Where Does Stress End and Mental Illness Begin—in the Workplace?
Where Does Stress End and Mental Illness Begin—
in the Workplace?
by James Porter
In the first part of this series, I asked a difficult question: Where does stress end and mental illness begin? The question arose from the tragic case of Lindsay Clancy and from the extraordinary phenomenon of postpartum psychosis. But you don't have to look inside a psychiatric hospital—or a courtroom—to encounter the boundary between stress and mental illness. You can find it in almost any workplace.
Consider the employee who has always been dependable but suddenly begins missing deadlines. The person who used to be engaged in meetings but now sits silently. The manager who notices that a normally outgoing employee has withdrawn, or that someone who once handled pressure well now seems overwhelmed by the smallest problem. We often call these people "stressed." Sometimes they are. But sometimes something more is happening.
That distinction matters because stress and mental illness are not opposites. Stress is a normal response to demands that exceed—or appear to exceed—our ability to cope. Mental illness is something different, but chronic or overwhelming stress can contribute to the development or worsening of mental-health problems. The CDC's National Institute for Occupational Safety and Health now explicitly recognizes that chronic exposure to occupational stress can worsen mental health. (CDC)
The problem for employers is that there is no bright line between the two.
A person can be having a terrible week and still be perfectly healthy. Another person can look perfectly functional while quietly descending into depression, anxiety, substance misuse or another serious problem. And a third person may be experiencing something that isn't a psychiatric disorder at all, but simply the accumulated effects of too much work, too little sleep, a difficult boss, financial pressure, family problems or some combination of all of them.
So what should a manager do?
The answer is surprisingly simple: Don't diagnose. Notice.
A manager doesn't need to decide whether an employee is depressed. HR doesn't need to determine whether someone has an anxiety disorder. A supervisor certainly shouldn't attempt to diagnose a colleague's mental health. What they can do is recognize a significant change in behavior and respond to the person rather than simply to the performance problem.
"You're missing deadlines" is a performance conversation.
"I've noticed that you don't seem like yourself lately. Is there anything going on that I can help with?" is a human conversation.
That difference can matter.
And this is where the workplace has an important role to play. The goal isn't to turn every manager into a therapist. It is to create an environment in which employees can acknowledge that they are struggling before a crisis makes the decision for them. The CDC recommends organizational changes and workplace practices—not simply asking employees to become more resilient—as an important part of addressing work-related stress and burnout. (CDC)
This is particularly important because we have a tendency to treat stress as a personal failure. We tell people to manage their time, exercise more, meditate, take a vacation or "find better balance." Those things can help. But sometimes the problem isn't that the employee isn't managing stress well enough. Sometimes the demands placed on that person are simply too great.
And sometimes the problem has moved beyond stress altogether.
That's why I keep coming back to the question.
Where does stress end and mental illness begin?
Perhaps the answer is that there isn't a precise line. There is a territory between the two—a place where ordinary human distress can become chronic, where chronic stress can contribute to illness, and where illness can begin to look, at first, like nothing more than someone who isn't coping very well.
Our responsibility in the workplace isn't to draw that line.
It's to notice when someone may be approaching it.
And perhaps that is one of the most important things a wellness program, an EAP, an HR department or a good manager can do: not diagnose the person, but recognize the person.
Because sometimes the employee who looks "stressed" doesn't need another stress-management tip.
They need someone to notice that something has changed.
And they need to know that it is okay to ask for help.
Erica Tuminski
Author