When Work Stress Requires Clinical Intervention
Work can cause stress in many ways, and it’s often something we think we should accept as a “normal” part of our lives. However, significant work stress can seriously impact quality of life and can sometimes escalate into diagnosable mental health conditions. Everyone deserves to enjoy their work, be supported by their employer, and be free from excessive levels of stress.
In order to tend to mental health difficulties properly, employers should understand the signs that typical job stress has become a serious concern. So, when does work stress call for mental health treatment?
This article answers this question by discussing:
- Common causes of stress in the workplace
- The different ways work stress can develop into mental health conditions
- Important signs that work stress requires therapy treatment
- The main types of clinical intervention employers should know about
Work Stress and Poor Mental Health
While they can give great meaning, structure, and community to our lives, jobs can also weigh us down and create a lot of stress.[1] In this way, workplaces have tremendous influence over our mental health. Yet, this effect can go both ways, as our mental health can also impact our performance and ability to function at work.
There are numerous workplace risks to mental health and many ways poor mental health can manifest at work. We’ll explore these now before delving into clinical interventions.
Causes of Stress at Work
Common causes of stress at work include:[1]
- Large workloads
- Long, antisocial, and inflexible hours
- Job insecurity and low job control
- Skills being underused or being underskilled for a role
- Lack of support and career development opportunities
- Discrimination, harassment, bullying, and exclusion
- Unsafe or poor physical working conditions
- Oppressive oversight from supervisors
Although these risks are found across many job sectors, some working professionals are at greater risk than others. For example, those in humanitarian and helping roles are more likely to be exposed to stressful events.[1]
Types of Work-Related Mental Health Experiences
The term “work stress” is a large umbrella. Not only can it have various causes, but it can also manifest in different ways. For example:
- Burnout and chronic stress: Involving both physical and emotional fatigue, burnout can arise from having too many responsibilities, interpersonal conflicts, and problems with work/life balance, among other factors.[2]
- Anxiety disorders: Characterized by excessive worry, fear, and/or panic, anxiety disorders can revolve around socializing, separation, specific phobias, physical panic, or be generalized. If unmanaged, work stress could compound and develop into more serious anxiety.[3]
- Depression: Involving intense feelings of sadness, shame, and lack of pleasure, work stress has been found to be connected with depression symptoms. This is particularly the case when there is high work demand and effort, but low job control and reward.[4]
- Post-traumatic stress disorder (PTSD): Causing long-term physical and emotional symptoms of panic and anxiety, PTSD can be caused by various acute or chronic events. Some workers are vulnerable to PTSD if their working conditions risk injury, accidents, violence, and bullying.[5]
- Minority stress: Simply being a member of a marginalized group at work carries an emotional burden. The awareness of being different and past or present experiences of discrimination can cause stress, anxiety, and internalized shame. Sexuality, race, gender, religion, and cultural differences at work can give rise to mental health difficulties in both overt and implicit ways.[1], [6]
These different manifestations of work stress can impact employees significantly, particularly if early signs aren’t addressed. We’ll now explore the signs and reasons why work stress may become escalated and require professional intervention.
Reasons Why Work Stress Might Need Clinical Intervention
Sometimes, work stress is talked about in-house, meaning that employers can provide the necessary support and adjustments quite easily. For instance, they might implement interventions such as remote or flexible working, or directly tackle instances of harassment or discrimination.[1]
However, these interventions aren’t always enough. Here are the instances where work stress may require clinical intervention:
When Symptoms Are Diagnosable
If someone’s symptoms have reached a crisis point in the workplace or meet diagnosable criteria, it’s most likely time for clinical intervention.
For example, if someone has developed an anxiety disorder or is experiencing panic attacks caused by work, their symptoms are likely to meet diagnostic criteria. They’re most probably experiencing significant disruptions to daily functioning, perhaps avoiding people or places, and physical symptoms.[3] At work, diagnosable anxiety may also be causing headaches, nausea, chest pain, as well as reduced productivity and absenteeism.[3]
Similarly, clinical depression can significantly impact daily functioning. If someone is feeling persistently sad, ashamed, and empty, and experiencing other symptoms of depression, in-house employer support likely won’t be enough.[7]
Mental health crises are another circumstance requiring clinical intervention. The criteria for crisis can include:[8]
- Inability to perform daily tasks
- Rapid mood swings
- Agitation, threats, and violence
- Abuse of self and/or others
- Social isolation
- Seeming out of touch with reality
- Confusion and paranoia
While diagnostic criteria are a firm way to determine whether professional therapeutic support is needed, they’re not the only way. For example, burnout isn’t a clinical diagnosis, but people may still want clinical support with it.[2] As much as possible, it should be up to the person to make their own healthcare decisions.
When Daily Responsibilities Are Impacted
As indicated already, poor mental health can seriously impact daily functioning and work responsibilities. Severe job stress can call for psychiatric help if it is significantly impairing someone’s ability to concentrate, communicate, and feel comfortable in a professional environment.
This may have safety consequences in some workplaces, particularly if employees are working with machinery or are in helping professions with vulnerable clients. Furthermore, if someone is using substances to cope, they may be at risk to themselves and/or others.
When high levels of stress meet the clinical criteria for leave or if someone’s job stress leads to a mental breakdown, employers must be extra sensitive. Not only is that person coping with poor mental health, but commenting on their “performance” or ability to “function” can feel shaming and judgmental. Handling this sensitively involves:[9]
- Being specific about instances of unsatisfactory job performance
- Providing concrete and measurable examples instead of being vague
- Giving examples of the employee’s high-quality work when outlining your observations
- Being respectful of the employee’s privacy and confidentiality
- Avoiding labels and opinions about the employee’s personal difficulties
- Consulting with your HR department to ensure the meeting adheres to company policy
- Listening actively when the employee shares their feelings and experiences
When There’s Trauma
PTSD from workplace trauma is another circumstance that calls for formal clinical support. In some sectors, employees are consistently exposed to large-scale traumatic events. For example, the threat of or actual death, suffering and injury, mass disasters, and fatal accidents are more common in the emergency and healthcare services.[5]
These highly serious events can have long-term adverse health effects, necessitating quick and ongoing mental health support.
Furthermore, things like workplace bullying and harassment aren’t limited to certain employment sectors and are significant risk factors for PTSD.[5] These types of psychological trauma should also be taken seriously by employers and HR professionals.
Types of Professional Mental Health Intervention for Work Stress
When burnout or a mental health condition needs medical treatment, there are several options. Employers wanting to support their team should familiarize themselves with the types of support available. Then, you’ll feel competent when making a referral or talking to someone about their options.
The types of support available typically include:
- Counseling and psychotherapy: In-person counseling or therapy can take many forms, but in general it provides a confidential space to discuss difficult feelings. It’s either open-ended or time-limited and is an ideal space to work through stress, anxiety, depression, and traumatic experiences. Be aware that counselors, therapists, and psychologists in the US cannot prescribe medication.
- Workplace telehealth services: Some workplaces may have telehealth services for mental health, which are essentially counseling and psychotherapy provided online or via telephone. This is sometimes preferred for its accessibility and flexibility, particularly for working professionals.
- Inpatient stays: For those who are in crisis, at risk to themselves or others, or want more intensive support, inpatient services are a stabilizing option. Often with 24-hour care, medication management, group therapy, and crisis de-escalation, inpatient stays can be a supportive place for recovery from intense mental health experiences.
These forms of clinical intervention provide different levels of support. It should always be up to the person who’s experiencing distress to decide which option is best for them. However, understanding the services available can equip you to talk through someone’s options if necessary.
Mission Connection: Mental Health Support for Work Stress
Treatment for chronic work stress can take many forms depending on your personal history, preferences, and the severity of your symptoms. While some will find cognitive-behavioral therapy (CBT) useful, others may prefer psychodynamic. You might also want to explore alternative therapies, such as art or narrative therapy.
At Mission Connection, we offer a wide range of therapeutic approaches to suit your unique needs and preferences. Alongside therapy, we can also support you with an occupational stress clinical diagnosis or medication management.
We treat a wide range of mental health conditions across multiple facilities. Contact us today to discuss your treatment or take a self-test to learn more about your symptoms.
