Workplace Stress and Your Health

Experts explain the dangers of work-related stress and provide solutions.

From the WebMD Archives

If you have a cruel boss or rotten co-workers, beware. It may not be just your job that's on the line.

Clearly, a work environment that includes insults, back stabbing and belittling can erode an employee's morale. What's less understood is that such a toxic work atmosphere can also lead to deteriorating health. At WebMD, we talked to the experts to find out what it is about negative work relationships that can cause so much stress, how our bodies react to chronic workplace stress, and what it takes to find relief.

How many times have you watched someone get a promotion when your hard work goes unnoticed, or attempted to offer your insight to management, only to have it fall on deaf ears? Working in an unjust environment can make you sick -- really sick.

A Need to Be Heard

Feeling trapped in a workplace that isn't fair can actually increase your risk for coronary heart disease (CHD), a leading cause of death in the U.S. In a two-part landmark Finnish study conducted between 1985 and 1990, researchers surveyed more than 6,000 male British civil servants -- without presence of CHD -- regarding how fair, or unfair, they perceived their employers. Subjects who reported a high level of justice at work were 30% less likely to develop CHD than workers who consistently experienced injustice at work.

Just how did study participants define "justice" in the workplace? Those who felt their bosses considered their viewpoints, treated them truthfully, and included them in decision-making processes said they worked in "just" workplaces.

The results of the study show what many experts say: Feeling like you haven't been heard ranks as the most stressful aspect of interpersonal work relationships. "It's a helplessness that comes when employees feel like they've expressed themselves and been discounted, or someone hasn't taken the time to listen to them," says psychologist Carol Kauffman, PhD, an assistant professor at Harvard Medical School's department of psychiatry.

Others agree. "The workplace needs to feel meaningful. If you feel like you're not respected, that your opinion isn't meaningful, you're at an increased risk of heart disease," says Bruce Rabin, MD, PhD, a professor of pathology and psychiatry at University of Pittsburgh Medical Center. On the flip side, Rabin tells WebMD, "Feeling a part of the workplace is a meaningful buffer to the health effects of stress.

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Reacting to Co-Workers

How workers react to negative interpersonal relationships in the workplace, be it passive-aggressive co-workers or disgruntled bosses, also has a dramatic impact on subsequent stress levels.

"Some people are more prone to stress reactions. They're likely to be people who have difficulty managing on a day-to-day basis. They may not have effective problem-solving skills, or be predisposed to high levels of anxiety and uncertainty," says social worker Len Tuzman, DSW, an expert on stress management. This is particularly true for employees that Tuzman calls "catastrophizers" -- those who blow a situation out of proportion until it becomes a major calamity.

Just how great a toll does workplace stress take on employees' health? While it's impossible to tease out every illness and adverse health effect that began as a reaction to stress, Minnesota-based health management company StayWell compared the costs of stress with 10 other common health risk factors -- among more than 46,000 employees of both private- and public-sector companies. The risk factors included tobacco and alcohol use, overweight, high blood pressure, and high cholesterol. Cumulatively, these 11 modifiable health risk factors were found to comprise 25% of companies' total health care expenditures. The most costly risk factor? Stress.

How Stress Affects Your Health

Why does stress make you sick?

"When your brain perceives stress, you get reactions from the stress-reactive area, and an elevation of stress hormones -- cortisol and norepinephrine -- increase in concentration in the blood," Rabin tells WebMD.

What happens next? "We believe that each person has different organ vulnerabilities. One person will respond with panic attacks, another with headaches," says John Garrison, PhD, director of the stress management program at Lahey Clinic in Burlington, Mass.

While the impact of workplace stress varies from one person to the next, mounting evidence shows that stress can cause some very specific adverse health effects.

For instance, stress may make it harder to control diabetesby raising blood glucose levels. This is related to the "fight or flight" response, which prompts your body to raise blood sugar levels to help boost energy in response to the stress.

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Stress and Cholesterol Levels

Stress may even raise cholesterol levels, immediately and long term. British researchers evaluating the stress reactions of 199 healthy adult men and women found that participants who reacted more strongly to emotional situations also demonstrated immediate and significant increases in cholesterol levels. Three years later, these same study participants who initially responded more dramatically to stressful situations experienced a more significant elevation in cholesterol levels than other study participants. How significant? Those who had initial stress responses in the top third of the group were, three years later, more likely to have readings above the recommended levels for cholesterol than participants whose initial stress responses fell in the bottom third.

So, what's the stress-cholesterol connection? While researchers aren't certain, one theory is that stress might increase the body's inflammatory processes, in turn increasing lipid production.

Stress-induced health reactions aren't strictly physiological.

Stress also influences our behavior, which can in turn affect our health. "Chronic stress gets in the way of putting information that we know about health behaviors into action. When you're under stress, M&Ms are for lunch," says Joe Piscatella, president of Institute for Fitness and Health and author of The Road to a Healthy Heart Runs Through the Kitchen.

You can't simply will away the people with whom you find difficult to work. But it may help to learn a different way of interacting with them.

How to Respond to Stressful Situations

Feeling like you haven't been heard? "When in doubt, check it out," Kauffman suggests. "Say directly to the person, 'I'm not sure you understood me.' It could be that the person is under too much stress, and didn't have time to absorb [your suggestion or request]."

Trying to cope with a boss you feel is making unreasonable requests?

"Describe the situation objectively," Kauffman says. For example, tell your boss how many projects you have on your plate. She may not realize it.

Next, she suggests, "Express your opinion about the situation. You can say, 'I don't think it's possible for me to work at a faster capacity.'" And, when you explain yourself? Leave the histrionics behind.

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Don't end it there. "Ask for what you need," Kauffman tells WebMD. Be specific, in terms of resources, time, or whatever it is that will help you do your job.

Finally, urges Kauffman, "Reinforce the relationship." Show appreciation for the support you get from your boss.

Just can't seem to get along with someone at work? You're not going to click easily with everyone, but you can learn to make a relationship work. "If you don't have a natural rapport with someone, you've got to create it," says Karen Leland, president of Sterling Consulting Group and author of Watercooler Wisdom: How Smart People Prosper in the Face of Conflict, Pressure, and Change. Here's how. Learn to understand and evaluate a co-worker's style," Leland tells WebMD. Then, you can be "in step" with just about everyone you work with, whether they have a quiet and analytical working style or an expressive working style.

Ready to walk away from your job altogether? "Take some opportunity to step back from the situation and really assess what's going on. Most decisions that people think they need to make immediately, they don't. Look at some alternatives. Talk to people you trust before making a decision," Tuzman offers.

Behaviors That Promote Stress Relief

Even if you don't suffer a severe illness from work-related stress, it can leave you feeling fatigued and run-down, or anxiety-ridden. To combat these unhealthy, unbalanced feelings, try activities that are considered both "invigorators" and "soothers," encourages Scott Meit, PsyD, vice chairman for psychology with The Cleveland Clinic's department of psychiatry and psychology.

To get invigorated, exercise. "Exercise is very important for your emotional balance," Meit tells WebMD. What about those busy executives pressed for time? "Schedule exercise. If you treat it like a board meeting, it gets done," Meit says. Simply too tired? "The research is very clear that exercise, within your capacity, gives back energy," Meit says.

Soothe with relaxation. Garrison, who teaches stress management programs, says that of all the stress-relieving techniques he suggests, his students report the most relief from relaxation techniques.

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"From traditional techniques, such as progressive muscle relaxation to tai chi and meditation, these seem to be the No. 1 way for people to find balance," Garrison tells WebMD.

"Once you start to engage in these activities, it starts to provide a solution," Meit says.

WebMD Feature Reviewed by Louise Chang, MD on September 12, 2007

Sources

SOURCES: Carol Kauffman, PhD, assistant professor, department of psychiatry, Harvard Medical School. Bruce Rabin, MD, PhD, professor of pathology and psychiatry, University of Pittsburgh Medical Center. Len Tuzman, DSW, social worker. John Garrison, PhD, director, stress management program, Lahey Clinic, Burlington, Mass. Karen Leland, president, Sterling Consulting Group; author Watercooler Wisdom: How Smart People Prosper in the Face of Conflict, Pressure, and Change. Scott Meit, PsyD, vice chairman for psychology, department of psychiatry and psychology, The Cleveland Clinic. Kivimaki, M. Archives of Internal Medicine, October 2005; vol 165: pp. 2245-2251. Anderson American Journal of Health Promotion, September-October 2000; vol 15: pp. 45-52. Steptoe, A. Health Psychology, November 2005; vol 24.

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