Anxiety, Depression, PTSD Impacted By Occupational Stress

The 10 most stressful jobs in America tend to revolve around emergency services, transport control, public relations, and executive roles.
The 10 most stressful jobs in America tend to revolve around emergency services, transport control, public relations, and executive roles.

Mental health is closely linked to occupation, with work at the core of most adults' lives. For instance, the American Institute of Stress (AIS) recently indicated that approximately 66% of people's stressors are related to their jobs.1 A particular problem is the lack of work-life balance, which can trigger certain mental illnesses like depression and anxiety.2

Do Specific Jobs Pose a Mental Health Risk?

Numerous studies have explored the occupational characteristics related to mental health, such as job demands, supervisor support, and work stress,3 with the key finding being that people in certain occupations are more prone to mental disorders. Stress, in particular, has been found to be positively correlated with mental health.4

The 10 most stressful jobs in America tend to revolve around emergency services, transport control, public relations, and executive roles. 5

Emergency and Rescue Services

Firefighters, soldiers, police officers, and disaster response personnel are at high risk for mental health issues as a result of being involved in emergency situations and being exposed to varying degrees of violence. This population has an increased risk of being exposed to traumatic events through their daily work, often leading to work-related post-traumatic stress disorder (PTSD).6,7

For instance, a study found high rates of PTSD and depression in firefighters.8  Likewise, approximately 100,000 active police officers in the United States suffer from PTSD, and many also live with the comorbidities of depression, anxiety, and suicidal ideation.9 Research from Johns Hopkins University Bloomberg School of Public Health in Baltimore, Maryland, confirmed that police and firefighters are at higher risk for mental illnesses compared with civilians, and that their exposure to trauma is related to the development of alcohol use and mood and anxiety disorders.9 In a study of military personnel, almost 25% of 5500 Army soldiers were diagnosed with a mental disorder such as depression or PTSD, with PTSD rates being approximately 15 times higher than the general public.10

Transport Control

The Germanwings Flight 9525 incident in 2015 brought airline personnel's mental health status to the forefront. Indeed, the crash was reportedly caused by Andreas Lubitz, a pilot who had previously sought treatment for suicidal tendencies, depression, and psychosomatic illness. An international survey of 3485 pilots indicated that 12.6% of the sample population met depression thresholds and 4.1% were thinking about suicide.11 In addition to jet lag, the stressors experienced by pilots include long working hours, pressure from the responsibility of passenger safety, and cockpit conditions such as low oxygen levels and high noise levels. Some pilots may also be hesitant to seek treatment due to the impact this could have on career advancement.

Taxi driving is another highly stressful occupation. One study of 508 taxi drivers found that 33% presented with at least 5 symptoms of depression, which was mainly attributed to lack of leisure activities.12 Another study found that, compared with the general population, public transportation drivers had higher rates of alcohol abuse, major depressive episodes, burnout syndrome, and anxiety.13 Drivers are often required to deal with long working hours and night shifts, which could explain some of these symptoms and unhealthy coping mechanisms. Traffic jams and air and noise pollution may also have a negative influence on their mental health.

Public Relations (PR)

Like most people in PR jobs, newspaper reporters, broadcasters, and event coordinators face tight deadlines, managing unpredictable deals, covering violent social issues, and adapting to a hectic workplace environment. These factors may explain why approximately 34% of European PR professionals experience mental illness. Almost half of them reported that they perceive their colleagues as unaccepting of mental illness, and this lack of social support and taboo regarding mental illness is counterproductive to encouraging help-seeking behavior.14

Executives

An Australian study showed that 21% of 261 US-based senior executives are psychopaths.15 Furthermore, the antisocial characteristics often found in executives, such as deceitfulness and a lack of empathy, may further cause psychological turmoil for their subordinates. Indeed, middle managers, who often help senior executives, have higher stress levels than their bosses due to their job demands.16 Subsequently, managerial positions appear to be linked to high levels of depression and anxiety.17               

Evidence suggests that the key link between occupation and mental illness is high stress, which can increase the risk of PTSD, anxiety, depression, and mood and sleep disturbances. It is important for physicians to identify occupational stress as early as possible so that the appropriate interventions can be implemented before problems escalate. Tools such as the Job Stress Scale,18 Workplace Stressors Assessment Questionnaire,19 and Depression Anxiety and Stress Scales20 can assist with this. 

Once occupational stress has been identified, stress management interventions can be put into place. The physician can assist with secondary interventions by attempting to reduce the stress severity before it leads to serious health problems.21Such interventions are aimed at the individual and involve techniques like relaxation, deep breathing, meditation, time management, exercise, and goal setting.22 These techniques help individuals by encouraging them to monitor their stress levels, identify the causes of stress, and develop the necessary skills to manage the stress effectively.

References

  1. The American Institute of Stress. Workplace stress. www.stress.org/workplace-stress/. Updated 2017. Accessed April 17, 2017.
  2. Wang J, Lesage A, Schmitz N, Drapeau A.The relationship between work stress and mental disorders in men and women: findings from a population-based study. J Epidemiol Community Health. 2008;62(1):42-47.
  3. Thorsteinsson E, Brown R, Richards C. The relationship between work-stress, psychological stress and staff health and work outcomes in office workers. Psychology. 2014;5:1301-1311. 
  4. Jiang T, Ge H, Sun J, Li R, Han R, Liu J. Relationship between Occupational Stress, 5-HT2A Receptor Polymorphisms and Mental Health in Petroleum Workers in the Xinjiang Arid Desert: A Cross-Sectional Study. Int J Environ Res Public Health. 2017;14:402-413. doi:10.3390/ijerph14040402
  5. Career Cast. The most stressful jobs of 2017. www.careercast.com/jobs-rated/most-stressful-jobs-2017. Updated 2017. Accessed April 17, 2017.
  6. Skogstad M, Skorstad M, Lie A, Conradi HS, Heir T, Weisæth LWork-related post-traumatic stress disorder. Occup Med. 2017;63(3):175-182.
  7. Harvey SB, Milligan-Saville JS, Paterson HM, et al. The mental health of fire-fighters: An examination of the impact of repeated trauma exposure [published online Nov 24, 2016]. Aust N Z J Psychiatry. doi:10.1177/0004867415615217
  8. Alghamdi M, Hunt N, Thomas S. Prevalence rate of PTSD, Depression and Anxiety symptoms among Saudi Firefighters. J Trauma Stress Disord Treat. 2017;5(3):2.
  9. Moreno, D. PTSD: The hidden toll of policing. The Epoch Times. 2017. www.theepochtimes.com/n3/2115193-ptsd-the-hidden-toll-of-policing/. Accessed April 17, 2017. 
  10. Willingham V. Study: Rates of many mental disorders much higher in soldiers than in civilians. CNN. http://edition.cnn.com/2014/03/03/health/jama-military-mental-health/. Accessed July 17, 2017.
  11. Wu AC, Donnelly-McLay D, Weisskopf MG, McNeely E, Betancourt TS, Allen JG. Airplane pilot mental health and suicidal thoughts: a cross-sectional descriptive study via anonymous web-based survey. Environ Health. 2016;15(1):121.
  12. Bawa MS, Srivastav M. Study the epidemiological profile of taxi drivers in the background of occupational environment, stress and personality characteristics. Indian J Occup Environ Med. 2013;17(3):108.
  13. Ruiz-Grosso P, Ramos M, Samalvides F, Vega-Dienstmaier J,Kruger H. Common mental disorders in public transportation drivers in Lima, Peru. PloS one. 2014;9(6):e101066.
  14. Griggs I. A third of PR people have experienced mental ill health so what is the industry going to do about it? PR Week. www.prweek.com/article/1335436/third-pr-people-experienced-mental-ill-health-so-industry-going-it. Accessed April 17, 2017.
  15. Brooks N. The emergence of non-criminal psychopathy. Presented at: 2016 Australian Psychological Society Congress. September 13-16. Melbourne, Australia.
  16. Prins SJ, Bates LM, Keyes KM, Muntaner C. Anxious? Depressed? You might be suffering from capitalism: contradictory class locations and the prevalence of depression and anxiety in the USA. Sociol Health Illn. 2015;37(8):1352-1372.
  17. Edwards KL, Walker SL, Bodenham RF, Ritchie H, Shultz S. Associations between social behaviour and adrenal activity in female Barbary macaques: consequences of study design. Gen Comp Endocrinol. 2013;186:72-79.
  18. Lambert EG, Hogan NL, Camp SD, Ventura LA. The impact of work–family conflict on correctional staff: A preliminary study. Criminol Crim Just. 2006;6(4):371-387.
  19. Mahmood MH, Coons SJ, Guy MC, Pelletier KR. Development and Testing of the Workplace Stressors Assessment Questionnaire. J Occup Env Med. 2010:52(12):1192-1200.
  20. Crawford JR, Henry JD. The Depression Anxiety Stress Scales (DASS): Normative data and latent structure in a large non‐clinical sample. Br J Clin Psychol. 2003;42(2):11-131.
  21. Murphy LR, Sauter SL. The USA perspective: Current issues and trends in the management of work stress. Aust Psychol. 2003;38(2):151-157.
  22. Giga SI, Cooper CL, Faragher B. The development of a framework for a comprehensive approach to stress management interventions at work. Int J Stress Manag. 2003;10(4):280.

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