Workers and stress

Burnout vs Depression

The trail to solutions

1- Detection

To prevent, you have to first detect the presence of a problem. Even in a stressful work environment, a portion of people is always at risk of being affected by mental health problems. Such is the importance of detection for determining people at risk, something that is not without its own problems.   

Actually, talking about detection with management amounts to what when it is too late?  “We’re interested in problems and we try to control them when an individual already presents symptoms of « burnout » or of depression.” This is what qualifies as the « too late stage », since affected individuals will be pulled out of their workplace. They will be in absence and will need pharmacology or all kinds of other interventions to be remedied. They will be left little choice in terms of prevention.

However, what most employers do not seem to understand is that stress IS the determining factor for developing « burnout » and the most marking factor for the development of depression. Moreover, stress is implicated in 100% of « burnout » cases and 50% of depression cases in the workplace. Thus, detecting people with chronic stress in the workplace would help to prevent emergencies with troubles that are brewing well before they appear.

2- Can we actually detect stress?

After studying stress for seventeen years, we have come to the conclusion that the major problem with stress is that it is an overused term. This is very well illustrated by a New York Times citation : “Stress is a word that is as useful as a Visa card, and as satisfying as a Coke. It's non-committal and also non-committable” (Richard Schweder, New York Times, 2004).

This overused and misused word has become extremely ambiguous. There are as many definitions of the word stress as there are words in a dictionary. This forces people who are concerned with problems to think that there are few possible avenues for research.  

The popular definition of stress is limited to time pressure : a person is stressed when unable to accomplish tasks allocated within a set time frame. This definition of stress is false.  

Two big schools of thought

Two big schools of thought have studied stress : the school of psychology and the school of physiology.

1- School of psychology

Numerous studies of stress in the workplace have been carried out using the psychological approach. They have generated two principle models : the first perceives stress as arising mostly from the environment (stress as an environmental stimulus), while the second highlights an disequilibrium between resources and demands.

a- Environmental stimulus

We call it the « fly model », that is, we perceive events coming from outside as the generator of stress. Grief would be a stressor, marriage a stressor, the birth of a child a stressor, which would ultimately lead to pathology. The problem with this model is that it measures only the consequences of stress and brings no attention to the components which might explain why a marriage has become a stressor.

b- Disequilibrium between resources and demands

This is a model that explains just about everything (which becomes a major problem) but also gives information about the origins of a stressor since it must each time determine what are the resources and the demands. These are very abstract terms.

In these two types of models, psychological stress is measured with the help of questionnaires, where we interrogate the respondent on diverse subjects such as : « Do you often catch a cold? », « Do you feel tense ». Thus, these questionnaires measure the consequences of stress and not the cause. If the respondent obtains a high score on one of these tests, then it is already too late. Taking into account the big weakness of the psychological approach to stress, several researchers turned towards physiology where we have found some very interesting markers with enormous potential.

2- School of physiology

Adrenalin and cortisol are two hormones that the body secretes when a person is stressed. The first is very well known to specialists, so our attention falls more on cortisol.

In 1950, researchers successfully identified a measure of these two hormones in urine. During fifty years, researchers did but one thing : examine the characteristics of a situation that would push the body to secrete these hormones. After fifty years of research, they found four.

So when a person interprets a situation as being stressful, which would lead their body to secrete these two stress hormones, the person must be confronted by situations that are novel, unpredicted or unpredictable. In a more important manner, the person must have the impression that they have no more control over the given situation and finally, this situation must threaten certain aspects of their personality.

Indeed, stress is a personal experience, but also a result of interactions with the environment. If a person always stayed at home and never faced novelty in life, they would have few chances of being stressed, even if this situation would bring about certain disadvantages.

Cortisol can now be measured in saliva. Hence the interesting idea of researchers to use « Salivette®» where the tip is formed from a little piece of cotton imbedded in a polyester coating. Placed in the mouth to gather saliva, it is pulled out once completely saturated and then examined by specialists. It is the level of concentrations of the cortisol hormone measured with the « Salivette® » that determines the degree of the person’s exposure to stress.

A person is said to be exposed to chronic stress once cortisol causes a « domino effect ». That is to say, any variation of the bodies’ normal rate affects other hormones, since hormones act in the interior of a tightly closed system. Thus, once the body finds itself in a situation of increased cortisol secretion for a long time, the long-term effect will be a diminution of insulin, an augmentation of glucose then possibly diabetes, an augmentation of cholesterol leading to cardiovascular problems, and finally a diminution of the immune systems efficiency, causing immune problems.