Is work stressing you out? The dark underbelly of our tiger economy is the toll that stress is taking on the Irish workforce. Longer hours and new roles can strain the best of us, but when you introduce constantly changing technology and job insecurity as well, many people reach breaking point.

Today, the workplace demands mean having to deal with new ways of communication, which did not exist over a decade ago. The modern office is now fed with data by fax and email and many staff also have to be constantly available on a mobile phone. While the rewards may be greater, so too is the stress. An inability to relax or take a break, can result in burnout.

Everyone would admit to feeling stressed at work on occasions, but very few people perhaps are aware of just how stressed they are. The impact of stress can often be cloaked in other symptoms, for example, physical ailments. If you have trouble sleeping, feel run down, eat irregularly or have lost a lot of your enjoyment in recent times, the chances are that you could be suffering from stress. A certain amount of stress is good and is required for us all to perform well. Actors often talk of being physically-ill before a major performance. Going into a job interview or speaking in front of a large group is never easy and also causes stress. However, it is the manageable stress that helps the performance in these circumstances.

Occupational stress is on the increase worldwide. Over 30% of Americans experience enough daily stress to impact their performance at home or work. According to the US Centre for Disease Control, more than half of all deaths up to the age of 65 are the result of stressful lifestyles. In fact, a third of adult Americans admit that living a less stressful life is one of their New Year resolutions.

Britain is also more stressed than ever. In 1997, the 'Sunday Times' conducted a comprehensive survey of occupational stress in the UK. The newspaper compared their results to those of a similar study 12 years earlier. It found that stress levels in certain jobs had risen significantly over the intervening decade or so. The armed forces and social workers showed the greatest increase in stress levels, closely followed by teachers, ambulance workers and nurses.

The researchers also discovered which jobs are the most stressful. Measured on a scale of one to ten, each of these occupations rated eight or higher. In other words, people working in these occupations face high stress situations regularly throughout their working day. Top of the stress list in Britain are prison warders, followed by police, social workers, teachers, ambulance drivers, nurses and doctors.

In Ireland, the majority of workers in every industrial sector claim to be stressed. According to the Irish Congress of Trade Unions 90% of voluntary sector workers consider their job to be stressful. Teachers (88%) and workers in the health service (82%) also report high levels of stress. Construction workers have the lowest levels of stress at 63%. So basically, no matter what job you do, the likelihood is that it stresses you. Of course, different people handle stress differently and so one individual may perform poorly under stress while another views it as driving them on to work even better.

The Dublin County Stress Clinic is situated in the sweeping grounds of the St John of God Hospital in Stillorgan, South Dublin. Over 100 patients arrive here each year for help as they are suffering the physical and psychological effects of severe occupational stress. Patients are usually referred to the clinic's director, Dr Abbie Lane, after a GP has examined them for a physical complaint. Stress is often the root cause of such inexplicable pain.

"Around two-thirds of the people we see would have had a full physical examination before they attend here", says Dr Lane. "They may have neck pain, back pain, jaw pain from grinding their teeth. Many of these people are in genuine chronic pain".

Dr Lane says she is often surprised at how so many of her patients have managed to function for so long, under such physical and psychological pain. By the time they have been referred to the clinic, these patients have recognised their stress problem but have been unable to deal with it.

"The people who come to us have significant problems", she explains. "They have attempted solutions that have not worked, like exercise and other therapies. If you test them on recognised scales for depression and anxiety, they reveal moderate to severe difficulties, but yet they're still functioning". For people under real stress, there is an element of having to keep up the appearance of being well and an acceptance that one has to be stressed to get a job done.

"They believe that you have to work until seven, eight or ten o'clock at night", Dr Lane says.

Stress is difficult to isolate and difficult to treat because it tends to be caused by a range of pressures built up over time. The introduction of constantly changing technology is often blamed for the increase in occupational stress levels, but it is not the only cause.

"Technology may not be the sole culprit", claims Carole Spiers of the International Stress Management Association. "However there are plenty of other factors that contribute to stress in the workplace. These can be work overload caused by downsizing, longer hours, bullying, pressure to perform and lack of job security".

The patients at the Dublin County Stress Clinic are often successful people in high-pressure industries like finance and information technology. Their stress, according to Orla O'Neill, the co-ordinator of the stress clinic at St John of God Hospital, is usually caused by a change in pace of work, a change in their degree of control, a lack of clarity about their role, or job insecurity.

"Anecdotally, we hear from people who are in senior business posts and also in middle management, that multinationals in Ireland have changed the style of our way of working", she explains.

"Because of competitiveness, there is a lot of pressure to provide the 24-hour economy and to meet targets. There is often a more aggressive, market-driven approach that can be very stressful for some people. Rather than being very personable, some managers have become quite aggressive in their style of dealing with people. If someone is primed to be sensitive, they can react quite strongly to that".

The most commonly reported causes of occupational stress, according to the Irish congress of Trade Unions, include:

• Inadequate time to complete the job properly
• No clear job description or chain of command
• No recognition or reward for doing well
• No way to voice complaints
• Too much responsibility with too little authority
• Unco-operative fellow workers
• Job insecurity
• Prejudice in the workplace
• Unpleasant or hazardous working conditions
• No opportunity to use personal talent and ability effectively

If ignored, workplace stress can have a knock-on effect on personal relationships, and on the family. Workplace stress can lead to stress spilling over into all aspects of life. The International Stress Management Association asked workers in England which situations or activities they found stressful. Their answers, below, show how a proportion of employees even become stressed about shopping and taking holidays.

Rush Hour Travel - 45%

Work - 34%

Managing the balance between work and home - 31%

Children's future - 31%

Financial planning - 29%

Paying household bills - 26%

Shopping - 26%

New technology - 20%

Domestic relationships - 19%

Housework - 16%

Holiday trips - 14%

"Stress is always multi-faceted", explains Dr Lane. "It is a combination of things, for example where a person in an insecure job also has a huge financial commitment like a mortgage. If another person in their family becomes sick this can unravel the whole situation. By the time we see people there is often a lot of tension in their home situation, because they have not been available for their family, or maybe they have been abusing alcohol to cope with their stress. There is often a lot of bridge-building to be done".

Not everyone experiences stress as severely as the clinic's patients, but many people are suffering from stress without even realising it. Stress can easily become a background factor in many people's lives, not so severe as to require clinical treatment, but serious enough to impact on their lives adversely.

"People can become very familiar with feeling unwell", agrees Orla O'Neill, the clinic co-ordinator. "They become used to being jittery or anxious all the time, to having broken sleep and not enough energy to enjoy holidays or play with the kids. They stop questioning. They do not make the connection between the demands being made on them and the way they are feeling. They need information to prompt them into taking remedial action".

Dr Lane and her colleagues are eager for the public to take better action to counteract the effects of stress. Looking after oneself, taking regular breaks and meals, and sharing feelings with people close to you to are all great protectors against the ravages of occupational stress.

"Job satisfaction, how the work fits with the person, is an important factor", says Dr Lane. "It explains how some people in a very stressful position get on with it and thrive and love it".

At the clinic, the doctors distinguish between stress that motivates and stress that causes problems. "It would be more helpful to refer to good stress as challenge", says Orla O'Neill.

"If we take the definition of stress as being whenever the demands in our lives overwhelm us and the consequences are quite significant, then challenge is something very different. You could work very hard in a very competitive environment, for long hours and interpret everything as a challenge if you are well matched to and motivated by your job. That can even be good for health".

The Dublin County Stress Clinic recently held a conference aimed at making employers recognise the damage that occupational stress can cause. Employers have a statutory obligation to protect their workers from stress in the workplace. Under regulations introduced via EU law in 1993, employers must identify stress hazards in the workplace and eliminate them. These interventions should be on the personal, individual level and across the entire workplace.

Dr Lane and her colleagues offer their services to companies who want to deal with the problem of occupational stress. They perform a 'stress audit' on firms, identifying causes of stress and making recommendations on how the employer can improve matters.

Many employers may feel that a stress audit is a waste of time or money, but in fact the opposite is the case. Stress costs European employers up to 10% of Gross National Product in terms of lost productivity and insurance claims.

Ivor O'Shea works for Irish Life, which claims to have a 60% share of the group disability insurance market. This kind of insurance is paid for by employers to cover paying an income to employees who are unable to work because of illness.

Mr O'Shea has seen the number of new disability claims soar by 47% over the last four years, following years of stability. The increase has occurred during the so-called Celtic Tiger boom. He believes that the economic success should have caused the opposite effect on claims.

"People can take less manual jobs today", he said. "Staff can switch from jobs they do not like and if they become ill, they have a better chance of finding a job they can cope with".

So why have disability claims risen so much? Mr O'Shea accepts that the increased level of stress in the workplace is causing the rise in claims. Mental illness continues to form the grounds for around 20% of disability claims and has gone up in pace with the overall level of claims. The increase in physical ailments is, according to Mr O'Shea, attributable to hidden stress.

"Take for example an employee who has suffered from a bad back for years. He is motivated to work, so he does not claim. But if the company restructures or introduces new work practices, that employee's stress rises and his morale falls. Since the employee is no longer as motivated about his work, he decides to claim in relation to his back. His claim shows up on our disability figures as a back injury, but stress is the real cause".

Irish Life estimates that stress related injuries have caused a 15-20% increase in average disability insurance costs. This rise might have been 10-15% higher again were it not for claims management techniques. Across the insurance industry, the cost of stress could be as high as £15 million.

Fergus Whelan, the Industrial Officer with the Irish Congress of Trade Unions, fears that companies are not doing enough to limit stress as they pursue profit by any means possible.

"When economic success is sought through leaner organisations, multi-skilling, work intensification and increased productivity, instances of noxious stress will increase", he says. "As work grows ever more demanding, workplace stress will make people ill unless we decide that workplace stress is as unacceptable and preventable as other occupational illnesses".

He emphasised that stress is not solely an illness of the working population. "High levels of stress can be associated with unemployment and poverty", Mr Whelan noted. "Most unemployed people would gladly trade the stresses of living in poverty for the normal challenges of the working life".

So if stress is a hazard for everyone, what can we do to manage our stress levels, if not avoid it entirely? Eating healthily is essential to keep up energy levels. Fruit and vegetables release energy slowly, ensuring that the body does not become dangerously low on blood sugar. It is at these times of feeling low or depleted that people are most likely to become stressed by the demands placed on them.

A good night's sleep can also be protective. Shift workers usually experience higher levels of stress than workers in other jobs because their circadian rhythms, the body's sleep cycle is constantly interrupted.

A glass of wine or a beer after work might appear to help you wind down, but too much can add to the difficulties caused by stress. Alcohol is a natural depressant, and can lead to a sluggish performance at work, which only increases the opportunities for stress.

Taking regular exercise is also important, and not only because a healthy body aids a healthy mind. The endorphins released during exercise actually help us feel better. The little euphoria of a successful jog or work-out can counteract many of the effects of stress.

Finding a way to relax and let the pressures of work ebb away is crucial for avoiding stress. For this reason, Dr Lane frowns on those who work longer and longer hours, allowing one day to flow into the next without a proper period of relaxation in between. Having someone to confide your worries in, whether they be a partner, friend, family member or pet, also helps to ease the pressure.

Protecting ourselves from the rigours of stress is becoming more important as we enter the new fast-forward economy. The stress management market is already a multi-million pound industry, as various experts and gurus attempt to cash in on the public's soaring stress levels. But though we may scoff at the self-serving claims made by some of the therapy industry, it pays not to ignore stress. If stress is left to become a chronic problem, it can literally be a matter of life and death.

"The end product of untreated stress is depression and even suicide", warns Dr Lane. "Given the nature of chronic stress, it tends to be complex to solve. No one single thing is going to fix it". It can take people many months to get back to managing the immediate demands of just day-to-day life after stress overload. The message is clear - do not ignore stress that is damaging your enjoyment of life.

Written by Jim Clarke of irishhealth.com