Research has long since established a clear link between substance abuse, including alcoholism, and stress, (Goeders, 2003). Often as a way of coping with tensions associated with life stressors, such as work, individuals can often partake in substance use behaviour as a form of self medication, however this can lead to problematic use and subsequent addiction which could result in rehab. (Levy, 2019).
The Hypothalamic pituitary adrenal axis, more simply known as the HPA axis is a complex set of mechanisms within the brain that interact to regulate bodily functions, including stress, (Malenka etal, 2009). Research notes how abnormalities in the regulation of the HPA axis such as the release of too much cortisol, the stress hormone, (Braveman & Gottlieb, 2014), have been extensively linked with problematic substance use, (Stephens & Wand, 2012).
As one of the main stress response pathways, the HPA axis is commonly activated in substance use, (Wand, 2008). As a result, during abstinence exposure to stressors or drug associated cues may stimulate the HPA, essentially reminding the individual of the highs of substance use, producing cravings and promoting relapse, (Goeders, 2003). This therefore emphasises the need to reduce or prevent stress, relevant to the workplace, therefore reducing HPA activation, subsequently reducing cravings and lowering the risk of a lapse.
As well as highlighting occupational stress as a major risk factor in terms of addiction. Work related stress can also have a detrimental effect on mental health, (Garbarino etal, 2013; Johnson, etal, 2005). The changing nature of industry and technology and the added challenge of economic uncertainty means employees are faced more and more with greater demands and less job security, (Khan, 2001), and as a result, more acute and in some cases chronic stress.
This stress can therefore have detriment on mental health of those exposed to it. Research in the field of occupational stress and general life events is consistent – acute work-related stressful experiences contribute to depressive symptoms, (Tennant, 2001). Research into the link between occupational stress and the prevalence of poor mental health symptoms is robust. For example, in a nationwide study with a sample of over 3000 employees aged between 30-64, job related ‘burnouts’, as a result of stress, correlated clearly with depressive disorders. Major depressive disorder was especially prevalent in over half of participants who had experienced a severe ‘burnout’ in the last 12 months, (Ahola, etal, 2005).
Adding to the point regarding added demand being placed on employees in the ever-changing workplace, Siegrist, (2008) notes how high demand and low control over the work being asked of employees is a primary risk factor when predicting depressive disorders. Explaining this is difficult without going into the neurobiological processes underpinning such complex mental health conditions. However, simply put, the increased levels of cortisol being produced over a prolonged period of time (chronic stress) suppress the amount of serotonin and dopamine being produced, (Cowen, 2002), the lack of the latter two neurotransmitters contribute significantly to feelings associated with depression.
MIND mental health charity recognises that work-related stress could be a risk factor in developing a mental health problem. As a result they suggest a few tips for anyone experiencing work related stress: Recognise the signs, identifying the causes is a good starting point, Try mindfulness, living in the present can help clear your head and focus you, allowing you to find new ways to respond to potentially stressful situations and coping techniques such as practicing breathing exercises, engaging in regular exercise and maintaining good sleep hygiene are all positive ways to help keep stress levels down.
The National Institute for Care Excellence (NICE) emphasise that mental health wellbeing of employees is in the best interest of the employers. For example, it is estimated loss in productivity and mental health associated work absences cost approximately £15.7 billion nationwide. This highlights how important mental health is, how important this is to businesses and employers to make sure employee mental health wellbeing is at the forefront of their agenda and how, if you are experiencing work related stress, support and solutions are available.
Ahola, K., Honkonen, T., Isometsä, E., Kalimo, R., Nykyri, E., Aromaa, A., & Lönnqvist, J. (2005). The relationship between job-related burnout and depressive disorders—results from the Finnish Health 2000 Study. Journal of affective disorders, 88(1), 55-62.
Braveman, P., & Gottlieb, L. (2014). The social determinants of health: it’s time to consider the causes of the causes. Public health reports, 129(1_suppl2), 19-31.
Cowen, P. J. (2002). Cortisol, serotonin and depression: all stressed out?. The British Journal of Psychiatry, 180(2), 99-100.
Garbarino, S., Cuomo, G., Chiorri, C., & Magnavita, N. (2013). Association of work-related stress with mental health problems in a special police force unit. BMJ open, 3(7), e002791.
Goeders, N. E. (2003). The impact of stress on addiction. European Neuropsychopharmacology, 13(6), 435-441.
Kahn, R. L. (2001). Psychology of stress in organizations. International encyclopedia of the social and behavioral sciences, 15179-15184.
Johnson, S., Cooper, C., Cartwright, S., Donald, I., Taylor, P., & Millet, C. (2005). The experience of work-related stress across occupations. Journal of managerial psychology, 20(2), 178-187.
Levy, M. (2019). The Many Faces (and Potential Dangers) of Self-Medication as an Explanatory Concept for Substance Use. International Journal for the Advancement of Counselling, 41(1), 15-24.
Malenka, R. C., Nestler, E. J., Hyman, S. E., Sydor, A., & Brown, R. Y. (2009). Molecular neuropharmacology: a foundation for clinical neuroscience. NY: McGraw-Hill Medical.
Siegrist, J. (2008). Chronic psychosocial stress at work and risk of depression: evidence from prospective studies. European archives of psychiatry and clinical neuroscience, 258(5), 115.
Stephens, M. A. C., & Wand, G. (2012). Stress and the HPA axi: Role of glucocorticoids in alcohol dependence. Alcohol research: current reviews.
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Wand, G. (2008). The influence of stress on the transition from drug use to addiction. Alcohol Research & Health, 31(2), 119.