Cover Story

No matter how hard you try to meet demands at work, your boss's feedback becomes increasingly hostile and abusive. Project requirements change after you've completed the task as assigned. Your boss resents being asked for clarification, tells you that you are unskilled and ignorant, threatens to fire you and undermines your reputation with co-workers and upper management. You feel isolated and scared. At night you have trouble sleeping, and you wake up with a headache. You don't know it, but your blood pressure has skyrocketed.

Although this kind of scenario is common-33 percent of workers have been verbally abused at work, according to a 2000 national survey by the National Center on Addiction and Substance Abuse at Columbia University-it is anything but acceptable, psychologists say. Other forms of abuse include withholding information necessary to complete work assignments, ostracizing co-workers, name-calling and spreading rumors. Such maltreatment can occur between supervisor and subordinate or among co-workers. Sometimes the behavior can be subtle, but the effects are often large: Workplace bullying can cause physical, emotional and behavioral problems that take a toll on workers' health and productivity, researchers have found.

In fact, findings suggest chronically bullied workers experience nearly constant levels of anxiety, says Kevin Kelloway, PhD, senior research fellow at the Canadian National Centre for Occupational Health and Safety.

"When you're exposed to this kind of stuff, it just eats away at you," he says.

A personal problem

Specifically, bullying undermines self-confidence by causing confusion and embarrassment, according to a 2003 World Health Organization (WHO) publication on psychological harassment at work. Related psychological symptoms can include depression, anxiety and panic attacks, irritability, apathy, hyperarousal, insecurity and intrusive thoughts.

Evidence of this comes from research by Ståle Einarsen, PhD, a psychologist at the University of Bergen in Norway. Einarsen has researched bullying among a variety of Norwegian workers, including teachers, hotel and restaurant employees, clerks, electricians, psychologists, health-care workers and industrial workers. In his studies, bullied participants often became increasingly suspicious, anxious, nervous and depressed. Many also had trouble sleeping and completing their work. In extreme cases, often involving longtime bullying, exclusion and systematic devaluation, as many as 75 percent of participants showed symptoms of post-traumatic stress disorder (PTSD).

In one 2004 study, published in the British Journal of Guidance & Counselling (Vol. 32, No. 3, pages 335-356), Einarsen and Stig Berge Matthiesen, PhD, compared a group of 180 currently or formerly bullied workers- most of whom had been bullied for more than two years or more-with victims of stressful events, such as going through a divorce or attending medical school. These bullying victims showed significantly higher levels of psychiatric distress than other groups, and also had higher post-traumatic stress scores than a comparison group that included U.N. personnel who had recently returned from a war zone.

Sick and tired

Unfortunately, bullying victims often compound the problem with unhealthy coping strategies, says psychologist Kathleen Rospenda, PhD, a psychiatry professor at the University of Illinois at Chicago. Indeed, victims sometimes cope by abusing alcohol: Nondrinkers don't suddenly become drinkers, but those who normally drink may start drinking much more, she explains, which can lead to performance problems at work, exacerbating the situation.

Also typical for bullied people are irritability, social withdrawal and family conflict, which can contribute to feelings of isolation. The escalation of symptoms usually stops once the bullying ends, but some victims still feel some effects a year or more after leaving a bullying environment.

Bullying doesn't just affect the mind; it can also harm the body. High blood pressure, palpitations, cardiovascular disease, migraines, fatigue, muscle pain and ulcers are just some of the health effects that WHO has linked to bullying.

And bullying may hurt the heart. In a 2003 study of 5,432 Finnish hospital employees, published in Occupational and Environmental Medicine (Vol. 60, No. 10, pages 779-783), researchers found that prolonged bullying resulted in an elevated risk of cardiovascular disease. Since many of the victims also gained weight during the bullying period, some of the risk may be attributable to excessive weight gain, they noted.

A no-win situation

Adding to bullying's toll is its entrenchment. Employees who speak out or fight back often face retaliation, according to a 2001 study in the Journal of Occupational Health Psychology (Vol. 8, No. 4, pages 247-265). The authors found that bullied employees who spoke out by confronting the bullying individual were frequently harassed or ostracized by co-workers. In some cases-especially when the bully held a position of power-they were fired, demoted, involuntarily transferred or given a poor performance review. Bullying is bad for the health of organizations as well. Bullied employees may become less willing or able to work as hard or as efficiently. Many bullied employees end up quitting or are fired. In addition, employees who witness bullying sometimes experience similar health or stress problems or lose faith in the company.

And when employees remain in bullying situations, their increasing levels of anger and distress can spur disability. In fact, Einarsen's research suggests that bullying-related stress is a leading cause of employee absence and is more detrimental to health than overwork, long hours or even being unemployed.

Bullying escalation can also turn violent. While verbal abuse doesn't necessarily lead to physical aggression, almost all physical aggression is preceded by nonphysical aggression, Kelloway stresses.

Although society may often view bullying as a normal-if unpleasant-part of office culture, Kelloway, among others, sees a change in attitude as inevitable. Anxiety and cardiovascular disease are driving increased health-care costs-hurting employers' bottom lines, he says. There is also growing awareness in many companies that bullying is no more acceptable than sexual or racial harassment. Some places, such as Norway and the Canadian province of Quebec, have even passed antibullying legislation.

As more findings emerge on bullying's negative effects, companies and employees elsewhere may also become less willing to bear the costs.