The challenge of work-related stress is now well-recognised by many employers. But how our emotions, the fluctuating emotional interplay with our environment that we experience every day, affects and feeds into stress and stress-related illnesses is much less well understood. Occupational psychologist Kyle Davies investigates.
Depression, anxiety and stress now account for the majority of days lost because of work-related ill health in the UK. Statistics published by the government show that around 300,000 people with mental health problems will leave their jobs each year, and that this is costing the UK economy around £99 billion each year.
Paul Farmer, chief executive of the charity Mind and co-author of the Thriving at Work report commissioned by the Prime Minister Theresa May, said at the time of the launch of that report in October 2017: “Mental health was a taboo subject in many workplaces. Opportunities are missed to prevent poor mental health and ensure that employees who may be struggling get the support they need.
“In many instances, employers simply don’t understand the crucial role they can play, or know where to go for advice and support.”
About the author
Kyle Davies BSc MPhil CPsychol AFBPsS is a qualified chartered occupational psychologist and business coach. He is also director of Energy-Flow Coaching and author of The Intelligent Body
Quite often employees will fail to inform a manager if they are suffering from stress and, if they do, no mitigating action is taken.
Lack of action can lead to deeply serious and complex afflictions amongst employees, such as Chronic Fatigue Syndrome or Fibromyalgia, but we are also talking about mild depression, anxiety and addiction. These are conditions that are becoming increasingly more common in the workplace.
Depression, stress and anxiety show now boundaries. They can affect any employee in any industry at any time whatever their age or experience
So how does stress present itself and what are the signs? In truth, the list is significant. Behavioural indicators can include lateness, a drop in workplace performance, incomplete tasks or duties, apathy and diminished motivation, mood swings that can impact relationships at work. There can be increases in coughs, colds and other viral symptoms.
Cognitive difficulties including concentration and memory problems, which can be generalised as a “foggy” head. A whole host of medically unexplained physical symptoms including groggy fatigue, muscular tension, heart palpitations, stomach upset, headaches, insomnia and sleep disturbance, and back or chest pain.
A number of these symptoms fall under the umbrella of anxiety and depression, and many fall into the significant category of medically unexplained or functional symptoms. In both instances, emotional stress is the biggest primary cause.
An even more worrying factor is that research is beginning to tell us that emotional stress plays a significant role in a host of chronic structural illnesses from heart disease to certain types of cancers.
The problem facing employers
The difficulty for employers is that many of these symptoms can be tricky to identify. Absenteeism as a result of stress-related symptoms and conditions is problematic; however, what is of far greater concern is “presenteeism”, where employees are present in work but under performing due to health challenges.
An employee could endure a significant period of presenteeism before absenteeism takes hold. The cost to the business of this prolonged period of presenteeism is potentially massive.
From the perspective of the individual suffering from stress-related symptoms, identifying when you have a problem can also be difficult. The gradual increase in symptoms over time can be stealth-like, rendering an individual unaware that their performance at work has dropped significantly and their workplace relationships are suffering.
Of course, this is not always the case and, in most instances, symptoms will be more obvious and potentially disturbing. Experiencing a health challenge and either not knowing what it is or what is causing it can lead to fear and worry about the symptoms and a fixation on what is wrong, all of which can exacerbate the situation further.
Stress and disease: the hidden connections
Seeing health problems as either physical or mental is no longer a useful categorisation. Growing evidence of the mind-body connection indicates that a body in a perpetual state of stress will break down and symptoms may present themselves as physical or psychological, however, the cause could be largely the same.
There are two extremely important facts about stress that are frequently overlooked. First, stress is a set of objective, measurable, biochemical events that take place throughout the body and brain. Far more than the nervous agitated feeling that people often associate with being “stressed”, a body can be in a state of stress in the absence of conscious awareness.
This essentially means that it is entirely possible for an individual to “think” that they are perfectly happy and that all is well, while at the same time their body is registering the stress response in the form of elevated heart rate and blood pressure, amongst other things.
That agitated feeling we have when we are overwhelmed is an emotional feeling and the fact that it can be felt means there is some action that can be taken to process and regulate it. Invisible or hidden stress is what causes problems, when our body is registering stress yet our conscious awareness is oblivious.
We are no longer running from bears in the forest where the stress response is obvious and short term – we either escape or are eaten. Modern-day stress is far more insidious and difficult to detect. A collection of perennial low grade “stressors”, such as timescales, the need for perfection, expectations of others, amongst other things, all result in the ongoing presence of invisible stress impacting body and brain.
The second important point is that stress is not merely a psychological phenomenon. The stress response triggered in the body is exactly the same regardless of whether the “trigger” is a physical injury, such as a car accident, an illness, such as a case of flu, or a build-up of emotional energy inside the body and brain.
Linking the physical and the emotional
There are a whole host of potential “stressors” ranging from ingested toxins, including drugs and alcohol, poor nutrition, excessive exercise, and lack of sleep, that all have the potential of kicking the body into a state of prolonged stress. With this new understanding, we can begin to see that there is no mind-body split as is often thought. Physical and emotional are potentially one and the same when looking from the perspective of understanding symptoms and moving towards health and optimum performance.
Emotional stress is in most instances the biggest concern because it can remain undetected, out of balance and blocked for long periods of time. Working in difficult circumstances, managing client expectations and emotions, and performing at the highest level can all register an emotional response in the body.
Emotion is a complex physiological process that affects all the body, including the major organs, and the brain. It is a biological feedback mechanism in exactly the same way as the feelings associated with hunger and tiredness. Stressors such as physical injuries and illnesses tend to be few and far between.
Other stressors such as lack of sleep, poor diet, overly strenuous exercise, and excessive alcohol intake can be identified and managed or rectified. Emotional stress, however, is different. Emotion can build-up and get blocked impacting the functioning of the cells of the body and brain without us realising it is happening.
A long-term build-up of invisible stress, particularly emotional stress, locks the stress response on, which causes a “re-wiring” of brain regions – structural changes in neuron-neuron connections. When the brain begins to re-wire the negative states or experiences that arise are amplified and accelerated.
The phrase used to describe the brain’s neuroplasticity is “neurons that fire together wire together”. In effect, this means that the more something is perceived in a negative light the more potent the negative response will be, and the more this will be seen as “reality” rather than merely a state of consciousness or mind.
In practice, this can result in a spiralling down where the higher thinking centres shut down and gaining perspective and a sense of logic can become increasingly illusive. In more extreme cases this can lead to irregularities and dysfunction within the immune, endocrine and autonomic nervous systems. This in turn results in the presence of symptoms and disease.
Wellbeing at work
Research suggests that organisational culture, work overload, and poor management skills are the primary causes of workplace stress. Whilst there may be a high degree of truth in this, we continue to see statistics telling us that the cost to industry and business of absenteeism and presenteeism are spiralling, so to what extent is it possible to effect a change in these areas?
There is a slightly different perspective from the conventional view that seeks to identify external events that cause stress. We’re used to seeing lists of disastrous occurrences such as job loss, relationship breakdown, moving to a new house and so on as being the most familiar sources of stress.
However, entertaining this externalised view renders us powerless, unable to manoeuvre in a fixed reality. There is a different perspective that is far more empowering and can make the difference between extended suffering and moving towards optimum health and high performance. Neuroscience tells us that our experience of reality comes from inside us and is fluid and flexible.
Understanding emotional triggers
Emotions are not triggered by external events, they are created inside us. Our sense of reality at any given moment is hugely affected by our feeling state, and our feelings can flow and change moment to moment if we let them. Often this has nothing to do with external events. Most people have had the experience of waking up in the morning and feeling completely different than the previous night even though there has been no change in life circumstances.
Emotions arise as a result of our interaction with the environment, the meaning placed upon the environment, and the deeper values and beliefs we hold about ourselves. External circumstances cannot be controlled and don’t need to be controlled. Orientating attention from outside to inside enables the practice of processing and regulating emotions to begin; the result being an ability to flow with life rather than trying to control it. The impact on the individual is potentially enormous with increased vitality and wellbeing, along with clarity of mind and improved performance.
Human beings have an in-built resilience that enables us to bounce back. Understanding and allowing our emotional feelings and moving beyond the desire to block them, label them or normalise them all facilitate this ability to bounce back quickly. Too often we see ourselves as “broken” and requiring major action to remedy the damage. The horrible irony in many instances is that these fixing strategies are the very things that keep our locked in the stress mode.
Despite the natural tendency to block uncomfortable feelings, when we recognise that our emotional feelings are never a problem, never need to be “solved”, or analysed, we begin to see them as guides, inviting us to be who we are.
They are not about other people, places or situations, they are invitations to be authentic. Fixating on environmental factors that simply cannot be changed only serves to intensity the negative feelings and stress experienced. Embracing this new inside-out perspective on stress and emotion is the path to health, wellness and high performance.
Kyle Davies runs workshops for businesses to help employers deal with stress-related problems in the workplace as well as individual coaching, and more can be found out about this at www.kyledavies.net and www.energyflowcoaching.com
Thriving at Work: a review of mental health and employers: An independent review of mental health and employers by Lord Dennis Stevenson and Paul Farmer, Department for Work and Pensions and Department of Health and Social Care, October 2017, https://www.gov.uk/government/publications/thriving-at-work-a-review-of-mental-health-and-employers