Get help before your office wears you out. By Sonia Boonchanasukit. Illustrations by Temsiri Pothipattananont.

American companies are spending some B396 billion a year on stress management and 20% of them run some kind of stress management program. In the Old World, the European Agency for Safety and Health at Work ranks stress as the second biggest work-related health problem—and says the number of people suffering from stress is on the rise. “People used to consult for depression or marital problems but, in Europe, work stress is now the number one reason people see a psychologist,” says Dr. Jean-Francois Botermans, a lecturer at Bangkok’s Assumption University and a psychologist at Psychological Services International. His colleague, Dr. Benjamin Weinstein, says the worrying trend is catching on in Thailand: “A fifth of the people that come to me for consultations are suffering from work-related stress.” We’ve reached a tipping point where the greatest source of dissatisfaction in our lives is no longer family or personal relationships but work. Increasingly complicated jobs, global competition, a bad economy: it’s a perfect breeding ground for the job stress epidemic. It’s been proven that stress reduces your ability to resist infections and can cause an array of symptoms, from backaches to nausea. It also comes at a cost for companies: absenteeism, reduced productivity and staff turnover. Here’s what causing it and a few tips to survive.

Change, the Fuel of Stress

One of the first studies to link stress and illness focused on life-changing experiences. By asking 5,000 medical patients to rank events in their lives, psychiatrists Thomas Holmes and Richard Rahe found proof that change creates stress and stress makes you ill. The top ranked stress causes? Death of a spouse (100 points), divorce (73) and marital separation (65).

Dismissal from work only ranked eighth (43 points) but that was in 1967 and in the West. Dr. Sutthi Srinkapaibulaya, a general psychiatrist at Bangkok Hospital, says that Thai people are more likely to get stressed out by the fear of unemployment than by problems in a personal relationship, like marriage. In other words, Bob signing his divorce papers in Los Angeles and Somchai getting laid off from his managerial position in Bangkok could roughly generate the same amount of stress.

If you’re fired, or think you might get fired, Dr. Boterman encourages you to get connected with your network: “Get in touch with your friends, family members, or anyone that could provide you with the support and encouragement you need. If need be, consult a lawyer to know the legalities of your situation and also a doctor to ensure that you are physically well.” Why a doctor? Some studies suggest risks of illness could be as high as 80% for someone suffering from severe stress.

Getting fired is the most drastic change that can occur in your career but it’s definitely not the only cause of stress. “A lot of people come for consultation sessions when they are stressed out due to major shifts in jobs, they either have been relocated someplace else or given more responsibilities,” says Dr. Sutthi. So how can getting a promotion, meant to be a change for the better, be a source of stress?

3,2,1...Burnout

“The work environment today is just naturally stressful,” says Dr. Weinstein. “It’s difficult to deal with a place where you have to deal with constant pressures and no slack.” And with a poor economy, things are not going to get any better. Due to downsizing, the same amount of responsibilities fall on fewer people. “It’s my observation that when this happens, it usually falls on someone who does the work really well. It’s not fair but he or she ends up taking on all the workload and the stress that goes with it,” says Dr. Botermans.

The ultimate risk is burnout, a psychological term used to describe patients suffering from exhaustion and diminished interest at work. You may already have experienced that sensation, those moments when you stare blankly at your screen, unable to get anything done.

Kamonwan Khamching, a kinesiologist who are involved in assessing and rehabiliating human movement, performance and functions, believes in think pink therapy: “If you choose to think about how stressful your world is, then you will just end up stressing yourself out even more. If you change your attitude, you will automatically see things in a better light.”

Dr. Weinstein disagrees: “Sati, the Thai word that means mindfulness, is not just about saying, ‘I’m going to think positive right now.’ That’s not mindfulness. You’ve got to stop and ask, ‘What’s happening right now?’ without getting attached to it, engaged in it. Just have a mindful moment at work, acknowledging what’s going on when it happens without trying to hide it by just being positive.”

Today, psychologists agree, cognitive therapy has real results to bust stress. The New York Times stated that “in 18 studies, including more than 850 people working in a wide variety of jobs … this kind of counseling has significantly reduced complaints, sometimes in as few as six sessions.”

“Cognitive therapy is an approach where the therapist tries to modify the way the person thinks about the problem. It’s relatively recent but it’s based on very old concepts of Buddhist teachings and Greek philosophy that allows you to change the way you look at things,” says Dr. Botermans. “What this kind of therapy does is it makes us realize that it’s not the things we experience that makes us feel bad, it’s the way we interpret them.”

“You can look at stress like a glass of water,” explains Dr. Sutthi. “The glass represents you and the water, the amount of stress. You have three choices, you can either 1.) widen your glass so you have the ability to absorb more stress, 2.) punch holes in the glass to release the stress or 3.) cover it with a lid to block the stress. I encourage every one to try and use all three methods because different stressful circumstances can be tackled differently.”

Crazy Bosses, Annoying Colleagues

can be the hardest to deal with. “When the stress deals with external circumstances, it can be easy to tackle, but when it deals with people and relationships, it becomes very hard to manage,” says Dr. Botermans. “I once had a real high performer come in for consultation. His company was going through a major downsizing and so he was given an increasing number of responsibilities. He dealt with it, lived up to the challenge. But then his supervisor changed and the real problems began.”

Nongrak Hanvesakul, an account manager for an advertising firm has it even worse. Pleasing one crazy boss is bad enough, not knowing who to please is as bad as it gets. “I have five people to answer to. It’s probably one of the most stressful things about this job. It’s great when all your supervisors agree on the same thing but when you have different people wanting different things, it’s a recipe for disaster. I have had occasions where I had to redo assignments and rework ideas based on one person’s opinion and then again for another person. It’s really stressful!”

Here’s the bad news: if your boss is truly an asshole, the experts we spoke to have only one piece of advice: quit. Sure, quitting creates a huge amount of stress but, in the long run, it could be worth it.

As easy as it is to blame superiors, a lot of work-related stress could also stem from your fellow colleagues—or even the people below you on the corporate ladder. “It’s true that for the most part the boss sets the tone and environment for the office, but maintaining relationships with your coworkers is just as important,” says Dr. Sutthi.

,” says Dr. Weinstein of the modern workplace, an environment where no one works alone. “Relationships with co-workers are so important global companies are spending huge amounts on team-building exercises,” he explains. Maybe it’s time to gently push your boss for that company retreat or think about organizing one if you’re the head honcho.

Work-Life Balance

“With more responsibilities and adjustments, I see patients who end up spending a lot more time at work and less time with their families,” says Dr. Suthi of his stressed-out patients. “It’s important to have social connections and meaningful activities outside of work,” says Dr. Weinstein. “For a lot of Thai people, I don’t think it’s a problem, because one of the things about the Thai culture is the emphasis on interpersonal connections.”

Good Stress

If your stress is the kind that lingers, it will have harmful lasting effects. But stress that comes and goes is, according to Sutthi, not only healthy but essential to your work life. Without some stress, you wouldn’t get anything done, you’d have no motivation to get out of bed or finish that report. One study even found that super achievers tend to be “blessed” with high levels of stress. Make sure you enjoy stress-free moments and don’t stress too much about being stressed.