By: Dr. Tyler Amell
Stress. Nobody is immune from it. We all experience it. And, unlike many health issues, there is no vaccine to prevent it. Stress is not a health condition per se, but a physiological and/or psychological response to how our bodies react to our environments and the situations we are placed in. Stress levels have increased exponentially since the arrival of the COVID-19 disease in early 2020.
We spend a large portion of our adult lives working and, as a result, stress is extremely commonplace and something we encounter every day in the workplace. Examples of stressful conditions include work deadlines, performance reviews, interpersonal conflicts, difficult customer interactions, downsizing, etc. Additionally, in many instances, stress does not stop once we leave the workplace for the day. We have grown accustomed to working longer hours, frequently work from home or out of the office, and, of course, we are always available virtually through our WIFI connections, smart phones, tablets, and laptops.
In some instances, stress has positive attributes and has been a part of the human condition since we were hunting woolly mammoths. It keeps you alert, engaged, motivated, and focused in a situation or work task. This is healthy stress.
In many instances, however, stress has a negative effect on our well-being and there is a strong link to numerous adverse health related issues commonly observed in the workplace. These include increased episodes and duration of absences, leaves, and work disability. Negative stress is also associated with chronic health conditions such as headaches, aches and pains in the musculoskeletal system (muscles, tendons and ligaments), stomach issues, high blood pressure, cardiac disease, sleep problems, and sexual dysfunction. Of note to employers is that according to the Cleveland Clinic, six of the leading causes of death are linked to stress; these include cancer, lung disease, heart disease, cirrhosis, accidents, and suicides.
Stress becomes unhealthy when our minds and bodies are affected by chronic stressors (both inside and outside of the workplace) and we are unable to recover adequately before we are faced with the next stressful issue. These conditions have a cumulative effect and we are at risk of becoming run down, leading to an increased risk of “rust out” and eventual burn out.
From a workplace health and productivity perspective, work stress is commonly the primary cause or co-morbid condition of short- and long-term disability claims. Further, it is increasing becoming accepted in workers’ compensation claims. In many instances, the compensable conditions are suitable for wage-loss, medical, health, and pharmaceutical coverage, and are, in fact, poly-morbid in nature. This means that more than two interrelated conditions are occurring simultaneously. As a result, these contribute to increased incidence, prevalence, and prolonged episodes of work disability duration.
Compounding this already critical issue, when stress is not addressed and managed appropriately it can lead to anxiety and/or depression. According to research published by the Integrated Benefits Institute (IBI), there is a strong relationship between work-related stress and mental illness, specifically anxiety and depression. According to the World Health Organization (WHO), depression is a mood disorder that is now the most prevalent disabling condition in the world. In addition, depression is a leading cause of work-disability, typically second only to musculoskeletal conditions. It is for these reasons that stress has been labeled a major health epidemic of the 21st century.
The Problems for the Workplace
Stress and its associated mental health conditions can lead to a variety of issues for people as they attempt to manage and alleviate the symptoms they experience. These issues can include compulsive and addictive use of alcohol, tobacco, food, drugs, gambling, sex, and other potentially destructive behaviors that often result in serious health and social consequences. These conditions frequently manifest in the workplace as issues such as lower job performance, lower productivity, higher absenteeism, lower presenteeism, and a significant increase in healthcare costs.
Correspondingly, the most reported reasons for utilization of Employee Assistance Programs (EAPs) in North America are stress (either work or personal related), particularly when coupled with financial issues. People do reach out for help when these solutions are available to them and when they are aware of the option. However, a great deal of those impacted by mental health conditions do not get the help that they need and these conditions unfortunately, and unnecessarily, worsen over time. The dramatic rise in behavioral health and mental health conditions observed by workplaces in the last decade has led to a decrease in stigma, greater understanding, and additional resources being available to those impacted.
In Canada, and globally, a significant milestone was achieved with the publication of a management system standard (CSA-Z1003), recognized internationally as a leading approach for workplaces to address and mitigate risk to psychological health and safety.
What Can Workplaces Do?
When we encounter a stressful situation, we frequently carry our response around for a while and can benefit from interaction with friends and family or ‘downtime’/ ‘unplugging’ for those who get their energy from being alone to recharge. Some people require support to reach out for help in a confidential manner and all they need is to be aware of the support available to them. But others may require a more targeted approach. Training leaders to be able to better identify those who may be negatively impacted by work-related or personal stress and how to introduce them to support options is a worthwhile investment for workplaces.
Employers can also implement programs that support their employees in building resiliency and how to adopt positive coping skills. By providing employees with the ability to deal with their stressors in a positive, timely, and constructive manner (and ultimately decreasing the impact of accumulated chronic stressors without sufficient recovery time) workplaces will have, in a sense, created an effective ’vaccine’ to treat workplace stress.
As a best practice, from a work-disability prevention perspective, workplaces should invest in technology that provides comprehensive health risk assessment and appraisal (HRAs) capabilities. These assessments can then be used to tailor supportive programming, such as gamification, challenges, and coaching, to help people modify and change their behaviors, reducing their risk of developing stress, anxiety, and depression-related chronic health conditions.
Health risks can be assessed actively, in the form of questionnaires, or passively, using advanced technology and wearable data from smart phones or other devices. These solutions are supported by evidence-informed research, and are effective in communicating to people their risk, and how to lower that risk to improve their quality of life. In the end, improvements in productivity, job performance and of course lower absenteeism, improved presenteeism, and reduced healthcare costs can be observed.
When work-disability prevention efforts are not enough, and at-risk people succumb to work-related stress and mental health conditions such as anxiety and depression, treatment options can be effective. Cognitive behavioral therapies (CBT) delivered online or in group settings, counseling, biofeedback, as well as sleep, exercise, and diet modifications are the most beneficial. Anxiolytic (anxiety reducing) or antidepressant pharmaceutical treatments, are also supported by some research as they are relatively inexpensive and easy to use. However, their efficacy pales in comparison to those treatment options above.
The Cleveland Clinic provides the following recommendations for reducing stress, and the subsequent risk of mental health issues such as anxiety and depression:
- Keep a positive attitude.
- Accept that there are events that you cannot control.
- Be assertive instead of aggressive. Assert your feelings, opinions, or beliefs instead of becoming angry, defensive, or passive.
- Learn and practice relaxation techniques; try meditation, yoga, or tai-chi.
- Exercise regularly. Your body can fight stress better when it is fit.
- Eat healthy, well-balanced meals.
- Learn to manage your time more effectively.
- Set limits appropriately and say no to requests that would create excessive stress in your life.
- Make time for hobbies and interests.
- Get enough rest and sleep. Your body needs time to recover from stressful events.
- Don’t rely on alcohol, drugs, or compulsive behaviors to reduce stress.
- Seek out social support. Spend enough time with those you love.
Stress. Nobody is immune from it. We all experience it. Unlike many health issues, there is no vaccine for prevention of it. Stress is not a health condition per se, but a physiological and/or psychological response to how our bodies react to our environments and the situations we are placed in.
With employers taking a more proactive role, stress can be mitigated and managed better by individual in the workplace, and help employees find effective ways to respond to those inevitable high-cortisol situations.
Dr. Amell is an internationally recognized thought leader on the topic of workplace health and productivity, as well as a frequent speaker and writer. He is Chief Medical Officer and Chief Relationship Officer at CoreHealth and faculty at Pacific Coast University for Workplace Health Sciences. He is a board member at the National Wellness Institute, the Work Wellness and Disability Prevention Institute and a past board member at the Integrated Benefits Institute and the Canadian Association for Research on Work and Health. In the past he was Partner/Vice President at a global HR firm, Chief Executive Officer of a HR technology company and Vice President of a large health care company.