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Cognitive Behavioural Therapy in the Workplace
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Stress at work


Work related stress is the adverse reaction people have to excessive pressures or other types of demand placed on them at work.

Mental health is how we think, feel and behave.

Common mental health problems are those that:

  • are most frequent and more prevalent; and
  • are successfully treated in primary care settings like GPs rather than by specialists such as Psychiatrists

 Anxiety is an unpleasant feeling when you feel worried, uneasy or distressed about something that may or may not be about to happen. (NHS Direct)

Depression is when you have feelings of extreme sadness, despair or inadequacy that last for a long time. (NHS Direct)

Signs of stress in a group

  • Disputes and disaffection within the group
  • Increase in staff turnover
  • Increase in complaints and grievances
  • Increased sickness absence
  • Increased reports of stress
  • Difficulty in attracting new staff
  • Poor performance
  • Customer dissatisfaction or complaints

It is not up to you or your managers to diagnose stress. If you or they are very worried about a person, recommend they see their GP. It is up to you and your managers to recognise that behaviours have changed, be aware that something is wrong and take prompt action. Take care not to over react to small changes in behaviour. You and your managers need to act when these behavioural changes continue. Use these symptoms (both individual and group) as clues. 

Common Mental Health Problems (CMHP)

One person in four in the UK will have a mental health problem at some point in their life. While mental health problems are common, most are mild. The family doctor and primary healthcare team can usually deal with them without referring the person for specialist help.

Anxiety and depression are the most common mental health problems. Often these are a reaction to a difficult life event, for example moving house, bereavement, or problems at work.

CMHPs tend to be short-term and are generally treated by medication from a GP. The GP will review this treatment and if there is no improvement, consider referring to a specialist.

How CMHPs and work related stress go together

Work related stress and mental health often go together. The symptoms of stress and common mental health problems are similar, for example, loss of appetite, fatigue and tearfulness can be symptoms of both.

Work related stress may trigger an existing mental health problem that the person may otherwise have successfully managed without letting it affect their work.

For people with existing mental health issues, work related stress may worsen their problem. If work related stress reaches a point where it has triggered an existing mental health problem, it becomes hard to separate one from the other.

How CMHPs and work related stress are different

Common mental health problems and stress can exist independently. For example, people can have work related stress and physical changes such as high blood pressure, without experiencing anxiety and depression. They can also have anxiety and depression without experiencing stress.

The key difference between the two is their cause and the way they are treated.

Stress at work is a reaction to events or experiences at work. CMHPs can arise through causes outside work, e.g. bereavement, divorce, postnatal depression or a family history of the problem. However, people can have CMHPs with no obvious causes.

Organisations can manage and prevent stress by improving conditions at work. Doctors usually treat common mental health problems by prescribing medication. However, you and your managers have a role in making adjustments and helping the person to manage the problem at work.

Mental health problems

In practice, it can be hard to distinguish when ‘stress’ turns into a ‘mental health problem’ and when existing mental health problems become exaggerated by stress at work.

Many of the symptoms are similar to those that people experience when they are under considerable pressure; the key differences are in the severity and duration of the symptoms and the impact they have on someone’s everyday life.

Usually a general practitioner (GP) will make the diagnosis and offer treatment e.g. medication, talking therapies or a combination of both.

The majority of people with mental health problems are treated by their GP and most are capable of continuing to work productively. Evidence shows that employment can be of great benefit, both to the employer and to the employee.

Find out more

Find out more about helping people with anxiety by going to the ANXIETY UK website link to external website[2]. ANXIETY UK is a national registered charity formed 30 years ago by a sufferer of agoraphobia for those affected by anxiety disorders; it is still a user-led organisation, run by sufferers and ex-sufferers of anxiety disorders supported by a high-profile medical advisory panel.

Key message

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. 

Health & Safety Executive
guidance reproduced withi n this section of our website is done so under the terms of an Open Government Licence

Causes of Stress
Signs & symptoms
Stress at work
Stress outside of work
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