Symptoms of Stress

Stress affects us all. If you can spot the symptoms, you can manage them.
Do note, of course, that these symptoms may also be indicators of other things. (If in
doubt, consult you doctor...).
Note also that a stressed person is unlikely to experience all of these symptoms and that
even one can be a sign of stress.

Emotional/cognitive symptoms
Emotional and cognitive symptoms of stress include:

• Feeling irritable
• Feeling frustrated at having to wait for something
• Feeling restless
• Unable to concentrate
• Becoming easily confused
• Having memory problems
• Thinking about negative things all the time
• Negative self-talk
• Having marked mood swings
• Eating too much
• Eating when you are not hungry
• Finding it difficult to concentrate
• Not having enough energy to get things done
• Feeling you can't cope
• Finding it hard to make decisions
• Having emotional outbursts
• Generally feeling upset
• Lack of sense of humor

Physical symptoms
Physical symptoms of stress include:

• Muscle tension
• Low back pain
• Pains in shoulders or neck
• Pains in chest
• Stomach/abdominal pain
• Muscle spasms or nervous tics
• Unexplained rashes or skin irritations
• 'Pounding' or 'racing' heart
• Sweaty palms
• Sweating when not physically active
• 'Butterflies' in stomach
• Indigestion and 'the gurgles'
 • Diarrhea
• Unable to sleep or excessive sleep
• Shortness of breath
• Holding breath

Muscles work in opposing pairs, with movement caused when one contracts whilst the
other relaxes. Stress can result in both muscles working at once. There is thus no
movement, but still muscular tension.

Autonomic nervous system

We have an involuntary nervous system called the Autonomic Nervous System (ANS),
which contains two types of nerves.

• Parasympathetic nerves conserve energy and keep the systems in a

relatively resting state.
• Sympathetic nerves prepare the body for action thorugh the Fight-or-Flight
reaction.

Thus it is the sympathetic system that is affected by stress.

So what?
Watch out for your own stress, and help others reduce theirs.
If you are using stress to persuade, watch for these symptoms as indication of your
success. Beware of over-stressing people and creating a Fight-or-flight reaction.

See also

While stress affects everyone in a unique way, there are certain factors that are common. If you are
experiencing any of the following, it could be a sign that you’re being affected by stress:

• Headaches: Certain types of headaches can be related to stress. If you’re experiencing more
headaches, especially tension headaches, stress could be the culprit.
• More Frequent Colds or Flu: There’s an inverse relationship between stress and immunity,
so if you’re under too much stress, you may be getting sick more often.
• Sleep Problems: There are many ways that stress affects sleep. Too much stress can rob you
of sleep and make the sleep you get less restorative.
• General Anxiety: Anxiety does serve an important function for survival, but if you’re feeling
anxious much of the time, it could be because you have too many stressors in your life, or it may
indicate a medical condition like generalized anxiety disorder. If you experience an increase in
anxiety, you may want to to talk to your doctor.
• ‘Fuzzy Thinking’: Your body’s stress response pumps your body with hormones that make it
possible for you to fight or flee quickly. When triggered in excess, this stress response can actually
cause you to think less quickly.
• Feelings of Frustration: If you’re faced with many demands at once, the natural result for
many people is increased frustration and irritability. The trick is to find ways to prevent frustration
and calm down quickly.
• Lowered Libido: Stress can affect your libido in several ways. If you’re too tired for sex, or
can’t seem find the time for your partner, this can be due to stress in your life as well.

These are just a few of the many ways that stress can affect your body and mind. For a more
thorough assessment of stress symptoms that you may have, take our free assessment test, The
Stress Symptom Quiz, and find more information to help with specific symptoms of stress that you
may be experiencing. Also, scroll down for more resources.

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Managing stress
Select the text below for guidance:

Managing stress(text summary from Flash piece, above)

First, recognize stress:
Stress symptoms include mental, social, and physical manifestations. These include
exhaustion, loss of/increased appetite, headaches, crying, sleeplessness, and oversleeping.
Escape through alcohol, drugs, or other compulsive behavior are often indications. Feelings
of alarm, frustration, or apathy may accompany stress.
If you feel that stress is affecting your studies,
a first option is to seek help through your educational counseling center.
Stress Management is the ability to maintain control when situations, people, and events
make excessive demands. What you can do to manage your stress?
What are some strategies?

Look around Set realistic goals for yourself

See if there really is something you can Reduce the number of events going on in
change or control in the situation your life and you may reduce the circuit
overload

Exercise in stress reduction through project management/prioritizing

Remove yourself from the stressful Don't overwhelm yourself

situation by fretting about your entire workload.
Give yourself a break if only for a few Handle each task as it comes, or
moments daily selectively deal with matters in some
priority

Don't sweat the small stuff
Try to prioritize a few truly important
things and let the rest slide
Learn how to best relax yourself
Meditation and breathing exercises have
been proven to be very effective in
controlling stress. Practice clearing your
mind of disturbing thoughts.

Selectively change the way you react,
but not too much at one time. Focus on
one troublesome thing and manage
your reactions to it/him/her
Change the way you see your situation;
seek alternative viewpoints
Stress is a reaction to events and
problems, and you can lock yourself in to
one way of viewing your situation. Seek
an outside perspective of the situation,
 compare it with yours. and perhaps lessen
your reaction to these conditions.

Avoid extreme reactions; Do something for others

Why hate when a little dislike will do? to help get your mind off your self
Why generate anxiety when you can be
nervous? Why rage when anger will do
the job? Why be depressed when you
can just be sad?

Get enough sleep Work off stress

Lack of rest just aggravates stress with physical activity, whether it's
jogging, tennis, gardening

Avoid self-medication or escape Begin to manage the effects of stress

Alcohol and drugs can mask stress.
They don't help deal with the problems
This is a long range strategy of adapting to
your situation, and the effects of stress in
your life. Try to isolate and work with
one "effect" at a time. Don't overwhelm
yourself. for example, if you are not
sleeping well, seek help on this one
problem.

Try to "use" stress

If you can't remedy, nor escape from, what is bothering you, flow with it and
try to use it in a productive way

Try to be positive
Give yourself messages as to how well you can cope rather than how horrible
everything is going to be. "Stress can actually help memory, provided it is
short-term and not too severe. Stress causes more glucose to be delivered to
the brain, which makes more energy available to neurons. This, in turn,
enhances memory formation and retrieval. On the other hand, if stress is
prolonged, it can impede the glucose delivery and disrupt memory." All
Stressed Up, St. Paul Pioneer Press Dispatch, p. 8B, Monday, November 30,
1998

Most importantly:
if stress is putting you in an unmanageable state or interfering with your
schoolwork, social and/or work life,
seek professional help at your school counseling center

of Stress

Simply stated, stress describes the many demands and pressures that we all experience, to some
degree, each day. These demands are physical, mental, emotional, or even chemical in nature. The word
"stress" encompasses both the stressful situation, known as the stressor, and the symptoms you
experience under stress, your stress response.
The problem with stress is that it activates your sympathetic nervous system, stimulating the release of
stress hormones throughout your body. These hormones give you super energy and cause other changes
in the body such as the "fight or flight" response.
The "fight or flight" response makes your heart beat faster. You might feel very nervous, making it difficult
to breathe. Short term, the "fight or flight" response causes changes that allow you to handle sudden
stressful events. When you face fear -- or even recall a stressful or frightening event from the past -- the
resulting hormonal changes super-charge your body to a state of high arousal. This prepares you for
action.
But long-term stress can be particularly difficult. When stress hormones stay elevated over time, there is a
gradual and steady stream of harmful changes to the body. Long-term stress can suppress the immune
system, which may lead to the development of diseases.
Stress can be positive or negative, depending on the situation. Positive stressors (called eustress) may
include an upcoming wedding, the holidays, or pregnancy. On the other hand, negative stress (called
distress) results in the full-blown stress response. If continuous, negative stress can lead to loss of
productivity, health problems, and exhaustion.

What Are the Symptoms of Stress?

Stress symptoms vary greatly from one person to the next, but the most universal sign of stress is a
feeling of being pressured or overwhelmed. Other symptoms include:

• Physical complaints (stomachaches, headaches, chest pains, nausea, and diarrhea, and a
sensation of numbness or tingling in your hands, arms, and face.)
• Problems getting along with family members, friends, and teachers.
• Changes in behavior at home (short temper, unexplained anger, crying for no reason).
• Regression -- behavior that is not age-appropriate.
• Dysfunctional sleep patterns, including nightmares, too little sleep, difficulty falling asleep, or even
oversleeping.
• Communication difficulty or personality changes, such as becoming withdrawn or requiring much
more attention than usual.
• Impatience.

If you are experiencing a few of these symptoms, chances are that your level of stress is high. If left
untreated, stress can lead to permanent feelings of helplessness and ineffectiveness

Stress Management - Effects of Stress

Stress causes changes in your body. It also affects your emotions.
How stress affects the body
Common symptoms of stress include:

• A fast heartbeat.
• A headache.
• A stiff neck and/or tight shoulders.
• Back pain.
• Fast breathing.
• Sweating, and sweaty palms.
• An upset stomach, nausea, or diarrhea.
Over time, stress can affect your:1

• Immune system. Constant stress can make you more likely to get sick more often. And if you
have a chronic illness such as AIDS, stress can make your symptoms worse.
• Heart. Stress is linked to high blood pressure, abnormal heartbeat (arrhythmia), blood clots, and
hardening of the arteries (atherosclerosis). It's also linked to coronary artery disease, heart attack,
and heart failure.
•
• Muscles. Constant tension from stress can lead to neck, shoulder, and low back pain. Stress
may make rheumatoid arthritis worse.
•
• Stomach. If you have stomach problems, such as gastroesophageal reflux disease (GERD),
peptic ulcer disease, irritable bowel syndrome, or ulcerative colitis, stress can make your
symptoms worse.
•
• Reproductive organs. Stress is linked to low fertility, erection problems, problems during
pregnancy, and painful menstrual periods.
• Lungs. Stress can make symptoms of asthma and chronic obstructive pulmonary disease
(COPD) worse.
• Skin. Skin problems such as acne and psoriasis are made worse by stress.

How stress affects your thoughts and emotions

You might notice signs of stress in the way you think, act, and feel. You may:

• Feel cranky and unable to deal with even small problems.

• Feel frustrated, lose your temper more often, and yell at others for no reason.
• Feel jumpy or tired all the time.
• Find it hard to focus on tasks.
• Worry too much about small things.
• Feel that you are missing out on things because you can't act quickly.
• Imagine that bad things are happening or about to happen.

How stress affects you depends on many things, such as:

• Your personality.
• What you have learned from your family about responding to stress.
• How you think about and handle stress. See:

Positive thinking: Stopping unwanted thoughts.

• Your coping strategies (What is a PDF document?) .

• Your social support.

The type of stress matters

Stress can affect you both instantly (acute stress) and over time (chronic stress).
Acute (short-term) stress is the body's instant response to any situation that seems demanding or
dangerous. Your stress level depends on how intense the stress is, how long it lasts, and how you cope
with the situation.
Most of the time, your body recovers quickly from acute stress. But stress can cause problems if it
happens too often or if your body doesn't have a chance to recover. In people with heart problems, acute
stress can trigger an abnormal heartbeat (arrhythmia) or even a heart attack.
Chronic (long-term) stress is caused by stressful situations or events that last over a long period of
time. This could include having a difficult job or dealing with a chronic disease. If you already have a
health problem, stress can make it worse.

Stress Management - Measuring Stress

Feeling stress is a fact of life for most people. But it affects everyone differently. What causes stress for
you may not be stressful for someone else. That's because how you view a situation affects how much
stress it causes you. Only you can figure out whether you have too much stress in your life.
Ask yourself these questions to find out what is causing your stress:

What job, family, or personal stress do I have?

Stress can be caused by an ongoing personal situation such as:

• Problems in your family or with a relationship.

• Caring for a family member who is elderly, has chronic health problems, or is disabled.
Caregiving is a major source of stress. For more information, see the topic Quick Tips: Reducing
the Stress of Caregiving.
• Your job.
• . Dealing with a family member who is under stress.

Have I had any recent major life changes?

Life changes such as getting married, moving to a new city, or losing a job can all be stressful You can't
always control these things, but you can control how you respond to them.
To find out your current stress level based on recent changes in your life, try this Interactive Tool: What Is
Your Stress Level?
Do my beliefs cause me stress?
Some people feel stress because their beliefs conflict with the way they are living their life. Examine your
beliefs to find out if you have this kind of conflict in your life.
How am I coping with stress?
Your lifestyle choices can prevent your body from recovering from stress. For example, as you sleep, your
body recovers from the stresses of the day. If you're not getting enough sleep or your sleep is often
interrupted, you lose the chance to recover from stress.
The way you act and behave can also be a sign of stress. Some people who face a lot of stress react by
smoking, drinking too much alcohol, eating poorly, or not exercising. The health risks posed by these
habits are made even worse by stress.
Your body feels stress-related wear and tear in two ways: the stress itself and the unhealthy ways you
respond to it. Use this coping strategies evaluation form (What is a PDF document?) to help you find out
how you cope with stress. You can also try this Interactive Tool: How Well Do You Bounce Back? It
measures your ability to deal with life's challenges.
Stress Management - Ways to Avoid Stress
Stress is a part of life, and you can't always avoid it. But you can try to avoid situations that can
cause it, and you can control how you respond to it. The first step is knowing your own coping strategies.
Try using a stress journal to record stressful events, your response to them, and how you coped.
After you know what is causing your stress, try making some changes in your life that will help you avoid
stressful situations. Here are a few ideas:
Manage your time
Time management is a way to find the time for more of the things you want and need to do. It helps you
decide which things are urgent and which can wait. Managing your time can make your life easier, less
stressful, and more meaningful. For more information, see:

Stress management: Managing your time .

Look at your lifestyle
The choices you make about the way you live affect your stress level. Your lifestyle may not cause stress
on its own, but it can prevent your body from recovering from it. Try to:

• Find a balance between personal, work, and family needs. This isn't easy. Start by looking at
how you spend your time. Maybe there are things that you don't need to do at all. Finding a
balance can be especially hard during the holidays. For help, see:
o Quick Tips: Reducing Holiday Stress.
• Have a sense of purpose in life. Many people find meaning through connections with family,
friends, jobs, or volunteer work.
• Get enough sleep.Your body recovers from the stresses of the day while you are sleeping. For
more information, see:

Insomnia: Improving your sleep.

• Adopt healthy habits. Eat a healthy diet , limit how much alcohol you drink, and don't smoke.
Staying healthy is your best defense against stress.
• Exercise. Even moderate exercise, such as taking a daily walk, can reduce stress.

Get support
Support in your life from family, friends, and your community has a big impact on how you experience
stress. Having support in your life can help you stay healthy.
Support means having the love, trust, and advice of others. But support can also be something more
concrete, like time or money. It can be hard to ask for help. But doing so doesn't mean you're weak. If
you're feeling stressed, you can look for support from:

• Family and friends.

• Coworkers, or people you know through hobbies or other interests.
• A professional counselor. (See tips for finding a counselor or therapist.)
• People you know from church, or a member of the clergy.
• Employee assistance programs at work, or stress management classes.
• Support groups. These can be very helpful if your stress is caused by a special situation. Maybe
you are a caregiver for someone who is elderly or has a chronic illness. For more help, see:
o Quick Tips: Reducing the Stress of Caregiving.
Change your thinking

Stress Management - Setting a Goal to Reduce Stress

Setting a goal in three steps
If you're ready to reduce stress in your life, setting a goal may help. Try following these three steps:

1. Find out what creates stress for you. Think about your coping strategies. Try using a stress
journal to record stressful events, your response to them, and how you coped.
2. Think about why you want to reduce stress. You might want to protect your heart and your
health by reducing stress. Or maybe you simply want to enjoy your life more and not let stress
control how you feel. Your reason for wanting to change is important. If your reason comes from
you-and not someone else-it will be easier for you to make a healthy change for good.
3. Set a goal. Think about a long-term and a short-term goal to reduce stress in your life.
Here are a few examples of how to set goals:

• Sheila is a customer service manager for a computer company. She's also the mother of two
young kids. Between her job and chores at home, she feels overwhelmed by all the demands on
her. She can't remember the last time she took a lunch break at work or took a class at the gym.
While she's lying awake at night, she is worrying about getting everything done. Sheila's long-
term goal: Find a better balance between personal, home, and family needs. Short-term goal:
Take a 15-minute walk each night.

Stress management: Managing your time

• Ray is a pretty easygoing guy most of the time. But he gets stressed over small things. If a
problem comes up at work, he spends the whole night thinking about it over and over. He feels
anxious wondering how he could have handled things better. Ray knows he needs to let go of
these events and move on. Ray's long-term goal: Practice positive thinking when stressful events
come up. Short-term goal: Try breathing and relaxation exercises when he feels stressed.

Positive thinking: Stopping unwanted thoughts

Stress management: Relaxing your mind and body

• Marta is a full-time caregiver for her elderly mother, who has Alzheimer's disease. Marta can't
remember the last time she took a vacation or even met a friend for coffee. Her sister helps with
care sometimes but is often too busy. Marta finds herself getting frustrated easily. She needs a
break. Marta's long-term goal: Involve her sister more in caregiving. She also plans to find respite
care so she isn't providing all the caregiving on her own. Short-term goal: Attend a caregiver
support group every week.
o Quick Tips: Reducing the Stress of Caregiving

Tips for staying on track

• Plan for setbacks. Use a personal action plan (What is a PDF document?) to write down your
goals, any possible barriers, and your ideas for getting past them. By thinking about these
barriers now, you can plan ahead for how to deal with them if they happen.
 • Get support. Tell family and friends your reasons for wanting to change. Tell them that their
encouragement makes a big difference to you in your goal to reduce stress. Your doctor or a
professional counselor can also provide support. A counselor can help you set goals and provide
support in dealing with setbacks. (See tips for finding a counselor or therapist.)
• Pat yourself on the back. Don't forget to give yourself some positive feedback. If you slip up,
don't waste energy feeling bad about yourself. Instead, think about all the times you've avoided
getting stressed by making changes.

Workers are facing difficult times in the current economic climate - competition is getting
tougher, deadlines tighter and incomes lower. So it makes sense to think that a promotion
might give you more control over your life and greater financial security. But will you really
be better off if you get a promotion?
A new study suggests that your mental health can take a turn for the worse after a job
promotion, and this is not a short-term effect.
"Getting a promotion at work is not as great as many people think," said Chris Boyce of
Britain's University of Warwick, who presented the study at the annual conference of the
Royal Economic Society on April 23.
By the numbers: stress on the job

• 40 per cent of workers reported their job was very or extremely stressful.
• 25 per cent view their jobs as the number one stressor in their lives.
• 75 per cent of employees believe that workers have more on-the-job stress than a
generation ago.
• 29 per cent of workers felt quite a bit or extremely stressed at work;
• 26 per cent of workers said they were "often or very often burned out or stressed by their
work";
• Job stress is more strongly associated with health complaints than financial or family
problems.

Source: U.S. National Institute for Occupational Health and Safety

In the past 20 years, work stress has increased around the world due to globalization,
increased competition and new technologies. In Canada, claims for mental illness —
especially depression — have overtaken cardiovascular disease as the fastest growing
category of disability costs. In the U.S., workers' compensation claims due to stress
increased by about 38 per cent from 1992 to 2002.
Work stress can have all sorts of effects both on physical health and on mental well-being.
People who are stressed at work not only have higher rates of burnout, lower self-esteem,
depression and anxiety, but also migraines and high blood pressure, according to a 2005
paper in the journal Occupational and Environmental Medicine.
Some researchers have suggested that workers with higher job status are healthier.
However, Boyce and his research team tested this notion and found the opposite is true.
The researchers interviewed more than 10,000 adults in Britain every year from 1991 to
2005. They looked at three possible types of promotions: workers promoted from non-
supervisor to supervisor, from supervisor to manager and from non-supervisor to manager.

Better job no guarantee of better health

When the researchers looked at the results for those who worked for at least five
consecutive years, they found no evidence that their health improved after their promotion.
But they did find that people who had been promoted had more mental strain.
Stress, burnout and mental health

• Depression, anxiety, stress and burnout affects one in 10 workers in the U.S. each year.
• In Finland, more than 50 per cent of workers have some kind of stress-related symptom,
such as anxiety, depressive feelings, physical pain, social exclusion and sleep disorders.
• Depressive disorders make up almost seven per cent of premature retirements in
Germany.
• Nearly 33 per cent of workers in the U.K. experience mental health problems.

Source: International Labour Office, 2002 study

What's more, mental health got worse faster for those who had the biggest promotions —
that is, those who had jumped straight to a managerial role from a non-supervisory role.
The researchers also found that people went to the doctor less often after they got
promoted, which would seem to indicate they got healthier. But the researchers stressed
that this change "may be something to worry about rather than celebrate," as it might be
due to the fact that promoted workers may have less time to look after their own health,
such as for regular checkups.
Further, the study found that people working in the private sector suffered more
psychological strain after a promotion than those in the public sector. "It could be that the
public sector has special features that make it possible to gain health protection from
improved work status," the researchers suggested.
Dr. Douglas Saunders, an assistant professor in the faculty of medicine at the University of
Toronto, said the greater stability, predictability and benefits enjoyed by public-sector
workers might be the reason.
"These people feel a sense of security and comfort" that might help prevent stress after the
job change, he said.
According to a 2002 Statistics Canada survey, prolonged job stress was linked to increased
risk of work injuries, migraines and high blood pressure.
Almost one in five men and women who perceived their regular work days to be stressful
took at least one disability day during the 2 weeks prior to the survey.
The effects of stress on workers affect employers as much as the employees themselves.
The 2002-2003 Staying@Work survey found that 79 per cent of employers surveyed said
depression, anxiety and other mental health-related conditions were the leading cause of
their short-term disability claims.
One report put the total cost of mental health issues to Canadian business at $35 billion
annually. In the U.S.. employees who miss work because of stress, anxiety or a related
problem are off for an average of 20 days and the cost of a day's absence can be 1.5 to 2
times the worker's salary.
Employers can prevent extended sick leave due to stress through management training and
leadership development. One useful tool for businesses is the prevention kit for work-
related mental health problems launched by the chair of Occupational Health and Safety
Management at Laval University. The kit — Mental Health at Work ... From Defining to
Solving the Problem — provides ways that workers and organizations can deal with this
problem.

Getting proactive
Some employers are using employee assistance programs (EAPs) that support issues
related to work and family life. The average annual cost of such services per eligible
employee was estimated to be about $28 for inhouse programs and about $22 for outside
programs. These costs are fairly low when compared with the costs of recruiting and
training replacements, estimated at about $50,000 for employers such as IBM.
The savings for each employee who gets access to treatment can be as high as $5,000 to
$10,000 each year. Also, workers with depression who take appropriate medication save an
average of 11 sick days a year.
At the University of Saskatchewan, the EAP provides faculty and staff, as well as their
immediate families, with counselling and consultation services. The program includes
training and other stress prevention resources.
People who are unhappy at work take more sick days.
In 2002, there were 129 disability days for every 100 workers who were unhappy at work,
compared with 47 days off for workers who were happy at work.
The annual cost of work time lost to stress was estimated at $12 billion in 2002.
Source: Statistics Canada
Air Canada and its labour unions have a joint EAP for employees and their families.
Specially-trained members of the union, management and non-management, available at
work, direct employees to the right professional resources.
The Employee Assistance Services (EAS) bureau of Health Canada provides a
comprehensive EAP that includes trauma response, wellness and organizational
development expertise and services. This office has provided professional and personal
counselling to members of public and para-public organizations and their families in
Canada, the U.S. and Europe for 25 years.
Whatever the type of stress-prevention policy that an employer chooses, they should have
the following key elements, according to the Chartered Institute of Personnel and
Development (CIPD):

• A clear statement to show commitment to promote health and well-being for all
employees.
• The support of senior management.
• Constant review to ensure the policies maximize employee well-being.
• Review of key indicators of employee well-being.
• Effective advice, support, counselling and training.
• Evaluation of all well-being initiatives.

The positive effects of such policies are considerable both to the employee and employer.
When these measures are in place, promoted workers can more easily step into their new
roles with a sense of confidence and remain healthy, while the organization reaps the
benefits in terms of financial outcomes.
A person can experience excessive pressure and demands outside work just as much as they can at
work. Stress tends to build up over time because of a combination of factors that may not all be work
related. Conflicting demands of work and home can cause excessive stress.
Problems outside work can affect a person's ability to perform effectively at work. Stressors at home can
affect those at work and vice versa. For example, working long hours, or away from home, taking work
home and having higher responsibility can all have a negative effect on a person’s home life – something
which is supposed to be a 'buffer' against the stressful events of work. In the same way, domestic
problems such as childcare, financial or relationship problems can negatively affect a person’s work. The
person loses out – as do their family and their employer. It becomes a vicious circle.
It is difficult to control outside stressors, but you need to take a holistic approach to employee well-being.
To manage work related stress effectively, you need to recognise the importance and interaction of work
and home problems.
"… I think if the managers took time out generally to get to know you personally, your home life, if you've got any problems at home that

might be affecting your work… [it would help] to know that they're available."

(Employee, London)

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Causes of stress outside work

Many things in people's lives outside work can cause them stress, for example:

Family

• Death (of a loved one)

• Divorce or separation from a partner
• Marriage
• Pregnancy
• Holidays
• Changes in health of a family member or close friend
• Trouble with in-laws
• Family arguments
• Children leaving home
• Childcare
• Remarriage of a family member
• Caring for other dependents, such as elderly relatives
• Family reunion
• Relationship breakdown or having a long-distance relationship
Personal or social issues

• Change in financial state, or debt or money worries

• Changes in personal habits such as giving up smoking, going on a diet.
• Problems with weight
• Experiencing prejudice or discrimination
• Lack of friends or support
• Personal injury or illness

Daily hassles

• Traffic jams
• Public transport
• Time pressures
• Car troubles

Other

• Moving house, including taking out a mortgage

• Difficulties with neighbours
• Living with someone with an alcohol, drug problem or other addiction.
• (If studying) a deadline for coursework, exam results or trying to balance work and study
• Unemployment
• Poor living environment

[back to top]

Do I have to do anything about stress outside work?

You don't have to, but it's good if you do. If you think about people's personal lives and outside stressors,
you will be able to anticipate stressful times.
Your employee is not obliged to tell you their personal problems, but there are some practical things you
could do to support them:

• Be sympathetic and proactive. Arrange a confidential meeting with the person, allowing them the
opportunity to discuss any problems they wish and allowing you time to voice your own concerns. It may help to
clarify whether the person’s problems are work related or personal.
• Be flexible. Consider offering the person more flexible working hours, or even offer them some paid time off
to deal with their problems.
• Offer outside support. If appropriate, you could suggest they visit their doctor and allow them time off to do
so. You could also suggest support groups.
• Outline the support and services your organisation offers. For example, your organisation may have a
work–life balance initiative in place. These are benefits, policies, or programmes that help balance out job
demands and a healthy life outside work. They can include:
 o childcare services;
o flexible working arrangements;
o family leave policies;
o employee assistance programmes; or
o fitness programmes.

Programmes of this kind can work effectively to

o retain staff;
o improve morale;
o reduce sickness absence and stress; and
o increase productivity and commitment.

Coping with work stress in today’s uncertain climate

For workers everywhere, the troubled economy may feel like an emotional roller coaster.
"Layoffs" and "budget cuts" have become bywords in the workplace, and the result is
increased fear, uncertainty, and higher levels of stress. Since job and workplace stress
grow in times of economic crisis, it’s important to learn new and better ways of coping with
the pressure. The ability to manage stress in the workplace can make the difference
between success or failure on the job. Your emotions are contagious, and stress has an
impact on the quality of your interactions with others. The better you are at managing your
own stress, the more you'll positively affect those around you and the less other people's
stress will negatively affect you.

You can learn how to manage job stress

There are a variety of steps you can take to reduce both your overall stress levels and the
stress you find on the job and in the workplace. These include:

• Taking responsibility for improving your physical and emotional well-being.

• Avoiding pitfalls by identifying knee jerk habits and negative attitudes that add to the
stress you experience at work.
• Learning better communication skills to ease and improve your relationships with
management and coworkers.

Warning signs of excessive stress at work

When people feel overwhelmed, they lose confidence and become irritable or
withdrawn, making them less productive and effective and their work less rewarding. If the
warning signs of work stress go unattended, they can lead to bigger problems. Beyond
interfering with job performance and satisfaction, chronic or intense stress can also lead to
physical and emotional health problems.

Signs and symptoms of excessive job and workplace stress

• Feeling anxious, irritable, or depressed • Muscle tension orheadaches
• Apathy, loss of interest in work. • Stomach problems
• Problems sleeping • Social withdrawal
 • Fatigue, • Loss of sex drive

• Trouble concentrating • Using alcohol or drugs to cope

Common causes of excessive workplace stress

• Fear of layoffs
• Increased demands for overtime due to staff cutbacks
• Pressure to perform to meet rising expectations but with no increase in job satisfaction
• Pressure to work at optimum levels – all the time!

Reducing job stress by taking care of yourself

When stress on the job is interfering with your ability to work, care for yourself, or
manage your personal life, it’s time to take action. Start by paying attention to your
physical and emotional health. When your own needs are taken care of, you’re stronger
and more resilient to stress. The better you feel, the better equipped you’ll be to manage
work stress without becoming overwhelmed.
Taking care of yourself doesn’t require a total lifestyle overhaul. Even small things can lift
your mood, increase your energy, and make you feel like you’re back in the driver’s seat.
Take things one step at a time, and as you make more positive lifestyle choices, you’ll soon
notice a noticeable difference in your stress level, both at home at work.

Get moving
Aerobic exercise –perspiring -is an effective anti-anxiety treatment lifting mood, increasing
energy, sharpening focus and relaxing mind and body. For maximum stress relief, try to
get at least 30 minutes of hear pounding activity on most days but activity can be broken
up into two or three short segments.
For more information, see Making Exercise Fun.

Make food choices that keep you going and make you feel
good
Eating small but frequent meals throughout the day maintains an even level of blood sugar
in your body. Low blood sugar makes you feel anxious and irritable. On the other hand,
eating too much can make you lethargic.
To learn more about food that have a calming effect, lift your mood and make you feel
good, see Tips for a Healthy Diet.

Drink alcohol in moderation and avoid nicotine

Alcohol temporarily reduces anxiety and worry, but too much can cause anxiety as it wears
off. Drinking to relieve job stress can also start you on a path to alcohol abuse and
dependence. Similarly, smoking when you're feeling stressed and overwhelmed may seem
calming, but nicotine is a powerful stimulant – leading to higher, not lower, levels of
anxiety.

Get enough sleep

Stress and worry can cause insomnia. But lack of sleep also leaves you vulnerable to
stress. When you're sleep deprived, your ability to handle stress is compromised. When
you're well-rested, it's much easier to keep your emotional balance, a key factor in coping
with job and workplace stress.
For more information, see Tips for a Good Night's Sleep.

Reducing job stress by prioritizing and organizing

When job and workplace stress surrounds you, you can’t ignore it, but there are
simple steps you can take to regain control over yourself and the situation. Your growing
sense of self-control will also be perceived by others as the strength it is, leading to better
relationships at work. Here are some suggestions for reducing job stress by prioritizing and
organizing your responsibilities.

Time management tips for reducing job stress

• Create a balanced schedule. Analyze your schedule, responsibilities, and daily tasks.
All work and no play is a recipe for burnout. Try to find a balance between work and
family life, social activities and solitary pursuits, daily responsibilities and downtime.
• Don’t over-commit yourself. Avoid scheduling things back-to-back or trying to fit too
much into one day. All too often, we underestimate how long things will take. If you've
got too much on your plate, distinguish between the "shoulds" and the "musts." Drop
tasks that aren't truly necessary to the bottom of the list or eliminate them entirely.
• Try to leave earlier in the morning. Even 10-15 minutes can make the difference
between frantically rushing to your desk and having time to ease into your day. Don’t add
to your stress levels by running late.
• Plan regular breaks. Make sure to take short breaks throughout the day to sit back and
clear your mind. Also try to get away from your desk for lunch. Stepping away from
work to briefly relax and recharge will help you be more, not less, productive.

Task management tips for reducing job stress

• Prioritize tasks. Make a list of tasks you have to do, and tackle them in order of
importance. Do the high-priority items first. If you have something particularly
unpleasant to do, get it over with early. The rest of your day will be more pleasant as a
result.
• Break projects into small steps. If a large project seems overwhelming, make a step-by-
step plan. Focus on one manageable step at a time, rather than taking on everything at
once.
• Delegate responsibility. You don’t have to do it all yourself, whether at home, school, or
on the job. If other people can take care of the task, why not let them? Let go of the desire
to control or oversee every little step. You’ll be letting go of unnecessary stress in the
process.

Reducing workplace stress by improving emotional intelligence

Even if you’re in a job where the environment has grown increasingly stressful, you
can retain a large measure of self-control and self-confidence by understanding and
practicing emotional intelligence. Emotional intelligence is the ability to manage and use
your emotions in positive and constructive ways. It's about communicating with others
in ways that draw people to you, overcome differences, repair wounded feelings, and
defuse tension and stress.
Emotional intelligence in the workplace:
Emotional intelligence in the workplace has four major components:

• Self-awareness – The ability to recognize your emotions and their impact while using
gut feelings to guide your decisions.
• Self-management – The ability to control your emotions and behavior and adapt to
changing circumstances.
• Social awareness – The ability to sense, understand, and react to other's emotions and
feel comfortable socially.
• Relationship management – The ability to inspire, influence, and connect to others and
manage conflict.

WHEN WORKPLACE STRESS STIFLES PRODUCTIVITY

More than ever before, business leaders agree that new approaches are needed to
reduce the employee stress they see as a major drain on corporate productivity.
The big question is how to accomplish this effectively and efficiently.

Employee assistance programs, stress management seminars, exercise programs,

smoking cessation, nutrition programs and other health-related activities have
helped hundreds of thousands of employees to manage their stress levels.
However, programs that focus only on changing employee behaviours, or placing
responsibility for stress management solely with employees are not enough. Solid
research increasingly and clearly indicates that characteristics of the workplace are
also critical. Some corporations produce employee stress just as surely as they
produce products and services.

By neglecting causes of workplace stress, employers may be nullifying their

investment in employee-focused health-promotion programs. The evidence linking
certain workplace characteristics to employee stress and health is as strong as the
evidence linking smoking to lung cancer.

Serious attempts to manage employee stress require a dual focus. First, they need
to help employees develop coping skills and positive lifestyles. Second, they should
focus on the characteristics of each local workplace situation. Two sets of workplace
factors are particularly worthy of attention.

One involves work settings characterized by ?high demand and low control?.
Employees have too much to do for too long, with constant imposed deadlines (high
demand), and too little influence over the day-to-day organization of their own
work (low control). At the extreme, high demand, low control conditions are
associated with significantly high rates of: heart and cardiovascular problems;
anxiety, depression and demoralization; alcohol and prescription/over-the-counter
drug use; susceptibility to a wide range of infectious diseases.

The second set of factors involves ?high effort and low reward?. Employees must
consistently expend high amounts of mental and/or physical energy (high effort),
and feel they receive inadequate compensation or acknowledgement of their efforts
in terms of status, financial gain or career advancement (low reward). At the
extremes, the high-effort, low-reward condition is associated with: high rates of
cardiovascular problems; high incidence of anxiety; depression and conflict-related
problems. Where both conditions are present, which occurs often, you find: high
incidence of back pain; high incidence of repetitive strain injuries (RSI).

Home and family stress has a cumulative effect with work-produced stress; both
feed off and reinforce each other. Workplace programs that help employees deal
with home and family stress will also reduce the impact of work-produced stress. It
is important to note that the impact of workplace factors on employee health is
independent of employee lifestyle factors and of home and family stress. These
workplace-produced effects occur regardless of employees? coping skills and
lifestyles.

According to research, stress from any source causes changes in brain chemistry
that imperil the immune system?s ability to defend against bacterial and viral
attacks. The effect of excessive stress and strain on brain chemistry is experienced
as mood?usually as depression, anxiety or anger. These moods, or mental stares,
are early warning signs.

The immediate impact is poor morale, absenteeism, and lower productivity. If these
changes in brain chemistry and mood persist, immune system deficiencies will
worsen, and more serious illnesses will occur. It is possible to obtain useful
information simply by asking employees how they feel about demands, controls,
efforts and rewards. If a large proportion score at the extreme ends of these
factors, action is called for.

What actions are effective? Many organizations are reluctant to ask, fearing that
major, if not insurmountable, efforts are needed. The evidence suggests otherwise.

In most workplaces, market competitiveness dictates the demands and efforts.

Redesign or reengineering to reduce demand and effort may indeed be major, but
are worthy of consideration in terms of increased productivity and reduced
employee stress.

More easily and quickly changeable are control and reward. Increasing employees?
control over the means of production gives them a say in how they meet the
demands, and can go a long way in reducing employee stress.

Similarly, the effort required of employees may not be easily changed, but the
associated rewards can be. Rewards are not restricted to money. Recognition,
status and appreciation are also significant.

Control, or influence, and reward are closely connected. For many employees
control is the reward they seek above almost all others. The satisfaction of having
appropriate influence over the way work is done can weigh heavily against the
stresses of high demand and high effort.

Soliciting and using employee input on decisions affecting space, design of

workstations, lighting, heating, cooling and general efficiency and safety can
provide a sense of control. Also highly appropriate is involvement of employees
affected by decisions on how and when to introduce new technology. At the core of
this approach to workplace stress is the ?no harm? principle. As the scientific
evidence relating workplace characteristics to employee health becomes more
widely known, the obligation on employers to ensure they are not producing health-
related stress problems will grow.

There is already abundant justification for ensuring that your workplace is not
producing stress-related health problems. It?s not only in the interests of
employees. It?s also simply good business.

By: Jack Santa-Barbara, PHD, C.Psych and Martin Shain, S.J.D

Stress
Management
SIGNS, SYMPTOMS, CAUSES, AND EFFECTS

Modern life is full of hassles, deadlines, frustrations, and

demands. Especially in today’s economic environment,
STRESS is at an on ALL TIME high, People are losing their
jobs and their homes; consequently, families are being
destroyed. For many people, stress is so commonplace that
it has become a way of life. Stress isn’t always bad. In small
doses, it can help you perform under pressure and motivate
you to do your best. However, when you’re constantly
running in emergency mode, your mind and body pay the
price.

Most people carry stress from the job home. It causes

insomnia, which can lead to strokes, heart attacks, and high
blood pressure. Even when people retire, they can carry the
stress from the past.
Job Conditions That May Lead to Stress

• The Design of Tasks. Heavy workload, infrequent rest breaks, long work hours and shiftwork;
hectic and routine tasks that have little inherent meaning, do not utilize workers' skills, and
provide little sense of control.
 Example: David works to the point of exhaustion. Theresa is tied to the computer,
allowing little room for flexibility, self-initiative, or rest.

• Management Style. Lack of participation by workers in decision- making, poor communication in

the organization, lack of family-friendly policies.

Example: Theresa needs to get the boss's approval for everything, and the company is
insensitive to her family needs.

• Interpersonal Relationships. Poor social environment and lack of support or help from
coworkers and supervisors.

Example: Theresa's physical isolation reduces her opportunities to interact with other
workers or receive help from them.

• Work Roles. Conflicting or uncertain job expectations, too much responsibility, too many "hats to
wear."

Example: Theresa is often caught in a difficult situation trying to satisfy both the
customer's needs and the company's expectations.

• Career Concerns. Job insecurity and lack of opportunity for growth, advancement, or promotion;
rapid changes for which workers are unprepared.

Example: Since the reorganization at David's plant, everyone is worried about their future
with the company and what will happen next.

• Environmental Conditions. Unpleasant or dangerous physical conditions such as crowding,

noise, air pollution, or ergonomic problems.

Example: David is exposed to constant noise at work.

Early Warning Signs of Stress

Headache
Sleep Disturbances
Difficulty in Concentrating
Short Temper
Upset Stomach
Job Dissatisfaction
Low Morale

Job Stress and Health

Stress sets off an alarm in the brain, which responds by preparing the body for defensive action. The
nervous system is aroused and hormones are released to sharpen the senses, quicken the pulse, deepen
respiration, and tense the muscles. This response (sometimes called the fight or flight response) is
important because it helps us defend against threatening situations. The response is preprogrammed
biologically. Everyone responds in much the same way, regardless of whether the stressful situation is at
work or home.

Short-lived or infrequent episodes of stress pose little risk. But when stressful situations go unresolved,
the body is kept in a constant state of activation, which increases the rate of wear and tear to biological
systems. Ultimately, fatigue or damage results, and the ability of the body to repair and defend itself can
become seriously compromised. As a result, the risk of injury or disease escalates.

In the past 20 years, many studies have looked at the relationship between job stress and a variety of
ailments. Mood and sleep disturbances, upset stomach and headache, and disturbed relationships with
family and friends are examples of stress-related problems that are quick to develop and are commonly
seen in these studies. These early signs of job stress are usually easy to recognize. But the effects of job
stress on chronic diseases are more difficult to see because chronic diseases take a long time to develop
and can be influenced by many factors other than stress. Nonetheless, evidence is rapidly accumulating
to suggest that stress plays an important role in several types of chronic health problems-especially
cardiovascular disease, musculoskeletal disorders, and psychological disorders.

Health care expenditures are nearly 50% greater for workers who report high levels of stress.

- Journal of Occupational and Environmental Medicine

Job Stress and Health: What the Research Tells Us

Cardiovascular Disease

Many studies suggest that psychologically demanding jobs that allow employees little control over the
work process increase the risk of cardiovascular disease.

Musculoskeletal Disorders

On the basis of research by NIOSH and many other organizations, it is widely believed that job stress
increases the risk for development of back and upper- extremity musculoskeletal disorders.

Psychological Disorders

Several studies suggest that differences in rates of mental health problems (such as depression and
burnout) for various occupations are due partly to differences in job stress levels. (Economic and lifestyle
differences between occupations may also contribute to some of these problems.)

Workplace Injury

Although more study is needed, there is a growing concern that stressful working conditions interfere with
safe work practices and set the stage for injuries at work.

Suicide, Cancer, Ulcers, and Impaired Immune Function

Some studies suggest a relationship between stressful working conditions and these health problems.
However, more research is needed before firm conclusions can be drawn.

Source: Encyclopaedia of Occupational Safety and Health

Stress, Health, and Productivity

Some employers assume that stressful working conditions are a necessary evil-that companies must turn
up the pressure on workers and set aside health concerns to remain productive and profitable in today's
economy. But research findings challenge this belief. Studies show that stressful working conditions are
actually associated with increased absenteeism, tardiness, and intentions by workers to quit their jobs-all
of which have a negative effect on the bottom line.

Recent studies of so-called healthy organizations suggest that policies benefiting worker health also
benefit the bottom line. A healthy organization is defined as one that has low rates of illness, injury, and
disability in its workforce and is also competitive in the marketplace. NIOSH research has identified
organizational characteristics associated with both healthy, low-stress work and high levels of
productivity. Examples of these characteristics include the following:

• Recognition of employees for good work performance

• Opportunities for career development

• An organizational culture that values the individual worker

• Management actions that are consistent with organizational values

Stress Prevention and Job Performance

St. Paul Fire and Marine Insurance Company conducted several studies on the effects of
stress prevention programs in hospital settings. Program activities included (1) employee and
management education on job stress, (2) changes in hospital policies and procedures to
reduce organizational sources of stress, and (3) establishment of employee assistance
programs.

In one study, the frequency of medication errors declined by 50% after prevention activities
were implemented in a 700-bed hospital. In a second study, there was a 70% reduction in
malpractice claims in 22 hospitals that implemented stress prevention activities. In contrast,
there was no reduction in claims in a matched group of 22 hospitals that did not implement
 stress prevention activities.

- Journal of Applied Psychology

According to data from the Bureau of Labor Statistics, workers who must take time off work
because of stress, anxiety, or a related disorder will be off the job for about 20 days.

- Bureau of Labor Statistics

What Can Be Done About Job Stress?

The examples of Theresa and David illustrate two different approaches for dealing with stress at work.

Stress Management. Theresa's company is providing stress management training and an employee
assistance program (EAP) to improve the ability of workers to cope with difficult work situations. Nearly
one-half of large companies in the United States provide some type of stress management training for
their workforces. Stress management programs teach workers about the nature and sources of stress,
the effects of stress on health, and personal skills to reduce stress-for example, time management or
relaxation exercises. (EAPs provide individual counseling for employees with both work and personal
problems.) Stress management training may rapidly reduce stress symptoms such as anxiety and sleep
disturbances; it also has the advantage of being inexpensive and easy to implement. However, stress
management programs have two major disadvantages:

• The beneficial effects on stress symptoms are often short-lived.

• They often ignore important root causes of stress because they focus on the
worker and not the environment.

Organizational Change. In contrast to stress management training and EAP programs, David's company
is trying to reduce job stress by bringing in a consultant to recommend ways to improve working
conditions. This approach is the most direct way to reduce stress at work. It involves the identification of
stressful aspects of work (e.g., excessive workload, conflicting expectations) and the design of strategies
to reduce or eliminate the identified stressors. The advantage of this approach is that it deals directly with
the root causes of stress at work. However, managers are sometimes uncomfortable with this approach
because it can involve changes in work routines or production schedules, or changes in the organizational
structure.

As a general rule, actions to reduce job stress should give top priority to organizational change to
improve working conditions. But even the most conscientious efforts to improve working
conditions are unlikely to eliminate stress completely for all workers. For this reason, a
combination of organizational change and stress management is often the most useful approach
for preventing stress at work.

How to Change the Organization

to Prevent Job Stress

• Ensure that the workload is in line with workers' capabilities and resources.

• Design jobs to provide meaning, stimulation, and opportunities for workers to

use their skills.

• Clearly define workers' roles and responsibilities.

• Give workers opportunities to participate in decisions and actions affecting

their jobs.

• Improve communications-reduce uncertainty about career development and

future employment prospects.
 • Provide opportunities for social interaction among workers.

• Establish work schedules that are compatible with demands and

responsibilities outside the job.

- American Psychologist

Preventing Job Stress - Getting Started

No standardized approaches or simple "how to" manuals exist for developing a stress prevention
program. Program design and appropriate solutions will be influenced by several factors-the size and
complexity of the organization, available resources, and especially the unique types of stress problems
faced by the organization. In David's company, for example, the main problem is work overload. Theresa,
on the other hand, is bothered by difficult interactions with the public and an inflexible work schedule.

Although it is not possible to give a universal prescription for preventing stress at work, it is possible to
offer guidelines on the process of stress prevention in organizations. In all situations, the process for
stress prevention programs involves three distinct steps: problem identification, intervention, and
evaluation. These steps are outlined beginning on page 17. For this process to succeed, organizations
need to be adequately prepared. At a minimum, preparation for a stress prevention program should
include the following:

• Building general awareness about job stress (causes, costs, and control)

• Securing top management commitment and support for the program

• Incorporating employee input and involvement in all phases of the program

• Establishing the technical capacity to conduct the program (e.g., specialized training for in-house
staff or use of job stress consultants)

Bringing workers or workers and managers together in a committee or problem-solving group may be an
especially useful approach for developing a stress prevention program. Research has shown these
participatory efforts to be effective in dealing with ergonomic problems in the workplace, partly because
they capitalize on workers' firsthand knowledge of hazards encountered in their jobs. However, when
forming such working groups, care must be taken to be sure that they are in compliance with current labor
laws.*

*The National Labor Relations Act may limit the form and structure of employee involvement in worker-management teams or groups.
Employers should seek legal assistance if they are unsure of their responsibilities or obligations under the National Labor Relations Act.

Steps Toward Prevention

Low morale, health and job complaints, and employee turnover often provide the first signs of job stress.
But sometimes there are no clues, especially if employees are fearful of losing their jobs. Lack of obvious
or widespread signs is not a good reason to dismiss concerns about job stress or minimize the
importance of a prevention program.

Step 1 - Identify the Problem. The best method to explore the scope and source of a suspected stress
problem in an organization depends partly on the size of the organization and the available resources.
Group discussions among managers, labor representatives, and employees can provide rich sources of
information. Such discussions may be all that is needed to track down and remedy stress problems in a
small company. In a larger organization, such discussions can be used to help design formal surveys for
gathering input about stressful job conditions from large numbers of employees.

Regardless of the method used to collect data, information should be obtained about employee
perceptions of their job conditions and perceived levels of stress, health, and satisfaction. The list of job
conditions that may lead to stress and the warning signs and effects of stress provide good starting points
for deciding what information to collect.

Objective measures such as absenteeism, illness and turnover rates, or performance problems can also
be examined to gauge the presence and scope of job stress. However, these measures are only rough
indicators of job stress-at best.

Data from discussions, surveys, and other sources should be summarized and analyzed to answer
questions about the location of a stress problem and job conditions that may be responsible-for example,
are problems present throughout the organization or confined to single departments or specific jobs?

• Hold group discussions with employees.

• Design an employee survey.

• Measure employee perceptions of job conditions, stress, health, and satisfaction.

• Collect objective data.

• Analyze data to identify problem locations and stressful job conditions.

Survey design, data analysis, and other aspects of a stress prevention program may require the
help of experts from a local university or consulting firm. However, overall authority for the
prevention program should remain in the organization.

Step 2 - Design and Implement Interventions. Once the sources of stress at work have been identified
and the scope of the problem is understood, the stage is set for design and implementation of an
intervention strategy.

In small organizations, the informal discussions that helped identify stress problems may also produce
fruitful ideas for prevention. In large organizations, a more formal process may be needed. Frequently, a
team is asked to develop recommendations based on analysis of data from Step 1 and consultation with
outside experts.

Certain problems, such as a hostile work environment, may be pervasive in the organization and require
company-wide interventions. Other problems such as excessive workload may exist only in some
departments and thus require more narrow solutions such as redesign of the way a job is performed. Still
other problems may be specific to certain employees and resistant to any kind of organizational change,
calling instead for stress management or employee assistance interventions. Some interventions might be
implemented rapidly (e.g., improved communication, stress management training), but others may require
additional time to put into place (e.g., redesign of a manufacturing process).

Before any intervention occurs, employees should be informed about actions that will be taken and when
they will occur. A kick-off event, such as an all-hands meeting, is often useful for this purpose.

• Target source of stress for change.

• Propose and prioritize intervention strategies.

• Communicate planned interventions to employees.

• Implement interventions.

Step 3 - Evaluate the Interventions. Evaluation is an essential step in the intervention process.
Evaluation is necessary to determine whether the intervention is producing desired effects and whether
changes in direction are needed.

Time frames for evaluating interventions should be established. Interventions involving organizational
change should receive both short- and long-term scrutiny. Short-term evaluations might be done quarterly
to provide an early indication of program effectiveness or possible need for redirection. Many
interventions produce initial effects that do not persist. Long-term evaluations are often conducted
annually and are necessary to determine whether interventions produce lasting effects.

Evaluations should focus on the same types of information collected during the problem identification
phase of the intervention, including information from employees about working conditions, levels of
perceived stress, health problems, and satisfaction. Employee perceptions are usually the most sensitive
measure of stressful working conditions and often provide the first indication of intervention effectiveness.
Adding objective measures such as absenteeism and health care costs may also be useful. However, the
effects of job stress interventions on such measures tend to be less clear-cut and can take a long time to
appear.

• Conduct both short- and long-term evaluations.

• Measure employee perceptions of job conditions, stress, health, and satisfaction.

• Include objective measures.

• Refine the intervention strategy and return to Step 1.

The job stress prevention process does not end with evaluation. Rather, job stress prevention
should be seen as a continuous process that uses evaluation data to refine or redirect the
intervention strategy.

Stress Prevention Programs: What Some Organizations Have Done

Example 1 - A Small Service Organization

A department head in a small public service organization sensed an escalating level of tension and
deteriorating morale among her staff. Job dissatisfaction and health symptoms such as headaches also
seemed to be on the rise. Suspecting that stress was a developing problem in the department, she
decided to hold a series of all-hands meetings with employees in the different work units of the
department to explore this concern further. These meetings could be best described as brainstorming
sessions where individual employees freely expressed their views about the scope and sources of stress
in their units and the measures that might be implemented to bring the problem under control.

Using the information collected in these meetings and in meetings with middle managers, she concluded
that a serious problem probably existed and that quick action was needed. Because she was relatively
unfamiliar with the job stress field, she decided to seek help from a faculty member at a local university
who taught courses on job stress and organizational behavior.

After reviewing the information collected at the brainstorming sessions, they decided it would be useful for
the faculty member to conduct informal classes to raise awareness about job stress-its causes, effects,
and prevention-for all workers and managers in the department. It was also decided that a survey would
be useful to obtain a more reliable picture of problematic job conditions and stress-related health
complaints in the department. The faculty member used information from the meetings with workers and
managers to design the survey. The faculty member was also involved in the distribution and collection of
the anonymous survey to ensure that workers felt free to respond honestly and openly about what was
bothering them. He then helped the department head analyze and interpret the data.

Analysis of the survey data suggested that three types of job conditions were linked to stress complaints
among workers:
 • Unrealistic deadlines

• Low levels of support from supervisors

• Lack of worker involvement in decision-making.

Having pinpointed these problems, the department head developed and prioritized a list of corrective
measures for implementation. Examples of these actions included (1) greater participation of employees
in work scheduling to reduce unrealistic deadlines and (2) more frequent meetings between workers and
managers to keep supervisors and workers updated on developing problems.

Example 2 - A Large Manufacturing Company

Although no widespread signs of stress were evident at work, the corporate medical director of a large
manufacturing company thought it would be useful to establish a stress prevention program as a
proactive measure. As a first step he discussed this concept with senior management and with union
leaders. Together, they decided to organize a labor-management team to develop the program. The team
comprised representatives from labor, the medical/employee assistance department, the human
resources department, and an outside human resources consulting firm. The consulting firm provided
technical advice about program design, implementation, and evaluation. Financial resources for the team
and program came from senior management, who made it clear that they supported this activity. The
team designed a two-part program. One part focused on management practices and working conditions
that could lead to stress. The second part focused on individual health and well-being.

To begin the part of the program dealing with management practices and job conditions, the team worked
with the consulting firm to add new questions about job stress to the company's existing employee
opinion survey. The survey data were used by the team to identify stressful working conditions and to
suggest changes at the work group and/or organizational level. The employee health and well-being part
of the program consisted of 12 weekly training sessions. During these sessions, workers and managers
learned about common sources and effects of stress at work, and about self-protection strategies such as
relaxation methods and improved health behaviors. The training sessions were offered during both work
and nonwork hours.

The team followed up with quarterly surveys of working conditions and stress symptoms to closely
monitor the effectiveness of this two-part program.

These examples are based on adaptations of actual situations. For other examples of job stress interventions, see the Conditions of Work
Digest, Vol. 11/2, pp. 139-275. This publication may be obtained by contacting the ILO Publications Center at P.O. Box 753, Waldorf, MD
20604 (Telephone: 301-638-3152). Or call NIOSH at 1-800-35-NIOSH.