Articles
To promote knowledge about workplace stress, how it affects employees and businesses, as well as what you can do about it, we semi-regularly publish articles on various platforms. However, to make it easier for you to find them all, we collate them here. Find what piques your interest in the table of contents below.

Table of Content




A woman viewed from behind touching a sore shoulder. The soreness is indicated by red colour

The Costly Pitfalls of Workplace Stress and Presenteeism

Bill is a manager of a department of 50 people in a SME. For the last few months a project involving most of his department has been quite busy, forcing many employees to work overtime a few days a week. Bill knows that many of the employees in the department have therefore started their workdays earlier than normal, taken care of their kids in the early evening and then worked a few more hours after having put the kids to bed.

Unfortunately some are starting to show signs that the stress is getting to them. There has been less information flow between different parts of the projects as well as less communication between individual employees. Team manager David has accused Laura’s team of purposefully withholding information and his stress-induced mood swings haven’t helped the situation. This has led to David and Laura having some public conflicts in online meetings. Bill has talked to them about the unprofessionalism of their behaviour and hopes the situation is now resolved. At the same time there have also been frequent complaints of headaches and muscle pains and some project members seem to have problems sleeping.

This morning Bill got an email from Claudia, another team lead in Bill’s department, saying she has some back pain and will therefore take some breaks during the day so as to be able to rest a bit. But Bill shouldn’t worry, she will make up for the breaks by working a bit longer in the evening. Claudia says that she is sure it will not affect the project or her team members in a negative way as they will be taking the breaks in between meetings and always be available on the phone. Is that ok?

Thinking of what is best for the company and the project, what should Bill answer?

A: That is a horrible idea. I expect you to work full-time as that is what we are paying you for. Some back pain never killed anybody.

B: That is a great idea! Thank you for thinking it through so as to not impact the project in a negative way at this stage, I really appreciate it. If there is anything I can do to help let me know. We’ll chat more during our one-on-one tomorrow.

C: Take all the time you need to take care of yourself and take the time off. The project will manage without you until you are well again. You can return to work once your back is back to normal.

Presenteeism behaviour rises when stress levels rises

Bill should answer C and this is why:

When employees are stressed it is common that they work even when they are not feeling well, be it the onset of a cold or something more severe. A study of a Dutch trade firm found that over 7% of the workforce experienced health problems while working an average day and a Swedish study of police officers found that 47% of the respondents had been working while ill at least twice in the last 12 months. The occurrence or behaviour of attending work when ill1, is called presenteeism. Presenteeism behaviour rises when stress levels rises.

At a first glance presenteeism could seem beneficial for both the company and the employee: Claudia’s work would get done without her job overflowing onto other colleagues, and she wouldn’t have to take sick-days with associated pay deduction or pay loss.

However… Presenteeism affects the company negatively in several ways:

1) Productivity and quality of work output will go down

Bill has himself worked while having the beginnings of a cold, with headaches and muscle pains, and knows from experience that he didn’t operate on optimal levels at these times. When he has been feeling better again he has usually discovered a few not so great decisions and less than great pieces of work. Looking back at these presenteeism days Bill can recognise that he was often more distracted, had a reduced attention span, low energy levels and was irritated during these times.

Loss: 35% productivity, 20% quality

Working while feeling like Bill has will have caused increased risk of mistakes and injuries, and even if Bill didn’t notice it during these days, the illness did affect him and his work negatively.

Employees with musculoskeletal disorders1, whether caused by stress or not, show a productivity loss of between 20% and 56% on presenteeism days.

When surveyed SME owners and managers under low to moderate psychological distress reported a 35% productivity loss on presenteeism days. Psychological distress is associated with stress stemming from low job control and low social support at work as well as work-life imbalance. A study in the US on presenteeism and associated costs found a productivity loss of 15% per employee per year due to depression/ sadness/ mental illness and an average of 21% due to migraine and headaches. Several other studies have also shown a clear connection between quality loss and the amount of pain experienced by the employee practicing presenteeism.

The quality loss is harder to measure but in a self-report study among dentists, the participants estimated a 20% loss in quality of their work when practicing presenteeism.

Bill therefore feels that it is better if Claudia doesn’t work. The project can manage the 100% productivity loss for a few days but not 20%, or worst case, 56% productivity loss and the added 20% quality loss for weeks or even months if her back continues to bother her.

2) Long-term employee health will decline

As Claudia has suffered from back pain before, Bill is wary about how her working today will affect the business in the long run. She is a very talented manager and it would be a pity to lose her.

Loss: 1 to 3 years

Even after taking base-line health into account, employees who often practice presenteeism have more and longer ensuing sick periods. To practise presenteeism more than five times in a base-line year will increase the risk of having more than 30 sick leave days per year. The long-term effects of this behaviour have been shown to last from one to three years. So, presenteeism today will not only affect the employee and the business baseline this year, but also next year and possibly another two years on top of that.

For Bill and the company it would therefore be better for all if Claudia instead of working visits a GP or a physiotherapist and gets her back sorted before she returns to work again. This way the company will fare better in the long run.

3) Costs will increase

Bill knows the project is right on budget but also knows there is little margin in it. How would Claudia being off affect the project timeline and budget?

Loss: Several thousands of dollars

Presenteeism cost companies more both in monetary value and working time than absenteeism2. Presenteeism is estimated to cause 1.5 times more lost working time than absenteeism and cost employers more, as presenteeism is more common among higher-paid staff and difficult to spot.

In a US study, the cost of presenteeism stood for 71% of all depression / sadness / mental illness related costs and for 89% of all migraine and headache related costs. When the cost of productivity and quality loss was added, it summed to several thousands of dollars per employee per year.

What makes employees more prone to presenteeism?

Bill knows Clauda well and is not surprised by her offer. Claudia is a very conscientious colleague who enjoys her work and is greatly appreciated by her team members.

Characteristics and Situation

An employee’s personal characteristics and situation will influence how prone they are to presenteeism. Older employees are less prone to presenteeism, while employees that are: unwilling to risk burdening colleagues; have a feeling of being indispensable; and/or enjoy work are more prone to presenteeism. Employees that are on fixed-term contracts; that can’t afford pay deduction or pay loss associated with a sick day; that have a child; and/or are highly-educated, are also more prone to presenteeism.

The employees’ role in the company also makes a difference. An employee is more prone to presenteeism if they have a “white collar” job; has a role where their input affects the productivity of an entire team; is a “high-responsibility” employee or is a specialist; or has a unique role difficult to substitute for.

Hence, Claudias personality and position as a manager in an SME makes her an almost perfect candidate for presenteeism behaviour.

Presenteeism prone work-environment

Bill knows there has been stress in the project for a while now and that David and Laura’s behaviour most likely is caused by stress. They might not be best friends normally, but they can usually get along ok.

Managers and Stress

The work environment influences employees well-being and behaviour in many ways and will affect employees tendency for presenteeism.

Managers play a significant role in inciting presentism behaviour. Managers who practice presenteeism will influence their employees to also do so, which in turn increases employee sick leave occasions and the number of sick days. Ironically, managers in SMEs are also more prone to presenteeism which, off course, will encourage their juniors to do the same.

However, most influential on presenteeism behaviour is work-place stress: low decision authority, low social support at work, time pressure, high workload, job insecurity, poor ergonomics, lack of resources, work problems, too much responsibility, managing work demands, negative behaviour from manager and more has been identified as increasing presenteeism propensity.

Hence Bill knows the most important thing for him to do in order to reduce presenteeism and to increase the quality of the project and its chances of success, is to get a grip on employee stress levels and find ways of managing them by primary interventions.


1 Employees with a chronic physical or mental illness will, of course, work ill every day. Their corresponding behaviour would be to work during a flare-up.

2 Absenteeism is “the practice of regularly staying away from work or school without good reason” and often occurs among stressed employees.




A person climbing an ice wall

See Challenges, not Problems

Originally Published on LinkedIn on April 20, 2020

I am currently digging into the topic of employee and team resilience for a client. (More on this topic will follow.)

Resilience is a trait that will benefit you as it helps you manage an ever changing and often uncertain, complex, and ambiguous work environment.

Research has shown that how resilient an employee is, is heavily dependent on his or her personality, positive personality traits are important, as well as the work environment and culture of the company they work for. It has also shown that the right kind of environment can help you build up your resilience.

"There are no problems, only challenges"

This reminded me of my previous department head James Williams who always said (and I am paraphrasing here) “There are no problems, only challenges”. James was, he is now retired, a great department head and I had immense respect for his knowledge, experience and how he led the department.

However, at first I felt it was a bit too “spiritual” for me. I couldn’t help to become a bit annoyed when he corrected me when I said “problem”. Why did it matter if I said “problem” and not “challenge”?

But within weeks I saw how the use of “challenge” changed the mindset of the entire team. To have a challenge is something positive, to have a problem is not. To have a whole team see a challenge, rather than a problem, builds resilience.

This only goes to show that small changes can make a world of difference.

What word did you change / would you like to change in your workplace?




An Egg in a vice

Shouldn’t every individual focus on improving how they relate to pressure overall and not just at work?

Originally Published on LinkedIn on March 3, 2020

Recently I published a short article titled “5 short things everyone should know about Burnout” and got two questions in return that I am answering in one article each. Last week I answered the question “Do we tend to blame stress on the workplace regardless of what is going on in our private lives?”. If you haven’t read that article yet I highly recommend that you do so, as it is closely connected to this one. The second great question I got was:

Question two: Shouldn’t every individual focus on improving how they relate to pressure overall and not just at work?

In context of the question answered in the previous article, refered to above, I have understood this question to have two meanings:

  • Shouldn’t individuals themselves work on how they handle stress on their own?
  • Doesn’t the responsibility to handle stress lie with the individual to do it themselves, rather than with the employer?

The answer two both of these questions are “No”.

In short: A vast amount of research has shown that social support affects physical and mental health in a positive way. When experiencing long term stress both a person’s physical and mental health will be negatively affected. Hence, asking for help and support is beneficial for an individual’s health. Therefore, an employee asking for support, when in stress, will benefit the company more than the employee who doesn’t.

Let’s look at this in a bit more detail.

In stress research they talk about coping skills and resilience to stress when they talk about how people “relate to pressure”. Firstly let me clarify what is meant by “coping”. Coping is any conscious effort to change how you view the situation and behave in it, that helps you master, reduce or tolerate the stressful situation. It is a process, not an outcome.

How resilient one is to stress is controlled by hormones and therefore not necessarily anything that can be affected without medication. On the other hand, how one copes with stress is something that can be improved, but perhaps not to a level that it is enough for every situation. Hence the possibility of improving how one “relates to pressure” is limited.

“With social support your body will
react less to stressful situations”

A person who is anxious, depressed, emotional, interpersonal sensitive or pessimistic will be less able to cope with stress and pressure. A person that is optimistic, has a purpose in life, uses positive reinterpretation and experience growth will fare better and social support is important. As stress can cause you to be anxious, depressed, emotional, sensitive and pessimistic, it follows that one is less able to cope when stressed.

Research has also shown that low social support in stressful situations are associated with heightened stress reactivity such as increased blood pressure, heart rate and cortisol levels (a stress hormone). With social support, your body will react less to stressful situations.

Asking for help and getting support in stressful situations is therefore a sensible thing to do as it will help you cope better as your bodily response will be lower and you might get help to positively reinterpret the situation.

“Choose the person who will give you
the kind of support you need”

Even if the “thing” you are stressed about is something at work, you don’t always have to talk to someone at work. Initially, it can be a partner, friend, parent, or a mental health professional that is a good person to talk to. However, try to choose the person who will give you the kind of support you need at the moment: Do you need emotional support, a different outlook on the situation, or practical tips on what you can do to resolve it?

Once you feel that you have gotten some perspective on the situation and/or feel emotionally better prepared to handle it, you might also turn to someone at work for help.

Coping and resilience is crucial when you are in a stressful situation. Assuming that you choose the right time to do so, working on improving one’s coping skills can be a good thing. These kinds of skills are usually learnt in Cognitive Behavioural Therapy, CBT.

CBT is scientifically proven to be effective and safe for most people and can be learnt in many different ways. I would highly recommend that you take help of a therapist to find what method that works for you and to make sure you practice your skills in a safe environment.

CBT works by you getting to know yourself well enough to know:

  • what kind of situation(s) that usually causes you stress;
  • how you respond to to the situation(s);
  • what you can do to manage the situation by way of acting and/or thinking; and, if possible
  • why this situation causes you stress.

This will help you cope better in stressful situations. It will also help you better prepare for foreseen stressful events which will help make them less stressful to you.

“Meeting at 5 am anyone?”

I know, for example, that if I have a meeting the next day at a location I haven’t visited before, I will be stressed. I also know this most of the time I wake up very early on such days and can’t go back to sleep.

To cope with this I avoid caffeine the day before the meeting and, if at all possible, I go to bed an hour earlier in the evening. If I have time and possibility to do so, I might even go there a few days before to make sure I know where I am going. I am also a great fan of Google maps street view.

I know this kind of situation causes me stress as I don’t like being late, and I am afraid I will arrive late.

Seeing it summarised like this, the source of and solution to this stress issue might seem obvious. However without CBT under the guidance of a therapist I am not sure I would have reached the right conclusion. The reason for the stress might just as well have been a fear of meeting unknown people, fear of forgetting to bring the meeting material etc.

On various medical information websites it is recommended that if you are feeling overwhelmed, you feel that you can’t cope, have suicidal thoughts or use drugs and/or alcohol to help you cope in a stressful situation, you should talk to a qualified mental health care provider.

I would say, regardless of how they put it: If you feel like the situation is too much for you, then it is too much for you, and you should ask for help. Research has shown that this is a healthier approach than trying to improve how you relate to the pressure you are under on your own while you are in a stressed situation.




A man pointing a finger at the camera against a black back-dropp

Do we tend to blame stress on the workplace regardless of what is going on in our private lives?

Originally Published on LinkedIn on February 24, 2020

Recently I published a short article titled “5 short things everyone should know about Burnout” and got two questions in return that I am going to answer in one article each.

Question One: Do we tend to blame stress on the workplace regardless of what is going on in our private lives?

I am sorry to have to say that I have no well-founded answer to this question.

This is a question where I haven’t been able to find any research to support a claim in either direction. Nor can I find any research on the topic of if people refuse to take responsibility for stress at home, and instead make work accountable for all the stress they experience.

Most research in relation to stress is in regards to work-place stress, or stress in the private life that is due to trauma. None of this research is about how people are placing blame / facing the responsibility for stress at home or work and relevant for this discussion (i.e. not trauma related). If anyone knows of published research that would answer this question, please let me know in the comments below.

"The hormones released by your body in
response to stress do not know the
difference"

It might be worth making an observation though: In response to stress, our bodies react the same regardless of if we are stressed at home and/or work. The hormones released by your body in response to stress do not know the difference between the two settings. If you are stressed in your private life you will be stressed at work, and the other way around.

It can therefore be argued that an employer benefits from creating a work environment with optimal* stress levels for all employees. It stands to reason that this would be the best way of making sure the employees can be as healthy and productive as possible. This regardless of who is to be “blamed” for the situation.

Similarly it can be argued that employees have a certain responsibility towards their employer to acknowledge when their life outside of work has become too stressful and to take action.

Next time I answer the question: Shouldn’t every individual focus on improving how they relate to pressure overall and not just at work?


* By optimal level of stress means that the employee has the right workload, work engagement etc. in order to feel motivated and stay focused. Too little stress and the employee will feel bored and inactive, too much and the employee will feel fatigue, exhaustion, experience anxiety etc.




The insides of a burnt out red brick building with burnt wooden beam.

5 short things everyone should know about Burnout

Originally Published on LinkedIn on February 12, 2020

Burnout:

  • is not a medical condition.

  • is the result of chronic workplace stress

  • prevention cost less than reaction for employee, employer and society.

  • interventions on unit level, such as team level, are more effective than on an individual level.




A robot from a Terminator movie in front of a wall of fire

Mindfulness is not a terminator of stress

Originally Published on LinkedIn on January 4, 2020
Original image was originally posted on Flickr by Al Lemos. Image published under creative commons licence https://creativecommons.org/licenses/by/2.0/legalcode. Background has been adapted.

On more than one occasion during my work life I have been under pressure and in a stressful situation. Being a self-sufficient and independent person, I never want to burden my colleagues with my shortcomings, as I would see it, regardless of the reason for the pressure.

So, I put my head down and somehow miraculously plough my way through it. The ploughing tends to require me starting work at the crack of dawn, eating lunch and dinner at my desk and working well past midnight, if not through the night.

This is in no way a healthy behaviour, and I wished that I had realised exactly how much it could cost me, 20 years ago. The studies on consequences of overtime work are many and most, if not all, point in the same direction: It is bad for your physical and mental health.

The research on the topic on how long-term stress affects human health is vast. Findings based on data from the longitudinal Whitehall II study in the UK that followed British civil servants for 30 years have for example shown:

  • being a woman working 55 h / week more than doubles your risk of depression and anxiety compared to if you work 35‒40 h / week,
  • 3–4 h overtime / day increases the risk of coronary heart disease for middle-aged employees by 160% compared with those with no overtime work,
  • for a majority of middle-aged people, working over 55 hours per week affects the cognitive functions of vocabulary and reasoning negatively compared to those working 40 hours per week. (The differences qualify as having clinical significance, however more research is needed in order to confirm this.)

As a business owner or leader you might not feel that you have “the luxury” of caring about your employees’ health. After all it is something that only affects them, isn’t it? This is not the case.

According to the European Union (EU) Framework Directive on safety and health at work employers have to manage the psychosocial issues in the workplace and prevent occupational risks. This means that you as an employer can be held liable if you fail to fulfil this responsibility.

The presence of workplace stress also negatively affects your company’s bottom line:

  • The International Labour Organisation states that in Europe the estimated cost of work-related depression for employees is €272 billion a year for absenteeism and presenteeism and the cost in loss of productivity is €242 billion. Put into perspective Portugal had a GDP of €216 billion in 2018 and has the 3rd largest national debt in the world with €232 billion in 2019. Exactly what these sums means for your individual business will depend on the size of the business, the gender split, ages of the employees, social benefits or other factors specific to your business and location.
  • The American Psychiatric Association Foundation has developed a tool for individual businesses to calculate the cost of not helping employees with depression or alcohol or substance abuse. This tool shows that if you have a business in management with 50 employees, three are likely to suffer from depression. From this your company would lose roughly an estimated 94 workdays per year to absenteeism and 84 workdays per year to presenteeism and, on top of that, it would cost your business over $30,700 per year in wages.

In one of my workplaces, HR recognised there were some of us who had a stressful work-life situation. In an effort to help they organised a mindfulness seminar that I attended. The seminar had, apart from a presentation, some practical exercises in it and at the end they recommended a mindfulness app. The purpose of the app was to help you achieve a mindful state that, if you practised regularly, would relieve the stress.

Being a conscientious person, always trying to be a “good employee”, I used the app. I worked really hard to squeeze in the mindfulness practice even after a 20 hour workday. I practised, a lot, and I got more and more stressed. By now I was anxious and slightly panicked over my lack of progress despite trying so hard. What was wrong with me? Why didn’t it help?

I felt really bad about it, as I felt that I didn’t fulfill my obligations to my employer, but eventually I gave up the app.

This company wasn’t the only one believing mindfulness would help their employees through stressful situations. Many companies today offer mindfulness training to their employees or try to have a mindful working environment, in order to help them cope with workplace stress.

However, this might not be the best solution at least not according to several critical reviews of existing research on mindfulness.

These reviews show there is little to no reliable evidence that mindfulness reduces stress. This might sound contradictory to what you have heard or read; there is plenty of research out there supporting the use of mindfulness to reduce stress. Likewise the media is full of reports on such studies, and how fantastic results can be achieved if employees just practice mindfulness in their (work)life.

The problem is that the majority of the research done, and reported on, is not yet at a stage where any conclusions on the effect of the use of mindfulness in the general public can be drawn. The evidence that mindfulness has any clinical effect as a stress management tool just isn’t there yet.

One important study on the topic of the effects of mindfulness, has looked at how many of the studies done on the topic of Mindfulness and its effects, that followed and completed all stages of the US National Institutes of Health tool “Stage Model for Behavioral Intervention Development”.

This model is used to ensure that mental health interventions are well researched before being used in the care of the general public and that there is a certain level of scientific rigour behind clinical research. The model has six stages ranging from stage 0 which involves the research done before an intervention is being designed to stage 5, where how to implement an empirically successful intervention in a community is being researched.

Of the research conducted on mindfulness only 1 % passes stage 4 “research examines empirically supported behavioural interventions in community settings, with community-based providers or caregivers […]”. Only if a study passes stage 4, the intervention has proven to be effective, can it be assumed safe to be used publicly.

In another large study, 15 researchers from diverse areas of expertise looked at the evidence for mindfulness and its effects based on behavioral and neuroimaging studies. They point out many areas of concern regarding the research that has been done:

  1. The studies don’t properly define what is meant by mindfulness, meaning it is hard to measure the effects of mindfulness on a test subject. This is concerning in many ways but let’s look at two reasons for concern:

    • One of the fundamentals of scientific research is that its results should be reproducible by independent research projects. Other researchers should be able to do the same test on a different population and see if they get similar results. This becomes impossible if what is meant by “mindfulness” is not defined in the first place.
    • In research it is not uncommon that researchers put data from several research projects together to get a larger population to draw conclusions from in a so called meta-analysis. This is fine when you know that the studies have analysed exactly the same thing. When this is done on mindfulness studies, and this is common as most studies are very small, this is problematic as extremely few actually define what their study means by “mindfulness”. Researchers end up comparing subjects using a random online mindfulness app, with subjects who have undergone Mindfulness Based Stress Reduction training (MBSR1), with people who have been on a three month mindfulness retreat as if they were all one and the same thing. Or as my secondary school maths teacher would have put it: You draw conclusions on what apples taste like based on fruit puree.
  2. Most studies rely on self-reporting questionnaires. These studies are troubled by the participant’s limited understanding of mental states (compared to the study writer) and are often biased as the participants know what is “expected” of them as the experimenters often fail to hide what effect they hope mindfulness will have on the participant.

  3. Many of the characteristics measured as a proof of mindfulness are also personality traits, i.e. what is being measured is not necessarily the state of mindfulness achieved but a mood change in the participant caused by other factors.

  4. Very few of the studies have a systematic way of detecting any adverse effects from the treatment. Mindfulness might sound harmless but in fact it is recommended that MBSR is not undergone by persons who are suicidal or suffer from a current psychiatric disorder. If occurrences of adverse effects are not systematically tracked, the studies can’t assure the method studied is harm-free. They can also not identify which patients it might be harmful for and what characteristics those patients have.

  5. Studies based on structural or functional neuroimaging have issues with a set of unique confounding factors. An example of this is that the recorded brain activity can be affected by heart and respiratory rate.

  6. Another issue affecting studies based on neuroimaging is that the technique is relatively new, so there is not yet a proven way of differentiating between practical significance and clinical importance in the changes being observed.

Instead of offering a mindfulness seminar that recommended a mindfulness app, what could my former employer have done? What can you as a business owner do?

The International Labour Organisation has, through extensive reviews of stress research, concluded that consideration of both physical and mental working conditions is needed to combat workplace stress.

What does that mean? There are many ways to approach this challenge but a good place to start is to look at how tasks are executed and in what kind of physical and mental environment the work is done. Then you can find ways of improving both.

Examples of preventative measures for stress management may include:

  • your organisation has an open attitude towards stress reporting and that it has positive, rather than negative, effects for employees when stress is reported.
  • your organisation has systems in place for reporting and following up on reported stress as well as detecting unreported stress.
  • your employees knowing how to manage the tools provided to them, such as computer software, to their full capability.
  • automating repetitive tasks done on a computer, e.g. by introducing macros or similar solutions.
  • having clear duty descriptions for all roles.
  • writing all directives, processes, standard operating procedures, duty descriptions etc. with disabled employees in mind, including those with invisible disabilities.
  • utilising the full competence of your employees.
  • that capabilities, resources, or needs of your employees are met and rarely exceeded.
  • making sure your employees feel appreciated for the work they do.
  • having managers that lead by example when it comes to stress management and working long hours.
  • that if you have an employee returning to work after a stress-related illness, you make sure they are not returning to the same stressful environment they had to leave.

To use efficient and well proven methods to tackle workplace stress is crucial for all employers. Despite the fact that googling “How to use mindfulness to reduce stress?” produces 49’700’000 search results, mindfulness is not one of them. If you use mindfulness and find it helpful by all means continue to practice it. However, don’t make the mistake of viewing it as a method that has been proven to be efficient in warding off, or reducing, workplace stress. Mindfulness is not a terminator of workplace stress, not even a baby terminator.


1 MBSR is an eight-week mindfulness based stress reduction course introduced in the 1990s.




It doesn’t matter what relaxation techniques you practice...

Stress vs Relaxation Techniques: Stress wins - Article 5(5)

Originally Published on LinkedIn on November 8, 2019

In article 1-4 we have explored what it means to be stressed, how to recognise stress in yourself and others as well as at some health risks that comes with work-related stress. Now we will look at what can be done by you and your organisation.

If you or a co-worker is already suffering from symptoms of stress related illnesses such as forgetfulness, difficulty planning, light-headedness or tummy issues, there is need for so called tertiary interventions.

Tertiary interventions are designed to treat the illness, be it physical or psychological. These interventions are most often managed by health care providers, so contact your general practitioner (GP) for help if you are showing symptoms.

However, if you are in a stressful situation but are not yet ill from it, you are in need of so called secondary interventions as well as primary interventions.

The purpose of secondary interventions is to help you cope with and manage the stress you are experiencing. There are many different approaches to this and the interventions span everything from relaxation techniques to cognitive therapies and conflict resolution training. Even a well chosen spare time interest can work as a secondary intervention.

Finding an intervention that helps you can take some time but is time well spent. One relatively simple thing you can do is to take a 20 minutes walk during lunch. Regardless of speed you walk it will help your body to deal with overflow of stress related hormones.

What is good to know when you choose your spare time interest is that you will help your brain relax by doing something different compared to your workday.

If you have a spare time interest that stimulates the other half of your brain than what is normally stimulated during work you will feel more refreshed and relaxed afterwards than if you don’t.

That is, if you have a very theoretical job, with focus on facts and analysis, a creative and/or artistic spare-time interest will help your brain relax. Of course the other way around applies as well, if you have a creative or artistic job you will benefit from fact and analytical spare time interest such as reading a biography or solving a Sudoku.

What is always needed, regardless of if you are already suffering from stress related illnesses or have not quite reached that level of stress yet, are what is called primary interventions.

Primary interventions are aimed at your workplace. They focus on finding what tasks or situations in the workplace that causes you stress and doing something about it.

Wouldn’t you feel less stressed if that high pressure task you preform each day was done by your computer? Or if you and your colleagues communicated better with each other? What about a bit more verbal appreciation for hard work you put in, wouldn’t that also make you feel a bit better?

The primary interventions will make the work environment healthier for both you and your co-workers and reduce the risk of you developing a stress related illness. If you are already there, it will reduce the risk of you developing permanent health issues.

Let’s face it, there is no amount of relaxation techniques and no spare-time interest that can fully counter the effects of workplace stress. The only long-term solution is an improved work environment.

How long will you let your workenvironment stay the same?




The effects of stress-related illnesses can remain with you...

Stress – The choice of a lifetime partner? - Article 4(5)

Originally Published on LinkedIn on November 7, 2019

In article 1-3 we have explored what it means to be stressed and how to recognise stress in yourself and others. Now we will look at a general overview of what health risks that comes with work-place stress.

When you are stressed the risk of you developing unhealthy behaviours is increased. Common such behaviours are heavy alcohol consumption, no exercise, eating a lot of unhealthy food, and taking up or increasing the use of tobacco or drugs. None of these behaviours will be very good for you in the long run.

The risks of stress doesn’t stop there. Most people know that if you are stressed your risk of heart problems are increased. But did you know that if you are in a situation where you experience the stress levels as high, the risk of you developing heart problems increases with at least 50%?

You are also at risk of developing Musculoskeletal disorders that often comes with severe long-term pain and possible disability.

And to make matters worse you are at high risk of developing mental health problems. The risk of developing depression when you experience your stress level as high is increased with up to four times. Examples of other mental health problems you are at risk of developing would be anxiety and burnout.

These are just some of the health issues you can experience as a consequence of work-related stress. Many of them can remain with you for the rest of your life.

Who will be your life-time partner?




If you have a stressed colleague...

Do you know when a co-worker is stressed? - Article 3(5)

Originally Published on LinkedIn on November 6, 2019

In my last article I talked about how you can recognise stress in your self. But perhaps it is not you who are stressed, but a co-worker? Would you recognise if your co-workers are stressed?

As you are not as likely to know how your co-worker is feeling a good start is to look at their behaviour:

They might be complaining of headaches, muscle tensions and/or pains, indigestion, dizziness fatigue and problems sleeping. Your stressed co-worker can also be absent from work more than usual as well as be more prone to accidents.

When you interact with them they might not seem to be as concentrated as usual and have problems remembering things as well as act confused. You might also notice that they don’t seem to listen to, or take in, what you say.

Emotionally your stressed colleague can be impatient, negative, moody and lose the temper quicker than usual. But he/she might also be anxious, tearful, have low self-esteem, and seem depressed. All sense of humour might seem lost and they can be increasingly aggressive and restless.

Your colleague’s behaviour might also change and they can become more withdrawn avoiding contact with you and other co-workers. Their usual drive and motivation can be lacking. Planing duties and performing them can suddenly seem difficult for them.

For some, the appetite for unhealthy food increases or the appetite is almost completely gone. As a coping mechanism they might inadvertently increase their use of use of tobacco, alcohol and drugs.

How many of your co-workers do you now think might be stressed and in need of a helping hand?




If you are not sure how you react to stress...

Are you sure you know that you are stressed before it is “to late”? - Article 2(5)

Originally Published on LinkedIn on November 5, 2019

The last article I published I talked about the difference between being stressed and being busy. Now it is time to look at symptoms of stress.

The best way of knowing if you are stressed is to observe your own behaviour as well as listen to your body and feelings. If these signal to you that you are stressed you should take action.

So what signals should you look out for? The symptoms of stress are many and some commonly mentioned are (listed alphabetically):

Body: difficulty breathing and frequent sighing, digestion problems, frequent colds and infections, lightheadedness/faintness/dizziness, low energy or fatigue, muscle pain and/or tension, problems with sleep.

Moods and mind: agitated, angry, anxious, constantly worried, depressed, disorganised, feeling overwhelmed, forgetful, frustrated, irritable, lack motivation, low self-esteem, problems concentrating, racing thoughts, restless, sad.

Behaviours: avoiding others and/or responsibilities, changes in appetite, communication difficulties, decreased physical activity, edginess, frequent crying spells, hostile, increased use of tobacco, alcohol and/or drugs , moodiness, nervousness, overreactions, procrastination.

So, what is your body telling you? Are you stressed?

Some of the symptoms listed can indicate other health issues than stress. If you experience some of these symptoms and/or feel not quite like your normal self, seek medical advice and talk to your doctor or another medical professional. This article is not to be seen as a medical advice, it is meant to help raise awareness.)




Stress is not an indication that people are weak...

Stressed or just busy? - Article 1(5)

Originally Published on LinkedIn on November 4, 2019

We have all felt stressed at some point in our life’s and in today’s world we tend to be quite busy. But have you ever asked yourself what’s the difference, if any?

When you are busy you might have a full calendar, “a million” things to do and move between tasks quickly. However, you are comfortable with what is asked of you, the pace you keep and the time you have to get through it all.

When you are stressed the demands on you, what you have to do, is more than you can cope with. Be that psychological or physical. A little bit of stress can help keep you feeling inspired and motivated, rather than bored, at work. However, if you find yourself in a stream constant ongoing stress, the stress will eventually be harmful to you.

So, are you stressed or just busy?




An Egg in a vice

What are you waiting for!?

Originally Published on LinkedIn on October 28, 2019

We have probably all been under pressure and stressed at work at more than one occasion. Often this result in lunch at the desk and one or several late nights. If this happens now and then it can be an inspiring event. However, if it happens “all the time” or is a constant state it will have negative consequences.

Not only will it affect your work performance in a negative way, it will also negatively affect your physical and mental health and, if you are an SME owner, your company. So, what can you as a business owner do to protect yourself?

The most effective approaches to reduce work-related stress looks at the working conditions and improve these. There are many ways to approach this challenge but a good place to start is to ask yourself the following questions:

How often during your workday do you focus on just one thing?

Research has shown that after every interruption you experience it will take you an average of 20-25 minutes to get back to full concentration. Be this an interruption by a phone call or an “you got mail”-notification.

If you are honest with yourself, how much concentrated work do you really do in a day?

How much time do you spend doing something other than what you had planned to do?

All SME owners know that unforeseen events are a part of running a business. A phone call can take longer than expected, you might get a request you can’t turn down, an employee might want to talk, and so on. Regardless of how necessary these time-consuming tasks are, they will still add to your stress.

How much less stress would you feel if you scheduled 25% extra time for every task you plan just to allow for the unforeseen to happen?

How much time in a work-month do you spend on “time wasters”?

If you regularly perform manual tasks on a computer, and these tasks, although necessary, feel like a waste of time, then these tasks are indeed wasting your time. With some programming, most tasks that are done on standard office software can be automated.

How much time would you be able to spend on more important things each month, if your computer did more of the work for you?

So, take a moment and think about what causes you stress at work. What can you do to remove it from your work environment? Can it be removed in just a few minutes?

Well then, what are you waiting for!?


Sources

The list of sources for individual articles are not exhaustive and only published for articles with an estimated reading time of more than two minutes.

The Costly Pitfalls of Workplace Stress and Presenteeism

  • Bierla I, Huver B, Richard S. New evidence on absenteeism and presenteeism. The International Journal of Human Resource Management 2012. DOI: 10.1080/09585192.2012.722120
  • Boezeman E J, Nieuwenhuijsen K. de Bekker-Grob E W, van den Akker-van Marle M E, Sluiter J K. The Relative Importance of the Domains of Work Functioning Evaluations of Health-Impaired Employees, Healthy Employees, and Employers. Journal of Occupational and Environmental Medicine 2015. DOI: 10.1097/JOM.0000000000000361
  • Brouwer WB, Koopmanschap MA, Rutten FF. Productivity losses without absence: measurement validation and empirical evidence. Health Policy 1999;48(1):13-27. DOI: 10.1016/s0168-8510(99)00028-7
  • Choi BK, Östergren PO, Canivet C, Moghadassi M, Lindeberg S, Karasek R, Isacsson SO. Synergistic interaction effect between job control and social support at work on general psychological distress. International Archives of Occupational and Environmental Health 2011 84:77–89. DOI: 10.1007/s00420-010-0554-y
  • Cocker F, Martin A, Scott J, Venn A, Sanderson K. Psychological Distress, Related Work Attendance, and Productivity Loss in Small-to-Medium Enterprise Owner/Managers. International Journal of Environmental Research and Public Health 2013, 10, 5062-5082. DOI: 10.3390/ijerph10105062
  • Dietz C, Zacher H, Scheel T, Otto K, Rigotti T. Leaders as role models: Effects of leader presenteeism on employee presenteeism and sick leave. Work & Stress 2020 34:3, 300-322. DOI: 10.1080/02678373.2020.1728420
  • Elstad J I, Vabø M. Job stress, sickness absence and sickness presenteeism in Nordic elderly care. Scandinavian Journal of Public Health 2008; 000: 1–8. DOI: 10.1177/140349480808955
  • Gilbreath B, Karimi L. Supervisor Behavior and Employee Presenteeism. International Journal of Leadership Studies, 2012 Vol. 7 Iss. 1. 114-131, ISSN 1554-3145
  • Goetzel R, Long, S R MS, Ozminkowski R J, Hawkins K, Wang S, Lynch W. Health, Absence, Disability, and Presenteeism Cost Estimates of Certain Physical and Mental Health Conditions Affecting U.S. Employers. Journal of Occupational and Environmental Medicine 2004 46(4):398-412. DOI: 10.1097/01.jom.0000121151.40413.bd
  • Johansen V, Aronsson G, Marklund S. Positive and negative reasons for sickness presenteeism in Norway and Sweden: a crosssectional survey. BMJ Open 2014;4:e004123. DOI: 10.1136/bmjopen-2013-004123
  • Johns G. Attendance Dynamics at Work: The Antecedents and Correlates of Presenteeism, Absenteeism, and Productivity Loss. Journal of Occupational Health Psychology 2011, Vol. 16, No. 4, 483–500. DOI: 10.1037/a0025153
  • Jung MH, Lee YM, Arakida M. Stress and Presenteeism in Workers of Small and Medium Enterprises. Korean J Occup Environ Med. 2007 Mar;19(1):47-55. DOI: 10.35371/kjoem.2007.19.1.47
  • Leineweber C, Westerlund H, Hagberg J, Svedberg P, Luokkala M, Alexanderson K. Sickness Presenteeism Among Swedish Police Officers. Journal of Occupational Rehabilitation 2011 21:17–22. DOI: 10.1007/s10926-010-9249-1
  • Marklund, S., Storm Mienna, C., Wahlström, J., Englund, E., Wiesinger, B. Work ability and productivity among dentists: associations with musculoskeletal pain, stress, and sleep. International Archives of Occupational and Environmental Health 2020 93(2): 271-278. DOI: 10.1007/s00420-019-01478-5
  • McTernan W P, Dollard M F, LaMontagne A D. Depression in the workplace: An economic cost analysis of depression-related productivity loss attributable to job strain and bullying. Work & Stress: An International Journal of Work, Health & Organisations 2013 27:4, 321-338. DOI: 10.1080/02678373.2013.846948
  • The Sainsbury Centre for Mental Health. Mental Health at Work: Developing the business case. The Sainsbury Centre for Mental Health, December 2007. https://www.centreformentalhealth.org.uk/sites/default/files/2018-09/mental_health_at_work.pdf
  • Wilkins K, Beaudet MP. Work stress and health. Health Rep. 1998;10(3). https://www150.statcan.gc.ca/n1/en/pub/82-003-x/1998003/article/4140-eng.pdf?st=sCpxsAzr
  • Yang T, Shen YM, Zhu M, Liu Y, Deng J, Chen Q, See LC. Effects of Co-Worker and Supervisor Support on Job Stress and Presenteeism in an Aging Workforce: A Structural Equation Modelling Approach. International Journal of Environmental Research and Public Health 2016, 13, 72. DOI: 10.3390/ijerph13010072

Shouldn’t every individual focus on improving how they relate to pressure overall and not just at work?

  • Folkman S, Lazarus RS. An Analysis of Coping in a Middle-Aged Community Sample.1 Journal of Health and Social Behavior 1980 Vol. 21, No. 3. DOI: 10.2307/2136617
  • Ozbay, F, Johnson D.C, Dimoulas E, Morgan CA, Charney D, Southwick S. Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont). 2007 May; 4(5). PMCID: PMC2921311
  • Smith BW, Zautra AJ. Vulnerability and Resilience in Women With Arthritis: Test of a Two-Factor Model. Journal of Consulting and Clinical Psychology 2008, Vol. 76, No. 5. DOI: 10.1037/0022-006X.76.5.799
  • Satterfield J. Coping With Stress: How to Survive in a Fast-paced World. Minding the Body: Cognitive-Behavioral Stress Reduction.2 University of California Television (UCTV) 2012. https://www.youtube.com/watch?v=0BbHW3H_xmo

1 Despite this article being published in 1980, and research on stress has made great progress since, their definition of “coping” still stands.

2 Please note that CBT should not be undertaken without guidance form a therapist in the beginning as it is not suitable for everyone.

Mindfulness is not a terminator of stress