The Hidden Causes and Costs of Work Stress

I have decided to write a series on industry problems regarding human performance. In this first article, I discuss hidden sources and costs of workplace stress.

Some time ago, I went to see the doctor. I was having problems remembering basic things, like what meetings were about or even my bank card PIN. I had further been told that these were actually signs of stress and so needed to know how badly my health was impacted.

I was not prepared for the news I received. My blood pressure was elevated as can be expected, and I had high blood cholesterol. But I also had blood sugar control issues bordering on type 2 diabetes. By reviewing the scientific literature I was able to tie all three of these to the work stress. I began a series of changes one after another but two years later the efforts to recover my health are still ongoing. Things are improving and I am once again generally healthy.

The problem affects many people and is not even new. I recently discovered that my great grandfather, following years of work on groundbreaking experiments that led to the discovery of several noble gasses, suffered a health breakdown from the stress and was unable to work for two years.

It's further worth noting that while peak performance requires some stress, our efficiency and ability to make good decisions at work drops off with too much stress. So our own safety and health, as well as the prosperity of our employers, often depends on us exercising good judgement on this matter and refusing to take on too much stress.

The Physiology of Stress

Stress is a physiological reaction which sometimes affects our psychology. In its proper place, it prepares our body and mind to be able to rise to challenges and overcome them. However, stress that is at too high of a level, lasts too long, or occurs frequently at night degrades both our mental abilities and our physical health.

The stress response begins in the adrenal glands above the kidneys with the release of the hormone cortisol. Cortisol is an important hormone which affects almost every tissue in the body.

Adrenaline may also be released. Adrenaline works both as a hormone along with cortisol (and affects many tissues in similar ways) but also acts as a neurotransmitter, speeding up heart rate and respiration.

The primary hormone to watch, however, is cortisol which also helps regulate the circadian cycles of sleeping and waking. Cortisol stimulates both sugar release by the liver and insulin resistance in order to reserve sugar in the blood for the brain. Cortisol also affects the hippocampus and inhibits memory formation and retrieval (and can eventually lead to atrophy in the hippocampus), and stimulates the amygdala which is why perpetually stressed individuals tend to misinterpret threats.

Adrenaline and cortisol work together to increase heart rate, respiration, and blood pressure.

Over time, perpetual stress and increased cortisol secretion can lead to high blood pressure, high blood cholesterol, memory problems, aggressiveness, defensiveness, dementia, and even type 2 diabetes.

Stress and Decision Making

Because stress affects the brain, it is unsurprising that it affects our ability to make good decisions. In many cases we actually need stress to make good decisions, for example when responding to an emergency late at night. However, again, stress that lasts too long, or is too high, can degrade our abilities.

Even in the best of circumstances, stress tends to lead to the following changes in our ability to take in information:

• Our perceptions narrow. For example we stop responding to auditory responses or no longer hear what people verbally tell us.
• We revert to patterns and behaviors that we are used to, even if more recent training or knowledge would have us act differently.
• We often fail to stop and think before we react, particularly if we are reacting to something sudden. This can lead to overreaction.
• In extreme cases, we can lock up, become fixated on the wrong thing, or otherwise fail to be effective and useful.

Stress affects our brain and helps us to optimize for emergency responses, but this often comes at the expense of a wider view of circumstances. For this reason, perpetual stress can result in a tunnel focus.

The effect of cortisol and adrenaline on the amygdala also has the effect of ensuring that we exaggerate threats. We may have trouble identifying when others agree, finding points of agreement, and working together in areas that require a wider focus, negotiations, etc.

Generally, emergency decision making, after the initial startle effect passes, benefit from moderate to elevated stress, but non-emergency decision making suffers because our perspective narrows, and we tend to exaggerate threats, particularly from other people.

Hidden Sources of Stress

Typically we think of stress as something we feel relating to long-term pressures of the job, worries, and uncertainties. These certainly play a role and do cause stress responses, but many greater stresses are more immediate.

Emergency Response

Emergencies require that we spring into action and that is itself deeply tied into the stress response. Particularly in IT, emergencies in critical services can be business-stopping, and have significant stakes attached. This is not as serious as in medicine or air transit, where lives are on the line, but the requirement for concerted, focused action is urgent.

Emergency responders generally are going to have to deal with extra stress. This includes EMTs, police officers, firefighters, and others often are subject to stress that is a fundamental part of their jobs. We also see similar stresses in IT.

Late Night Requests

The stress response is similar physiologically to the waking response. Often if we actually have to act in the late night, we can only do so because of the stress response. This affects on call personnel particularly, but also new parents, shift workers, and others.

Of course, late night emergencies contain both elements and are often the worst sources of stress in terms of how they impact our bodies and brains.

Fatigue

Stress partially counters fatigue, so when we continue to try to work through fatigue, this triggers a stress response. The cortisol and adrenaline together can mask feelings of fatigue allowing the sense of being able to continue. In cases where mere physical effort is required, this can sometimes be helpful, but where human judgment is required, the combination of stress and fatigue is quite dangerous.

Unlike stress, fatigue is associated with general degradation in mental performance in all areas and can sometimes be more serious than intoxication by alcohol. However, because of its insidious nature, fatigue causes many more problems in IT operations and other fields of knowledge work.

Stress and fatigue can form a deadly spiral, where stress counters the need to rest, and this leads to more fatigue, which leads to more stress. In these cases, recovery requires rest.

Signs You May Be Under Too Much Stress

Some occasional stress in moderate amounts is healthy and normal. How do you know that the stress is starting to cause problems, whether to your health or otherwise? You should keep a watch out for common signs.

Note that in many cases, it is a very good idea to see a physician when any of these symptoms become significant or persist for any length of time. Some of these can be caused by more serious underlying conditions, and stress itself can cause hidden damage that you might not casually notice.

You Keep Forgetting Things

Because stress affects both memory formation and retrieval, difficulties in remembering things is often a sign of a stress-related breakdown.

It is normal for people to have some memory issues as they age, but stress-related breakdowns tend to come up faster. You may experience sudden and temporary memory blocks concerning things you know very well. The problems are likely to have a somewhat sudden onset and may be intermittent.

Digestive Symptoms

Frequent indigestion, diarrhea, and constipation can all be caused by stress, since adrenaline and cortisol affect the digestive system. In general an increasing frequency of digestive upsets should be cause for concern especially when coupled with other stress symptoms or obvious stressors.

Blood Sugar Symptoms

The cortisol released by the adrenal glands directly increases blood sugar by stimulating the liver to release glucose into the blood and instructing many tissues of the body to react less to insulin. This process is an important part of how we wake up in the morning and it is intrinsic to the stress response.

Under normal stress response, our blood sugar increases, leading to an increase in insulin in our blood. Once the stress is over, the blood sugar crashes as the insulin takes effect suddenly. This can lead to sudden exhaustion and sleepiness following a few hours of stress and is a healthy response.

With longer-term stress, however, the blood sugar and insulin levels may not return to normal for some time. This can lead to some of the classic diabetes symptoms including unquenchable thirst and frequent urination.

If you are having these symptoms and your A1C is still in the prediabetic range, and you have clear stressors at work, it is extremely important to reduce the stress so you can recover. Many studies have tied cortisol levels to diabetes risk and stress reduction is one way you can reduce these cortisol levels and hence this risk.

Diabetics also find blood sugar management far harder when enduring too much stress. Because stress increases insulin resistance and leads to blood sugar release, it complicates treatment at every step. The medical community has started to recognize the importance of stress management in diabetes treatment.

Social Symptoms

The over-stimulation of the amygdala has a number of symptoms. This part of the brain recognizes threats and produces responses to them including fear, anxiety, and anger.

Although we often associate anxiety with stress, this is one possible symptom. It is also possible to develop anger issues, become argumentative even in cases of agreement, and develop a habit of becoming combative or defensive.

Sleep Disruption

The stress response mirrors the waking response, and so perpetual stress interferes directly with sleep. Sleep is a low cortisol state (and this means it is also a lower blood sugar state).

While sleep disruption can cause stress, stress can also cause difficulty sleeping. A good simple measurement is how many times you wake up in the night, whether to get water, use the restroom, or other reasons. A larger number of times can indicate a larger amount of stress.

Recognizing Stress in a Colleague

Recognizing stress in other people, in my experience, usually centers on recognizing social and work-related impacts. These include colleagues slowly becoming more irritable or having an increasing number of outbursts of various forms at work. In many of these cases, the first question should be one of stress.

Similarly, colleagues whose organizational skills or memory seems to be declining may be suffering stress-related breakdowns. Similarly uncharacteristic errors of judgment in late night emergencies often, in my experience, indicate problems with both fatigue and stress together.

How to Reduce Stress and Its Impacts

Fortunately there are solutions to the problem of too much stress. Just as we create the problem, we can solve it.

Build Time To Recover Into Your Schedule

Our bodies require time to recover from the stress response when it reaches a certain threshold. Taking that time ultimately improves efficiency and the amount of work done, and it improves judgement in relation to knowledge work.

The simplest way to reduce stress is to allocate rest points into your schedule particularly following late night requests. This means stepping away from work for a while in order to recover from the effects of the stress.

At least in my experience, the need for actual recovery time away from work is rarely if ever needed if emergency responses occur in the morning or even through mid afternoon. If they stretch into the evening, or worse, reach late night times, then there is often a need to take a little time off to maintain one's health and perspective. Failure to do this can lead to decreased productivity generally and eventually poor judgment and health problems.

The amount of recovery time may depend on circumstances. This is is a matter to be decided with feedback from management, on call personnel, and more,

Exercise

Physical exercise is one of the most effective ways at reducing the effects of the stress response generally. Exercise affects how our bodies use energy, and can counter some of the effects of cortisol and adrenaline on the body.

Some research has suggested that intensity of exercise can lead to increased cortisol levels, however. This is particularly a concern for endurance athletes. A closer look at the relationship between cortisol and exercise shows that cortisol spikes do happen, but that they are more of a problem with evening exercise because the shape of the daily cortisol curve is affected. Evening exercise is less effective at reducing cortisol levels at night, and it increases cortisol levels in the morning.

In my experience as well, morning exercise is far more effective at reducing the effect of the stress response than evening exercise is. In fact, switching from evening to morning exercise had dramatic effects for me.

Meditation, Prayer, and Artistic Hobbies

Several studies have shown benefits of meditation in lowering cortisol levels. Making a daily practice of some sort of reflective, calming activity is therefore something I would recommend as a stress management strategy.

We can each choose something that works for us, whether it be mindfulness practices, daily prayers of thanks, or even artistic endeavors.

The Workplace Component

In the end, we are all capable of fixing the problems associated with work stress. However, part of the equation has to be in looking at work culture and environment as well. Employers who help ensure that organizational stress management is a priority help lay the groundwork for individual stress management as well. This leads to better decision-making and better productivity.

If we make room for positive health, we will all rise together.

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