Stress is the body’s natural response to any change in an individual’s immediate environment. This change could be physical, psychological, social, financial or spiritual. This is sometimes also called the ‘fight or flight’ response and in prehistoric times, helped man to battle or escape from predators.

A mild amount of stress (also called ‘eustress’) enhances an individual’s ability to perform.

Stress causes certain temporary changes in the body – the heart rate and blood pressure rise (to pump more blood into the muscles), pupils dilate to allow more light to enter the eyes (helping to see better), perception of sound and smell increases, muscles tense, palms begin to sweat and immune response is enhanced. This kind of stress is typically seen before an exam, a job interview, a sporting competition etc. and pushes the individual to do better.

However, when stress becomes prolonged, these same changes persist for a longer duration and can give rise to medical conditions like various diseases, infections and other physical and mental disorders. Let us consider some of these detrimental effects.

One of the most common and widespread consequences of stress are musculoskeletal disorders presenting as pain and stiffness in the neck and back muscles, which may be caused by conditions like tension headaches or even chronic low back pain (CLBP). Continuing stress can make the individual neglect proper ergonomic methods of working and worsen these conditions.

Stress is a major cause of new and worsening cardiovascular diseases. Constant activation of the body's stress response leads to sustained high blood pressure, and high heart rate, which may precipitate a heart attack or stroke over time. Monitoring employees for hypertension regularly can help.

Stress can also impact the functioning of the gastrointestinal system and cause digestive disturbances. Heartburn (acidity), indigestion, repeated infections and irritable bowel syndrome can manifest as recurrent stomach pain, epigastric burning and abdominal bloating. Trying to manage stress by resorting to unhealthy coping methods like excessive alcohol consumption, increased tobacco use and self-medication make matters worse in such situations.

A constantly stress-activated immune system does eventually weaken and makes individuals more susceptible to infections. Employees suffering from repeated episodes of colds, cough and fever sometimes say that they have a weak immune system but are often not able to relate it to the constant underlying stress they are undergoing.

Since the pandemic, clinicians and corporate physicians are reporting a higher number of consultations for psychological conditions like anxiety disorders, burnouts, prolonged depressive episodes and unfortunately even self-harm tendencies. However, mental health and wellbeing remains an under-addressed area and the reason for this is the continuing stigma, which can be a significant barrier to speaking out and seeking care among employees. “How will I be perceived”, “what will my colleagues and managers think of me”, “will talking about how I feel impact my chances of promotion” – these are some of the doubts that I have heard from patients during consultations.

Anxiety disorders if not addressed early, can result in a generalised anxiety disorder (GAD) with frequent (and sometimes debilitating) panic attacks.

The term burnout has never been more relevant in a corporate environment than it is today. The race to overachieve, the rush to “make a mark” and to trounce the ‘competition’ is making employees push harder than ever. The physical effects of stress get exacerbated by exhaustion, cynicism, and result in lowered productivity after a point.

Prolonged stress can also lead to depression, characterised by a perceptible loss of interest, feelings of hopelessness and sadness. Withdrawal from social interactions, changes in mood, non-normal behaviour are all signs of an impending or established state of depression.

Other common signs and symptoms that managers and colleagues should watch for:

· Disturbed sleep patterns: Stress often disrupts sleep cycles, leading to insomnia or poor-quality sleep and results in fatigue.

· Changed eating habits and patterns: Loss of appetite over several days or a tendency to overeat, which results in unhealthy weight gain or loss may indicate a struggle with stress.

· Social withdrawal: When stress takes its toll, individuals may withdraw from social activities and isolate themselves. An employee who suddenly stops participating in team events or appears distant from colleagues may be experiencing this withdrawal.

· Decreased performance and productivity: Cognitive function, decision-making and productivity are known to be affected by stress disorders. If an employee suddenly exhibits a slack performance, struggles to meet normal deadlines and one who delays routine tasks may be a victim.

· Conflicts: Stressed employees may exhibit irritability and intolerance which can lead to a difficulty in managing emotions, leading to conflicts with colleagues and managers. These should serve as a red flag and call attention to the individual’s stress levels.

Recognising these stress-related symptoms and warning signs is the first step towards safeguarding employee health. And though the signs and symptoms of stress may be readable, what can organisations do to manage and mitigate the adversities that accompany them? Addressing stress and other mental wellbeing requires a concerted effort between leaders, managers, employees and their families.

International SOS’ medical experts include psychiatrists, counsellors and psychological support staff to ensure that the continuum of awareness, de-stigmatisation, disorder identification, management, rehabilitation and reintegration of employees forms the framework for tailored programmes and strategies.

To ensure a happy, harmonious, productive and progressive workplace, employees need to be equipped with tools to not only be resilient but also to thrive.

This article is authored by Dr Vikram Vora, medical director, Indian subcontinent, International SOS.