How to recognize chronic stress and mental illness in your employees

An excerpt from 'The Burnout Epidemic: The Rise of Chronic Stress and How We Can Fix It'
September 28, 2021, 6:00 AM UTC
September 2021 Books-burnout-epidemic
“The Burnout Epidemic: The Rise of Chronic Stress and How We Can Fix It”
Courtesy of Harvard Business Review Press

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I’ve spent the greater part of my career analyzing, researching, and reporting on organizational culture and their well-being strategies. It took me a few years to realize that we’re getting it all wrong. Despite good intentions, wellness programming often looks more like we’re bailing people out of the water downstream rather than preventing them from falling in upstream.  

This understanding led me to investigate what really detracts from our well-being. I found that if we aren’t identifying the root causes of chronic stress and burnout, wellness perks make little to no impact. A costly miscalculation for many global firms.

Our research, of which I discuss in the following excerpt, and existing evidence, point to a need for more openness about mental health discussions in the workplace. For anyone who has lived with a mental illness, it can be extremely challenging to exist in a culture where being unhappy creates feelings of shame and fear of stigma.

In companies where silencing conversations about mental health are common, it may be viewed as discriminatory. Structural stigma, also known as workplace stigma, refers to system-level discrimination—in which employees fear that discussing their mental health could cost them a promotion or even lead to being fired. And yet, a McKinsey report found that 75% of employers acknowledge the presence of stigma in their workplaces.

And yet, there are significant benefits to organizations that promote conversations about mental health and normalize discussions about mental illness. Research data shows that feeling authentic and open about mental health at work leads to better performance, engagement, employee retention and overall wellbeing.

In this excerpt from my new book, The Burnout Epidemic, I detail what chronic stress may look like in ourselves and others. If we can identify the signs, we can access prevention tools before it gets too far. I also share tips for more effective communication—whether you’re a manager or a peer—while addressing mental health concerns at work.

I always tell managers, you’re not supposed to be mental health experts, but you should know where those experts exist inside your organizations. It’s important to have the basics to handle conversations about mental health so your discomfort doesn’t get in the way of helping your people. Read on for ways to increase psychological safety in your workplaces. 


According to the World Health Organization (WHO), one in four people in the world will be affected by mental or neurological disorders at some point in their lives. Around 450 million people currently suffer from such conditions, placing mental disorders among the leading causes of ill health and disability worldwide.

Therefore, it’s a high statistical probability that we will deal with mental health issues in our workplaces at some point in our careers. I’m constantly surprised at how challenging it is for organizations to properly address this problem.

In our survey data, we found that discussions about mental health were still stigmatized in far too many companies worldwide. Despite data that shows 65% of people who couldn’t discuss their mental health at work experienced burnout often or always, nearly 50% of respondents didn’t believe they could openly discuss their mental health at work.

This is a problem. We need to make our workplaces safe for discussions related to mental health and mental illness. We can start off by first recognizing the signs of someone struggling with mental health issues.

  1. Changes in work habits. It’s easy to confuse poor work behaviors with performance problems, but in more cases than we realize, mental illness is the real issue. Examples can include lack of motivation, increased errors, difficulty concentrating, or lower-than-normal productivity.
  • Behavior changes. Look for signs of personality changes like more volatility in their moods (up and down), increased restlessness, anxiety or worry, or irritability; perhaps they are quick to anger or have trouble coping with regular work stuff that shouldn’t trigger a stress response.
  • Frequent absences from work. When someone is normally punctual and suddenly is constantly late or calling in sick, it is important to check in.
  • Recurring complaints of physical symptoms. Often, someone struggling with mental illness will develop physical symptoms like fatigue or insomnia, headache, abdominal distress (nausea, pain, etc.), and change in weight.

Now, if you’ve recognized a combination of these changes in your employees’ behavior and want to address it with them, here’s where to start.

I’ve observed that managers shy away from discussions related to mental health simply because they didn’t feel equipped to handle the conversation. I remind them that they are not expected to be mental health experts. Rather, they need to know where the experts live in the organization and what support tools, programs, and applications are available. Leaders are a conduit to the mental health professionals—they are not expected to be one.

It is critical, however, for managers to be informed. Know something about mental health, mental illness, and the impacts of chronic stress on your employees. There are countless online resources that offer mental health training—something that should be handled right at onboarding and part of an overall well-being strategy. Every employee should know the fundamentals of dealing with mental health at work for their benefit and the benefit of their peers.

The Canadian Centre for Occupational Health and Safety suggests the following tips for effective verbal communication when addressing mental health concerns. It also offers tips for how we can present more effective nonverbal cues:

  • Use calm body language. Unclench hands and be attentive.
  • Position yourself at a right angle to the person, rather than directly in front of them.
  • Give the person enough physical space. Normally between two and four feet is considered appropriate.
  • Get on the other person’s physical level. If they are seated, try kneeling or bending rather than standing over them.
  • Pay attention to the person. Do not do anything else at the same time, such as answer phone calls, read emails, and so on.
  • Do not appear challenging or threatening, for example, standing directly opposite someone, putting your hands on your hips, pointing your finger, waving your arms, crossing your arms.

After we engage in a conversation about mental health with someone on our team, the next steps should include providing access to support tools that may reside in an employee assistance program or elsewhere. Make sure you have that follow-up information on hand before you initiate a dialogue about mental health. You want to be ready with help, because the conversation might be difficult. And, remember, if you need help before going down this road, just ask. Your HR team can provide suggestions for how to lead through these types of scenarios.

Excerpted from The Burnout Epidemic: The Rise of Chronic Stress and How We Can Fix It by Jennifer Moss. Copyright © 2021 by Jennifer Moss. Reprinted with permission of Harvard Business Review Press. All rights reserved.

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