Stress at work is something we all experience to a degree, and can be a positive. It can help us stay motivated and get things done. But too much stress is harmful to our health, putting us under both physical and emotional strain and leading to sickness and depression.

Stress is at heart a physical reaction of the sympathetic nervous system. When our body perceives there is a threat, it reacts with a 'fight or flight' response, producing larger amounts of hormones like cortisol and adrenaline. While the alertness and rush of energy this can provide is useful in a serious crisis and likely served us well historically, it's often not so helpful with most modern daily stressors.

On the other hand, nowadays with our understanding of stress we are more advanced in knowing how to control and limit its onset. In many ways a stress reaction is a choice we make by our decision to see something as either a challenge or manageable.

It's very common. Stress is behind a huge 40% of all work-related illness in the UK, proving an issue for both employees, employers, and the economy.

The Health and Safety Executive Committee (HSE) reports that the highest rates of workplace stress in the UK are found in the industries of social work, human health, public administration, defence, and education.

As for what jobs were found the most stressful, they were nursing, teaching, and welfare and housing advising, respectively.

While both men and women are affected by workplace stress, women were almost 70% more likely to experience it, especially in the age group of 35-44 year olds.

There is nothing wrong with hard work and it's been shown that an organised workplace that is managed well can be positive for our health, providing a sense of purpose, achievement, and camaraderie.

Stress arises if a workplace is neither organised, well managed, or supportive. This can stem when employees are faced with one or many of the following challenges:

• Lack of clarity of what is being asked of them
• Given more work than they can handle or that is outside of their skill set
• Being under-trained for their position
• Given very high responsibility
• Not having any say in what their work is and how to carry it out
• Asked to do things within strict or unrealistic time frames
• Offered no encouragement and feeling under-valued
• Not given access to the right resources to carry out their job
• Issues with other colleagues including bullying
• A role that conflicts with another person's role
• Disorganised change within their organisation
• Not allowed to give feedback
• Are working too many hours
• A job or environment that is unstable
• A job that threatens their health or life
• Exterior pressures like demanding clients, negative press, a parent company
• Sexual harrassment

There are many physical, physiological and behavioral signs of being highly stressed while at work.

Physical signs can include:

• Elevated heart rate/ high blood pressure
• Increased sweating
• Rushes of energy followed by fatigue
• Headache and muscle tension
• Chest pain or back pain
• Lower immunity to infections
• High blood pressure
• Digestive problems
• Weight gain or loss
• Sleeping problems
• Fainting spells
• Loss of libido
• Unexplained rashes

Emotional signs can include:

• Depression, despair or hopelessness
• Anxiety
• Anger, agitation
• Feeling insecure and vulnerable
• Forgetfulness
• Lacking in motivation
• Restlessness

Behavioural signs can include:

• Unable to concentrate
• Avoidance of social situations
• Substance use
• Eating too much or too little
• Crying often
• Relationship problems
• Angry outbursts
• Nail biting

Workplace stress can lead to poor job performance, possible redundancy and financial difficulty and the further anxiety that brings, strain on interpersonal relationships, and less effective everyday functioning.

Physical implications include risks of pre-mature ageing. There is evidence that stress also plays a role in cardiovascular disease and musculoskeletal disorders.

Psychologically, long term work-related stress can cause the onset of mental health conditions like depression, low self-esteem, anxiety, eating disorders, nervous breakdown, and post-traumatic stress disorder (PTSD).

Medicine is not usually prescribed for managing stress. Anti-anxiety and anti-depressant medication can sometimes ease symptoms, but often does not alleviate the problem, so they are not considered in and of themselves an effective treatment. Research suggests instead that the best approach to treatment of occupational stress is a psychological approach.

Ideally, both the individual and the organisation should be targeted with stress management advice and support including new coping strategies and improvement in well-being standards.

If you are suffering from work-related stress the first step is to discuss your concerns with your HR department or line manager. If this does not feel a possible option, then you can seek help privately in the form of a coach, support group, counsellor or psychotherapist.

Cognitive-behavioural therapy (CBT) is a popular short-term therapy for workplace stress. It focuses on the way your thoughts create your feelings and choices, and helps you manage your thoughts and therefore your perspective and reactions. Talk therapies like psychodynamic psychotherapy and person-centred counselling can also prove helpful.

Some therapists will include relaxation and mindfulness techniques in their sessions. Mindfulness helps you focus on the present moment instead of the soundtrack of your mind which can do wonders at helping you stay grounded during stressful episodes and react less aggressively when challenged.

If you are interested in the guidelines recommended to health providers in the UK for dealing with occupational stress, read the guide for wellbeing in the workplace produced by the National Institute for Health and Clinical Excellence (NICE) here.

Helpful tips for dealing with Workplace Stress 

• Make lists to help you keep on top of your workload
• Learn to say no – if it's not your responsibility saying no helps you do what is better
• Delegate work to others if possible
• Set realistic deadlines for yourself
• Set aside some time for relaxing In your week
• Talk to others such as friends outside of work about your worries
• Exercise – it lets off steam, releases endorphins, helps sleep and increases energy
• Eat healthily
• Get enough sleep
• Ensure you take breaks at work including a lunch away from your desk
• Do take away from from work (i.e. weekends and holidays)
• Lower or remove your consumption of alcohol and drugs that act as depressants
• Watch your caffeine intake
• Breathe - three deep, focussed, intentioned breaths throughout your day calms nerves
• Try relaxation techniques like massage, mindfulness, or yoga

It is important to have trained and impartial HR personnel who can provide guidance and support to employees who are experiencing high stress levels. If necessary, NICE recommends that an employer could arrange for a detailed assessment from relevant specialists if an individual is experiencing high stress levels.

Team building exercises and activities including through exterior providers can bring real benefits to individuals, teams, management and the overall efficacy of the organisation.

It can also be beneficial to arrange an organisational stress workshop or mindfulness workshop for your staff.

Useful self-help books include:

• Overcoming Your Workplace Stress: A CBT based Self Help Guide. Martin Bamber, 2011.
• Chained to the Desk: A Guidebook for Workaholics, their partners and children, and the Clinicians who Treat them. Brian E. Robinson, 2007. 
• Career Counselling.  Robert Nathan and Linda Hill Estate, 2005. 

Helpful websites include:

• NHS Direct Guide to Stress
• Citizens Advice 

Useful telephone numbers include:

• Anxiety UK Hotline 08444 775 774
• Combat stress (for the military community and their families) - 0800 138 1619

Advice for seeking help: 

There are now many counselling and therapeutic services and organisations available. As well as a private practice like Harley Therapy there is the option of seeing your GP and asking for a referral. 

• Local charities or organisations may provide support groups and advice in your local area. Contact your local council for further information.