Chronic emotional stress

Chronic Stress > Fact Sheets > Yale Medicine

Overview

Many people, over the course of their lives, have experienced acute stress, a dramatic physiological and psychological reaction to a specific event. Chronic stress, however, is a consistent sense of feeling pressured and overwhelmed over a long period of time.

“We humans are very good at facing a challenge, solving a situation, or reaching out to someone to get support,” says Rajita Sinha, PhD, director of Yale Medicine’s Interdisciplinary Stress Center. “We’re wired to respond to stress and remove it, sometimes even automatically. But life has become more complex, and many situations don’t have easy answers.”

Sinha founded the Yale Stress Center in 2007 to study stress from an interdisciplinary perspective and to improve the treatment of stress-related diseases.

What causes chronic stress?

Causes of chronic stress could include poverty, a dysfunctional marriage or family, or a deeply dissatisfying job. In today's hectic society, there are many possible sources. Chronic stress slowly drains a person’s psychological resources and damages their brains and bodies. “People experiencing chronic stress might feel incapable of changing their situations,” Sinha says.

What are the symptoms of chronic stress?

There are cognitive, emotional, physical and behavioral signs of chronic stress. “Not all four of these categories of symptoms are necessarily going to show up in one person,” Sinha says. “But if someone has three to five of these symptoms for more than several weeks, they might be suffering from chronic stress.” Those potential symptoms include:

Aches and pains
Insomnia or sleepiness
A change in social behavior, such as staying in often
Low energy
Unfocused or cloudy thinking
Change in appetite
Increased alcohol or drug use
Change in emotional responses to others
Emotional withdrawal

Ongoing stress reactions can interfere with productivity, relationships and health. “People suffering from chronic stress often describe it as feeling ‘stuck,’” Sinha says.

What other conditions are related to chronic stress?

Chronic stress is linked to other conditions, both psychological and physical. These can include:

Diseases such as hypertension, heart disease, obesity and metabolic syndrome, Type II diabetes, and arthritis
Addiction to alcohol, nicotine and/or prescription drugs, and behavioral-related such as addiction to the internet, food, or gambling
Mood disorders and anxiety disorders, which are common secondary diagnoses for people with chronic stress

Hypertension, depression, addiction and anxiety disorders are the conditions most related to chronic stress.

How is chronic stress diagnosed?

A mental health professional can interview a patient to gather information about the overall presence of stress. Given the wide range of symptoms and linked conditions, the diagnosis may require input from other specialists. "An integrative approach is best,” Sinha says. “I might pull in an endocrinologist to see a patient if I think a patient’s issues are related to metabolic problems, for instance.” Stress biology, such as stress hormones and other physiological changes related to stress, may also perpetuate a chronic stress state and related conditions, so assessing those factors is also important.

How is chronic stress treated?

Patients with chronic stress often receive a treatment plan that targets their specific symptoms. A patient with digestive issues rooted in stress could go on medication, change his or her diet and also focus on stress reduction. As Sinha says, “It’s better to address these earlier, as a preventative approach.”

Yale Medicine’s stress management recommendations include:

Exercising
Eating healthy foods
Learning time management techniques
Setting realistic goals
Getting more sleep
Making time for leisure activities
Building stress reduction skills
Learning and practicing mindfulness (learning to control attention)

What makes Yale Medicine’s approach to chronic stress unique?

The Yale Stress Center conducts clinical trials that attempt to find biomarkers of stress that relate to chronic disease risk. Researchers at the center also develop and test new interventions to prevent and treat stress-related diseases. The Stress Center also holds classes and training workshops for the public on mindfulness and other stress-reduction techniques.

“An interdisciplinary approach to stress is the wave of the future,” Sinha says. “We are working to understand the mechanisms behind all manifestations of stress, and also studying its effects in diseases that are the endpoints of chronic stress.”

Symptoms, examples, effects, and recovery

Short-lived feelings of stress are a regular part of daily life. When these feelings become chronic, or long-lasting, they can severely impact a person’s health.

In this article, we look at what chronic stress is, how to identify it, and the medical consequences it can have. We also describe ways to manage stress, including medical treatments and when to see a doctor.

Stress is a biological response to demanding situations. It causes the body to release hormones, such as cortisol and adrenaline.

These hormones help prepare the body to take action, for example, by increasing the heart and breath rates. When this occurs, a doctor might describe a person as being in a state of heightened alertness or arousal.

Many factors can trigger a stress response, including dangerous situations and psychological pressures, such as work deadlines, exams, and sporting events.

The physical effects of stress usually do not last long. However, some people find themselves in a nearly constant state of heightened alertness. This is chronic stress.

Some potential causes of chronic stress include:

high-pressure jobs
financial difficulties
challenging relationships

Chronic stress puts pressure on the body for an extended period. This can cause a range of symptoms and increase the risk of developing certain illnesses.

Chronic stress affects the whole body. It can have several physical or psychological symptoms, which can make functioning on a daily basis more challenging.

The type and severity of symptoms vary considerably from person to person.

Signs and symptoms of chronic stress can include:

irritability, which can be extreme
fatigue
headaches
difficulty concentrating, or an inability to do so
rapid, disorganized thoughts
difficulty sleeping
digestive problems
changes in appetite
feeling helpless
a perceived loss of control
low self-esteem
loss of sexual desire
nervousness
frequent infections or illnesses

A variety of life experiences can cause stress, and these may begin in childhood. When children experience traumatic events, it can lead to the development of chronic stress that may last into adulthood.

These types of events are known as adverse childhood experiences (ACEs). In research by the Centers for Disease Control and Prevention (CDC), 61% of adults surveyed across 25 states said they had experienced at least one type of ACE, and nearly 1 in 6 had experienced four or more types.

Examples of ACEs include:

mental illness in one or more parents
emotional, physical, or sexual abuse
substance misuse in the family
parental divorce
homelessness
incarceration of a parent or close family member

In adulthood, chronic stress can happen as a result of very similar causes, as well as:

problems in the workplace
unemployment or financial problems
injury that impacts a person’s daily life
concern about problems in the country or the world

According to the Stress in America 2020 survey by the American Psychological Association (APA), 65% of people surveyed said the current uncertainty in the nation is stressful, and 60% are overwhelmed by the issues the country is facing.

In addition, 70% of parents reported family responsibilities as a source of stress, and 63% are stressed by the impact of COVID-19 on the 2019-20 school year.

Chronic stress can also affect historically marginalized groups differently than others. In 2019, surveys showed that Black and Hispanic people are three times more likely to be stressed by lack of food and safe housing, discrimination, and health inequities.

More recently, the APA also reported that nearly three-quarters of Black adults (74%), 60% of Hispanic adults, and 65% of white adults said the Capitol breach in 2020 caused them a lot of stress.

If strategies such as those listed above are not helping, it is important to see a healthcare professional for advice and support. A doctor may recommend psychological therapy, such as cognitive behavioral therapy (CBT).

One established aim of CBT is to help people deal with chronic stress. In structured sessions, a therapist works to enable a person to modify their behaviors, thoughts, and feelings concerning stressors.

CBT can also help a person develop tools and coping mechanisms to manage stress responses.

Sometimes, a doctor recommends medications to help treat some symptoms of chronic stress. For example, they may prescribe antidepressants to treat anxiety or depression. For people with trouble sleeping, doctors may prescribe sedatives.

Research has shown that chronic stress can impact the brain and the immune system. The brain’s neural networks, especially in the prefrontal cortex (PFC), can actually reduce in size. Doctors have seen this in imaging of people’s brains. When this happens, it may lead to cognitive, emotional, and behavioral dysfunctions.

When a person experiences stress, this stimulates their immune system to react. Over time, when stress is chronic, the immune system can become overstimulated. This may lead to the development of diseases and health problems.

Over long periods, chronic stress can contribute to the development of a range of physical and mental disorders, including:

heart disease
high blood pressure
diabetes
obesity
a weakened immune system
sexual dysfunction
gastrointestinal disorders
skin irritation
respiratory infections
autoimmune diseases
insomnia
burnout
depression
anxiety disorders
post-traumatic stress disorder (PTSD)
schizophrenia

Generally, acute stress is stress that a person experiences short-term. Acute stress typically manifests immediately after a person experiences a stressor as a fight-or-flight reaction.

An acute stress disorder is more serious and typically occurs in the first month after a person experiences trauma. This is similar to post-traumatic stress disorder (PTSD), but a person cannot have a diagnosis of PTSD until they have experienced symptoms for longer than a month.

Stress can also be episodic, which means a person experiences it over a long time but inconsistently. They experience stressful periods and periods with less or no stress. In comparison, chronic stress is stress that a person experiences continuously throughout their life to the point where feeling stressed becomes a normal state of being.

Chronic stress can seem overwhelming, and a person may feel unable to regain control over their life.

However, a number of strategies can help to reduce stress levels and improve well-being.

Some methods for managing stress include:

Understanding the signs and symptoms. These indications vary, but if a person can recognize their own signals of stress, they will be better able to manage them.
Speaking to friends and family. They can provide emotional support and the motivation to take action.
Identifying triggers. It is not always possible to avoid triggers of stress. However, taking note of specific triggers can help a person to develop coping and management strategies, which may involve reducing exposure.
Exercising regularly. Physical activity increases the body’s production of endorphins, which are chemicals that boost the mood and reduce stress. Exercise can involve walking, cycling, running, working out, or playing sports.
Trying mindfulness. People who practice this form of meditation use breathing and thought techniques to create an awareness of their body and surroundings. Research suggests that mindfulness can have a positive impact on stress, anxiety, and depression.
Improving sleep quality. Getting too little sleep or sleep of poor quality can contribute to stress. Try to get at least 7 hours every night, and set regular times for going to sleep and waking up. Avoid caffeine, eating, and intense physical activity in the hours before bed.

It can also help to unwind before sleeping by listening to music, reading a book, taking a warm bath, or meditating, for example.

Do not try to deal with chronic stress alone. If self-help strategies are not working, a doctor can provide support and advice about treatment options. They can also refer a person to a more specialized healthcare provider, such as a psychologist or psychiatrist.

Anyone feeling overwhelmed by stress should see a doctor as soon as possible, especially if they are having suicidal thoughts or using drugs or alcohol to cope.

Strategies to recover from chronic stress can include practicing mindfulness activities such as meditation and breathing exercises. People can also have a support system composed of family and friends, as well as a counselor or a psychiatrist if needed.

A psychiatrist can prescribe medication to reduce stress. A counselor can help a person explore the causes of their stress in order to recognize them and find a healthy coping mechanism. The earlier a person seeks help or treatment, the quicker their recovery may be.

Stress is a regular part of daily life. Short-lived stress is generally harmless, but when it lasts and becomes chronic, it can cause a range of symptoms. It can also contribute to the development of physical and mental disorders.

Self-help techniques include identifying triggers, developing coping and avoidance strategies, reaching out to friends and family, and practicing mindfulness.

If these techniques are not working, or if stress is becoming overwhelming, a person should speak to a healthcare professional.

Chronic stress: how to detect, manage and prevent

Health

Author Irina Rudevich

06 February 2019

Chronic stress leads to a burnout syndrome, a decrease in the physical and psychological capabilities of the body. We figure out if you have signs of stress, how to get rid of it, prevent it from appearing in the future and enjoy life.

According to VTsIOM, one third of Russians blame problems at work and stress, which is the body's physical and psychological reaction to negative events, for feeling unwell and getting sick. It is expressed in increased heart rate and respiration, the release of stress hormones: cortisol, adrenaline and norepinephrine. Short-term stress passes quickly, after which the body recovers and returns to its normal rhythm. Chronic can last for days, months and even years, at this time cortisol is constantly at a high level, a person is overcome by causeless fears and anxieties.

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A 2018 study found that stress exacerbates physical illness.

Getting rid of chronic stress, you can improve your mood and well-being, improve sleep patterns and nutrition.

If you feel like a threat is coming, and this condition lasts for several weeks, this is an occasion to reconsider your lifestyle and consult a therapist, without waiting for the physical manifestations of chronic stress. The exceptions are cases when the nervous state is justified by real events: you got a new job, you are going through a move, divorce or loss of a loved one, you are preparing for important exams. Ask yourself questions: “What is the reason for my fear?”, “Are there any rational explanations for this state?”. If it is a matter of real temporary difficulties, you should be more careful about your mental state and try to survive them with the least loss to health, and then see if negative feelings remain.

If you have identified signs of chronic stress that do not go away for a long time, try to determine its source. Nervous work, unpleasant surroundings, excessive fatigue can be causes that need to be dealt with, sometimes radically. It is necessary to act according to the situation: lay soundproofing on the wall with noisy neighbors, limit communication with negative people or change jobs - all means are good in the fight for your health. If there are no obvious reasons or you cannot identify them, contact a psychotherapist to identify hidden factors.

If symptoms flare up, use simple methods to relieve stress instantly: breathe, walk, listen to music. Such therapy in the long term will help reduce the frequency of unpleasant experiences if you have already eliminated the root cause of the discomfort. Control and encourage the development of good habits: sleep for seven to eight hours a night and move more, start meditating and playing sports. Food also helps to cope with stress, but this desire is important to track and seize stress correctly: add magnesium and vitamins to the diet, healthy complex carbohydrates and exclude simple sugars.

Neuroendocrinologist Robert Sapolsky argues that the hierarchical system has a bad effect on the body, and the level of happiness and self-esteem of a person are important factors in reducing stress. The scientist conducted a study on baboons, which proved that monkeys with a lower status in the hierarchy of the flock had more stress hormones in the blood and increased blood pressure more often. Therefore, it is especially important to feel in your place in a team, with friends or at work. Seek support from loved ones: when a person feels that he is understood, cortisol levels decrease. In addition, loneliness promotes reflection and enhances reactions to unpleasant events. The opposite effect, according to psychologists, is hostility towards the whole world around us, when the brain receives less positive reinforcement. This principle is based on psychological support groups in the fight against stress, the effectiveness of which is determined by the social needs of a person.

Psychologist David D. Burns in Feeling Good. The New Mood Therapy advises you to control the amount of time we spend venting negative emotions. These should be periods of no more than 50 minutes each when you can get angry, cry, grieve, scream or complain. In the intervals between them, you need to focus as much as possible on positive emotions and situations. The main thing is not to start negative states and track positive changes. A great mindfulness practice is to create daily checklists: they write down the main tasks that you consider important. It can be as much as half an hour for reading, or an hour for a relaxed rest and talking on the phone with friends. It is important that as a result of daily repetition of correctly coordinated good habits, you feel a boost of strength and a sense of gratitude.

Tags: Stress

Chronic stress as a cause of burnout: how should HR act?

The International Labor Organization ¹ recognizes chronic stress as one of the leading causes of death at work among people of working age. Studies have shown that people die more often from exacerbation of chronic diseases caused by nervous strain than from industrial accidents. The vast majority of workplace deaths are caused by heart disease.

What is the level of stress among the economically active population in our country? The results of a survey by the Ministry of Labor show that 60% of employees associate their state of nervous overexertion with work.

At the same time, 13% of specialists experience severe stress at work every day, and about 33% (every third) at least once a week. Abroad, too, things are not the best way. For example, in the United States, over 90% of respondents admit that their depressed psycho-emotional state is determined by the negative situation at work.

Should an organization deal with employee stress as a cause of burnout? Does one always lead to the other? How to distinguish burnout from stress? Read the new material Yva.ai.

The concept of stress in medicine and psychology

Scientists knew about the harmful effects of nervous overload on the human body as early as the beginning of the 20th century. The term "stress" itself (English stress - load) was introduced into psychology, medicine and physiology by the American scientist Walter Bradford Cannon ² in 1929.

His student Hans Selye devoted his life to researching stress and its effect on bodily functions. G. Selye formulated the main provisions of the theory of stress and the hypothesis of a general adaptive syndrome as a non-specific response of the body to the requirements.

In 1952, in the publication "The General Practitioner and the General Adjustment Syndrome" ³, Bernard Goldstone criticized and proposed the development of Selye's theory, describing the 3 stages of development of the General Adjustment Syndrome, today better known as stress.

First stage of stress - stage of shock , or "anxious reaction". At this stage, the body actively resists pressure, which manifests itself in a variety of clinical symptoms (both somatic and mental).

The second stage of stress - the stage of resistance , or opposition. If at the first stage the body reacted with mobilization, traumatic for the internal systems, now it is “licking its wounds” at the molecular-cellular level. If the employee continues to try to maintain high productivity instead of dealing with stress, then the stress moves to the final stage and becomes chronic.

The third stage of stress - exhaustion stage , manifests itself under the constant influence of a stressor and ultimately leads to a complete subsidence of the biological mechanisms of adaptation, serious damage to health, loss of productivity.

Attention is drawn to the correlation between the stages of development of chronic stress and the stages of development of the professional burnout syndrome.

How does chronic stress affect the health and performance of employees?

In moderate doses, stress accompanies a person all his life and is a normal reaction of the nervous system to any non-standard situation: both negative and positive.

The main stress hormones are corticosterone, cortisol, norepinephrine and epinephrine ⁴ . Due to a change in their concentration in the blood, the work of the digestive and immune systems is temporarily inhibited, the mechanisms necessary for a quick response are activated (the famous "fight or flight"). As a result, thought processes are accelerated, perception is sharpened, muscle tone, blood pressure and respiratory rate increase.

Short-term stress stimulates the human body and forces it to expend additional resources, which has a positive effect on professional activity. But if the nervous tension becomes constant and prolonged, the reserves are depleted, and this undermines the health of a person, negatively affecting his productivity.

The main systems of the body are inhibited in order to save energy as much as possible and “save” the remaining resources. In medicine, this condition is often associated with the so-called. tired adrenal syndrome, since they are responsible for the production of stress-associated hormones adrenaline and norepinephrine.

Symptoms and manifestations of chronic stress

People of working age can observe various symptoms of chronic stress.

⁵ . A person is accompanied by a feeling of constant fatigue and lethargy. Sleep does not improve the condition. Weekends and holidays are not enough to restore energy. A person wakes up tired every day and already after breakfast feels a desire to rest, which does not improve his results at work.

Typical problems - insomnia, dizziness, headaches, excessive sweating, sudden attacks of rapid heartbeat, hypersensitivity to loud noises, bright lights, temperature changes. Due to physiological discomfort, the employee has to spend energy not so much on work as on fighting irritation and apathy.

Appetite becomes uncontrollable and develops into gluttony or noticeably decreases until the complete refusal of food. Weakening of the immune system leads to frequent respiratory infections and exacerbation of chronic somatic diseases. The absence of an employee from work for health reasons affects his efficiency.

Emotional disorders. The state of an employee suffering from chronic stress is characterized by instability: the intensity of the affect is not adequate to the strength of the stimulus. During the day, the mood often changes from depressed or aggressive to upbeat and cheerful. By the evening, fatigue accumulates faster than usual.

An employee may be aware of a decrease in the effectiveness of his work and fall into depressive experiences - a feeling of uselessness, loneliness, misunderstanding by others. With a strong temperament, there is a decrease in control over emotions, which develop into whims, excitability, even hysteria. The inability to relax, take a break from overload can provoke alcohol and even drug addiction.

Problems in the social sphere. A person feels insecure, his motivation decreases both in professional activity and in communication. He refuses informal activities at work, family holidays and friendly meetings, citing poor health or being busy.

In parallel, there is a strong tendency to avoid any activity that requires physical or mental effort. In the field of cognitive functions, there is a decrease in stability and concentration of attention, difficulties in assimilation and memorization of new information.

A large percentage of people with chronic stress in the team leads to losses for the employer. Professional violations occur: the number of errors increases, productivity decreases, accuracy in performing tasks deteriorates.

Research by the International Association for Human Values shows that 60% of absenteeism and 40% of layoffs occur due to nervous exhaustion. In addition, stress is an indirect cause of about 80% of occupational injuries. And the Workplace Outcome Suite (WOS), based on 2018 analytics, calculated that an employee who is in a state of nervous tension loses up to 62 hours of productive work time every month.

Another severe consequence of chronic stress is professional burnout, which quenches enthusiasm and interest in work. In fact, this is a natural response of an exhausted body to prolonged excessive stress. This mechanism allows a person to dose and economically spend energy and emotional resources, literally ensuring his survival.

A specialist subject to such a disorder is faced with a sense of his own uselessness and exhaustion, the collapse of ideals and hopes. He is not able to perform quality work and observe labor discipline.

A burned-out employee avoids professional duties and refuses responsible tasks. When communicating with colleagues and clients, he shows negativity and seeks to distance himself. Also, the problem leads to frequent delays (later start of the working day remotely) and the need to increase the duration of breaks.

What is the key difference between stress and its consequence - professional burnout? The first state is characterized by the manifestation of excessive emotions, the second - by their oppression. Stress strikes at the physical condition of a person and leads to a critical loss of energy. As a result of burnout, the employee's motivation is completely lost, and he becomes an easy target for headhunters and a potential candidate for voluntary dismissal.

Stress during self-isolation and its consequences

In 2020, due to the pandemic, the interest of society and researchers in the causes and manifestations of stress caused by isolation and restrictive quarantine measures has increased.

In Russia, 34% of companies were forced to completely switch to remote work due to strict quarantine. After the abolition of non-working days, 35% of ⁶ organizations retained the home office format, at least for part of the staff.

As a result, many employees have been left to work at home and have experienced the stress of self-isolation surrounded by family and in confined spaces.

Astronauts who live on the ISS for several months are in a similar situation. They are also limited in movement and communication, they are afraid of the unknown.

However, cosmonauts go through lengthy psychological preparation before the flight and practice exercises to deal with stress. In addition, when forming the crew, the compatibility of members according to many criteria is necessarily taken into account. And at the beginning of the pandemic, after the transition to self-isolation “one day”, many people were deprived of this opportunity.

What factors negatively affected the mental health of people during the period of self-isolation?

Read more about this in the article “Statistics of the motivation of remote employees: how to motivate in 2021?”. Let us briefly recall the main ones.

Fear for one's own life and well-being of loved ones
Uncertainty
Problems with adapting to a new work format
Combination of housework and professional duties
Difficulties with teaching children and organizing their leisure
Broken daily routine: lack of time for rest and hobbies
Extremely inactive
Routine and a minimum of positive emotions and changes

Returning to work has become a new source of stress for employees. This phenomenon has been called the post-pandemic syndrome ⁷ . During the adaptation period, namely in the next six months or a year, employers run the risk of encountering such problems as conflicts, increased emotionality of employees, claims to tasks and work schedules.

Increased physical fatigue is also predicted. Companies that can quickly deal with these problems will benefit from staff loyalty and efficiency. Ignoring the post-pandemic syndrome will inevitably lead to burnout and the loss of valuable specialists.

How can an HR professional reduce employee stress?

The most important recommendation is to understand the causes of employee stress and, if possible, eliminate them. We have formulated several universal recommendations that will suit most companies, as they will not require serious expenses and are definitely necessary for employees in 2021.

#1 Working conditions just got more important

Carl Söderström of Stockholm University and Andre Spicer of City University London ⁸ believe that employers should not invest in expensive gyms, apps and as long as employees do not have access to a hygienic minimum: comfortable lighting, fresh air and time for physical activity, at least in the form of a daily half-hour walk.

If your employees suffer from a lack of movement and an irregular schedule - take care of the schedule, analyze who overworks more often and more than others and why this happens. This will provide guidance on transformations to improve employee well-being and satisfaction.

Basic needs, including the need for a healthy working environment ⁹, are more relevant than ever in 2021.

#2 Flexible break system

If your team has partially or completely switched to remote work, then employees have definitely faced the problem of “working around the clock”. If it is not possible to quickly and systematically regulate and normalize working hours, it is useful to introduce a flexible system of breaks to begin with.

This will allow an employee to legally mark a break in a corporate messenger or social network and devote half an hour to their favorite pastime: for example, read a little or do a little invigorating exercise.

If the team understands that they have the right to take a short break during the working day, relieve tension and switch to something pleasant, and then continue working with renewed vigor, this will help your employees, and the overall stress background will decrease.

#3 Caring for the abilities of employees

It seems that now is not the time to develop employee competencies? "We would survive the crisis"? This misconception most likely prevents you from not only dealing with employee stress, but also effectively managing your team's competency capital. For a good specialist, there is nothing more valuable in work than the awareness of the usefulness of his work.

Analyze what your employees would like to do. Assess their leadership qualities, skills and level of social influence in the company (for example, using Yva.ai artificial intelligence, which does this in a flexible and objective way).

Very soon, the Yva.ai Academy will release a series of videos about informal leadership, in which we will talk about the strengths and weaknesses of each type of leader and about which positions in the company each one reveals himself most effectively.

Sign up to Yva. ai Academy to keep up to date with the latest releases in January 2021. All videos are free after registration.

The main thing in 2021 is to cope with stress adaptively. Management and HR managers must be prepared to interact with employees ¹⁰ and quickly change tactics when required.

We don't know what 2021 has in store, but we do know how AI can help motivate and manage the stress of remote and distributed teams. Get the details from an expert in Master Class David Yang “How to increase efficiency and transform a company using AI and behavioral analytics?” . Watch the recording right now!

Ministry of Labor: For 85% of Russians, work brings stress and illness // Life.ru. 2016.
Stress and professional burnout // Buyanova A. S. B17.ru. 2020.
The general practitioner and the general adaptation syndrome // Goldstone B.
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