Psychology says people who work even when they are ill and don’t take a leave may be trapped in a cycle of pressure

Some people treat sick leave almost like a last resort. They may have a fever, headache, stomach problem or feel completely exhausted, yet still open their laptop, answer emails and attend meetings. They may tell themselves, “I can rest after I finish this,” or “There is too much work to take a day off.”

Psychology calls the broader behaviour of working despite illness presenteeism. Research suggests that it is not always simply a sign of ambition or commitment. People may continue working because of workload, job insecurity, workplace expectations, personal beliefs, emotional attachment to work or a feeling that taking leave will create even more problems.

Psychology Says Working While Sick Can Be About More Than Hard Work

Research by organizational psychologists Gary Johns and Mariella Miraglia shows that sickness presenteeism can have multiple causes. Their meta-analysis covered 109 samples and 175,965 participants and found associations with job demands, stress, constraints on absenteeism, low support, job insecurity and positive attitudes such as engagement and commitment.


That means two people can both work while sick for completely different reasons.

One may genuinely enjoy their job and feel capable of doing a small amount of work. Another may be terrified of falling behind or being judged for taking leave. The behaviour looks identical from the outside, but the psychological motivation can be very different.

The Psychology Of “I’ll Just Finish This First”

One powerful explanation comes from Conservation of Resources Theory, developed by psychologist Stevan Hobfoll.

The theory proposes that people try to acquire, protect and maintain valued resources. Losing resources, including time, energy, money, status or social support, can become psychologically stressful.

For someone with a huge workload, taking sick leave can therefore feel like creating another resource loss: unfinished tasks, an overflowing inbox and a difficult return to work.

Research applying Conservation of Resources theory to sickness presenteeism suggests that long working hours and heavy workloads can contribute to a resource-loss cycle, where people keep working while sick because they are trying to prevent work from accumulating.

The irony is that continuing to work may consume even more of the energy they were trying to protect.

Why Some People Feel Guilty About Taking Sick Leave

Self-Determination Theory, developed by psychologists Edward Deci and Richard Ryan, distinguishes between different types of motivation.

A person can work because they genuinely value what they do, autonomous motivation, or because they feel pressure, guilt or an internal obligation to keep performing, controlled motivation.

Research on workaholism found that excessive work can have different motivational roots. Autonomous motivation was associated with vigor, while compulsive work driven by controlled motivation was associated with exhaustion. This distinction matters.

Someone thinking, “I enjoy my work and I can handle one small task today,” is psychologically different from someone thinking, “If I stop working, I’m letting everyone down.” Both may open the laptop while sick. Their relationship with work is not the same.

Workplace Culture Can Make Sick Leave Feel Risky

Sometimes the individual is not the main problem. Research on presenteeism consistently identifies organizational factors such as high workloads, strict absence policies, job insecurity, low support and workplace expectations as important influences.

A 2024 longitudinal study using the Theory of Planned Behaviour found that attitudes toward presenteeism, perceived social norms and perceived behavioural control were associated with working while ill. The research also identified quantitative demands, work-privacy conflict and leadership culture as relevant factors.

For example, an employee may technically have the right to take sick leave but believe their manager will see them as unreliable. The formal policy says take the day off; the perceived workplace culture says prove you're committed. That psychological conflict can push someone toward work.

When Working While Sick Becomes A Pattern

There is an important difference between occasionally answering one urgent email while recovering and consistently refusing to stop working despite illness.

The latter can overlap with workaholism, which researchers distinguish from healthy work engagement.

A 2024 review in the Annual Review of Organizational Psychology and Organizational Behavior describes workaholism as involving high work effort combined with an internal drive to work, including persistent thoughts about work and working beyond what can reasonably be expected. It also notes that workaholism can have negative consequences for health, well-being and family life.

So the person who proudly says, “I haven't taken a sick day in five years,” is not necessarily psychologically healthier or more committed than someone who rests when they are unwell. Sometimes the ability to stop is itself a sign of healthy boundaries.

Why “I Can’t Take Leave” Can Become A Mental Habit

Repeatedly working through illness can also reinforce a behavioural pattern.

If someone works while sick and successfully avoids an immediate deadline crisis, they may learn that continuing to work is the safest response whenever they become unwell. Over time, the behaviour can become habitual.

Research on sickness presenteeism shows that personal attitudes interact with workplace demands and perceived control, rather than there being one universal personality type behind the behaviour.

This is why calling every person who works while sick a “workaholic” is too simplistic.

Taking Sick Leave Is Not A Sign Of Laziness

Psychology does not support the idea that productivity is always evidence of good health.

Sickness presenteeism has been studied precisely because being physically present at work does not necessarily mean someone is functioning at their best. Researchers have linked presenteeism with productivity loss and health-related consequences.

Someone who takes a day off may actually be making a more sustainable decision than someone who spends five days working at half capacity while sick.

People who work through illness may be motivated by dedication, responsibility, financial pressure, fear of falling behind, workplace culture or a deeper psychological difficulty with switching off.

So when someone says, “I never take sick leave,” the more interesting psychological question may not be How hardworking are they? It may be: “What do they believe will happen if they stop?”

FAQs

Why do some people work even when they are sick?

Research suggests that presenteeism can be influenced by workload, job insecurity, workplace culture, stress, personal attitudes toward work, commitment and perceived pressure to remain productive.

Does working while sick mean someone is a workaholic?

Not necessarily. Occasional presenteeism can have many causes. Workaholism involves a persistent, compulsive relationship with work and is different from simply being highly engaged or occasionally working while unwell.