physician Sergey Saadi has answered a few questions and busted some of the myths. 
<h3>Does eating eggs cause  higher risk of cardiovascular disease?</h3>
Eggs are high in cholesterol indeed, however, its impact on our blood cholesterol level is minimal compared to the impact of saturated and trans fats.
Most people in good health can eat up to 7 eggs a week without increasing the risk of cardiovascular diseases. Certain studies have shown that this kind of consumption can in fact decrease the risk of numerous types of strokes. Then again other studies have shown that even just 4 eggs a week cause the risk of cardiovascular diseases to increase by 4.5%. This applies most to diabetics and the obese.
It’s important to note that while the daily cholesterol limit is about 300 mg, an average egg has about 200 mg of cholesterol. Cholesterol can be found in egg yolks only, so you can eat the rest without limits.
<h3>Do eggs cause constipation?</h3>
No, they do not if you don’t eat more than 4-5 eggs at a time. Although eggs don’t contain fibers, they are high in protein, which tends to slow down digestion. To avoid that have some vegetables with your eggs &#8211; fibers help to boost the natural function of intestine.
<h3>Are there any diseases that require eggs to be cut out of the menu?</h3>
There are no diseases in which case you are 100% not allowed to eat eggs. There are health conditions in which it is necessary to decrease the intake of protein and cholesterol. However, this is more about the whole diet than just the eggs.
<h3>How many eggs is it healthy to eat per day?</h3>
Eating up to 7 eggs per week should not have any effects on your health, just don’t go over that limit. Try to boil the egg rather than frying it.
<h3>Is there a difference in eating the egg raw, boiled or fried?</h3>
It is recommended to eat eggs raw or half raw only if you can be certain of its origin and freshness. The perks of raw eggs are its high nutrition and they are also easier to digest.
Wash the eggs before eating or cooking, but do so only if you are going to eat them straight away. Washing the eggs can damage their shells which then won’t be able to protect the egg from bacteria.
The freshness of the egg is extremely important, store eggs in a refrigerator for not more than 28 days.
<h3>Are the harmful substances in the egg color absorbed into the egg?</h3>
If the egg shell is not cracked, wasn&#8217;t harmed when being boiled, and the egg white doesn&#8217;t show any marks of color, it is extremely unlikely. There are also special colors that are meant for dyeing eggs but make sure they are approved by the EU. Try to go for natural materials, for example onion skins.
Minudoc.ee nutritional consultant Reelika Õigemeel emphasizes that the level of cholesterol and risk of cardiovascular diseases is all about our everyday diet. Eggs are high in vitamins and minerals. At the same time they are also high in cholesterol so it is important to have a balanced diet.
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Article was first published in Estonian in <a href="https://www.virtuaalkliinik.ee/uudised/2019/04/16/munade-soomine-ja-terviseriskid" target="_blank" rel="noopener noreferrer">Virtuaalkliinik</a>

6 common questions about chicken eggs answered

We all have probably felt a little anxious before stepping onto the stage, giving a speech or talking to a secret crush. Our nervous system has an autonomic parasympathetic part which is responsible for our heartbeats, digestion, respiratory rate, etc. Stress and worry may cause many sensations in our bodies that prepares us for danger. When the danger feeling system is activated it prepares us to run or hide. Evolutionarily we have that system to stay alive but nowadays it may give us unpleasant feelings at the wrong time. Being under pressure and having to worry about exams during a longer time may lead to exam stress.
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<h2>Good and bad stress</h2>
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When we are stressed, activation of the autonomic nervous system releases neurochemical &#8211; adrenaline which helps us to be focused and productive. A little stress can be good and may even motivate you to put in the work.  When stress level increases, our performance level also increases and we call it eustress or beneficial stress. But sometimes stress levels can get out of hand. Even though stress can be helpful, when it is prolonged, it gets us into some troubles. A problem arises when we reach fatigue point and our performance level starts to decline. If we are exhausted for a long time it could lead to mental illness, burnout or somatic illness. We may feel excessive worry, anxiety, depression, sleep deprivation, irritation, exhaustion, overwhelmed and unfocused. Stress response curve was portrayed by Nixon in 1979. It is important you ask yourself – in which level I am?
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<h2>What do we stress about?</h2>
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Usually, there can be many reasons why stress during exam period arises. Commonly we want to be perfect or we are afraid of failure, letting down or disappointing our parents and teachers and even being judged negatively by others. It is important to know that one failure doesn’t define you as a person. Failure can help you learn from that situation and be even more successful afterward. It is very important to learn how to overcome failure. Also, you can have a backup plan in case you should fail so that the idea of failing doesn&#8217;t feel like the end of the world anymore. Then you know what you can do and what you’re your possibilities and may feel less anxious about the exam. Remember: failure isn’t as bad as it seems and it happens to everyone.
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<h2>What to do with stress?</h2>
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Firstly, the most helpful method to prevent and get control over your exam stress is to make a plan and organize your time. One reason for higher stress level during an exam period is the fear of how and when I am going to study and whether it is enough. Good preparation makes us more confident and lowers stress levels. Also, when you start planning your study sessions, it is important to plan some time for resting and make room for small breaks during the intense studying. A plan can be beneficial but without rest, you may find yourself drinking too much coffee and feeling even more exhausted.
Secondly, you may learn techniques that help you calm down. Perhaps practice meditation or yoga to keep your focus. During meditation we breathe deeper and relax our body and nervous system.
Thirdly, make sure you load your body with nutritious food and also exercise regularly. Our physical and mental health benefits even just from a good long walk or a short but intense training. During a workout, our heart pumps fresh blood into our brain which supports our memory and learning abilities. Also, it improves our mood, sleep and reduces stress and anxiety.
Last but not least &#8211; if you feel that stress is out of your hands, there are school psychologists, school social workers or counselors who are happy to help you with your stress. It also helps if you share your thoughts and worries with friends or family.
All in all, there are several methods and things you can do to prevent exam stress. Start with these steps today to build a habit that works for you to feel more relaxed during a potentially stressful time.
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What is exam stress and how to manage it?

You may know people who just never catch a cold and are never ill so you can’t help but wonder how could it be.  Here are some tips that can help you become one of these people.
<h4>Wash your hands</h4>
Everything you touch during the day, from door knobs, cash to your own cell phone, are covered with bacteria. Not washing your hands enough is the most common reason for getting infected.
Make sure to wash your hands regularly, and not only before eating as germs can also find their way in by touching your face and scrubbing your eyes.
<h4>Keep it clean</h4>
Having a hot shower or a relaxing bath helps to clear your airways and kick that runny nose before it gets serious.
In addition to shower and bath, hot drinks like tea and broth with some extra spices help to clear out your airways as well. This also gives less chance for the germs to break in.
<h4>Eat healthy</h4>
Eating lots of vegetables and fruits provides your body with plenty of vitamins that help to support your immune system.
For example, citrus fruits like oranges, grapefruits and tangerines are high in vitamin C which helps to produce white blood cells and therefore fight infections.
Make sure to take vitamin supplements if you don’t get enough from food, and of course drink plenty of water!
<h4>Stay active</h4>
Physical activity is well-known to lower stress, boost mood and help maintain weight – all these factors contribute to a strong immune system.
Be careful, as working out too intensely may work against you and weaken your immune system instead of making it stronger.
<h4>Keep the stress level low</h4>
Go out, stay sociable &#8211; having a good time and sharing a laugh with friends helps to lower stress.
Take some time off every once in a while and just relax.
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Tips and tricks to never get sick

Illnesses and accidents can struck at the most inconvenient times and therefore it is highly recommended to have a first aid kit in hand. But why stop there if you could have a full home pharmacy and be prepared for anything? Family physician Sergey Saadi explains what should one proper home pharmacy kit contain and how to store it.
According to Minudoc doctors it is recommended to have at least one first aid kit at home and in your car. “These should be easily accessible, however, out of reach for children. Should there by older children in the family, it is good to let them know the location of the kit.” says Saadi. He adds that the all the items in a home pharmacy should be numbered and instructions how to take different medication written down on a paper.
One proper first aid kit should contain:
<ol>
<li>Elastic bandage for skin injuries</li>
<li>Tourniquet to stop bleeding</li>
<li>Dressing retention bandage</li>
<li>Gauze bandage to stop bleeding and clean to wound</li>
<li>Ice bag</li>
<li>Disposable rubber gloves &#8211; not with latex</li>
<li>Ice gel</li>
<li>Tweezers and scissors</li>
<li>Antiseptic liquid or cream</li>
<li>0,9% NaCl solution to rinse eyes</li>
<li>Thermometer</li>
<li>Medical Disposable Face Masks</li>
<li>A spoon or a needle for liquid medication</li>
<li>First aid handbook</li>
</ol>
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Recommended medication for home:
<ol>
<li>Aloe Vera gel</li>
<li>Medication for diarrhea</li>
<li>Laxative</li>
<li>Medication for reflux disease</li>
<li>Allergy medication</li>
<li>Cough medication</li>
<li>Adrenaline in case of severe allergies</li>
<li>Painkillers</li>
<li>Stomach ache relief</li>
</ol>
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What should everyone have in a home pharmacy kit

Winter blues, or seasonal affective disorder (SAD), is a mental health disorder that comes and goes with different seasons. It is also called winter depression as it is most common during winter as it is mainly caused by reduced sunlight during this period.
The symptoms of winter blues are similar to those of a depression. Most common symptom is persistent low mood and lack of energy. Person suffering from SAD may be feeling anxious or stressed and become less sociable. Feeling easily irritable or having abnormal low self-esteem may also be referring to the disorder.
Some people tend to sleep more than usually and find it extremely hard to wake up in the morning. Concentrating may be difficult due to lack of energy. For the same reason appetite may increase, especially for foods that are high on carbohydrates.
Minudoc family physician Kadri Riivik gives some easy tips to beat the winter blues.
<h4>1. Keep active and get outside</h4>
Go outside and breath in some fresh air.  Exercise like walking can help your energy levels stay up and give you more strength.
It is recommended to spend every day  at least 30 minutes outdoors during light hours of the day.  Take the most from the few sunny days you get during this time of the year.
<h4>2. Keep it warm</h4>
Feeling constantly cold may make you feel more depressed. Why not do it by enjoying a cup of hot chocolate or a chai latte! Eating hot foods also helps to keep it warm.
Make sure to wear warm clothes while outside and cover yourself up with a cozy blanket while relaxing on the couch. Hot baths and sauna can also be beneficial.
<h4>3. Eat healthy</h4>
Healthy diet full of vitamins and nutrition will boost your mood, give you energy and support your resistance.
Enjoy seasonal fruits and vegetables and take vitamin supplements if necessary.
<h4>4. Pick up a new hobby</h4>
Having a hobby not only helps you to stay distracted but it also motivates you to get up do something with your day.
Why not start taking online courses and learning new skills, or finally sign up for that yoga class you have been thinking about.
<h4>5. Socialize</h4>
See your friends and family as much as possible. Going out and socializing helps you to get out of your daily routine and keep you distracted. It is also good to have someone to talk to in case you are feeling low
If you still feel like winter blues is getting to you and you can’t handle it alone, make sure to talk to a specialist. Counselling and therapy will help you to cope with the disorder. Contact your family physician or a general practitioner if you feel like your symptoms are stopping you from living a normal life!
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You can find the next available <a style="color: #0000ff;" href="https://www.minudoc.ee/?category=PSYCHOLOGY&amp;utm_source=Blogi">PSYCHOLOGIST APPOINTMENT HERE</a>

How To Survive Estonian Winter: Beating The Winter Blues

Minimum daily need of vitamin D for an adult is 600 IU, starting from the age 70 it raises to 800 IU. In theory it is possible to get the minimum required amount from food. In reality, an average daily menu doesn’t contain enough vitamins. This means that the body needs to get some extra vitamin D from the sunlight.
According to Sergey Saadi, Minudoc.ee family physician, in most cases, it is not necessary to take vitamin D supplements. &#8220;Most adults don’t have a lack of vitamin D in their body. But, of course, there are some exceptions. Exceptions are, for example, people who do not go outside too often, and people who are on a strict vegan diet,” says Saadi
Family physician Kadri Riivik recommends people to take a test to know what the vitamin D level is exactly. In this way it is possible to say if and how much one should take vitamin D.  “However, I still recommend my patients to take vitamin D supplements. Studies have shown that people living in the Nordics don’t get enough sunlight and therefore the level of vitamins in the body is low.”
<h3>Vitamin D and small children</h3>
“Vitamin D helps to enhance normal bone growth for infants. For this reason, it is highly recommended to give babies starting from the second week vitamin D supplements,” explains nurse Lilli Gross. In this case the recommended amount is 400 IU a day.
Kadri Riivik highlights that it is important to adjust the amounts according to the milk the infant is having. Babies who are having infant formulas shouldn&#8217;t be given vitamin supplements. Most of the formulas are already fortified with vitamin D and other nutrients. At the same time, babies who are being fed with breast milk usually can’t get enough vitamin D even if the mother is taking supplements herself.
Note that children should be kept safe from the direct sunlight. It is important include in the menu foods that are high in natural vitamin D.
<h3>Is it possible to overdose with vitamin D?</h3>
Vitamin D toxicity, also called hypervitaminosis D, is a rare but potentially serious condition. It occurs when you have excessive amounts of vitamin D in your body. This can cause vomiting, weakness, frequent urination and kidney stones.
“Vitamin D supplements should be taken with caution and I do not recommend taking more than 1000 IU a day as a preventive mean. Right and harmful doses depend on personal metabolism, age, weight and overall health condition,” Saadi points out.

Family Physicians Explain: Do You Really Need to Take Vitamin D Supplements?

Family physicians are struggling as their patient directories are full and work load keeps growing. Minudoc.ee family physician Sergey Saadi believes that many problems could be solved if doctors started giving consultations over video calls.
In 2017, Saadi had 2000 patients in his directory. Even when working with two nurses, managing all his patients and the documentation that was required for every consultation took up a significant amount of time.  All this can be handled to one point, but during autumn and winter period, when the flu and cold are more common, doctors are forced to choose between quality and quantity. 
“You either do your work with lower quality and get to go home once the working day is over, or you do your job well, and end up working overtime,” says Saadi.
Many countries, Estonia being one of them, are working on more innovative approaches to fix the issue. In addition to already existing phone consultations, most recent development has been video consultation. Saadi is sure that this is a good way to ease the existing work overload. 
Both, doctors and patients, can benefit from video consultations. This new way helps patients to save up their time as they no longer must go to the clinic or wait on the phone. In addition, patients avoid being exposed to viruses and diseases that sick people bring to the clinics. Patients can get a consultation, a new prescription or a referral letter from the comfort of their home as doctors still have access to medical history. 
While video-consultations are very convenient for patients, they also make health care services more flexible for doctors. “New technology helps to divide the workload between different family physicians and allows them to fully focus on each patient. In my experience, a significant amount of appointments could be done over a video call. Both sides benefit from it,” Saadi sums up.
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<a href="https://www.minudoc.ee/?category=GENERAL_MEDICAL_PRACTICE&amp;utm_source=Blogi"><img decoding="async" loading="lazy" class="alignnone size-full wp-image-148" src="https://blog.minudoc.ee/wp-content/uploads/2018/12/ViitepiltENG.jpg" alt="" width="800" height="333" /></a>

Family physician Sergey Saadi: doctors should start giving video consultations

<h3>WHAT KIND OF HEALTHCARE IS AVAILABLE IN ESTONIA?</h3>
In Estonia, there are broadly two routes to health care services: public and private healthcare.
<img decoding="async" loading="lazy" class="wp-image-176 aligncenter" src="https://blog.minudoc.ee/wp-content/uploads/2018/12/healthcare-guide_1.jpg" alt="" width="585" height="390" />
The public healthcare is provided by Estonian Health Insurance Fund. This you can access if you have an employment contract in Estonia. In this case, your employer is paying social taxes on you. However, often the waiting times for secondary care specialist in public healthcare system are long.
Private healthcare is rather affordable in Estonia and you purchase a private health insurance with one of the insurance companies. Private healthcare tends to be quicker &#8211;  providers can generally meet you in a few days to a week.
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<h3>ARE YOU ENTITLED TO HEALTHCARE IN ESTONIA?</h3>
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<img decoding="async" loading="lazy" class="wp-image-177 aligncenter" src="https://blog.minudoc.ee/wp-content/uploads/2018/12/healthcare-guide_2.jpg" alt="" width="585" height="390" />
If you have an employment contract in Estonia, and your employer is covering your social taxes, then Estonian Health Insurance Fund covers your medical bills.
If you are a freelancer, you  need to pay your own social taxes, from which 13% will be transferred into your health insurance.
Make sure you have a registered right of residence in the country.
The health insurance also includes the right to receive benefits for temporary incapacity for work.
If you are currently unemployed, but registered in the Unemployment Insurance Fund, then you also have access to health insurance.
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<h3 class="3vff3xh4yd" style="margin: 0cm; margin-bottom: .0001pt; background: white;">HOW DOES THE ESTONIAN HEALTHCARE SYSTEM WORK?</h3>
<ol style="padding: 10px 20px 10px 20px;">
<li>Find a General Practitioner (aka „family doctor“) by calling Estonian Health Board at +(372) 650 9850. They will help you to find (English speaking) GPs in your area.</li>
<li>Register for the appropriate clinic by submitting an <a href="http://www.haigekassa.ee/sites/default/files/Blanketid/avaldus_perearstile.pdf" target="_blank" rel="noopener noreferrer">application </a> either in person, via the post or e-mail. Bear in mind you’ll have to submit the application in Estonian – find a friendly local to help you with that.</li>
<li>Wait for the reply for up to 7 business days – hopefully it gets approved.</li>
</ol>
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A doctor in Estonia may decline to add you, if their directory is already full, or you do not live in their service area. If that happens, you should apply to another clinic.
If you are not sure whether the selected GP directory is full or not, you can get information by calling the Health Insurance Fund’s Information line: 16363.
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<h3 class="3vff3xh4yd" style="margin: 0cm; margin-bottom: .0001pt; background: white;">GOOD TO KNOW</h3>
!!! Everyone in Estonia has a right to emergency healthcare, so don’t worry if your insurance has not been sorted out yet &#8211; the state will cover your costs.
Should you need emergency care, you can call  112 or go to one  of the emergency rooms located at hospitals.
<img decoding="async" loading="lazy" class="wp-image-178 aligncenter" src="https://blog.minudoc.ee/wp-content/uploads/2018/12/healthcare-guide_3.jpg" alt="" width="585" height="390" />
<h3 class="3vff3xh4yd" style="margin: 0cm; margin-bottom: .0001pt; background: white;">HOW DOES THE PRIVATE HEALTHCARE WORK?</h3>
There are two ways to get a private health insurance:
<ol style="padding: 0px 20px 10px 20px;">
<li>Through a private company providing health insurances for expats,</li>
<li>Directly from Estonian Health Insurance Fund* &#8211; if you’ve been insured with them in for at least 12 months within the past two years, or if someone who meets that criteria buys the insurance for you.</li>
</ol>
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*This whole process is called “voluntary insurance contract”, it can last up to a year, and you’ll have to pay insurance premiums to the Health Insurance Fund.
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<h3>HOW TO BOOK A TIME FOR A DOCTOR?</h3>
General Practitioner – call up the front desk of your GP&#8217;s practice or come personally to the practice to make an appointment. You will get the contacts once you are listed with the GP.
Secondary Care Specialist– Generally, to access secondary care specialist you will have to get a referral letter from your GP. Then the service will be for free to you, but you may encounter long waiting times depending on the specialist area.
Otherwise, you will need to call any of the clinics or hospitals and ask for a paid appointment. There are also several private clinics, who provide a broad spectrum of secondary care services such as Fertilitas, Qvalitas, Medicum, Confido etc.
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WHAT ARE THE ALTERNATIVES? 
Minudoc.ee is a virtual clinic that combines general practitioners and secondary care specialists. It is possible to get a video consultation with a general practitioner with just a few hour waiting time. Also the waiting times for secondary care specialists are shorter.
As you can choose the doctor you prefer you don’t need to have a registered GP so you can skip all the hassle.
For making an appointment in Minudoc environment <a href="http://www.minudoc.ee">www.minudoc.ee</a> you will just need:
<ol style="padding: 0px 20px 10px 20px;">
<li>a laptop or a smartphone with a camera,</li>
<li>one of the Estonian authentication methods (ID card, mobile-ID or Smart-ID),</li>
<li>an e-mail address.</li>
</ol>
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<h3>WHAT ARE THE WAITING TIMES?</h3>
There is a statutory requirement that in case of acute health condition your GP has to see you within the same day, otherwise within 5 days. Through Minudoc it is a matter of just a few hours.
The secondary care specialist has to make an appointment with you within 6 weeks from contacting.
Private health service providers are significantly more accessible, with secondary care specialist time available within 1-2 weeks. Again, to use the private healthcare services we kindly suggest to purchase private health insurance.
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Your Healthcare Guide to Estonia

Probably most of us have heard someone say that they’ve caught a cold. Well, living in the crispy climate of the North, it is important to know that a cold is not an actual disease. “Catching a cold” just gives a good ground for bacteria and  mostly viruses to form an infection as it weakens the body and lowers the resistance of our immune system.
Therefore, what we call an ordinary cold is actually a group of different viruses causing an illness. As there are numerous different viruses causing the symptoms, there is no specific cure and the body has to handle the pathogens on its own.
And this is exactly why our immune system is there for. Unfortunately, it takes time for the body to work out the cure, so the defense mechanism kicks in only at the end of the first sickness week.
As it takes time for our systems to process the illness, it is completely normal that the sick may feel weak and ill for at least 5-7 days.  As the pathogens are different and some of them are extremely “mean” it can take even up to 10-14 days to get completely well and recover.
Given the lifestyle we have right now, who has the time to be home ill for that long? Most of us probably don’t have that luxury and everyone is asking for special cure that would help them come out of it straight away. Unfortunately there is no such cure…
Until then, all that is possible is to give relief to the symptoms. As the “cold” is caused by different viruses, not even antibiotics can help in this case, because antibiotics are meant for bacterial diseases only, and when it comes to a cold, bacteria makes up only a very small part.
Just be patient, stay in as long as possible and this too shall pass.
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How to survive Estonian Winter: Explaining why getting a cold is a myth.

Weather in Estonia can be quite frustrating and challenging in the winter (read all year around). Cause of this, flu and cold are rather common visitors during this time of the year. 
Both flu and cold are infections caused by viral pathogens affecting mainly the respiratory system.
<h3>Symptoms of a cold or flu</h3>
Once the virus has entered the body through mouth or nose, or conjunctiva of the eye, it begins to multiply. In places of viral invasion occurs inflammation; this process usually makes your eyes feel painful and your fever gets higher. You may have a runny nose and sore throat. It&#8217;s also quite common to sneeze, cough and find your lymph nodes increased.
It&#8217;s important to know that flu virus is more aggressive and has more severe symptoms than usual cold. Fever is much higher, and you might have a severe headache, muscle pain, weakness and dizziness.
<h3>How to treat the symptoms</h3>
Don&#8217;t give in just yet. There are few tips and tricks to beat the flu or cold. First you have to stay home and have a rest. Make sure to drink lots of liquids! It&#8217;s highly recommended to drink water or herbal tea.
To reduce fever, take Antipyretics as Paracetamol 500mg or Ibuprofen 400mg. However, do so only if the temperature rises above 38.5-39 degrees. 
Same medicine may be used in case of a headache and muscle pain caused by the fever.
To relieve puffiness and other symptoms of runny nose use nasal drops or sprays, such as Septanasal, Otrivin or Xymelin.
Also sore throat can be very unpleasant. Paracetamol and Ibuprofen help to soothe this symptom as well. In addition use throat spray Hexoral and Jox orlozenges like Strepsil or Neo-Angin.
Make sure to take in warm drinks like milk with soda, add some honey to that, or expectorant drugs such as ACC, Brontex, Fluditec etc, to stimulate the release of sputum from the respiratory tract and get rid of the cough faster.
<h3>Contact a doctor</h3>
In case persistent fever has lasted more than three days call your family physician or Minudoc.ee doctor. As this can be a sign of another bacterial infection it should be treated differently.
This also applies if you have persistent coughing for more than two or three weeks, painful swallowing lasting longer than 3-4 days or persistent headaches.
Minudoc doctors can prescribe long-lasting decongestants for stuffy nose, cough suppressants in case of severe cough or antibiotics if needed.
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