Why sustainable performance requires us to think differently about stress, recovery and the design of work

We are good at designing and redesigning work. We design for productivity, engagement, inclusivity and collaboration. We have redesigned work around new technologies, hybrid working and changing customer expectations. Now we are redesigning it again around A.I. Overall, we tend to design work around what people need to produce and then expect the human stress response to accommodate the conditions we create.

It is a bit like designing food production around human consumption and convenience without considering the environmental impact. Output can be sustained for a time, even as the capacity of the ecosystem supporting it is gradually being depleted.

What would change if we designed work to support the natural rhythms of the human stress response? In other words: are the conditions of work compatible with the way human beings sustain energy, clear thinking and performance under demand?

The problem begins before absence

Indicators of an unsustainable fit between work demands and human capacity don’t tend to begin with sickness absence. They appear much earlier, while people are still working, trying to meet the demand.

Research from the Institute for Public Policy Research estimated that employee sickness cost UK businesses £103 billion in 2023. Employees lost the equivalent of 44 days of productivity, on average, through working while unwell; far more than the 6.7 days attributed to sickness absence.

This reflects a wider problem identified by the Policy Liaison Group on Workplace Wellbeing: workplace health systems still tend to intervene too late, often after someone has become unwell or left work, even though the conditions contributing to that outcome emerge much earlier.

Absence creates a visible event. Presenteeism is much harder to see and harder still to interpret. The person is still attending meetings, answering messages and producing work. There may be no single point at which normal effort clearly becomes unsustainable.

The numbers point to the need for systems that measure workforce stress and recovery over time, helping organisations identify emerging trajectories and act earlier to protect both wellbeing and performance.

What appears to be performance may, for a time, be adaptation to high demand without the recovery needed to prevent that adaptation from carrying a longer-term cost.

That distinction is becoming even more important as work intensifies. Economic uncertainty, legislative change and organisational transformation are already creating sustained pressure. AI is now expanding what people can produce and how quickly they can produce it.

Research reported by Berkeley Haas found that employees using generative AI worked more intensely for longer, often without being asked. Upwork’s research similarly found that 88% of employees reporting the greatest productivity gains from AI also reported burnout, and they were twice as likely to consider leaving.

Somewhere along the line, we have lost track of the fact that it isn’t just human minds that come to work. It is human bodies, with finite energy and a finite capacity to be productive without adequate recovery.

Productivity and human capacity need to be in a workable relationship.

Stress is not only a psychological experience

Stress is often discussed through the language of thoughts, emotions and coping, but stress is also a physiological process.

When we encounter demand, our body and brain mobilise resources to meet it. Breathing, muscle tone, energy availability, attention and decision-making all change. In the short term, this can be highly useful. We become more alert, more focused on what is immediately relevant and more ready to act.

The stress response is one mechanism that makes performance possible. But for that response to remain adaptive, activation also needs to come down. When activation is repeatedly called upon without sufficient opportunity to regulate and recover, it can remain elevated even after the immediate demand has passed.

Regulation is our capacity to move flexibly between activation and deactivation as demands change. Recovery restores the resources depleted through effort and stress, helping to maintain energy and cognitive capacity over time. When demand, regulation and recovery remain reasonably well matched, people can mobilise when needed, settle back down afterwards and restore what they need to rise to the next challenge.

Without this natural physiological rhythm, maintaining the same level of performance can begin to require more effort and draw more heavily on available resources. When external demands remain high and recovery does not match them, fewer resources are available for the restoration and repair on which health and continued performance depend.

People pushing themselves to keep up can appear to be performing well, but at a cost not yet accounted for in their physiological budget.

The missing physiological layer

Looking closely at the workplace wellbeing and performance space, I see the lasting influence of cognitive and behavioural approaches. Many initiatives focus on helping people change how they think, behave and cope. But these approaches can be incomplete when physiological state is left out of the picture.

Seventeen years working in mental health taught me that understanding thinking and behaviour is vital to making informed choices about how we operate and perform at work. But the mind does not operate independently of the body. How we think and behave is heavily influenced by the body and brain state we are operating from. Prolonged stress activation can affect attention, judgement, emotional reactivity and access to flexible thinking, regardless of how motivated or intelligent we are. Over time, it can also carry a cost to energy and physical health.

The risk of emphasising thinking and behaviour without equal attention to physiological state is that we may inadvertently help people become better at overriding the bodily signals that something needs to change. Someone can continue thinking constructively, behaving appropriately and meeting expectations while becoming increasingly disconnected from their signals of fatigue, tension and the need for recovery. This was something I observed frequently in clinical practice.

A helpful addition to current workplace initiatives would be practical knowledge about how the body and brain function under long-term stress, how to recognise changes in physiological state and work with them, and how to design work structures with our biological realities in mind.

This also means creating workplace cultures that recognise physiological limits and support the breaks, transitions and working rhythms that human functioning requires.

A lunchtime wellbeing session cannot create recovery if the accepted norm is to work through lunch. A resilience workshop cannot compensate for continuous back-to-back meetings. Encouraging employees to switch off has limited effect if after-hours responsiveness remains an unspoken expectation.

Better organisational conditions do not remove individual responsibility. They support it. People can learn to recognise their state, regulate more effectively and become more deliberate about recovery. These are necessary and teachable capabilities.

This creates the opportunity for individual capability and organisational conditions to work together.

Otherwise, resilience risks becoming the ability to tolerate a poorly designed system for longer.

What would it mean to design work around the stress response?

Designing work around the human stress response means recognising that activation and recovery are both part of sustainable professional performance and designing conditions that allow both to occur.

There will inevitably be periods of change or increased workload when people need to pull together and usual working structures have to flex. The importance of having established structures that support stress regulation and recovery is that they provide a baseline to return to once the period of exceptional demand has passed.

In the right balance, activation and recovery can support adaptation and growth as work demands increase, without progressively diminishing human capacity.At a structural and cultural level, this includes examining:

• whether meeting patterns allow any transition between demands;
• whether employees have genuine opportunities to pause, move, refuel and reset;
• whether the pace of work permits reflection as well as output;
• whether quality of working relationships is understood as support for performance;
• whether after-hours expectations allow psychological detachment;
• whether leadership behaviour supports recovery or quietly rewards continuous activation; and
• whether new technology is creating capacity or simply enabling more work intensity.

At an individual and managerial level, it means giving people a better understanding of stress, regulation and recovery. A shared language can support clearer conversations, social connection and mutual support at work. Employees can be supported to recognise changes in their energy, concentration and physiological state before those changes become entrenched, while managers can be equipped with language that helps them recognise and respond to emerging overextension.

At an organisational level, it also requires better insight.

The Policy Liaison Group has described employers as “awash with data” but lacking meaningful insight into wellbeing, organisational culture and emerging risks. This raises an important question about what organisations measure. Absence, turnover and formal performance problems become visible late, while annual wellbeing surveys provide only intermittent snapshots of what may be changing across the workforce.

A more preventative approach would examine stress and recovery together, combining validated measurement with structured conversations about workload, job design, working norms and how people are adapting to ongoing demand.

Meaningful insight into wellbeing means generating useful organisational intelligence before depletion becomes illness, disengagement or departure.

A different design brief

The world of work is entering another period of significant change. AI will continue to change how we work. Economic and organisational pressures are unlikely to disappear. Asking people simply to become more resilient to each new layer of demand is not a sustainable response.

The better question is whether the way work is designed and the culture we are embedded within support the physiological conditions on which performance depends.

Humans can absorb a great deal of stress. But that adaptability can hide a growing cost for some time. By the time it shows up as sickness, absence, burnout, or turnover, the underlying pattern may have been developing for months or years.

If people are to keep delivering under challenging conditions, then now is the right time to start designing work to ensure they can maintain the health and capacity to do so.