Dr. Elliott Lee is seeing the human toll that tough economic times can take more often than he used to these days.
And while that is not unusual in itself, it is at Lee's sleep clinic in Ottawa, a city where a government job at one time virtually guaranteed a steady fiscal future, but where that's not necessarily the case any more.
"I feel like I'm seeing more of those people who are either being laid off or worried about being laid off from their government jobs," says Lee, a sleep specialist at the Royal Ottawa Health Care Group sleep disorders clinic.
"About 50 to 60 per cent of people who come in complaining of insomnia cite finances as at least a contributing factor," Lee says, adding that he is also seeing more seniors.
"They're much more worried about their finances and retirement portfolios. That’s also a cause for concern for them."
Statistics on the effect of money on stress and loss of sleep among Canadians don't grow on trees.
But one poll for the Canadian Medical Association two years ago suggested that 23 per cent of Canadians were losing sleep over economic worries, with the figure rising to 33 per cent among those without a university degree.
Tips for better sleep
- Don't look at the clock in the middle of the night — the more you think about sleep, the worse your sleep will be.
- Try to go to bed and get up at the same time every day.
- Keep the bedroom dark.
- Have the bedroom temperature around 21 C.
- Don't exercise, drink alcohol or caffeine too close to bedtime.
- Avoid the computer — stock market reports, sports scores etc. — just before bed.
- Develop an early-evening habit of writing down ways — short-term, medium-term, long-term — you might address your financial worries, and tell yourself not to think about them for the rest of the night. "People have to do it consistently for this to be helpful, but it can help people develop a little sense of control over at least the small things they can do to control their finances," says Dr. Lee.
In doctors' exam rooms and sleep clinics, economic worries are coming through loud and clear, though, and there is some evidence that they appear to be growing.
"Since 2008 there has been a tremendous increase in people’s stress around money," says Dr. Mel Borins, a Toronto family physician.
"Especially couples. The thing that they're most fighting about or most arguing about in terms of relationships is around money and the challenges that people are facing these days."
Borins has had patients talking about selling their houses, moving into apartments and downsizing because of having to cope with the cost of living.
"It's a big worry. I think the whole work ethic puts a great strain on people associating their work with their integrity," says Borins. "If they don’t have a job, they really lose their self-esteem."
He also sees people after they have lost their job and says "it’s like losing a close relative. It's very, very devastating and people can get quite gloomy and depressed after a job loss."
What's worse is if these fiscal worries evolve into a chronic stress situation, then they can end up affecting how a person thinks, feels and behaves. The physical manifestations can be diverse: headaches, muscle tension, especially around the head and neck, stomach problems, and loss of sex drive.
Chronic stress can also lead to difficulty concentrating and focusing on tasks as well as moodiness and low morale.
How stressed are you about your financial situation? Take our survey.
"The other thing is that sometimes we might get feelings of helplessness," says Dr. Katy Kamkar, a clinical psychologist in the work, stress and health program at the Centre for Addiction and Mental Health in Toronto.
But we may not be as helpless as we think, even when faced with excessive stress or anxiety.
"We might have the tendency to overestimate the stress, to overestimate the danger, and we underestimate our abilities to cope with problems," says Kamkar. "We might underestimate the resources available to us."
When it comes to financial problems, there are numerous resources out there that can help, including credit counsellors, financial planners and even bank staff. Health-care professionals, too, are getting better at pin-pointing the root cause of what is bothering people.
When it comes to trouble sleeping, much of the problem lies in how the body responds to stress. When people are stressed, they produce the hormone cortisol in greater amounts.
"Over a long period of time," says Lee, "that can adversely affect our sleep."
Normally, a surge of cortisol in the morning helps people get up for the day, as part of the body's intricately tuned circadian (24-hour) rhythm.
But if cortisol levels fluctuate during the day and night, that will take its toll on sleep.
For patients seeking relief for their insomnia or their stress brought on by fiscal worries, finding ways to cope can be difficult.
But Borins, Kamkar and Lee have long lists of suggestions that focus on everything from the importance of having a positive attitude, getting adequate exercise, having a good diet and regular sleep habits to remembering to take time for yourself (go to the free night at the local art gallery, for example) and to not withdrawing from family and friends.
To overcome sleep difficulties, Lee looks first to people's routines.
"The best thing they can do is to try to have a regular routine for their sleep and try not to let their anxiety get the best of them."
Go to bed and get up at the same every day, whether it’s a weekday or a weekend. Make sure the bedroom is dark and at a good temperature for sleeping — around 21 C is ideal. Don’t exercise, drink alcohol or caffeine too close to bedtime. And stay away from the computer just before putting your head to the pillow.
Lee says that if you are looking at something distressing on the internet, whether it's the stock market or how a favourite sports team is fairing, that stress can impair sleep. "But it's also the light from the computer screen that also plays a role in disrupting our sleep cycle," he adds.
That cycle depends on getting light exposure at the right time — light in the morning, darkness at night — and the particular brightness of the computer screen can be very confusing for our inner body clock.
Kamkar emphasizes the need for people to look after themselves directly when faced with stress.
"During those times we might feel more vulnerable and we might even neglect ourselves, which then again makes it even more difficult to cope with those stressors."
Lee says studies have shown that people are more prone to gamble or take more risks if they are sleep-deprived.
"It can clearly affect our decision-making as well. People are more accident-prone as well when they're sleep-deprived. They're more likely to get sick, too. If you get sick, and you take time off work then that can make the financial situation worse."
While there are strategies people can adopt to try to cope with their fiscal worries, Borins feels that governments have a role to play as well.
"With the downturn in the economy, not a lot of money is being placed into things that perhaps it should be," he says.
"When you start to cut out swimming pools and parks and libraries and things like that, I think it really impacts on people's wellbeing."
There's also a tendency that when times are tough, groups who are more vulnerable — those who are homeless, or disabled, or who have mental health issues — suffer the most, he says.
"I think it's a time when we really have to not cut resources to these groups, to actually attempt to provide a bigger social net at times of distress."