“John” was referred to me for counseling services by his primary physician. John’s primary complaint: Panic attacks one to two times per day. I conducted a standard intake interview, asking him about all areas of his life. He had never experienced any panic attacks until one night a few months prior to his appointment with me. Like many people who experience their first panic attack, he spent an evening in the local emergency room being checked for a possible heart attack.

Since his first attack, the attacks became more frequent and more severe. “Now,” he said, “I get a panic attack because I’m afraid I’m going to have (another) panic attack.” This is a common experience.

As a practitioner, nothing can replace obtaining a thorough history, screening, and intake. I discovered that he had experienced some degree of anxiety throughout his life. Generally speaking, he was a worrier. But there was more to it than perhaps being biologically predisposed to panic attacks. At the time of the appointment, he was experiencing some difficulties in his relationship with his wife. She was very critical of the fact that he was currently not working. They had several children between the two of them, and money was tight.

There were multiple options for my work with him. We discussed cognitive behavioral strategies to address relaxation, communication strategies that he could use with his wife, and — what turned out to be the most important element — career counseling.

After he revealed that a job, any job, would drastically improve his life, he was on his way to feeling better. It seemed his first attack happened not too long after he lost his previous job. Now the attacks were consuming his life. Having a job equaled less stress over finances, less conflict with his wife, less worry over providing for his children, and less time to worry about worrying.

As a counselor, there is not a clear separation for me between “career counseling” and “personal counseling”. I can’t really conduct career counseling without covering personal issues. Even when I see someone for personal counseling, they quite often discuss work to some extent. Having a job we dislike makes us miserable in other parts of our life. Our work affects our mental health, and our mental health affects our work.

People wrap so much of their identity in their work. Let me illustrate, what is one of the first things people say when meeting someone for the first time… “So… what do you do for a living?”

Quite often, work (paid or unpaid) is how we identify ourselves to others. We develop a sense of who we are based on what we do and what we have accomplished (some more than others). Unemployment takes away part of who we are, and how we feel about ourselves.

It makes sense that work is important to our health and has such an impact on our life. For most full-time workers, the majority of time awake each day is spent at work or completing work-related tasks at home.

How does work (or the absence of work) affect you?