American workers are stressed out, and in an unforgiving economy, they are becoming more so every day.
Sixty-two percent say their workload has increased over the last six months; 53 percent say work leaves them "overtired and overwhelmed."
Even at home, in the soccer bleachers, or at the Labor Day picnic, workers are never really off the clock, bound to BlackBerries, cellphones and laptops. Add iffy job security, rising health care costs, ailing pension plans and the fear that a financial setback could put mortgage payments out of reach, and the office has become, for many, an echo chamber of angst.
It is enough to make workers sick - and it does.
Decades of research have linked stress to everything from heart attacks and stroke to diabetes and a weakened immune system. Now, however, researchers are connecting the dots, finding that the growing stress and uncertainty of the office have a measurable impact on workers' health and, by extension, on companies' bottom lines.
Workplace stress costs the nation more than $300 billion each year in health care, missed work and the stress-reduction industry that has grown up to soothe workers and keep production high, according to estimates by the American Institute of Stress in New York. And workers who report that they are stressed, said Steven L. Sauter, chief of the Organizational Science and Human Factors Branch of the National Institute for Occupational Safety and Health, incur health care costs that are 46 percent higher, or an average of $600 more per person, than other employees.
"The costs are significant," Dr. Sauter said, adding, "Those are just the costs to the organization, and not the burden to individuals and to society."
American workers are not the only ones grappling with escalating stress and ever greater job demands. European companies are changing once-generous vacation policies, and stress-related illnesses cost England 13 million working days each year, one British health official said.
"It's an issue everywhere you go in the world," said Dr. Guy Standing, the lead author of "Economic Security for a Better World," a new report from the International Labor Office, an agency of the United Nations.
White-collar workers are particularly at risk, Dr. Standing said, because "we tend to take our work home."
Most stress-related health problems are a far cry from the phenomenon known in Japan as karoshi, or "death from overwork." But downsizing, rapid business expansion, outsourcing - trends that some have credited with increasing the nation's economic health - translate into increases in sick days, hospitalization, the risk of heart attack and a host of other stress- related problems, researchers find.
The changing workplace, said Hugo Westerlund, a researcher at the National Institute for Psychosocial Medicine in Stockholm, "does pose a threat to people's health."
Growth of the Untraditional Job
The days when an employer said "if you do your job, you'll have a job" are long gone.
The traditional career, progressing step by step through the corridors of one or two institutions, "is finished," said Dr. Richard Sennett, a sociologist at New York University. He has calculated that a young American today with at least two years of college can expect to change jobs at least 11 times before retirement.
Business has moved away from traditional employment, now an almost quaint concept described in a recent RAND Corporation study as "full-time jobs of indefinite duration at a facility owned or rented by the employer."
Instead, that study found, one in every four workers in the United States is "in some nontraditional employment relationship," including part-time work and self- employment. Four out of 10 Americans now work "mostly at nonstandard time," according to figures cited by Harriet Presser of the University of Maryland. The odd hours include evenings, nights, rotating shifts and weekends to meet the demands of global supply chains and customers in every time zone.
These jobs require an increasing amount of time as well. Workers in the United States already put in more than 1,800 hours on the job a year: 350 hours more than the Germans and slightly more than the Japanese, according to the International Labor Office.
Nonwork hours have also been increasingly invaded by technologies that act like a virtual leash.
"The distinction between work and nonwork time is getting fuzzier all the time," said Donald I. Tepas, professor emeritus of industrial psychology at the University of Connecticut, who has studied the health and safety effects of overwork and sleeplessness.
One result is an office culture where too much work is not enough.
And while some workers thrive in the changing workplace, others find their workplaces ruled by what one expert, Joanne B. Ciulla of the University of Richmond, calls "the work ethic of fear."
More than 30 percent of workers say that they are "always" or "often" under stress at work, according to the National Opinion Research Center at the University of Chicago, and a quarter of those surveyed in 2002 said there often were not enough co-workers to get the job done.
Other surveys show no end in sight. In a new report, Kronos Inc., a human resources firm, found that 62 percent of American workers said that their job activities and responsibilities had increased over the past six months and that they had not used all of their allotted vacation time in the past year. And 60 percent of those surveyed said they did not expect any respite from increased working hours in the next six months.
Little wonder, then, that Dr. Richard A. Chaifetz, chief executive of ComPsych, the largest provider of employee assistance programs, said "the stress levels today are clearly higher than they were a few years ago."
The strain of working in an uncertain economic world weighed heavily on Sergey Shevchuk, a former programmer for financial services companies. He said he was caught in an emotional vise while the companies tried to weather the post-2000 stock slump by purging the ranks and looking toward cheaper labor through outsourcing.
"I was depressed and getting easily sick very often," he recalled. "I was coming home empty."
Mr. Shevchuk has since left the world of programming, where his work could bring $135,000 a year, and started Distinct Construction Service, a home contracting business in Fairlawn, N.J.
Diane Knorr, a former dot-com executive, said she believed that the stress of her job contributed to persistent stomach pain and sleeplessness. At first, she said, the feeling of being on call at all hours was exciting.
"The first time I got a call way after hours from a senior manager, I remember being really flattered" and thinking, "Wow! I'm really getting up there now."
But gradually, her work and family life became a blur with hours that were hard to scale back.
"If I leave at 5 and everyone else leaves at 6:30, I might look like the one who is not pulling his weight," she said.
In college, Ms. Knorr set a goal of making a six-figure salary by the time she was 49. She reached it at 35, and "nothing happened; no balloons dropped," she said. "That's when I really became aware of that hollow feeling."
A doctor suggested that she begin taking an antidepressant for the stomach pain, "which struck me as bizarre," she said.
The doctor described it as a treatment to increase the amount of serotonin in the digestive tract, but Ms. Knorr said she now realized he might have been giving her a subtle message about her own level of anxiety and depression. She eventually quit her job, and used her savings to start a nonprofit group, Wonder Inc., which provides mentors and activities for foster children.
Work can be seductive, said Dr. Arlie Hochschild, a sociologist at the University of California, Berkeley. One in five of the people she interviewed in the course of research for her book "The Time Bind" said the rewards of work could actually become stronger than the comforts of home, so "home became work, and work became home."
Dr. Hochschild warns of "the splintered self," a state of constant distraction, doing one thing and expecting another.
"It's not just time" that is lost, she said, "it's basically attention: what we give to one another."
Stress Equals Illness
Researchers are beginning to document the toll that the changing nature of work takes on health. The National Institute for Occupational Safety and Health, which has studied the links for decades, began a major initiative two years ago to study "the changing organization of work" and has worked with the American Psychological Association to build up the field of occupational health psychology at a dozen academic institutions nationwide.
Downsizing, studies find, is associated with poorer health, whether workers are fired or survive the downsizing and continue in their jobs.
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"I never took a nap without the two phones in the room," she said, and people called constantly. "It was still exhausting," she said. She resigned in June 2002 and now lives on disability.
The Benefits of Slowing Down
Recognizing workplace stress might be as simple as counting the broken pencils on a desk, but doing something about it is harder.
"We cannot stop change," Dr. Westerlund said, although it may be possible to "help the people cope with the environment."
The advice that most experts offer is deceptively simple: Dr. McEwen, for example, recommends getting enough sleep, avoiding cigarettes and alcohol, eating sensibly and exercising.
Emotional support can also make a difference, Dr. Kiecolt-Glaser said.
By "overworking, not spending time with family and friends, you're limiting the things that are most likely to do you good," she said.
Career consultants tell clients to examine the degree to which they themselves are the ones cracking the whip.
"Consider the possibility that you are colluding in your own demise," said Rayona Sharpnack, founder of the Institute for Women's Leadership in Redwood City, Calif. "Suffering," she said, "is optional." Ms. Lepow, whose work stress contributed to her disability, calls her illness "a kind of gift," because without it, she said, "I could have lived my whole life without stopping." She recalled striding across her deck to her home office without ever taking in the view. "It took something like this disease to make me stop and slow down," she said.