In 10-20 years, our country may look back on stress the way we look back on concussions. For many years, the risk of concussions was well known, but little was done to address the issue. People in positions of power – particularly in the sports industry – downplayed the severity of concussions: “It’s normal to get your bell rung. Just sit on the bench for a bit – maybe take a game off. You will be fine.” Today we know that the cumulative effective of those concussions is devastating.
Until we had clear research, it was easy to write off the risk of concussions. They are relatively common, and concussions, when viewed individually, may not appear very serious. One mild concussion can have health consequences, but it is not likely to have severe, long-lasting mental and physical effects that compromise your overall well-being; however, a series of mild concussions occurring over several years can result in major health issues.
Similarly, stress is extremely common, and stressful experiences, when viewed individually, may not appear very serious. It is easy for leaders to write off the issue: “Everyone feels overwhelmed now. Do some breathing exercises. Take a mental health day. You will be all right.” And, to be fair, one stressful experience is not likely to take a serious toll on your health.
That said, much like with concussions, experiencing chronic stress over the course of several years is devastating. The effects on mental health might seem obvious – it is not particularly surprising to learn that chronic stress increases the risk of developing depression (Madsen, et al., 2017). Less obvious are the profound and far-reaching physical effects of stress, but the research is clear on this point:
- Chronic stress affects brain function, disrupting the ability of neurons to form connections and decreasing the volume of certain brain structures (Mariotti, 2015). For example, research has shown that chronic, long-term work stress results in reductions in gray matter and shrinking of the basal ganglia (Blix, Perski, Berglund, & Savic, 2013).
- Psychological stress can cause the immune system to react as though it is fighting an infection, which in turn causes inflammation (Black, 2002). When that stress occurs repeatedly over an extended period, it can cause a state of chronic, low-grade inflammation (Gu, Tang, & Yang, 2012). This type of inflammation has been linked to a variety of illnesses including cardiovascular disease, cancer, arthritis, and Alzheimer’s – among many others (Pahwa, Goyal, & Jialal, 2022)
- Workplace stressors – including excessive workloads and long working hours – are associated with a 10-40% increase in heart disease and stroke (Kivimäki & Kawachi). Feeling burntout at as result of work is associated with a variety of health issues, including heart disease, diabetes, and musculoskeletal pain, and – most alarmingly –a significant increase in risk of death for those under age 45 (Salvagioni, Melanda, Mesas, González, Gabani, & de Andrade, 2017)
You may notice that I highlighted workplace stress in some of the citations above. That was not accidental. A recent survey showed that 71% of American workers reported feeling stressed during the workday (American Psychological Association, 2021). Research suggests that exposure to workplace stressors directly results in 120,000 deaths a year in the United States and accounts for 5-8% of our healthcare costs (Goh, Pfeffer, & Zenios, 2016).
If you are a leader in your workplace, you have the ability to make a difference, and what you do in the coming years could come to define your company and your legacy. Do you want people to look at you and your organization the way people today look at the NFL and the way it handled concussions? Or do you want people to say that you took the health of your workers seriously and stepped up to change things? If you are serious about solving the workplace health crisis, here are some tips to start moving things in the right direction:
Take Stress Seriously
Many leaders are dismissive when the issue of workplace stress is brought up. Some leaders are explicit about this. When met with complaints, they will say, “Work isn’t supposed to be fun – that is why they call it work!” (by the way, I am not saying work necessarily should be fun. But even a job that isn’t particularly enjoyable should not be miserable and negatively affect your health).
Other leaders are dismissive in subtler ways. They may empathize when workers talk about stress, and they use their active listening skills to engage them in a conversation; however, they are only willing to offer token concessions to address the issue, like mental health days. They are not willing to make deeper changes, such as redesigning jobs and modifying work processes.
If you want to start addressing stress in the workplace, you have to listen to your employees. Cultivate psychological safety so employees can openly share what is on their mind. Regularly check in with them about their stress levels during one-on-one meetings. Ask what parts of their job are causing them the most stress. Even if the concerns they raise seem minor, you must listen – remember, those small stressors add up.
Deal with Your Stress Effectively
In addition to taking employee stress seriously, you must take your own stress seriously. Remember, as a leader your actions set the tone for your organization. If you are chronically stressed, employees will sense it. They are unlikely to respond to your efforts to address workplace stress if they see that you are not willing to take steps on your own to manage your stress and well-being.
Small lifestyle changes can make a big difference – schedule regular breaks in your day, make sure you actually take time for yourself during your lunch hour, establish an exercise routine outside of work, and set aside quality time for friends and family.
If you make these changes and you are still struggling, consider reaching out for counseling. The therapists here at Cornerstone Mental Health Solutions specialize in dealing with workplace mental health issues. We can help you develop better coping skills, improve your relationships both in and outside of the office, and rediscover a sense of purpose and enthusiasm for your work.
Look at the Data
While listening to employees is important, it only gives a micro-level view of the issue. It is vital that you gather quantitative data so you can see what levels of stress are like across your organization. Many surveys on workplace stress are available free of charge, such as the NIOSH Quality of Worklife Questionnaire or the Copenhagen Psychosocial Questionnaire. It is also helpful to look at data that offers an indirect measure of stress, such as rates of absenteeism and rates of health plan/EAP utilization.
Be sure to measure stress regularly. Doing so will help you proactively anticipate problems, evaluate whether your interventions are effective, and pinpoint areas of specific difficulty. Not all parts of your organization are going to be equally stressed. If one department or team is scoring higher on measures of stress, that is the time to step in and look at the issue more closely.
Be Open to Change
As the data and employee feedback start to clarify opportunities to change, make sure you pause to look within yourself. Really examine whether you are ready to make changes to the workplace and identify the internal barriers that might make accepting change difficult.
I have found that generational differences often create barriers to change. Attitudes about work are evolving, and many younger employees are simply no longer willing to work a grueling schedule (Deloitte, 2022). Some leaders are resentful about this – “When I started at this company, I worked 80 hours a week and didn’t get to see my kids!” Leaders in this position should ask whether that was fair to them and take time to grieve the time they lost to work rather than doubling down and refusing to change their management style.
Some leaders have a resigned, fatalistic attitude toward workplace stress, believing that it is simply a part of the job and nothing can be done about it. While it is certainly true that some jobs have inescapable stressors (e.g. first responders), it is usually possible to modify the job and offer resources to minimize the impact of those stressors.
Whatever the barrier is, be sure to work on it. If you gather data and employee feedback, but then do nothing with it, it can be devastating to employee morale. The issue of stress is likely to get worse, and the next time you try to address it, you will have lost the goodwill of your workers. Any efforts made at that point are less likely to be successful.
Ask Employees what they Need
Changes are most effective and enduring when the people affected by them are driving the process. Your employees are the ones that experience these stressors every day – they are intimately aware of their presence and can identify them and ways they can be fixed. Employees should drive the process of change. Let them propose ways their job description could be modified. Let them identify workplace wellness initiatives they believe would make a difference.
I sometimes find that employers are overly eager to solve the issue. They want me just to tell them the solution so they can implement it. It is important to remember that the process involved in creating the solution is just as important as the solution itself.
When employees drive stress reduction initiatives, they are more likely to take ownership over them, actively participate, and maintain them moving forward. Implementing a stress-reduction initiative in a top-down fashion reduces buy-in, and if employees are not active participants in the initiative, it is less likely to work.
Consult Experts and Use the Scientific Literature
The demand for organizational wellness services is substantial, and many consultants –regardless of their credentials or expertise – are trying to get in on the action. Unfortunately, many wellness initiatives are simply ineffective. Some may even backfire and alienate your employees further (Lieberman, 2019).
Much of the standard advice in the wellness industry for managing stress does not stand up to scientific scrutiny. For example, the ever popular resilience workshops that are offered by many organizations are not effective under most circumstances (Daisley, 2022).
Some wellness initiatives that intuitively seem effective simply are not when subjected to scientific scrutiny. For example, one team developed a protocol to help oncology nurses dealing with the stress of losing patients to cancer. This protocol involved allowing nurses to openly express feelings of grief, connect with colleagues experiencing similar feelings, and engage in a farewell ritual for the patient. Ultimately, this intervention did not effectively reduce stress and burnout (Cocker & Joss, 2016).
If you want your organization to address workplace stress, it is vital that you collaborate with experts who have experience and know the scientific literature. If you need a partner to help you figure out the most effective strategies for managing workplace mental health and stress management, please contact us here at Cornerstone Mental Health Solutions. Our team of consultants are licensed mental health professionals, and we have both the scientific knowledge and applied skills to help.
Citations
American Psychological Association. (2021). The American workforce faces compounding pressure. Retrieved March 1, 2023, from American Psychological Association: https://www.apa.org/pubs/reports/work-well-being/compounding-pressure-2021
Black, P. H. (2002). Stress and the inflammatory response: A review of neurogenic inflammation. Brain, Behavior, and Immunity.
Blix, E., Perski, A., Berglund, H., & Savic, I. (2013). Long-term occupational stress is associated with regional reductions in brain tissue volumes. PLoS ONE.
Cocker F, Joss N. (2016) Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review. International Journal of Environmental Research and Public Health. 2016; 13(6):618. https://doi.org/10.3390/ijerph13060618
Daisley, B. (2022, September 29). Why quick-fix resilience doesn’t work: Our obsession with solving resilience may be driving the wrong solutions. Retrieved March 1, 2023, from Psychology Today: https://www.psychologytoday.com/us/blog/finding-fortitude/202209/why-quick-fix-resilience-doesnt-work#:~:text=Some%20peer%2Dreviewed%20studies%20show,people%20draw%20from%20each%20other.
Deloitte. (2022, May). Striving for balance, advocating for change: the Deloitte global 2022 Gen Z and Millenial survey. Retrieved June 14, 2022, from Deloitte: https://www2.deloitte.com/content/dam/Deloitte/global/Documents/deloitte-2022-genz-millennial-survey.pdf
Goh, J., Pfeffer, J., & Zenios, S. (2016). The relationships between workplace stressors and mortality and health costs in the United States. Management Science, 608-628.
Gu, H., Tang, C., & Yang, Y. (2012). Psychological stress, immune response, and atherosclerosis. Atherosclerosis, 69-77.
Kivimäki , M., & Kawachi, I. (n.d.). Work stress as a risk factor for cardiovascular disease. Current Cardiology Reports.
Lieberman, C. (2019, August 14). What wellness programs don’t do for workers. Retrieved March 1, 2023, from Harvard Business Review: https://hbr.org/2019/08/what-wellness-programs-dont-do-for-workers
Madsen, I. H., Nybert, S. T., Magnusson Hanson, L. L., Ferrie, J. E., Ahola, K., Alfredsson, L., et al. (2017). Job strain as a risk factor for clinical depression: systematic review and meta-analysis with additional individual participant data. Psychological Medicine, 1342–1356.
Mariotti, A. (2015). The effects of chornic stress on health: New insights into the molecular mechanisms of brain-body communication. Future Science OA.
Pahwa, R., Goyal, A., & Jialal, I. (2022, November 8). Chronic Inflammation. Retrieved February 14, 2023, from National Library of Medicine: https://www.ncbi.nlm.nih.gov/books/NBK493173/
Salvagioni, D. A., Melanda, F. N., Mesas, A. E., González, A. D., Gabani, F. L., & de Andrade, S. M. (2017). Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLoS One.
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