View: How 21st century office space contributes towards increased stress levels

Shamsah Sonawalla, MD Consultant Psychiatrist, Jaslok Hospital and Former Faculty, Harvard Medical School

My newest patient seemed to have it all – a beautiful home, a worldclass education, a loving family, two children, career success – but one of the first things Nikhil said to me was, “I can barely keep my head above water. I feel I may drown anytime.”

He was sleep deprived, working much of his waking hours, and overwhelmed by stress. Over time, he became irritable, started losing interest in work, his marriage was falling apart, he was diagnosed with high blood pressure, and his confidence started to plummet. He was reaching breaking point and was contemplating taking a sabbatical, a step that potentially – to him – could damage his career. His wife urged him to seek help. He was eventually diagnosed with depression, brought on by work-related stress. He seemed to have it all, only he didn’t.


Statistically, we spend a third of our day at work but in the office of the twenty-first century, we don’t need to be at work to keep working. Technology has long tethered us to our desks, and between the pings that never stop pinging, and the mails that never stop coming, even weekends and vacations aren’t safe from the onslaught of a job that never seems to end. Workplaces have become more competitive and post-work work has become more of a thing with off-sites, after-work drinks and office parties becoming unwritten deliverables.

This kind of culture that encourages putting work before self has inevitably led to a rise in stress. Defined as a biological and psychological response to stimuli that disturb our equilibrium, stress is good in small amounts. Our body’s stress response mechanism heightens both situational awareness and performance. Too much, however, can have damaging physiological and psychological consequences.

While there is awareness on the physical toll overwork takes on the individual to include hypertension, cardiovascular disease, weight gain and diabetes – over 75% of physical illnesses have been triggered by stress – work-related stress can also trigger mental health problems. Which is why, in the workplace, we see a lot more depression than in the general population, especially in industries that require frequent or complex interactions with the public or clients like service industries (Wulsin et al, 2015). Depression Is Common Nikhil was not alone.

Assocham India reported that 42.5% of employees in the private sector suf fer from anxiety, depression and stress triggered by difficult or inhumane working conditions (Assocham Survey, 2015). Globally, depression is the leading cause of poor health and disability (World Health Organization, 2017). It is estimated that more than 300 million people are now living with depression, a spike of more than 18% between 2005 and 2015 (WHO, 2017).

And that even doesn’t include the economic impact: $ 1 trillion per year are lost in productivity (World Health Organization, 2017). Some are more prone to depression. It runs in families: there is a genetic vulnerability to chemical (serotonin, norepinephrine, dopamine) imbalances in the brain – that cause depression – as well as inherited temperament. External factors can trigger depression in people with greater biological vulnerability but when stress is unyielding, even some people with moderate/mild vulnerability can crack.

Either way, employers cannot ignore the professional and financial impact of mental health. The direct and indirect annual costs of major depression to the US economy were estimated to be $210.5 billion, with 50% being attributable to workplace costs (Greenberg et al, 2015). Also, longer hours don’t mean greater productivity.

Maybe you could also practice a little self-care. Maybe you don’t check your phone on waking up or practice relaxation exercises. Maybe you delegate more. Maybe you focus on your strengths instead of practicing negative self-talk. And don’t be afraid to talk. People cannot help you if they don’t know that you need help. Depression is wonderfully treatable with high rates of success.

With a combination of medication and sessions of Repetitive Transcranial Magnetic Stimulation (rTMS), Nikhil recovered. He forgot about the sabbatical and instead, in a few months, managed to get a promotion. Work is supposed to provide you with a sense of purpose and fulfilment. There are many steps you can take to make sure it stays that way.

(Names of patients have been changed to protect identity)