March 2021   MENTAL HEALTH

The Stress Test

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The Stress Test

How to tell if your employees are suffering in silence

Stress testing is a fairly common practice in many of our professions; we use it to evaluate the stability and resilience of the systems that we rely on, given the importance of their operation. The same significance can be attributed to the co-workers and employees that make up the heart of our organisations. It can, however, be much harder to understand the nuances of stress amongst individuals, though that should not excuse a lack of trying. In our 2019 Cigna 360° Well-Being Survey1, we found that 92% of employed respondents in Singapore were stressed, exceeding the global average of 84%. Despite this, only 55% felt that they were aware when their co-workers were stressed and 44% of them believed that the existing programmes in their workplaces did not focus enough on mental health and wellbeing. If we are to target stress more effectively, we must first learn to identify and distinguish between the different types of stress that employees can face.

Eustress & distress

In the workplace, stress is not necessarily avoidable, nor is that a bad thing. When we encounter new challenges and engage in meaningful work, we experience a form of good stress that psychologists call eustress. Eustress brings with it its own set of benefits that can allow us to rise to the occasion and expand our skills. It keeps us motivated, boosts our performance, and even fosters creativity in the right settings.

On the flipside, harmful stress, which is also known as distress, can seriously disrupt our physical and mental health if it continues unchecked for a prolonged period of time. Research has shown that the consequences can include cardiovascular diseases, high blood pressure, musculoskeletal pain, diabetes, as well as depression and anxiety2. It is also not uncommon for employees to miss the connection between stress and its effects on their physical health altogether. More often than not, these symptoms are perceived as age-related problems than issues stemming from the mismanagement of stress, causing us to waste more resources on ineffective solutions rather than the identification of the root cause. In time, all this can lead to further problems for our productivity and job performance, culminating in lower overall job satisfaction, higher turnover rates, loss of capable talent, increased healthcare spending, and burnout, amongst many others3.

Worryingly, the boundary between eustress and distress is often unclear. Stress is, after all, a deeply personal experience for every one of us, resulting in varying individual thresholds that can be unknowingly crossed when we reach our tipping point. Without a proper system to keep ourselves in check, stress can easily overwhelm us and catch us off guard. To prevent that, it is important to implement an easy and reliable method that can gauge individual stress.

Identifying & measuring distress

An effective system that can identify stress quickly and accurately should be one that is both easy to remember and thorough enough to cover all the critical issues that need to be addressed. One strong example of this is the Stress-APGAR barometer4. Adapted from an earlier system that was introduced in 1952, this barometer encompasses a set of five comprehensive factors that are affected by stress. By understanding them, it can help us to better identify and track our individual stress levels.

  1. Appearance: If an employee often looks tired, has noticeably gained or lost weight or even shows signs of substance abuse, it may be a sign of excessive stress

  2. Performance: A noticeable decrease in work performance over a period of time or forced efforts to over-perform by staying late and working extra hard is another sign of an employee being over-stressed

  3. Growth Tension: If new assignments are causing employees to become overwhelmed, or conversely, get bored, it may be a sign of stress as new challenges tend to be seen as opportunities for growth and development

  4. Affect Control: If your employees seem to be having a harder time controlling emotions at work, resulting in visible mood swings, outbursts and inappropriate behaviour, it could be another indicator of excessive stress

  5. Relationships: If employees become more isolated, indifferent and have trouble getting along with their colleagues at work, it could be a sign of stress-related neglect

Generally, there are no good and bad scores since each individual is different. The point of the Stress-APGAR barometer is to be an easy, quick assessment that gives a general sense of the stress level any employee is feeling. Because of its ease of use, employees can even conduct the Stress-APGAR barometer test as a self-assessment, with a simple-self rating of 1-10 for each category, before giving themselves an overall score. These assessments can also be done regularly over time to measure any significant changes in stress levels according to our personal benchmarks.

Further steps to manage employee stress levels

Beyond the issues of identification and self-management, it is also important to keep in mind the deep-rooted mental health stigma that is prevalent in countries like ours. Even with a greater understanding of our own wellbeing needs, employees can still be reluctant to disclose their actual stress levels or openly seek help because of the negative perceptions that are associated with it. This is why senior team members also have to take further steps to create a comprehensive and holistic strategy to tackle excessive stress in the workplace. The following are some suggestions to get you started.

  • Invest in communication channels and systems that will allow you or your team leaders to check in with your employees regularly and easily. This can help you to better understand their struggles as well as how you can best support them.
  • Be empathetic and sincere, since employees might face issues that are personal and difficult to talk about. By doing so, you can build trust as well as encourage them to engage in open conversations as a way to seek help and support.
  • Come up with new work arrangements that can allow employees flexibility to cope with their own personal issues. This could mean options like flexible working hours, reducing working hours or even arrangements like working from home.
  • Provide a variety of programmes and resources for your employees as a way to reinforce mental health support. Examples such as counselling, therapy and peer support networks can cater to the various expectations and needs that different employees may have.
  • Identify structural issues and pain points. If entire teams of employees seem overly stressed, it could be an indication of a structural issue at hand, such as the workflow or the tools involved.
  • Move away from the culture of presenteeism, as it not only worsens the physical and mental health of your employees but reduces your organisation’s overall productivity levels as well.

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Over to you

From the general lack of mental health support to the stigma that surrounds mental health, there are multiple facets as to why stress management remains a serious issue in organisations around Singapore. Our hope is that the Stress-APGAR barometer could become a starting point for courageous conversations on how to create better places to work. With most of us spending the majority of our time at work, reforming our work cultures and creating stronger support networks there can be a great starting point in helping us change the way we view and manage our mental health.



1. Cigna. (2019). 2019 Cigna 360 Well-Being Survey: Well & Beyond.
2. Cigna (2019). Chronic Stress: Are we reaching health system burn out?
3. Garton, E. (2017). Employee Burnout Is a Problem with the Company, Not the Person. Harvard Business Review.
4. Hellwig, T., Rook, C., Florent-Treacy, E., & Kets de Vries, M. (2017). An Early Warning System for Your Team’s Stress Level. Harvard Business Review. 

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