When work takes more than it gives: understanding the psychological cost of workplace stress

Work can be demanding without becoming harmful, but the nature of a role, the expectations attached to it and the support available all influence how manageable those demands become.

For some people, stress eases when a particularly busy period comes to an end. For others, it becomes a more persistent part of working life. Responsibilities increase; priorities conflict; and decisions have to be made without sufficient information or support. Gradually, the effort involved in managing these demands begins to affect psychological wellbeing.

There is also an important relationship between stress and performance. Although pressure can sometimes encourage focus and short term productivity, sustained stress can have the opposite effect. Concentration becomes more difficult, decision-making requires greater effort, and the ability to approach problems creatively may suffer. For people in positions of responsibility, this can create a difficult situation. The instinct may be to work longer hours or take on more responsibility, even as their capacity to manage those demands becomes increasingly compromised.

The wider impact is considerable. The World Health Organization estimates that 12 billion working days are lost globally each year because of depression and anxiety, at an annual cost of US$1 trillion in lost productivity. Although these figures relate to mental health conditions rather than workplace stress alone, they illustrate the significant relationship between psychological wellbeing and the world of work.

Understanding workplace stress means looking beyond an individual’s response to pressure. The circumstances creating it, the scope for changing them and the available support all deserve consideration.

The demands of work and the resources available

Workplace stress is often associated with having too much to do, but workload alone does not explain why certain situations become difficult to manage. The balance between what a role requires and the resources available to meet those demands is equally important.

A person may manage a substantial workload when expectations are clear, priorities are realistic, and they have sufficient authority to make decisions. The same workload becomes considerably more difficult when deadlines are constantly revised, responsibilities are unclear, or important decisions depend on factors outside their control.

The degree of control someone has over their working circumstances is also significant. Having the autonomy to organise priorities and influence decisions can make a demanding role more manageable. Being held accountable for outcomes without sufficient authority or resources can create a persistent sense of frustration and powerlessness.

This is particularly relevant for people in management positions. They may be responsible for a team’s performance whilst having limited influence over budgets, staffing or organisational decisions. Business owners face different pressures, including financial uncertainty and responsibility for the people whose livelihoods depend on the business. In both cases, the difficulty lies as much in the conditions surrounding the work as in the volume of tasks involved.

Working relationships are another important influence. Poor communication or a lack of trust can make everyday responsibilities more stressful, particularly if people feel unable to raise concerns. Bullying, discrimination and persistently unreasonable demands can have a more serious impact, requiring action beyond individual stress management.

Why the source of stress matters

When work becomes difficult to manage, it is natural to look for ways to reduce the pressure. Taking leave or changing routines can provide relief, particularly when demands are temporary. However, these measures have limited lasting value if the circumstances creating the stress remain unchanged.

Consider someone whose responsibilities have gradually expanded without additional time or resources. A period away from work may offer a welcome break, but returning to the same expectations is likely to recreate the original difficulties. 

One of the difficulties with prolonged workplace stress is that its effects accumulate. Someone may initially compensate for increased demands by working longer hours or postponing time away from work. As this continues, opportunities for rest and psychological recovery become more limited. The additional effort required to maintain performance can itself become another source of pressure, creating a cycle that is increasingly difficult to break.

The potential consequences of sustained overwork also extend beyond psychological wellbeing. Research published in the journal Environment International in 2021, based on analysis by the World Health Organization and International Labour Organization, found that people working 55 hours or more per week had a 35% higher risk of stroke and a 17% higher risk of dying from ischaemic heart disease compared with those working 35–40 hours. The findings highlight the potential health implications of consistently working excessive hours and the importance of recognising when professional demands are becoming unsustainable.

Workplace stress is not simply a question of how well someone manages their emotions. Sometimes the demands placed upon them need to be reconsidered. Clearer expectations or better support can make a meaningful difference, although more fundamental changes may be necessary in some working environments.

Making these changes is not always straightforward. Financial commitments, caring responsibilities and concerns about job security can limit someone’s options. They may recognise that their circumstances are affecting them without knowing how to move forward.

Identifying which aspects of the situation contribute most to the pressure, which can be changed and where additional support is needed provides a practical starting point.

For a closer look at the signs that work is affecting mental health, our blog, Is your job affecting your mental health?, explores harmful workplace conditions and their impact on other areas of life.

When workplace stress becomes a mental health concern

Stress is a response to demands that feel challenging or difficult to manage. When these demands persist, the effects can extend beyond the immediate situation and begin to affect psychological wellbeing.

Ongoing stress can interfere with sleep and concentration, whilst uncertainty may contribute to anxiety or intensify existing symptoms. Some people find their motivation declining or become less able to manage their emotional responses. Others develop a sense of detachment from their work, particularly when their efforts seem to make little difference to the circumstances they are trying to manage.

Burnout is one possible consequence of chronic workplace stress that has not been successfully managed. The World Health Organization describes it as an occupational phenomenon characterised by exhaustion, increased mental distance from one’s job or feelings of cynicism towards it, and reduced professional efficacy. Burnout is not classified as a medical condition in its own right.

Burnout should also be distinguished from other mental health difficulties. Anxiety and depression have multiple potential contributing factors, and workplace stress may be one part of a wider picture. Equally, existing mental health difficulties can make professional demands harder to manage.

A clinical assessment can help clarify what someone is experiencing and inform decisions about appropriate support. Where distress persists or begins to affect everyday life, speaking to a GP or mental health professional is a sensible next step.

The role of coping and the risk of additional difficulties

People respond to sustained stress in different ways. Talking with someone they trust or spending time away from work can provide perspective. Others begin to rely on behaviours that offer temporary relief but create further difficulties over time.

Alcohol may become a way of marking the end of a stressful day or briefly distancing oneself from work-related concerns. When drinking becomes a regular means of managing anxiety or sleeping, it deserves closer attention. Similar difficulties can arise when someone relies on medication outside medical guidance or struggles to reduce a behaviour that provides temporary relief.

Stress does not inevitably lead to dependency or addiction, but it can contribute to circumstances in which alcohol or other substances become an increasingly important coping mechanism. Understanding what someone is trying to manage, and the role these behaviours play in their lives, is an important part of determining appropriate support.

Where substance use has become difficult to control, addressing it in isolation may not be enough. The emotional difficulties surrounding it, including continuing workplace pressures, also need to be considered.

Finding an appropriate way forward

Addressing workplace stress begins with understanding its causes. Depending on the circumstances, this might involve reviewing responsibilities, discussing expectations with an employer or seeking changes to the working environment. Bullying, discrimination and other serious workplace problems may also require specialist employment advice.

Psychological support can help when stress begins to affect mental health. An assessment provides an opportunity to explore the difficulties involved and understand the personal and environmental factors contributing to them. This is particularly valuable when workplace pressures overlap with anxiety, depression or difficulties with alcohol or other substances.

For some individuals, outpatient support is sufficient. Others benefit from a more comprehensive period of treatment away from their usual responsibilities, particularly when several concerns have become intertwined, or their mental health has deteriorated significantly. Residential treatment offers a structured environment for assessment and individualised care, with the opportunity to address the wider factors affecting wellbeing.

Planning for life after treatment is equally important. If someone returns to the same working environment, considering what needs to change and identifying appropriate ongoing support can help them maintain progress and make informed decisions about their longer-term wellbeing.

Understanding the wider picture

Workplace stress is not always resolved through individual changes, particularly when the conditions contributing to it remain difficult to influence. Understanding the relationship between working demands, personal circumstances and mental health helps identify where change is possible and whether further support is needed.

For a broader exploration of the relationship between professional achievement and psychological wellbeing, our article, Are you functioning or flourishing? Thriving or surviving? The hidden cost of high-performance living, considers how the pursuit of achievement can influence a person’s wider experience of life.

At Ibiza Calm, we recognise that workplace stress can form part of a more complex picture involving mental health and personal circumstances. Our multidisciplinary team provides personalised, evidence-based treatment, with psychiatric oversight and psychological therapies tailored to each individual’s needs. Where appropriate, treatment also addresses difficulties involving alcohol or other substances.

Understanding the factors contributing to someone’s difficulties is an important part of determining the right support and making meaningful changes that extend beyond the period of treatment.