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Stress and resilience

Is it Stress or Burnout? A Breakdown For Employers

March 29, 2023
By Pivot
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You can’t sleep at night because of a looming deadline.

Your heart is pounding every time your boss calls.

Your marriage is falling apart. 

Your head is stuck in lamenting the past.

Each of these situations sounds stressful. But it’s important to not put all stress in one bucket – as the drivers, behavior patterns, and costs are remarkably different. This primer will help you to distinguish between  “just” stress vs burnout; and suggest what that critical distinction means for your employees and workplace. 

Let’s start with stress. 

It comes in a few flavors. 

Eustress: Just the right amount of stress to get you motivated, creative, energized to do your best work. 

We actually need stress to function well, but this only works when we feel confident that we have the resources and skills to handle the challenge = coping confidence. Good news: this coping confidence can be developed and results in greater resilience and performance. 

Acute Stress: the immediate reaction of your mind and body to an inherent danger. 

Ex. You are driving to work thinking about what to say in a meeting. The car next to you cuts you off and suddenly you are in the other lane, heart pounding, breathing rapidly, having totally forgotten your brilliant meeting agenda…all before you can even curse! 

This is your brain doing its #1 job = keeping you safe. Acute stress reactions are fast, hugely energy demanding, and subconscious. Did you think about the steps of what you did? No… you just did them before you could even think, “Turn the wheel.” That’s because you are hard-wired to respond to danger. This is your Sympathetic Nervous System using adrenaline and cortisol to handle the danger. And to do so, it directs your blood away from your smarter, slower frontal brain to your big muscles.  

But… and this is a big but! You were also designed to maintain health by following this energy dump with a recovery period. We know this in sports and plan for it, but not so much in business or life. During recovery the Parasympathetic Nervous System does its job of returning your heart and breath to healthy rhythms, digesting your food for nutrients, scavenging for cell damage, and replenishing nutrients wherever they are needed—like in your brain so you can run a good meeting. 

Chronic Stress: When the challenge (stressor) is too big, lasts too long, or is added onto many other stressors, it feels like it overwhelms your coping skills. 

Your body enters a chronic stress state that depletes energy from every other system of the body, affecting physical and mental health, not to mention forcing you to keep attempting to cope without your smartest brainpower or best energy. It's important to remember that stress is additive, meaning work stress is added to stress from other sources, tipping many into the chronic stress category. The 2022 APA Stress in America study found that 27% of participants reported feeling so stressed most days that they cannot function. Top stressors included inflation (83%), violence and crime (75%), the current political climate (66%), and the racial climate (62%). 

In chronic stress states, cortisol levels rise and negatively affect digestion, all immune functions, memory, focus, skin health, heart health, mental health, etc., etc. There is not enough parasympathetic recovery time to offset the sympathetic activity—they are often revved up and fatigued at the same time. This explains why chronically stressed employees drive up healthcare costs, are absent more often, make expensive mistakes (=legal costs), are less engaged, and less productive (presenteeism). Sadly, the vast majority of us were not taught appropriate self-management skills in our pursuit of “success” and the result is far too much shame and suffering.

According to the American Institute of Stress, the financial cost of workplace stress is a whopping  $3 Billion a /year. 

If the stress load is reduced, recovery improved, and the resources and support boosted to create more coping confidence, then the mind and body return to healthier states. It takes a multifactorial approach to lessen the extraordinary toll of workplaces stress, including:

  • reducing inequities and overwhelm in workload and flow,
  • making sure resources are optimized, 
  • creating a positive culture of transparency focused on supporting energy management (self-care), meaning and purpose, and human connection,
  • and offering on-going opportunities to learn new skills to handle the challenges of life.

 But if the stress continues, the employee is at risk for developing burnout. 

Burnout: Officially defined by the World Health Organization as a psychological syndrome resulting from chronic interpersonal stressors on the job and leading to 3 responses:

  • Overwhelming exhaustion 
  • Feelings of cynicism or detachment
  • Sense of ineffectiveness and lack of accomplishment

According to FutureForum studies, 42% of the 10,243 adults interviewed reported signs of burnout in late 2022. While numbers vary between surveys, millennials, gen Z-ers, and women seem to be suffering the most, and burnout is the greatest driver of resignation.  

The burned-out employee is often overwhelmed, emotionally exhausted, lacking hope, withdrawn, suffering from sleep and mood disturbances, and a variety of other physical and mental symptoms, many of which overlap with depression. (More on that in later post.) They feel stuck in this state and often make choices that create more stress… a vicious cycle. Burned-out employees 

Once an employee reaches burnout more intervention is necessary for full reversal, and it is a slow process. The same multi-pronged approach is still beneficial, especially in creating a culture to support the best of human potential. But much more is needed: job support, often professional support, a comprehensive self-care plan, reset of expectations, reflection to identify key triggers and strengths, and guidance to recreate meaning and purpose (the greatest human driver) in work and relationships. 


The alarming stress and burnout rates are driving a lot of research to better understand precipitating factors, risks, and solutions. The expectations that the rate spikes would resolve as the pandemic waned have not played out and just maybe that is good: we are being forced to explore how we can better align human thriving with business success. In the long run that will be the best business economic pivot ever! 

Cynthia Ackrill, MD, PCC, FAIS

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