How Work Conditions Impact Mental Health

Most of us spend the majority of our waking lives hard at work. Whether you’re washing windows, jockeying a desk, teaching a gaggle of ungovernable kindergarteners or burning the midnight oil to get your small business off the ground, you know that a good gig can be hard to find. And a bad one can really drag you down.

But did you realize that your work conditions could also be impacting your mental health in concrete, measurable ways? It’s true. We talked to psychiatrist Douglas McLaughlin, DO, about how the way we work impacts the way we feel — and when it’s time to get help.

Mental health and work

Having a job can positively affect your mental health in many ways.

“We focus on pay and benefits, but we often don’t think about all the secondary gains of work,” Dr. McLaughlin explains. “Working engages you, gives you routine and structure, builds self-esteem and helps you stay connected with others. All those things reduce anxiety.”

A good job can improve your life and mental health. But work-related stress is just as powerful.

In a 2021 survey about workplace health and well-being, 76% of respondents said they had at least one symptom of a mental health condition. And 84% said that at least one thing about their workplace was negatively impacting their mental health.

Dr. McLaughlin isn’t surprised to hear it. “I wouldn’t have been surprised if it was 100%,” he admits. “We already know that mental health issues are widespread. And work conditions add extra stressors that make the problem more serious.”

Mental health in the workplace has become an extra hot topic recently. That’s because the early COVID-19 pandemic had a seismic effect on work conditions. In the years since, employees’ expectations have changed.

“It’s easier now than ever to find job opportunities because remote and hybrid work models are more common,” Dr. McLaughlin notes. “That’s allowed many workers to ask for more and feel more empowered.”

Ninety-two percent of the respondents of The American Psychological Association’s 2024 Work In America Survey said it’s important to work for an organization that 1) offers support for employee mental health and 2) values their emotional and psychological well-being.

The need is clear. But how do companies meet it? They can start by addressing the work conditions that most negatively impact employee mental health.

Work conditions that hurt mental health

In April 2023, the U.S. Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics released data showing a significant correlation between specific work conditions and poor mental health. Dr. McLaughlin walks us through a few of them.

No paid sick leave

The CDC found working adults without paid sick leave are more likely to experience serious psychological distress than those with paid sick leave.

Work suffers when employees have to choose between a paycheck and caring for their (or their loved one’s) health. Faced with that choice, many opt to come to work sick. Researchers call this behavior presenteeism. It spreads illness, which, over time, causes labor shortages. Working while unwell also leads to poor performance and lower productivity.

Working the night shift or rotating shifts

Researchers have long known that working night or rotating shifts can impact mental health. The CDC found serious psychological distress is greater among adults who usually work the evening or night shift.

The primary reason? Evening and night shifts mess with your sleep. There’s even a term for it: Shift Work Sleep Disorder.

“The erratic sleep patterns that shift work sets up cause dysregulated sleep rhythms. That dysregulation makes it harder to get into deep wave sleep,” Dr. McLaughlin explains. “And the sleep you do get isn’t rejuvenating.”

Sleep deprivation makes it harder to concentrate and regulate your mood, increasing your risk of depression. That’s a big deal because about a fifth of the U.S. workforce does shift work.

Dr. McLaughlin believes in the healing power of sleep. He’s seen it firsthand, working with people receiving inpatient psychiatric care.

“I sometimes think taking a break and getting some sleep does more than the medications and therapies we offer,” he poses.

Unpredictable pay and job insecurity

Maybe you have a seasonal gig. Maybe you make your money through tips or commissions. Maybe you’re a freelancer, temp, adjunct or contractor.

Whatever you do, if you can’t foresee what your earnings or employment situation will look like a week, a month or a year from now, your mental health is more likely to suffer.

A 2022 review of studies broke down the impact of what’s called “precarious employment.” Yes, precarity can cause anxiety and depression. But that’s not all. Instability also impacts mental health by limiting the benefits of working. Those benefits are:

• Time and structure
• Social contacts
• Social purpose
• Status and identity

Inconsistent scheduling

The CDC didn’t find a correlation between psychological distress and unpredictable work schedules. They concluded that what really matters is flexibility. Serious psychological distress is greater for people who can’t easily change their work schedule.

A larger body of research drives that point home. Multiple studies suggest the following can reduce anxiety and improve psychological well-being:

• Reduced work hours
• Hybrid or work-from-home options
• Ability to take time off when needed

The ‘five essentials’ of employee mental health

In 2022, The Surgeon General’s office released a Framework for Workplace Mental Health & Well-Being. It explained the connection between work conditions and mental health. The report also listed the “Five Essentials” that support employee wellbeing. They are:

1. Protection from harm. Psychological safety is all about the climate you work in. Do you feel safe to be yourself and express your ideas? To take professional risks? To rest? To ask for help? Physical and financial security are also crucial to building psychological safety.
2. Connection and community. Feeling supported and welcome at work is critical to your overall mental health. A workplace can build community by prioritizing inclusion, teamwork and trust.
3. Work-life harmony. Employees are most likely to be satisfied at jobs that recognize they have lives beyond work. Flexible scheduling is part of the equation. The other part is respecting vacations, paid leave and other boundaries between your personal and professional life.
4. Mattering at work. It’s important that employees feel their work is dignified and meaningful. Workplaces can achieve that goal, in part, by paying fair salaries, recognizing accomplishments and empowering employees to be a part of decision-making processes.
5. Opportunity for growth. When we’re learning new things, our confidence in (and enthusiasm about) the work we do goes up. Companies can foster growth by creating opportunities for advancement and providing the education, feedback and mentorship their employees need to move forward.

When to get help for workplace stress

One of the most powerful indicators that your work stress is too high? Other people noticing a change.

“When your sibling, spouse, children or people that are close to you notice that you’re acting strange or different, that’s a red flag,” Dr. McLaughlin states. “We can be in denial about our health issues. So, it’s important to listen when your inner circle says that something's wrong and you need help.”

Anticipatory anxiety — sometimes called the “Sunday Scaries” — is another symptom he urges you to look out for. If anticipating going back to work fills your weekend with dread or sadness, that’s a telltale sign that something has to change.

Physical symptoms might include:

• Fatigue
• Difficulty falling or staying asleep
• Trouble concentrating
• Weight gain or loss
• Increased or decreased appetite

If that sounds like you, it’s time to reach out to a mental health professional for support. If you don’t have one, talk to your primary care provider. They can refer you to either a psychiatrist, a psychologist, or both.

When it’s time to make a change

You aren’t just working — you’re “doing the work.” You’re going to therapy, working with a psychiatrist and practicing self-care. But you don’t feel any better. If anything, you feel worse because all that effort you’re putting in doesn’t seem to be helping. You’re worried you’re on the verge of a nervous breakdown.

If that’s where you are, Dr. McLaughlin says, “You can't keep fighting through it.”

“If you see a broken leg on an X-ray, you know you can’t walk on it or use it,” he continues. “You know it needs time to heal. And if you have a physical job, you’d acknowledge you have to get well before returning to work. You need to think about your mental health the same way.”

That might mean taking a leave of absence — through the Family and Medical Leave Act (FMLA), if you live in the United States.

“Some people take FMLA, get well and get back to work. That’s the model. And the model is awesome,” Dr. McLaughlin says. “But other people don’t have that experience. And it often depends on whether you like your work environment. If you don’t, it’s frequently just a matter of time before you either sabotage your work and get fired or quit.”

Grim as that may sound, he shares that these stories often have a happy ending. That’s precisely because work conditions have such a profound impact on our mental health.

“It can be scary to stop doing what you’ve been doing, to step out of your comfort zone. But I’ve found people are better off and happier when they take the time to hone their insight and awareness, assess their situation and make a change,” Dr. McLaughlin encourages.