Like many others working from home during this deadly crisis, Erin Spahn Erenberg has days when she feels overwhelmed trying to meet the needs of her job and her family, frustrated by relentless competing demands that drain her physically and emotionally.
"The saddest thing for me is that it has chipped away at my joy in motherhood," said Erenberg, a small-business operator. "I find myself raising my voice more than I ever thought I would."
Erenberg is hardly the only one trying to keep it together and failing sometimes, a societal problem grown large enough in the age of COVID-19 to crack the old unspoken agreement between many employers and their workers to keep personal issues away from the job.
Homebound workers and those out serving the public have struggled to keep their equilibrium during a traumatic year of mass disease and death. Long work hours, tiring videoconference calls and tense mask wars have added to the stress.
Their mental health is a growing issue for employers — who have not historically been of much help. Now, with more people heading back to their workplaces, companies need to make profound changes in how they approach employees' psychological and emotional well being, advocates say.
The issue was spotlighted this week when Citigroup Inc. Chief Executive Jane Fraser told staff that the company was taking work-life balance seriously by banning internal video calls on Fridays, promoting regular work hours and encouraging vacations. At Goldman Sachs Group, a leaked internal survey showed widespread burnout among junior bankers working 100-hour weeks; Chief Executive David Solomon vowed guaranteed Saturdays off — it is Wall Street, after all — and better support.
Even before COVID isolation, workers harbored concerns that if they used company mental health benefits it might hurt their careers, according to a 2019 study commissioned by online care provider Ginger. More than 80% said they faced barriers to getting behavioral healthcare.
The pandemic year's wide-ranging stresses have heightened the need. The Centers for Disease Control and Prevention said last summer that 40% of survey respondents reported anxiety, depression, suicidal thoughts and increased use of alcohol and other substances, sharply higher than the year-earlier level.
Still, many employers aren't willing to engage with the interior lives of their workers, experts said.
"Some organizations are doing the same old garbage" and tuning out their employees' emotional needs, said Patricia Grabarek, an adjunct professor of psychology at USC who specializes in workplace wellness issues.
Employers may expect workers on the job at home to put in more hours because they don't have to commute, she said, or pressure them to be constantly online. And working from home under duress has made a mockery of work-life balance, which was already maddeningly elusive.
"Having both domains of life in the same place demanding time from you is extremely exhausting," said Grabarek, co-founder of workplace wellness consulting firm Workr Beeing. Add the stress and dread of the pandemic, and the likelihood of burnout escalates.
Grabarek described burnout in terms familiar to many laboring at home: feelings of emotional or physical exhaustion, a sense of being disconnected from your job or family, and feeling that you're getting less effective at getting tasks accomplished.
"If you're really exhausted," she said, "you're not always able to fully mentally connect to anything."
In a better future, companies would eliminate the taboo of talking about burnout and other psychological stresses such as isolation, said Elizabeth Brink, a director in the workplace consulting practice of architecture firm Gensler.
Although videoconferences are loathed by so many, there's a positive side effect, Brink said, of cracking the strictly business personas people present at the office.
"We're seeing into people's homes and immediately reconnecting with the humanity of the people we work with," she said. "Recognizing their personal struggles as we're having our own."
Seeing co-workers in their native habitats may boost bonding, but some people report feeling stressed about being judged on camera, and not all bosses are moved by the revealed humanity of their workers.
Emily Barnes, who lives in north San Diego County and was laid off in the fall from an educational nonprofit, said she has seen a shortage of understanding from managers. Friends and family who are parents are not given the flexibility to work around their family's needs, she said, "not allowed to have excuses even with a baby in their lap."
Having flexibility to set your own hours working from home doesn't always result in a healthy outcome, said Erenberg, especially for women, who typically bear the brunt of overseeing childcare and the household while trying to keep up with their jobs.
Our culture still values men's time more than women's time, said Erenberg, an attorney who lives in South Carolina and is the founder of Totum Women, a company making cookie mixes that support lactation and other products for new mothers.
Although Zoom labor "has torn away the myth that children cease to exist when parents are at work," she said, "what you find is that a lot of women are working deep into the night and setting alarms for 4 and 5 a.m."
It's hard to get to business when they are faced with urgent family needs, she said,
"You can't get your footing when you are constantly interrupted," she said. "I have experienced this pandemic as a series of times of the rug being pulled out from under me."
Men may commonly be less inclined to articulate how the pandemic is making them feel but aren't immune to the strain. Neither are leaders of companies trying to keep their businesses afloat in a troubled economy.
"I know founders of successful companies that some days can't get out of bed," said April Uchitel of Los Angeles, former chief executive of two beauty companies including Violet Grey, which laid her off last summer.
"There is a vulnerability being forced on people right now. Sometimes it just takes a few people to be open about their vulnerability and everyone is is like, 'Me too.'"
Working from home in an environment that never changes is like L.A.'s "seasonlessness on crack," she said. "We've all lost sense of when to stop working and what a weekend means."
Uchitel said she hopes internal struggles even among top executives will compel companies to get more serious about how they support employees' mental health.
Dramatic change would require most employers to elevate mental health to a far higher priority than they give it now, to make support of it part of company culture and destigmatize the process of asking for help.
Emanuel Maidenberg, a clinical professor of psychiatry at UCLA, said corporate attitudes must change, and this moment offers business leaders an incentive to reevaluate their approaches to mental health support.
"I think the stress of last year could be used as an opportunity to open up to that investment, financially and otherwise, because it's well worthwhile," he said.
Leaders could help employees learn what Maidenberg calls "emotion hygiene" through "evidence-based skills and tools that are proven effective in maintaining equilibrium emotionally and allows us to get through stressful circumstances or periods of time like this one. These can be taught."
Simple examples include assertiveness training, regular cardio workouts and programs to help people sleep better. A broader goal is to normalize mental health difficulties, which have been exacerbated by the pandemic.
"Now more people can understand it and relate to it," Maidenberg said, "so it's a good time to make it part of the human experience that doesn't have to be avoided or shunned or be a source of embarrassment."
A jumping-off point for employers may be contracting with companies such as Lyra Health or Big Health, which provide mental health services to employees, including therapy, medication and treatment of sleep problems, he said.
Many businesses are aware of having employees in distress over events of the last year, said Joe Grasso, a clinical psychologist at Lyra.
"We're hearing from prospective and current customers a general sense of exhaustion and panic at the same time," Grasso said. They're asking, "'How do we deal with this crisis that is already upon us?'"
In a survey of non-Lyra customers the Burlingame, Calif., company conducted in December, 40% of workers reported dealing with one or more acute mental health conditions such as anxiety, depression or post-traumatic stress disorder, double the early 2020 level. Half the workers said mental health challenges affected their capacity to work last year.
Such hits to the bottom line may spur more company leaders to focus on the mental state of their teams.
"Employers are recognizing it's in their best interests to care about this," Grasso said. When employees are struggling with emotional issues they are less productive, they are more likely to take absences and they are at greater risk of leaving the company.
"Ultimately it erodes your work culture because you have employees that are probably demotivated," he said. "They are not able to function well and communicate with their colleagues. They're consumed by their distress."
Shifting generational attitudes are also likely to propel companies to address mental health concerns, he said, as millennials and especially their younger co-workers in Gen Z grow more assertive than their older counterparts about getting help.
Factors motivating younger workers include a higher awareness about what mental health problems look like as therapy grows more common and high-profile people, including celebrities, speak plainly about their personal issues. Younger workers have also grown up more burdened with escalating academic pressures and other stressors including unhealthy social media consumption while isolated with electronic devices "constantly telling you how you don’t measure up with someone else," he said.
Employers who have to compete for young talent have noticed the trend, he said, and stepped up their mental health benefits. Lyra declined to reveal how many clients it has, but Grasso said the company's customer base doubled last year. Lyra was founded in 2015 and lists clients including Morgan Stanley, Pillsbury and Amgen.
Like many companies, Cheesecake Factory has long offered an employee assistance benefit to help workers resolve personal problems affecting their work performance, but in August the Calabasas restaurant operator introduced a telemedicine program that allows employees to get face-to-face counseling online with therapists and psychiatrists at no cost to them.
"Supporting the mental health needs of our staff is incredibly important to us, especially during these challenging times when so many people are experiencing increased anxiety, depression and stress," said Dina Barmasse-Gray, senior vice president of human resources.
Details about employee connections with the company's provider Doctor on Demand are not shared with Cheesecake Factory, she said, but the primary reasons for visits are anxiety and depression.
"With so much uncertainty during the pandemic, including general health concerns and local restrictions impacting restaurants’ hours and operating models, everyone in our industry is under additional stress right now," she said.
Barmasse-Gray didn't reveal how many of the company's approximately 42,000 workers use the counseling service, but said the number of mental health visits by employees has almost doubled since 2019.
Facebook offers employees and their families counseling through Lyra along with a "wellness reimbursement" of as much $720 per year to pay for things such as gym memberships, golf green fees, sports leagues, smart watches and weights.
Citing the rise of domestic abuse during the pandemic lockdown, Facebook recently announced that people can take off up to 20 days a year with pay if the employee, a household member or family member experiences domestic abuse. Workers will tell their managers they need to take an emergency leave but won’t have to specify the reason, a company representative said.
An on-demand dog-walking service called Wag provides employee counseling through Ginger, which reported that 40% of Wag workers signed up for the videoconferencing service to get emotional support for issues in their work or personal lives.
At Sanofi, an international pharmaceutical company based in France, management tells workers "it's OK not to be OK," said Clint Wallace, head of human resources for the United States.
During the pandemic, Sanofi has seen an uptick in use of the company's programs to support parents. Among them are assistance with virtual schooling and providers who step in to help employees manage child care or elder care.
Providing counseling and other mental health benefits helps staff manage their stress and focus on work, Wallace said. A company goal is to double participation in its well-being programs.
"Businesses have to look at this as an investment, not a cost," he said, "to enable people to be their best selves when they come to work every day."
With the pandemic showing signs of ebbing, there is anxiety among many workers about returning to their offices and other workplaces shut down a year ago, said Brink of Gensler.
"There is a fear that there is a day when there will be a switch, like a light switch, and they have to go back to the way things were," she said.
Companies have spent months trying to determine what post-pandemic offices should look like to protect occupants' physical health, but Brink said decision makers should also be looking at how they can support mental health as they prepare to return.
"The workplace was for the desks, the offices, the copy machines and the files," she said. "Now the role of the workplace is shifting to be about the people."
Better offices might include spaces for respite, where workers can find sanctuary and privacy when they feel the need. Opportunities to get outdoors would be helpful, and the more daylight people can see, the better.
But to really emphasize people, the workplace needs a recalibration toward empathy, Brink said, "a reconnection to humanity" that recognizes each of us is having our own personal struggles — especially after a year that's been stressful and anxiety-provoking for everyone.
"There needs to be a destigmatization of conversations about burnout and isolation, and having those conversations not be so taboo in the workplace," she said. "People need to feel just as supported going through mental health issues as when they're going through physical health issues."
This story originally appeared in Los Angeles Times.