can homework cause depression and anxiety

Homework Struggles May Not Be a Behavior Problem

Exploring some options to understand and help..

Posted August 2, 2022 | Reviewed by Abigail Fagan

• Mental health challenges and neurodevelopmental differences directly affect children's ability to do homework.
• Understanding what difficulties are getting in the way—beyond the usual explanation of a behavior problem—is key.
• Sleep and mental health needs can take priority over homework completion.

Chelsea was in 10th grade the first time I told her directly to stop doing her homework and get some sleep. I had been working with her since she was in middle school, treating her anxiety disorder. She deeply feared disappointing anyone—especially her teachers—and spent hours trying to finish homework perfectly. The more tired and anxious she got, the harder it got for her to finish the assignments.

One night Chelsea called me in despair, feeling hopeless. She was exhausted and couldn’t think straight. She felt like a failure and that she was a burden to everyone because she couldn’t finish her homework.

She was shocked when I told her that my prescription for her was to go to sleep now—not to figure out how to finish her work. I told her to leave her homework incomplete and go to sleep. We briefly discussed how we would figure it out the next day, with her mom and her teachers. At that moment, it clicked for her that it was futile to keep working—because nothing was getting done.

This was an inflection point for her awareness of when she was emotionally over-cooked and when she needed to stop and take a break or get some sleep. We repeated versions of this phone call several times over the course of her high school and college years, but she got much better at being able to do this for herself most of the time.

When Mental Health Symptoms Interfere with Homework

Kids with mental health or neurodevelopmental challenges often struggle mightily with homework. Challenges can come up in every step of the homework process, including, but not limited to:

• Remembering and tracking assignments and materials
• Getting the mental energy/organization to start homework
• Filtering distractions enough to persist with assignments
• Understanding unspoken or implied parts of the homework
• Remembering to bring finished homework to class
• Being in class long enough to know the material
• Tolerating the fear of not knowing or failing
• Not giving up the assignment because of a panic attack
• Tolerating frustration—such as not understanding—without emotional dysregulation
• Being able to ask for help—from a peer or a teacher and not being afraid to reach out

This list is hardly comprehensive. ADHD , autism spectrum disorder, social anxiety , generalized anxiety, panic disorder, depression , dysregulation, and a range of other neurodevelopmental and mental health challenges cause numerous learning differences and symptoms that can specifically and frequently interfere with getting homework done.

The Usual Diagnosis for Homework Problems is "Not Trying Hard Enough"

Unfortunately, when kids frequently struggle to meet homework demands, teachers and parents typically default to one explanation of the problem: The child is making a choice not to do their homework. That is the default “diagnosis” in classrooms and living rooms. And once this framework is drawn, the student is often seen as not trying hard enough, disrespectful, manipulative, or just plain lazy.

The fundamental disconnect here is that the diagnosis of homework struggles as a behavioral choice is, in fact, only one explanation, while there are so many other diagnoses and differences that impair children's ability to consistently do their homework. If we are trying to create solutions based on only one understanding of the problem, the solutions will not work. More devastatingly, the wrong solutions can worsen the child’s mental health and their long-term engagement with school and learning.

To be clear, we aren’t talking about children who sometimes struggle with or skip homework—kids who can change and adapt their behaviors and patterns in response to the outcomes of that struggle. For this discussion, we are talking about children with mental health and/or neurodevelopmental symptoms and challenges that create chronic difficulties with meeting homework demands.

How Can You Help a Child Who Struggles with Homework?

How can you help your child who is struggling to meet homework demands because of their ADHD, depression, anxiety, OCD , school avoidance, or any other neurodevelopmental or mental health differences? Let’s break this down into two broad areas—things you can do at home, and things you can do in communication with the school.

Helping at Home

The following suggestions for managing school demands at home can feel counterintuitive to parents—because we usually focus on helping our kids to complete their tasks. But mental health needs jump the line ahead of task completion. And starting at home will be key to developing an idea of what needs to change at school.

• Set an end time in the evening after which no more homework will be attempted. Kids need time to decompress and they need sleep—and pushing homework too close to or past bedtime doesn’t serve their educational needs. Even if your child hasn’t been able to approach the homework at all, even if they have avoided and argued the whole evening, it is still important for everyone to have a predictable time to shut down the whole process.
• If there are arguments almost every night about homework, if your child isn’t starting homework or finishing it, reframe it from failure into information. It’s data to put into problem-solving. We need to consider other possible explanations besides “behavioral choice” when trying to understand the problem and create effective solutions. What problems are getting in the way of our child’s meeting homework demands that their peers are meeting most of the time?
• Try not to argue about homework. If you can check your own anxiety and frustration, it can be more productive to ally with your child and be curious with them. Kids usually can’t tell you a clear “why” but maybe they can tell you how they are feeling and what they are thinking. And if your child can’t talk about it or just keeps saying “I don't know,” try not to push. Come back another time. Rushing, forcing, yelling, and threatening will predictably not help kids do homework.

Helping at School

The second area to explore when your neurodiverse child struggles frequently with homework is building communication and connections with school and teachers. Some places to focus on include the following.

• Label your child’s diagnoses and break down specific symptoms for the teachers and school team. Nonjudgmental, but specific language is essential for teachers to understand your child’s struggles. Breaking their challenges down into the problems specific to homework can help with building solutions. As your child gets older, help them identify their difficulties and communicate them to teachers.
• Let teachers and the school team know that your child’s mental health needs—including sleep—take priority over finishing homework. If your child is always struggling to complete homework and get enough sleep, or if completing homework is leading to emotional meltdowns every night, adjusting their homework demands will be more successful than continuing to push them into sleep deprivation or meltdowns.
• Request a child study team evaluation to determine if your child qualifies for services under special education law such as an IEP, or accommodations through section 504—and be sure that homework adjustments are included in any plan. Or if such a plan is already in place, be clear that modification of homework expectations needs to be part of it.

The Long-Term Story

I still work with Chelsea and she recently mentioned how those conversations so many years ago are still part of how she approaches work tasks or other demands that are spiking her anxiety when she finds herself in a vortex of distress. She stops what she is doing and prioritizes reducing her anxiety—whether it’s a break during her day or an ending to the task for the evening. She sees that this is crucial to managing her anxiety in her life and still succeeding at what she is doing.

Task completion at all costs is not a solution for kids with emotional needs. Her story (and the story of many of my patients) make this crystal clear.

Candida Fink, M.D. , is board certified in child/adolescent and general psychiatry. She practices in New York and has co-authored two books— The Ups and Downs of Raising a Bipolar Child and Bipolar Disorder for Dummies.

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Can Excessive Homework Cause Depression? – 17 Reasons

Does Homework Cause Depression?

You or a loved one may currently be struggling with excessive amounts of homework and are wondering if can homework cause depression. The short answer is that depression can absolutely lead to depression for a variety of reasons. Identifying the cause of your homework-related depression below is the first step toward bettering your mental health. Excessive homework, lack of social support, and perfectionism are just a few of the reasons homework can lead to depression.

Reasons Why Homework Might Cause Depression:

1) multiple hours of homework.

Starting in high school, or sometimes even middle school, students begin to slowly receive more and more hours of homework. There are various reasons why multiple hours of homework per week might lead students to depression, with stress and procrastination being at the top. Certain subjects, such as mathematics or science-related classes (i.e. chemistry) might also be challenging for some students to comprehend, leading them to feel drowned in stress and procrastination. Many hours of homework on a subject that one does not understand may start as stress and procrastination, but across multiple weeks or months may gradually turn into strong feelings of inadequacy and ultimately depression.

2) Extracurricular Activities May Interfere

Only some people in high school are distinguished academics capable of effortlessly finishing hours of homework each week. Other students are naturally gifted in different areas, such as athletics, arts (such as music or drawing), or even gaming! However, these activities can also get in the way of valuable time each student needs to complete homework and be successful in school. If the student prioritizes extracurricular activities significantly more than homework, this certainly can have negative mental health consequences. Ultimately, a school/leisure balance is key when it comes to avoiding student depression and maintaining overall happiness and success!

3) Excessive Homework From Classes or Teachers

Certain subjects or teachers might also be prone to assign excessive homework that might initially be daunting. For example, mathematics, chemistry, and physics are examples of classes that high school students find both challenging and overwhelming. If these classes are not already difficult enough, a bad professor might add excessive homework that is clearly not necessary for the student’s growth. The combination of excessive homework and poor teachers can easily lead students to mild depression over time.

4) Prior Struggles With Mental Health Issues

Mental health issues in the United States and across the world are higher now than at any point in much of human history. This means that many students already have mild to severe forms of depression, anxiety, PTSD, and other mental health issues. When students receive homework that they feel incapable of completing with little to no support outside school, this may only worsen their mental health. Unfortunately, depression is only one of many mental health issues students may face when confronted with challenging homework.

5) The Sleep Deprivation Cycle

Many students, especially in high school and college, naturally prefer to stay up late and wake up late. These individuals are commonly referred to as “night owls” since they mostly thrive at night. Being a “night owl” is not an inherent problem until the student’s sleep begins to fall below the recommended range of 7-9 hours per night. Sleep deprivation is defined as “a state caused by inadequate quality or quantity of sleep.”

Although side effects of sleep deprivation depend on a few factors, depression is one of the most common. Students might feel stressed during the day and procrastinate until night when they make the logical decision to stay up and finally complete the homework for the following day. This is the day-to-day reality for many students since they have yet to break the sleep deprivation-depression cycle.

6) Concern With Getting Good Grades

Although getting good grades is applauded by almost everyone ranging from students and parents to teachers and principals, some students take it to the extreme. Perfectionism is the need to appear perfect, which might be reflected by extremely good grades or high GPAs (that are often unrealistic or unnecessary). Most colleges do not require students to have anywhere near perfect good grades or GPAs, meaning students should set realistic goals while still making it possible to achieve long-term goals. Setting realistic goals for good grades can also lead students to minimize stress, depression, and other negative effects that come with perfectionism.

7) Physical Health Problems

Some students might also suffer from physical health problems that are either genetic (such as Type I Diabetes) or behavioral health problems (such as obesity). In the case of a young student with obesity, his or her most difficult class might be the physical exercise (PE) class. This student might look at other students performing the daily physical activity for class and feel a sense of inadequacy that can grow over time and lead to depression, especially if not properly addressed or guided.

There is also a slew of other physical health problems that might contribute to a student’s struggle and depression when in school. These health problems might also make it difficult for students to complete homework when away from school, due to a variety of factors.

8) Weight Loss Problems (Homework Cause Depression)

Weight loss may occur when students are overly focused on school and have little to no time to eat a highly nutritious meal. Since food gives energy to the brain and is responsible for many vital functions of the human body, it is no wonder why depression might arise out of weight loss. In addition, many students, particularly young female students, go through a time that challenges their self-image. Other students and social media might pressure these students into conforming to non-realistic beauty standards via weight loss.

9) Young Adults and Lack of Balance

High schoolers and college students are still very young in the grand scheme of life, with many lacking the crucial ability to balance school and homework with other parts of their lives. Especially with the amount of homework some classes assign, students might not balance enough time that is necessary to complete the assigned work. Students might spend much time procrastinating homework and doing fun, but less productive activities, such as playing sports or video games. Mental health counselors (either at school or in a clinical setting) can be extremely effective at helping students manage school work and ultimately avoid depression.

10) Homework and Test Scores

High schoolers and older students must find enough time to complete homework and study to get optimal test scores. Although this does vary from class to class, most individuals will have at least a few classes where balancing homework and testing is critical for success. Test anxiety is a big factor that might lead students to heavily prioritize studying for an exam instead of completing homework. If students are overly concerned with test scores and neglect to complete assigned homework, depressive symptoms may occur.

11) The Importance of Time Management

As mentioned earlier, young children or young people, in general, might often struggle to effectively complete a lot of homework. Building daily habits around homework completion for just 30 minutes per day can add up to make a massive difference (that is 4.5 hours by the end of the school week!). Not only does effective time management make it easier to complete homework, but it also removes much of the stress, procrastination, and even depression that might come as a result of little to no time management.

For younger children or even high schoolers, an adult role model can significantly help develop these necessary habits sooner rather than later.

12) Prestigious Schools Like Stanford University

High schoolers looking to get accepted into prestigious colleges like Stanford University, or college students already in prestigious schools likely have higher chances to suffer from homework-related depression. High schoolers that are accepted into Stanford University have an average GPA of 3.95 out of 4.00.

This means students trying to get into ivy league schools hold themselves to an extreme standard. This extreme standard will inevitably cause a lack of sleep, depression, and a variety of other negative effects. This does not mean that it is impossible to successfully be accepted into Stanford University, it just means it will be very challenging.

13) Teachers Assign Busy Work

Sometimes teachers (mostly in high school) assign work that is repetitive, not super challenging, and time-consuming to complete. These types of assignments are generally referred to as “busy work,” and can be the bane of some high schoolers’ existence. The problem with busy work is that students begin to focus on the completion of the homework due to the sheer amount of time they know it will take to complete it. This takes away from the overall learning experience of the student and will lead many high school students to procrastinate. Procrastination can lead to piled-up homework and can have a negative impact on the student’s depression levels. Ultimately, teachers that assign busy homework cause depression.

14) Family Stress at Home (Homework Cause Depression)

Sometimes the cause of depression is much deeper than meets the eye, with homework simply exacerbating these untouched issues. One deeper issue revolves around family members and the lack of much-needed social support from parents, siblings, and other family members in the household. These family members might simply be unwilling to provide homework support to young adults, or the issue might be as bad as mental or physical abuse. If you know someone that is being abused, please seek help immediately to help them in the long run. It is clear that these issues could easily lead one to depression.

15) Lack of Friendships and Social Life

Being isolated at school and/or at home might be one of the risk factors for developing depression from homework. Friendships can be mutually beneficial when completing tasks such as homework since students are able to check each others’ work and reduce the overall stress of heavy workloads. Students that always seem to be alone or are even bullied might be at an increased risk of serious mental health problems. It is true that some young people and older students work best alone, but this is definitely a warning sign to keep an eye out for if you are a parent.

Putting isolated students into a club or sport they have an initial interest in might be a fantastic way to help them create valuable bonds with those around them and prevent depression!

16) Social Media and Student Well-Being

Social media is something that has had clear negative effects on the mental health of many age groups in the United States but also across the world. Social media often promotes the action of comparing one’s self to others, which might be academic success in this case. Individuals that are constantly watching other students succeed online may feel like they are the only one that does not understand the course material.

The amount of time spent on social media can also often take away from time that high schoolers could be spent completing homework and other important things. Ultimately, social media is best, like many things, when consumed in moderation and is not used to negatively compare oneself with others.

17) Stomach Problems Such as Celiac Disease

Stomach problems include, but are not limited to celiac disease, inflammatory bowel disease (IBD), lactose intolerance, and constipation or gas. Most of these stomach problems have nausea and even vomiting as some of their primary negative effects. Attempting to do homework or even come to school when having severe nausea is challenging, to say the least. Students with these issues will often have less time as a result, and may even feel as though homework cause depression.

From the list above, there are many clear reasons why excessive homework assignments might lead a student of any age to depression. If you or someone you know struggles with severe depression, please seek professional help. Although there are many ways homework can cause depression, we are strong and capable of overcoming the depression and still achieving success. Ultimately, social support from family and friends, academic guidance, and a consistent homework routine are just a few of the things that might help reduce depression caused by homework.

2 thoughts on “Can Excessive Homework Cause Depression? – 17 Reasons”

Wowwww!! This is extremely insightful ❤️‍🔥Can’t wait for your next post !

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Stanford research shows pitfalls of homework

A Stanford researcher found that students in high-achieving communities who spend too much time on homework experience more stress, physical health problems, a lack of balance and even alienation from society. More than two hours of homework a night may be counterproductive, according to the study.

Education scholar Denise Pope has found that too much homework has negative effects on student well-being and behavioral engagement. (Image credit: L.A. Cicero)

A Stanford researcher found that too much homework can negatively affect kids, especially their lives away from school, where family, friends and activities matter.

“Our findings on the effects of homework challenge the traditional assumption that homework is inherently good,” wrote Denise Pope , a senior lecturer at the Stanford Graduate School of Education and a co-author of a study published in the Journal of Experimental Education .

The researchers used survey data to examine perceptions about homework, student well-being and behavioral engagement in a sample of 4,317 students from 10 high-performing high schools in upper-middle-class California communities. Along with the survey data, Pope and her colleagues used open-ended answers to explore the students’ views on homework.

Median household income exceeded $90,000 in these communities, and 93 percent of the students went on to college, either two-year or four-year.

Students in these schools average about 3.1 hours of homework each night.

“The findings address how current homework practices in privileged, high-performing schools sustain students’ advantage in competitive climates yet hinder learning, full engagement and well-being,” Pope wrote.

Pope and her colleagues found that too much homework can diminish its effectiveness and even be counterproductive. They cite prior research indicating that homework benefits plateau at about two hours per night, and that 90 minutes to two and a half hours is optimal for high school.

Their study found that too much homework is associated with:

• Greater stress: 56 percent of the students considered homework a primary source of stress, according to the survey data. Forty-three percent viewed tests as a primary stressor, while 33 percent put the pressure to get good grades in that category. Less than 1 percent of the students said homework was not a stressor.

• Reductions in health: In their open-ended answers, many students said their homework load led to sleep deprivation and other health problems. The researchers asked students whether they experienced health issues such as headaches, exhaustion, sleep deprivation, weight loss and stomach problems.

• Less time for friends, family and extracurricular pursuits: Both the survey data and student responses indicate that spending too much time on homework meant that students were “not meeting their developmental needs or cultivating other critical life skills,” according to the researchers. Students were more likely to drop activities, not see friends or family, and not pursue hobbies they enjoy.

A balancing act

The results offer empirical evidence that many students struggle to find balance between homework, extracurricular activities and social time, the researchers said. Many students felt forced or obligated to choose homework over developing other talents or skills.

Also, there was no relationship between the time spent on homework and how much the student enjoyed it. The research quoted students as saying they often do homework they see as “pointless” or “mindless” in order to keep their grades up.

“This kind of busy work, by its very nature, discourages learning and instead promotes doing homework simply to get points,” Pope said.

She said the research calls into question the value of assigning large amounts of homework in high-performing schools. Homework should not be simply assigned as a routine practice, she said.

“Rather, any homework assigned should have a purpose and benefit, and it should be designed to cultivate learning and development,” wrote Pope.

High-performing paradox

In places where students attend high-performing schools, too much homework can reduce their time to foster skills in the area of personal responsibility, the researchers concluded. “Young people are spending more time alone,” they wrote, “which means less time for family and fewer opportunities to engage in their communities.”

Student perspectives

The researchers say that while their open-ended or “self-reporting” methodology to gauge student concerns about homework may have limitations – some might regard it as an opportunity for “typical adolescent complaining” – it was important to learn firsthand what the students believe.

The paper was co-authored by Mollie Galloway from Lewis and Clark College and Jerusha Conner from Villanova University.

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What to Know About Depression in Students

Depression is a common occurrence among students of all ages, whether you’re in high school, college, or grad school.

The Healthy Minds Study in 2020 found that of almost 33,000 college students in the United States, 50% of them had depression or anxiety (or both).

When you consider the stresses that college students face, that number isn’t too surprising.

Final exams and the pressure to keep up an active social life while navigating lots of new life experiences can be pretty tough to balance. Not to mention, for those who have to balance work, school, and family responsibilities, it can be even more overwhelming.

Depression isn’t just limited to college students, though. It can first start in elementary school, middle school, or high school.

The average age of depression onset is the late teens to mid-20s , and 1 out of every 15 adults will experience some type of depression.

Even though depression in students isn’t uncommon, it’s important to take it seriously. Depression can impact nearly every area of your life — from studying and classes to your social life. In some cases, depression can also cause suicidal thoughts or thoughts of self-harm.

Signs of depression in students

In students, depression may show up in some specific ways that aren’t quite so obvious at first.

For example, a student with depression might suddenly avoid meeting up with friends when previously they were pretty social. If this starts becoming a regular occurrence, it could be a symptom of depression .

Final exams or big projects can certainly cause anxiety for students. But if you find it hard to shake the worry even after your exam or deadline has passed, it may be a good idea to review whether you’re experiencing depression or an anxiety disorder.

If you suspect you may be going through depression, you’re not alone.

You may be experiencing depression if you’ve had some of the below symptoms most of the time for the last 2 weeks:

• ongoing feelings of sadness
• being on-edge or snapping at people
• low self-esteem
• feeling like you’re not “good enough”
• finding it hard to sleep or sleeping too much
• eating less or more than you usually do
• difficulty remembering things
• feeling like you don’t want to do anything
• having suicidal thoughts
• feeling physically ill without knowing why
• isolating or avoiding friends
• changes in weight

Some people might also notice an increase in alcohol or drug use. Students, whether they’re in high school or college, may have experimented with drugs or alcohol.

Depression might make students feel the need to turn to substances more often as a way to cope. If this isn’t addressed, it could turn into a substance use disorder .

Suicide prevention

If you or someone you know is considering suicide, you’re not alone. Help is available right now:

• Call the National Suicide Prevention Lifeline 24 hours a day at 800-273-8255.
• Text “HOME” to the Crisis Text Line at 741741.
• The Trevor Project provides crisis support for LGBTQIA+ individuals. Call their hotline at 866-488-7386 or text “START” to 678-678.
• Contact the teen-to-teen peer hotline, Teen Line , at 800-852-8336 or text TEEN to 839863.

Not in the U.S.? Find a helpline in your country with Befrienders Worldwide .

Causes of depression in students

What could be causing your depression? There are a number of factors that might contribute to developing depression, and many people can have different causes.

In some cases, your genes can come into play. Having a close relative, like a parent or sibling, with depression can increase the chances that you experience depression. But genetics are not a guarantee that you’ll have depression yourself.

If you went through a traumatic experience, that could also increase your likelihood of having depression . Various forms of abuse, losing a loved one, and similar situations could usher in depression.

Big changes can be a trigger as well. Some students may experience depression when they transition from middle school into high school, for instance. This can be a major stressor for students.

Leaving home to go to college for the first time can also bring on depression since there are so many things to figure out all on your own — from class schedules to dorm life and everything in between. Furthermore, final exams can put a lot of pressure on students and weeks of studying can feel isolating.

Finally, many people with depression may simply have an imbalance of chemicals within their bodies. They may not have experienced trauma or gone through a stressful life event, but they’re still experiencing depression.

All of these causes of depression are valid and anyone experiencing depression deserves compassionate, supportive help.

Preventing depression

No matter what the cause of depression, there are ways to help prevent it.

It can be all too easy to have exercise or physical movement low on the priority list as a student. After all, it’s mentally tiring to learn for several hours per day. You also probably have quite a bit of homework waiting for you to complete after classes end.

Making exercise and movement a priority can help you ward off depression, so it can really help to pencil in some exercise time on your schedule.

You don’t necessarily have to go to a gym to fit in some activity — you could simply go for a quick 15-minute walk after school. As an added bonus, this activity can help give your brain a break, so you have a clearer mind as you work on any assignments.

Another important key in preventing depression is to socialize — you want to avoid isolating yourself.

Spending time with supportive friends and family brings many benefits, not least of which is that it can help stop depression from creeping up.

Research suggests that spending time with others can positively impact your mental health. As with physical activity, it might help if you schedule something on your calendar.

For college students, scheduling a weekly study session with a classmate at a local coffee shop can work wonders for mental health. After all, it can be really helpful to share what’s going on in your life with a friend. They’re often experiencing something similar and that can leave you feeling less lonely.

Attending social events like a football game or even volunteering with a favorite nonprofit are both excellent ways to connect with other students.

Prioritize sleep

Having a regular, healthy sleep schedule can help prevent depression.

It might take some time to find your rhythm, but keep at it — making a plan to try and fall asleep at the same time each night can do wonders for your energy levels through the day.

Try reading a book, doing some gentle breathing exercises, or listening to a meditation podcast before bed to help you fall asleep. Keeping active throughout the day can help you feel more tired when bedtime arrives, too.

Treatments for depression

Preventing depression in the first place is worth the effort. However, if you find yourself feeling depressed, there are several treatment options you can try.

Many medications exist for people going through depression. A variety of different therapy types are also available, and you may be able to access it through your school.

It can be overwhelming to explore medications or therapy options on your own. Scheduling an appointment with a counselor or other mental health pro can be important for managing your depression.

If you think you might have depression, getting help is a critical first step. By reaching out, you’re taking an important step in protecting your mental health.

Other students are going through similar things. In fact, many students have reported that they don’t think negatively about someone reaching out for a little help.

As a student, you have access to many resources when it comes to mental health and depression. High school and middle school students can reach out to a guidance counselor to help navigate depression. College students typically have access to an on-campus health center.

Check with them to see if they offer mental health services at a reduced price. It may even be included with your tuition at no extra cost to you.

Reaching out to a trusted relative or close friend can be another good idea. Be certain that this person is someone you trust who will help you find the resources you need. A religious figure, mentor, or close family friend are good places to start if you’re thinking about talking over your options.

Remember that you’re not alone. You’re brave for reaching out for help with your depression!

Last medically reviewed on June 22, 2021

4 sources collapsed

• Depression. (2018). https://www.nimh.nih.gov/health/topics/depression/
• The Healthy Minds Study: Fall 2020 data report. (2020). https://healthymindsnetwork.org/wp-content/uploads/2021/02/HMS-Fall-2020-National-Data-Report.pdf
• Umberson D, et al. (2010). Social relationships and health: A flashpoint for health policy. (2011). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150158/
• What is depression? (2020). https://www.psychiatry.org/patients-families/depression/what-is-depression

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The Truth About Homework Stress: What Parents & Students Need to Know

• Fact Checked

Written by:

published on:

• December 21, 2023

Updated on:

• January 9, 2024

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Homework is generally given out to ensure that students take time to review and remember the days lessons. It can help improve on a student’s general performance and enhance traits like self-discipline and independent problem solving.

Parents are able to see what their children are doing in school, while also helping teachers determine how well the lesson material is being learned. Homework is quite beneficial when used the right way and can improve student  performance.

This well intentioned practice can turn sour if it’s not handled the right way. Studies show that if a student is inundated with too much homework, not only do they get lower scores, but they are more likely to get stressed.

The age at which homework stress is affecting students is getting lower, some even as low as kindergarten. Makes you wonder what could a five year old possibly need to review as homework?

One of the speculated reasons for this stress is that the complexity of what a student is expected to learn is increasing, while the breaks for working out excess energy are reduced. Students are getting significantly more homework than recommended by the education leaders, some even nearly three times more.

To make matters worse, teachers may give homework that is both time consuming and will keep students busy while being totally non-productive.

Remedial work like telling students to copy notes word for word from their text books will  do nothing to improve their grades or help them progress. It just adds unnecessary stress.

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Effects of homework stress at home

Both parents and students tend to get stressed out at the beginning of a new school year due to the impending arrival of homework.

Nightly battles centered on finishing assignments are a household routine in houses with students.

Research has found that too much homework can negatively affect children. In creating a lack of balance between play time and time spent doing homework, a child can get headaches, sleep deprivation or even ulcers.

And homework stress doesn’t just impact grade schoolers. College students are also affected, and the stress is affecting their academic performance.

Even the parent’s confidence in their abilities to help their children with homework suffers due increasing stress levels in the household.

Fights and conflict over homework are more likely in families where parents do not have at least a college degree. When the child needs assistance, they have to turn to their older siblings who might already be bombarded with their own homework.

Parents who have a college degree feel more confident in approaching the school and discussing the appropriate amount of school work.

“It seems that homework being assigned discriminates against parents who don’t have college degree, parents who have English as their second language and against parents who are poor.” Said Stephanie Donaldson Pressman, the contributing editor of the study and clinical director of the New England Center for Pediatric Psychology.

With all the stress associated with homework, it’s not surprising that some parents have opted not to let their children do homework. Parents that have instituted a no-homework policy have stated that it has taken a lot of the stress out of their evenings.

The recommended amount homework

The standard endorsed by the National Education Association is called the “10 minute rule”; 10 minutes per grade level per night. This recommendation was made after a number of studies were done on the effects of too much homework on families.

The 10 minute rule basically means 10 minutes of homework in the first grade, 20 minute for the second grade all the way up to 120 minutes for senior year in high school. Note that no homework is endorsed in classes under the first grade.

Parents reported first graders were spending around half an hour on homework each night, and kindergarteners spent 25 minutes a night on assignments according to a study carried out by Brown University.

Making a five year old sit still for half an hour is very difficult as they are at the age where they just want to move around and play.

A child who is exposed to 4-5 hours of homework after school is less likely to find the time to go out and play with their friends, which leads to accumulation of stress energy in the body.

Their social life also suffers because between the time spent at school and doing homework, a child will hardly have the time to pursue hobbies. They may also develop a negative attitude towards learning.

The research highlighted that 56% of students consider homework a primary source of stress.

And if you’re curious how the U.S stacks up against other countries in regards to how much time children spend on homework, it’s pretty high on the list .

Signs to look out for on a student that has homework stress

Since not every student is affected by homework stress in the same way, it’s important to be aware of some of the signs your child might be mentally drained from too much homework.

Here are some common signs of homework stress:

• Sleep disturbances
• Frequent stomachaches and headaches
• Decreased appetite or changed eating habits
• New or recurring fears
• Not able to relax
• Regressing to behavior they had when younger
• Bursts of anger crying or whining
• Becoming withdrawn while others may become clingy
• Drastic changes in academic performance
• Having trouble concentrating or completing homework
• Constantly complains about their ability to do homework

If you’re a parent and notice any of these signs in your child, step in to find out what’s going on and if homework is the source of their stress.

If you’re a student, pay attention if you start experiencing any of these symptoms as a result of your homework load. Don’t be afraid to ask your teacher or parents for help if the stress of homework becomes too much for you.

What parents do wrong when it comes to homework stress

Most parents push their children to do more and be more, without considering the damage being done by this kind of pressure.

Some think that homework brought home is always something the children can deal with on their own. If the child cannot handle their homework then these parents get angry and make the child feel stupid.

This may lead to more arguing and increased dislike of homework in the household. Ultimately the child develops an even worse attitude towards homework.

Another common mistake parents make is never questioning the amount of homework their children get, or how much time they spend on it. It’s easy to just assume whatever the teacher assigned is adequate, but as we mentioned earlier, that’s not always the case.

Be proactive and involved with your child’s homework. If you notice they’re spending hours every night on homework, ask them about it. Just because they don’t complain doesn’t mean there isn’t a problem.

How can parents help?

• While every parent wants their child to become successful and achieve the very best, it’s important to pull back on the mounting pressure and remember that they’re still just kids. They need time out to release their stress and connect with other children.
• Many children may be afraid to admit that they’re overwhelmed by homework because they might be misconstrued as failures. The best thing a parent can do is make home a safe place for children to express themselves freely. You can do this by lending a listening ear and not judging your kids.
• Parents can also take the initiative to let the school know that they’re unhappy with the amount of homework being given. Even if you don’t feel comfortable complaining, you can approach the school through the parent-teacher association available and request your representative to plead your case.
• It may not be all the subjects that are causing your child to get stressed. Parents should find out if there is a specific subject of homework that is causing stress. You could also consult with other parents to see what they can do to fix the situation. It may be the amount or the content that causes stress, so the first step is identifying the problem.
• Work with your child to create a schedule for getting homework done on time. You can set a specific period of time for homework, and schedule time for other activities too. Strike a balance between work and play.
• Understanding that your child is stressed about homework doesn’t mean you have to allow them not to try. Let them sit down and work on it as much as they’re able to, and recruit help from the older siblings or a neighbor if possible.
• Check out these resources to help your child with their homework .

The main idea here is to not abolish homework completely, but to review the amount and quality of homework being given out. Stress, depression and lower grades are the last things parents want for their children.

The schools and parents need to work together to find a solution to this obvious problem.

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The Consequences of Academic Pressure on Students' Mental Health

As students advance in education, their workload increases year to year. Momentum theory proposes an increase in workload increases performance. A Sci Alert study shows that workload quantity and stress are closely related. In 2021, University and College Union did a workload survey. They found that the workload is becoming unmanageable as time progresses.

The American College Health Association surveyed student stress. They found that stress is the main block to academic success. A report by Frontiers shows academic workload can lead to anxiety and depression. Today academic pressure has become a growing problem among students. Research shows it can lead to serious mental health consequences.

Different forms of academic pressure ‍

Academic pressure is a situation where learners get overwhelmed by education demands. It makes them rush against time. They use more energy to achieve educational goals. Pacific Teen Treatment reports that the pressure can come from different sources. It can come from a lack of finances, expectations, and poor grading systems. The main causes of academic pressure are as follows. 

Excessive assignments

The University of San Diego reports that high schoolers spend 16.8 hours weekly on homework. In a study by Better Sleep Council, 74% of teens say homework causes stress. Excessive assignments tend to cause more academic pressure on girls. In an Edweek online poll, most parents lack time to assist kids with homework. This leaves students alone to handle assignments. 

In a student class, academic competition is very high. The teaching staff places high expectations on learners too. The current education system is grade and performance-based. This puts more pressure on students when handling assignments. The use of writing resources to rewrite essays can help ease off the pressure. Instead of spending too much time writing, a student can use a free essay rewriter. It is a powerful essay rewriting tool that uses AI to generate essays. They are plagiarism free and highly appealing. 

Tough exams

Throughout the school years, students do a variety of exams. In high school, they do exit exams in the final year. Within a few months, they sit for college entrance exams. They do continuous assessment tests and a final exam in college. 

These exams determine if the student will progress to the next phase in education. If they fail, they cannot transition to the next level. A report by Edutopia shows high stake testing causes panic, anxiety, and frustration. Some students feel irritated, have headaches, and have low self-esteem. 

High expectations

A report by New South Wales Education shows realistic expectations are good. They cause students to work harder and improve academic performance. Unrealistic expectations can cause many negative challenges. A student suffers from academic pressure and mental health challenges. The American Psychological Association links perfectionism with depression. A student may experience eating disorders or self-harm. 

The negative impact of academic pressure on student’s mental health

In every phase of education, students are prepared for the next phase. The preparation comes in the form of class lessons, assignments, and exams. Teachers follow a predetermined syllabus which they are expected to complete. They are also expected to prove their productivity through good student grades. Due to this, they put more academic pressure on students. It affects the mental health and academic performance of students. 

The Biomedical and Pharmacology Journal has published a report on academic stress. The report notes that mental health for students has been ignored for many years. Society thought that students were the least affected by stress. Statistics by the departments in various countries show 1 student commits suicide per hour. 1.8% committed suicide after they failed exams. The report cites that India has the highest rate of teenage suicide. The main trigger of suicide is depression caused by academic pressure.  

Stress and anxiety

A Cross River Report shows that 45% of students experience stress daily. The report further says that 61% of teenagers get stressed due to poor grades. These statistics resonate with figures published by the American Institute of Stress. Stress happens when a student has to work on assignments fast and deal with tough demands. This is according to a study by the International Journal of Humanities and Social Science Invention. The report notes stress causes poor concentration and academic anxiety. 

Negative mood and eating disorder

The National Institutes of Health report that academic stress causes eating disorders. The report says female students are the most affected by this mental disorder. It climaxes when there are upcoming exams. A report by Scientific Research Publishing shows eating disorders and stress are related. Students experiencing the disorder tend to be moody and are easily irritated. It can affect their relationships and social life. Withdrawn students advance their stress levels to depression. They might start to have suicidal thoughts or commit suicide. 

Mental health and academic performance are interrelated. When a student cannot contain pressure, they begin to burn out. A Gitnux report shows from 5% to 75% of students suffer from Burnout. The report says the main contributor is academic pressure. BioMed Central says academic Burnout is a mental disorder symptom. It is triggered by increasing academic stress and burden. It leads to emotional and physical exhaustion and academic anxiety. An increase in Burnout can cause psychological problems such as depression. 

Strategies for alleviating academic pressures

Academic pressures can be managed and reduce their effects on students. There are different ways of promoting students' mental health in and out of the classroom.

Have a changed mindset

Most students suffer academic pressure and mental health due to attitude. If a learner believes certain subjects are boring, they will hate studying them. A learner needs to believe exams and assignments are good. A fixed mindset prevents a change in attitude and could lead to stress. 

Mental health and academic performance go hand in hand. If you suffer from mental disorders, your academic performance will be poor. Do not retrieve and suffer alone if you experience academic pressure. Communicate as much as possible. Talk to a friend, family member, or teacher. Let them know how you are feeling and let them help you overcome it. Another alternative is to get help from professionals such as counselors. Get ways to get help with your academic assignments. 

Check on your sleep patterns

When you have a lot of academic workload to handle, your sleep time can be affected. If it persists for many days, it can have an impact on your mental health. A report by NIH says poor sleep causes mental health disorders. A student might have challenges making decisions or controlling emotions. Poor sleep patterns can cause depression, suicide, and bad behavior. 

Manage time well

Simpli Learn reports that good time management increases confidence. Students who manage their time well are less stressed. The report says they complete their tasks on time and perform well in school. Know your priorities and follow a strict schedule. Have time for exercising and time for socializing. 

The amount of student workload increases as they advance in education. When it becomes unbearable, a student starts to develop stress and depression. Academic pressure can lead to poor academic performance and irritation. Learners get academic anxiety and suffer various mental disorders.

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Can Homework Lead to Depression?

Homework is an after-school task that nobody bargained or asked for. It is simply that extra work that every student has to put in over a specific period every day after school. Kids in first grade are known to spend at least 10 minutes on their homework every day; those in high school (particularly the seniors) spend at least two hours on their homework every night. This is not conclusive; the amount of time spent could be higher or lesser, depending on the school, teacher, and the students’ abilities.

According to Sierra’s Homework Policy recommendation, students shouldn’t get more than ten minutes of homework every night and a maximum of fifty minutes of homework per term. While this recommendation is not binding or absolute, it mostly serves as a conceptual guide for teachers and tutors alike. Spending this amount of time on homework every night after a hectic day at school is not in any way fun for students, no matter the age or class. No student enjoys doing homework, especially when it has become a daily routine, and now that homework score is calculated as part of their cumulative score for the term. To ease the homework burden, students can ask for help at 123 Homework service and get it at an affordable price.

Whether homework can lead to or cause depression is an age-long question, and this article aims to explain the ‘if’ and ‘how’ too much homework can cause depression.

Studies have shown that the more time spent on homework means that students are not meeting their developmental needs or imbibing other critical life skills. While focusing on their homework, students are likely to forgo other activities such as participating in hobbies, seeing friends and family, and having meaningful and heart-to-heart conversations with people. Homework steals all the attention and spare time. Eventually, it puts students on the path of social reclusiveness, which would sooner or later tell on their mental and emotional balance.

Also, when a group of Harvard Health researchers asked students whether they experience any physical symptoms of stress like exhaustion, sleep deprivation, headache, weight loss, and stomach ache, over two-thirds of the participating students claim that they cope with anxiety thanks to their use of drugs, alcohol, and marijuana.

A Stanford University study showed that homework affects students’ physical and mental health because at least 56% of students attribute homework to be their primary source of stress. According to the study, too much homework is also a leading cause of weight loss, headache, sleep deprivation, and poor eating habits.

As beneficial as homework is to the students’ academic development, the fact remains that an additional two hours spent on homework after spending around 8 hours in school is too much and could lead to a massive mental breakdown.

Even though research has shown that homework can lead to depression, that doesn’t take away the fact that assignment is the only way to ensure and ascertain that students fully understood what they have learned in class; however, the question remains, is two hours on homework every night not too much?

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Is Excessive Homework the Cause of Many Teen Issues?

Sydney Trebus , Business Manager | September 15, 2019

Does excessive homework really make a student perform worse? Is homework a big influencer on the emotional and physical health of students? Can we change the bad reputation homework has obtained over the years or is it too late?

Today, schooling is ever-changing, currently focusing on a “necessary” end goal of attending college. Standards are rising, teachers are better trained, and students are left with rigorous courses riddled with hours and hours of homework. People are now wondering how important homework really is. Is that just the overload talking or does homework actually have a negative impact on students? 

Popular opinion would suggest yes, claiming that homework is a useless and stress-inducing part of school at any age. Many Boulder High students communicate a similar complaint. 

Seniors Carson Williams and Carson Bennett voiced their opinions. Bennet says that “Homework results in later bedtimes which means we get less sleep and therefore, have less energy the next day.” Williams agreed and added,“Homework is good if you need it to study, but if it is just busywork then it is useless.” 

Another student, Bishal Ellison, commented that in some classes “homework doesn’t impact [his] success, there is no point … In one of [his] classes, homework is just for extra credit.”

While student opinions are extremely significant, teachers are the ones in control of this so-called “stress inducing and useless activity.” 

Mr. Weatherly, an AP World Geography teacher here at Boulder High, commented that homework has an enormous impact on the success of students within the class; he claimed that there is simply not enough time in class to review everything. He does, however, agree with popular opinion, saying, “Teachers give homework thinking about their own class, not the five or six others students have.” 

So which is it? How important is homework? Homework has been seen both beneficial and detrimental in association with time. Homework over a certain time limit can cause stress, depression, anxiety, lack of sleep, and more. 

Homework distracts from extracurriculars and sports as well, something colleges often look for. Homework is ultimately leading students to resent school as a whole.

According to a study done by Stanford University, 56 percent of students considered homework a primary source of stress, 43 percent viewed tests as a primary stressor, while less than one percent of the students said homework was not a stressor. They were able to conclude that too much homework can result in a lack of sleep, headaches, exhaustion, and weight loss. 

Experts denote that the homework assigned to students today promotes less active learning and instead leads to boredom and a lack of problem-solving skills. Active learning, done through students learning from each other through discussion and collaboration, enhances a student’s ability to analyze and apply content to aid them in a real-world setting. 

This negative attitude towards homework can, unfortunately, arise at a young age, especially in today’s schooling systems. 

Students in all grades are required to extend the hard rigor of school past the average eight hours they need to spend inside the building. According to an Education Week article by Marva Hinton, kindergarteners are often required to do a minimum of 30 minutes of homework a night; these young students are expected to read for 15 minutes as well as work on a packet for another 15-30 minutes. 

Kindergarten is forcing children to learn concepts they may not be ready for, discouraging them at a young age. As a principle rule, the National PTA recommends 10 to 20 minutes of homework per night for children in first grade and an additional 10 minutes for every grade after that. 

After this time marker, homework begins to be detrimental to the success of a student. Additionally, according to the Journal of Educational Psychology , students who did more than 90 to 100 minutes of homework per night actually did worse on tests than those with less than 90 minutes of homework.

The hours of homework students receive takes time that could be spent on extracurriculars, with family and friends, or on sports or activities. Children and young adults focus a large part of their time and energy on school, removing time to replenish and work on other skills in life, including socializing. 

Physical activity can actually be very beneficial to the success rates of students, improving self-esteem, well-being, motivation, memory, focus, and higher thinking. 

According to the   US Center for Disease Control and Prevention (CDC ) , exercise has an impact on cognitive skills such as concentration and attention, and it enhances classroom attitudes and behaviors. 

The more time taken away from the emotional and physical health of a student, the more resentful they will be towards school. In kindergarten, over 85 percent of students are enthusiastic about learning and attending school, whereas 40 percent of high school students are chronically disengaged from school and any learning that takes place. 

What’s even more baffling is that as students enter high school, they are expected to be enthusiastic about school, obtain perfect grades and test scores, and do extracurricular activities and sports in order to get into a good college. 

Logan Powell, the Dean of Admissions at Brown University asks when accepting students, “Have they learned time management skills, leadership, teamwork, discipline? How have they grown as a person and what qualities will they bring to our campus?” 

These are unrealistic standards for students who most likely already have negative attitudes towards school and homework and aren’t given the opportunity to work on the skills colleges look for by exploring their community through clubs, volunteering, and working.

Experts see how detrimental homework can really be for a plethora of reasons; Donaldson Pressman reported that homework is not only not beneficial to a students grades or GPA, but it is also  detrimental to their attitude towards school, their grades, their self-confidence, their social skills, and their quality of life.” 

Homework, however, helps student achievement, reinforces good habits, involves parents in their students’ learning, and helps students remember material learned in class. 

This is all based on the circumstances however, if schools keep making homework more prominent in the learning system, students will lose their passion for learning. Unfortunately, many of us already have. So when teachers consider giving homework to their students, they should ask themselves how they believe it will improve their students’ learning and abilities.

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Chris • Feb 23, 2023 at 6:24 am

I hate homework in 5th grade

Jason • May 24, 2023 at 8:25 am

good luck in 7th grade then cuz that’s where finals start to get difficult. I’m barely keeping up right now and have to stay up late to keep up with the work.

John • May 9, 2022 at 11:40 am

Good article very informative.

Garrett • May 19, 2022 at 7:01 pm

yes i agree

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Does Homework Cause Stress? Exploring the Impact on Students’ Mental Health

How much homework is too much?

Jump to: The Link Between Homework and Stress | Homework’s Impact on Mental Health | Benefits of Homework | How Much Homework Should Teacher’s Assign? | Advice for Students | How Healium Helps

Homework has become a matter of concern for educators, parents, and researchers due to its potential effects on students’ stress levels. It’s no secret students often find themselves grappling with high levels of stress and anxiety throughout their academic careers, so understanding the extent to which homework affects those stress levels is important. 

By delving into the latest research and understanding the underlying factors at play, we hope to curate insights for educators, parents, and students who are wondering  is homework causing stress in their lives?

The Link Between Homework and Stress: What the Research Says

Over the years, numerous studies investigated the relationship between homework and stress levels in students. 

One study published in the Journal of Experimental Education found that students who reported spending more than two hours per night on homework experienced higher stress levels and physical health issues . Those same students reported over three hours of homework a night on average.

This study, conducted by Stanford lecturer Denise Pope, has been heavily cited throughout the years, with WebMD eproducing the below video on the topic– part of their special report series on teens and stress : 

Additional studies published by Sleep Health Journal found that long hours on homework on may be a risk factor for depression while also suggesting that reducing workload outside of class may benefit sleep and mental fitness .

Lastly, a study presented by Frontiers in Psychology highlighted significant health implications for high school students facing chronic stress, including emotional exhaustion and alcohol and drug use.

Homework’s Potential Impact on Mental Health and Well-being

Homework-induced stress on students can involve both psychological and physiological side effects. 

1. Potential Psychological Effects of Homework-Induced Stress:

• Anxiety: The pressure to perform academically and meet homework expectations can lead to heightened levels of anxiety in students. Constant worry about completing assignments on time and achieving high grades can be overwhelming.

• Sleep Disturbances : Homework-related stress can disrupt students’ sleep patterns, leading to sleep anxiety or sleep deprivation, both of which can negatively impact cognitive function and emotional regulation.

• Reduced Motivation: Excessive homework demands could drain students’ motivation, causing them to feel fatigued and disengaged from their studies. Reduced motivation may lead to a lack of interest in learning, hindering overall academic performance.

2. Potential Physical Effects of Homework-Induced Stress:

• Impaired Immune Function: Prolonged stress could weaken the immune system, making students more susceptible to illnesses and infections.

• Disrupted Hormonal Balance : The body’s stress response triggers the release of hormones like cortisol, which, when chronically elevated due to stress, can disrupt the delicate hormonal balance and lead to various health issues.

• Gastrointestinal Disturbances: Stress has been known to affect the gastrointestinal system, leading to symptoms such as stomachaches, nausea, and other digestive problems.

• Cardiovascular Impact: The increased heart rate and elevated blood pressure associated with stress can strain the cardiovascular system, potentially increasing the risk of heart-related issues in the long run.

• Brain impact: Prolonged exposure to stress hormones may impact the brain’s functioning , affecting memory, concentration, and cognitive abilities.

The Benefits of Homework

It’s important to note that homework also offers many benefits that contribute to students’ academic growth and development, such as: 

• Development of Time Management Skills: Completing homework within specified deadlines encourages students to manage their time efficiently. This valuable skill extends beyond academics and becomes essential in various aspects of life.

• Preparation for Future Challenges : Homework helps prepare students for future academic challenges and responsibilities. It fosters a sense of discipline and responsibility, qualities that are crucial for success in higher education and professional life.

• Enhanced Problem-Solving Abilities: Homework often presents students with challenging problems to solve. Tackling these problems independently nurtures critical thinking and problem-solving skills.

While homework can foster discipline, time management, and self-directed learning, the middle ground may be to  strike a balance that promotes both academic growth and mental well-being .

How Much Homework Should Teachers Assign?

As a general guideline, educators suggest assigning a workload that allows students to grasp concepts effectively without overwhelming them . Quality over quantity is key, ensuring that homework assignments are purposeful, relevant, and targeted towards specific objectives. 

Advice for Students: How to balance Homework and Well-being

Finding a balance between academic responsibilities and well-being is crucial for students. Here are some practical tips and techniques to help manage homework-related stress and foster a healthier approach to learning:

• Effective Time Management : Encourage students to create a structured study schedule that allocates sufficient time for homework, breaks, and other activities. Prioritizing tasks and setting realistic goals can prevent last-minute rushes and reduce the feeling of being overwhelmed.

• Break Tasks into Smaller Chunks : Large assignments can be daunting and may contribute to stress. Students should break such tasks into smaller, manageable parts. This approach not only makes the workload seem less intimidating but also provides a sense of accomplishment as each section is completed.

• Find a Distraction-Free Zone : Establish a designated study area that is free from distractions like smartphones, television, or social media. This setting will improve focus and productivity, reducing time needed to complete homework.

• Be Active : Regular exercise is known to reduce stress and enhance mood. Encourage students to incorporate physical activity into their daily routine, whether it’s going for a walk, playing a sport, or doing yoga.

• Practice Mindfulness and Relaxation Techniques : Encourage students to engage in mindfulness practices, such as deep breathing exercises or meditation, to alleviate stress and improve concentration. Taking short breaks to relax and clear the mind can enhance overall well-being and cognitive performance.

• Seek Support : Teachers, parents, and school counselors play an essential role in supporting students. Create an open and supportive environment where students feel comfortable expressing their concerns and seeking help when needed.

How Healium is Helping in Schools

Stress is caused by so many factors and not just the amount of work students are taking home.  Our company created a virtual reality stress management solution… a mental fitness tool called “Healium” that’s teaching students how to learn to self-regulate their stress and downshift in a drugless way. Schools implementing Healium have seen improvements from supporting dysregulated students and ADHD challenges to empowering students with body awareness and learning to self-regulate stress . Here’s one of their stories. 

By providing students with the tools they need to self-manage stress and anxiety, we represent a forward-looking approach to education that prioritizes the holistic development of every student. 

To learn more about how Healium works, watch the video below.

About the Author

Sarah Hill , a former interactive TV news journalist at NBC, ABC, and CBS affiliates in Missouri, gained recognition for pioneering interactive news broadcasting using Google Hangouts. She is now the CEO of Healium, the world’s first biometrically powered immersive media channel, helping those with stress, anxiety, insomnia, and other struggles through biofeedback storytelling. With patents, clinical validation, and over seven million views, she has reshaped the landscape of immersive media.

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Is there a connection between working from home and depression?

Working from home (WFH) became essential for many people during the COVID-19 pandemic, and it was common to continue WFH following the lockdown. Research shows that WFH may have negative effects on mental well-being for some people, particularly those with existing mental health conditions.

Anyone who feels as though they are experiencing mental health symptoms as a result of WFH should speak with a healthcare professional, who can recommend coping strategies, medical treatments, or both.

In this article, we look at research from the past couple of years investigating whether there is a connection between WFH and depression .

We also list some factors that may influence a person’s mental well-being while WFH and offer strategies for coping with WFH struggles. Finally, we offer advice on when to see a doctor about symptoms of depression .

Is there a connection between WFH and depression?

Research suggests that there may be a connection between WFH and depression. This association appears to be stronger for people with existing mental health conditions.

A 2022 study found that employees who experienced a reduction in their well-being due to WFH were more likely to have an existing mental health condition. The study also found that working regular overtime exacerbated existing health issues, such as:

• lack of sleep

A 2021 study had similar findings, showing that WFH was associated with a worsening of the following:

• sleeping difficulties
• feelings of loneliness

Factors associated with WFH and depression

Certain factors appear to play a role in the likelihood of WFH affecting a person’s mental health.

A 2021 study found that the following factors were associated with a decline in both physical and mental well-being while WFH during the lockdown:

• decreased physical activity
• a nonnutritious diet
• being a parent or caregiver to a toddler
• having more distractions at home
• a lack of communication with co-workers

The results of a 2022 study suggest that stress and depression affect females and younger adults more acutely while WFH. Among females, factors that appear to increase depression include family responsibilities and conflicting work-life balance. Among people aged 16–39 years, these factors include loneliness, work uncertainty, and financial insecurity.

How WFH affects mental health

The relationship between WFH and mental health is complex. It is dependent on a variety of factors that may influence a person’s experience in a negative or positive way. Some of these factors include:

• existing mental health conditions
• home working environment
• time management
• management of boundaries between work and home life
• parental or caregiving responsibilities
• distractions in the home
• connections with co-workers
• other social connections
• feelings of isolation
• concerns about technology security
• level of physical activity

The research suggests a complex relationship between the factors affecting an individual’s work and personal life and the ways in which these factors may interact. For some, these interactions may increase mental well-being, whereas for others, they may cause or exacerbate mental health issues.

Coping with WFH struggles

People who feel as though WFH negatively affects their mental health may benefit from the following:

• taking regular breaks from work
• maintaining a regular schedule for both work and relaxation time
• staying in touch with colleagues regularly to combat feelings of isolation
• exercising regularly
• eating nutritious, well-balanced meals and snacks
• maintaining a regular sleep schedule

When to contact a doctor

Depression is a serious mental health condition that can have a significant effect on the quality of life. A person should contact a doctor or mental health professional if they have been experiencing symptoms of depression regularly for at least 2 weeks .

These symptoms include:

• an anxious or sad mood
• feelings of hopelessness
• feelings of guilt or worthlessness
• irritability
• restlessness
• difficulty concentrating
• difficulty sleeping or waking
• thoughts of death or suicide
• changes in appetite or weight
• digestive issues
• aches and pains that do not respond to treatment

Treatment options for depression

A doctor or mental health professional will typically treat depression with a combination of psychotherapy and medication.

Various types of psychotherapy are effective in treating depression, including:

• cognitive behavioral therapy (CBT)
• problem-solving therapy
• interpersonal therapy

Some common antidepressant medications include:

• selective serotonin reuptake inhibitors (SSRIs)
• serotonin-noradrenaline reuptake inhibitors (SNRIs)
• noradrenaline and specific serotonergic antidepressants (NASSAs)

In some cases, a person may need to try different treatments or combinations of treatments to find an approach that works best for them.

The outlook for people experiencing depression due to WFH will differ depending on individual circumstances.

People who find ways to cope with any added stresses or depressive symptoms that WFH causes may find that their depression improves.

Without treatment, major depressive episodes can last for 6–12 months . Seeking treatment early for depression can improve a person’s outlook.

A person may need to try different treatment methods before finding one that works for them. Anyone who feels that an existing treatment is not working should notify their prescribing doctor, who may recommend changing the treatment plan. Possible changes include:

• starting a medication
• adjusting a medication dosage
• switching to an alternative medication
• starting talking therapy
• changing therapists or trying a different form of talking therapy

A large body of research suggests that working from home may cause or exacerbate depression for some people. The likelihood of experiencing depression while WFH appears to be higher for those with existing mental health conditions and for females and young adults.

Certain coping strategies may help alleviate feelings of depression due to WFH. Examples include exercising regularly, maintaining a regular schedule for work and relaxation time, and keeping in touch with colleagues.

A person who experiences depression while WFH should talk with a doctor or mental health professional. Some people may require treatment in the form of talking therapy, medication, or a combination of the two. Seeking treatment early for depression can improve a person’s outlook.

Last medically reviewed on April 28, 2022

How we reviewed this article:

• Bains, N., et al . (2021). Major depressive disorder. https://www.ncbi.nlm.nih.gov/books/NBK559078/
• Depression. (2018). https://www.nimh.nih.gov/health/topics/depression
• Depression [Fact sheet]. (2021). https://www.who.int/news-room/fact-sheets/detail/depression
• Kraus, C., et al. (2019). Prognosis and improved outcomes in major depression: A review. https://www.nature.com/articles/s41398-019-0460-3
• Oakman, J., et al. (2020). A rapid review of mental and physical health effects of working at home: How do we optimise health? https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09875-z
• Overview — antidepressants. (2021). https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/antidepressants/overview/
• Perelman, J., et al. (2021). Does working at home compromise mental health? A study on European mature adults in COVID times. https://onlinelibrary.wiley.com/doi/full/10.1002/1348-9585.12299
• Platts, K., et al . (2022). Enforced home-working under lockdown and its impact on employee wellbeing: A cross-sectional study. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-12630-1
• Steidtmann, D., et al. (2021). Experiences of mental health clinicians and staff in rapidly converting to full-time telemental health and work from home during the COVID-19 pandemic [Abstract]. https://www.liebertpub.com/doi/abs/10.1089/tmj.2020.0305
• Working anytime, anywhere: The effects on the world of work. (2017). http://www.ilo.org/wcmsp5/groups/public/---dgreports/---dcomm/---publ/documents/publication/wcms_544138.pdf
• Xiao, Y., et al . (2020). Impacts of working from home during COVID-19 pandemic on physical and mental well-being of office workstation users. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934324/
• Yu, Y., et al . (2021). Working from home and positive/negative experiences due to social distancing as interacting factors of depressive symptoms during the COVID-19 pandemic in a Chinese general population. https://link.springer.com/article/10.1007/s00127-021-02179-6
• Zhdanava, M., et al. (2021). The prevalence and national burden of treatment-resistant depression and major depressive disorder in the United States. https://www.psychiatrist.com/jcp/depression/prevalence-national-burden-treatment-resistant-depression-major-depressive-disorder-in-us/

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Workplace Impact on the Rise of Anxiety & Depression

Anxiety disorders are the most commonly diagnosed mental health conditions, affecting almost 2 in 10 adults each year , and it’s not uncommon for them to go hand-in-hand with depression. Amid economic recession and financial worries, depression and anxiety rates are reported to have recently increased by 25% .

Here, we’ll explore the connection between anxiety disorders and depression, and how employers can support employees who may be struggling.

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Understanding anxiety disorders and depression

Feeling down or anxious now and then can be common. For people with anxiety disorders and depression , these feelings are ongoing and can be more severe. Anxiety disorders involve intense, excessive or continuous worry about everyday situations to the point where it can be difficult to control and may interfere with work, relationships and everyday functioning.

Similarly, depression can cause severe symptoms that affect how a person feels, thinks and handles daily activities, such as sleeping, eating or working. A person struggling with depression may have persistent feelings of hopelessness, irritability, frustration, restlessness, guilt, a loss of interest in hobbies and activities, low energy or fatigue.

The relationship between anxiety disorders and depression

While anxiety disorders and depression are different mental health conditions, it’s not uncommon for them to occur together . For example, depressive symptoms may cause a person to postpone or avoid activities, making them feel anxious when they can no longer put them off. Similarly, anxiety disorders may cause a person to avoid activities they would normally enjoy, which can increase feelings of depression. The two can also have overlapping symptoms , like agitation and restlessness. These symptoms can stem from the same structures or processes in the brain or be triggered by the same stress or trauma.

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The workplace plays a significant role in a person’s overall health and well-being and can either contribute to or detract from anxiety disorders and depression. Factors like long hours, excessive workloads, job insecurity, inflexibility and a work environment that lacks a supportive culture can increase stress levels and worsen overall mental health .

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Employers can help support well-being in the workplace by:

• Offering a strong mental health benefits package – A survey found that 81% of people say they’ll be looking for workplaces that support mental health when seeking future job opportunities. Flexible options, such as in-person therapy, teletherapy and digital solutions, give employees more inclusive ways to receive the help they may need.
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By raising awareness and understanding for mental health issues like anxiety and depressive disorders and creating an organization that works to be part of the solution, employers can foster a happier, healthier workforce.

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How Did Work-Related Depression, Anxiety, and Stress Hamper Healthcare Employee Performance during COVID-19? The Mediating Role of Job Burnout and Mental Health

Jianmin sun.

1 School of Management, Nanjing University of Posts and Telecommunications, Nanjing 210006, China

Muddassar Sarfraz

2 School of Management, Zhejiang Shuren University, Hangzhou 310015, China

Larisa Ivascu

3 Faculty of Management in Production and Transportation, Politehnica University of Timisoara, 300191 Timisoara, Romania

Kashif Iqbal

4 School of Business, Shanghai Dianji University, Nanhui Xincheng Town, Shanghai 201306, China

Athar Mansoor

5 Division of Public Policy, Hong Kong University of Science and Technology, Hong Kong

Associated Data

The current study data can be obtained from the corresponding author.

The study objective was to examine the psychological impact of the COVID-19 pandemic on the performance of healthcare employees. The study was informed by a theoretical framework that incorporates different psychological issues (i.e., stress, depression, and anxiety) that influence healthcare workers’ performance through the mediating roles of job burnout and mental health. The study data was gathered through structured questionnaires from 669 participants working in the healthcare sector in Pakistan. A structured equation modeling (SEM) technique was used for data analysis and hypothesis development. It was found that stress, depression, and anxiety positively affected healthcare employees’ job performance during COVID-19. Psychological factors had a positive and significant impact on job burnout and mental health. Job burnout and mental health mediated the relationship between stress, anxiety, depression, and employee performance. The ongoing repercussions of COVID-19 include their impact on employee performance in the healthcare sector. Healthcare worker performance is critical to fostering industrial economic growth. Elevated levels of stress, depression, and anxiety have profoundly exacerbated employee mental health issues. COVID-19 has created challenging working conditions in organizations requiring that they address the growing psychological issues which impact negatively on worker performance.

1. Introduction

In recent years, the emergence of the COVID-19 pandemic has demonstrated how a new virus can significantly alter human life. The profound changes caused by COVID-19 have presented major social challenges across the world with significant effects across a variety of domains [ 1 ]. The prolonged nature of the crisis, and its widespread impact, has led to its declaration as a global health emergency. The sudden onset of the COVID-19 pandemic caused psychological distress across industries throughout the world [ 2 ]. Notably, the very significant mental health impacts arising have exacted an extreme toll on the healthcare industry, with a particularly severe impact on healthcare performance.

For these reasons, COVID-19 has become a global threat to healthcare performance [ 3 ]. The prevalent psychological problems occurring in the healthcare sector can be partly attributed to the disease’s ability to cause previously healthy employees to become vulnerable caretakers. COVID-19 has also exacerbated existing mental health problems among healthcare employees due to the psychological trauma and distress they face in their work. Research has shown that front-line workers in the healthcare sector (e.g., nurses, doctors, medical staff, and health professionals) are presently facing unprecedented psychological challenges [ 4 ].

In dealing with these exacerbated health vulnerabilities, Pakistan’s economy has experienced a setback with front-line workers exposed to significant risks to their health. A recent study from Pakistan found that the COVID-19 crisis meant that healthcare workers had experienced increasing psychological pressure, leaving them ill-equipped to tackle the increasing challenges they faced [ 5 ]. The virus has caused healthcare workers to experience significant psychological repercussions, which have detrimentally affected their job performance. The crisis has created an enhanced sense of helplessness in health professionals, that can further deteriorate employee performance [ 6 ]. The literature demonstrates, however, that, despite growing evidence of mental health problems, the healthcare workforce is not seeking the mental healthcare necessary to ensure their well-being and performance [ 7 , 8 ]. Therefore, to limit the impact of COVID-19, it has become imperative for global healthcare institutions to recognize their responsibility toward their workers’ well-being, specifically regarding the increase in the COVID-19-related psychological burden. Previous studies have emphasized the need for multidisciplinary research in the healthcare sector concerning the growing psychological issues that influence employee mental health and job performance.

This global threat of COVID-19 has impacted the psychological health of individuals, with outbreaks representing stressful events for front-line workers. The COVID-19 crisis provoked nations globally to take action to combat the devastating spread of the pandemic. The authors of one study observed that the significant repercussions of COVID-19 have damaged employees’ psychological well-being, thereby negatively impacting their normal intellectual functioning [ 9 ]. Overall, the pandemic has overwhelmed the healthcare sector by reducing employees’ work performance [ 10 , 11 ].

The COVID-19 pandemic has gravely impacted the psychological health of individuals, causing them to experience significant mental health issues. The ongoing crisis has negatively impacted employees, making them psychologically ill-prepared to perform their normal tasks. Further, the situation has exacerbated existing psychological problems (e.g., stress and anxiety) [ 12 ], substantially impeding individuals’ job performance. Aguiar-Quintana et al. [ 13 ] found that high levels of COVID-19 exposure led to stress, anxiety, and depression symptoms, thus influencing workers’ performance. Overall, the pandemic has imposed significant strain on an already traumatized workforce, with increased anxiety and tension further exacerbating its impact on healthcare performance [ 14 ].

Employee mental health during the pandemic has also increased the burnout rate in the healthcare industry. Accelerating absenteeism and turnover intentions among healthcare employees caused by COVID-19, with high burnout rates reported, have had very damaging consequences,. Unsurprisingly, job burnout detrimentally impacts individuals’ mental health [ 15 ], thereby hampering their performance. Factors contributing to increasing burnout increase workplace mental pressure, affecting healthcare workers’ ability to perform their work tasks [ 16 ].

Therefore, to address the negative consequence of the pandemic, this study sought to investigate the effect of COVID-19 on healthcare workers in Pakistan. This paper presents evidence of the adverse effects of COVID-19 in the light of previous literature. The paper highlights the harsh realities of fighting the virus, and the need to safeguard healthcare employees against the psychological impacts of the pandemic and to prepare them physically and psychologically. Previous studies have investigated the clinical characteristics of the pandemic, its negative features, and the health measures implemented. In this regard, this study represents a valuable addition, providing information to help address the uncertainties of an unprecedented pandemic situation. Adding to previous studies that have considered the psychological and mental health impacts of COVID-19, this study provides a unique perspective by considering the role of both mental health and job burnout. The study provides essential information by highlighting these vital factors to increase awareness regarding the impact of COVID-19 on health workers’ mental health and performance.

The study calls for urgent action to mitigate the devastating effects of COVID-19 on employee performance and psychological health. The study findings provide vital tools to combat the increasing impact of stress, anxiety, and depression influencing healthcare performance. It provides a concrete basis for adapting and executing appropriate mental health policies to address the psychological vulnerabilities generated by COVID-19. It encourages government bodies, health professionals, and policymakers to protect the psychological well-being of healthcare workers in different parts of the world, specifically in Pakistan.

2. Theoretical Background

2.1. stress and employee performance.

In recent years, globalization and technological advancement have enhanced individuals’ working standards. However, the sudden outbreak of the COVID-19 pandemic has altered the working environment and job demands. In recent years, this profound crisis has made working conditions difficult, significantly raising organizations’ concerns regarding employee management. Yunita and Saputra [ 17 ] found that stress is the foremost factor that has influenced employee functioning during the pandemic. Stress has adversely affected individuals’ morale, performance, and motivation. In particular, the negative changes caused by COVID-19 have altered healthcare workers’ lives by significantly impeding their work performance. Prasada et al. [ 18 ] demonstrate that the growing pandemic stress has created a sense of chaos, leading organizations to report poor worker performance.

Various studies have reported that stress is the prime determinant influencing employee performance [ 19 ]. The pandemic has caused healthcare employees to experience workplace stress to an unprecedented extent. The increasing COVID-19 stress has exerted intense pressure on healthcare workers by creating additional job demands. The literature suggests that employees who experience stress tend not to meet job expectations. In the healthcare industry, the crisis situation has increased stress symptoms in frontline workers, with detrimental impacts on employee output. Tu et al. [ 20 ] observed that COVID-19-induced stress has influenced individuals’ ability to perform well, leading to substantial decreases in employees’ quality of work.

The occupational stress experienced during the pandemic outbreak has significantly influenced the economic functioning of nations, necessitating a focus on workers’ job performance. Evidence provided in the literature indicates that stress occurring as a result of the COVID-19 pandemic is prevalent as an issue affecting healthcare employee performance [ 21 ]. An employee experiencing a high degree of stress has lower motivation to perform the task. The COVID-19 crisis has caused individuals’ to focus less well on work-related tasks, substantially reducing their overall work performance. The pandemic has affected the flow of work, potentially increasing individuals’ workload. The perceived work burden has elevated stress in individuals, resulting in a decrease in individuals’ work performance [ 22 ].

In sum, the uncontrollable nature of COVID-19 has negatively affected healthcare workers, provoking anxiety and stress. COVID-19 has caused increasing uncertainty, with healthcare staff reporting psychological symptoms, emotional exhaustion, and workload stress. As the pandemic worsened, these symptoms accelerated, causing healthcare workers to face increased traumatic stress [ 23 ]. The issue of social stigmatization and shortages of healthcare equipment have made it difficult for employees to deal with the impacts of COVID-19 [ 24 ]. As this industry has faced a particularly marked increase in stress and depression during the pandemic, it is important to focus on the health of Pakistan’s healthcare workers to ensure enhanced work output.

2.2. Depression and Employee Performance

In recent years, the growing strain of the pandemic has encircled the globe, negatively impacting countries across the world. The COVID-19 outbreak has impacted healthcare services internationally, including in the Pakistan healthcare sector. The aggregate effect of the pandemic has meant healthcare employees have experienced an increasing intensity of demands due to the crisis, giving rise to the need for immediate investment in healthcare recovery. Healthcare workers are at risk of being affected psychologically by the pandemic situation. Depression has emerged as a harmful outcome that hinders employee functioning [ 25 ]. In healthcare, depression has become a major obstacle to employee performance. Healthcare employees are vulnerable to depression during the pandemic because of their exposure to various psychological stressors. Examination of mental responses related to COVID-19 has confirmed that depression drastically impedes healthcare performance. One study demonstrated how intense workloads occurring during the pandemic have increased depression among individuals, in turn negatively affecting work quality [ 26 , 27 ].

The pandemic has resulted in significant changes in the work environment of healthcare workers. The pandemic has led to worsened working conditions, causing employees to be more vulnerable to depression and distress. The elevated psychological pressure has raised management concerns, leading to demands for a reduction in employee workloads. Studies on the causes of poor healthcare performance suggest that the alarming COVID-19 situation has meant that employees are at risk of depression, impeding their performance [ 28 , 29 ]. Depression considerably affects the work status of healthcare workers, overwhelming them and negatively impacting their work performance. Research findings indicate that depression results in poorer work outcomes, negatively affecting healthcare performance [ 30 ]. Research into the impacts of the pandemic suggests that measures must be taken so that healthcare employees can deal with the increasing depression that can influence their productivity.

2.3. Anxiety and Employee Performance

COVID-19 has altered the typical working patterns of healthcare workers and significantly affected the psychological well-being of medical staff. Combating this new virus, initially without proven prevention measures or treatments, imposed a significant burden on the medical workforce. This situation has required that organizations globally take care of their workers and protect them against the psychological effects of their vulnerability to COVID-19 exposure. Despite awareness of this need, healthcare workers have been significantly affected across the globe. One empirical study found that around 53.8% of healthcare employees have been diagnosed with psychological issues [ 21 ]. Additionally, 21.3% of healthcare workers have experienced anxiety [ 31 ]. Results of studies from the Asian region indicate that, currently, healthcare employees are experiencing a high level of stress, anxiety, and depression symptoms [ 32 ].

Depression and anxiety significantly influence individuals’ professional lives, and coping with anxiety has become a widespread challenge in today’s world. In the era of COVID-19, increasing work anxiety has led to significant impacts on the healthcare industry. The pandemic has increased anxiety in individuals, necessitating the study of its effect on individuals’ job performance. Work anxiety experienced as a result of the COVID-19 situation can potentially influence healthcare performance. For example, Fu et al. [ 33 ] found that prevalent COVID-19 anxiety heightened job-related concerns, substantially diminishing employees’ healthcare performance.

Several factors affect employee performance, but among them, anxiety is a critical factor that demands the attention of researchers. Due to the uncertainty brought about by the pandemic, employee anxiety has had a devastating impact as a result of changed working environments, contributing to reduced work performance. Clercq et al. [ 34 ] suggested that anxiety associated with the pandemic has elevated job-related worries in healthcare workers, causing them to exhibit poor performance. The negative influence of COVID-19 has caused employees to experience excessive tension and anxiety, particularly in the healthcare sector. Anxiety has been demonstrated to have a toxic effect on employee performance, with Kumar et al. [ 35 ] stating that the high prevalence of anxiety and depression during the pandemic has undermined the performance of the healthcare workforce. Consistent with this discussion, Nadeem et al. [ 36 ] observed that the healthcare workforce had encountered severe anxiety, making it difficult for individuals to cope with work complexities brought about by COVID-19.

2.4. The Mediating Role of Job Burnout

Burnout is a global phenomenon and has been exacerbated as the world’s healthcare industry has faced the growing consequences of the pandemic. In 2020 and 2021, the progressive impact of COVID-19 has generated burnout. Inevitably, the pandemic has negatively influenced the lives of healthcare workers. Since the beginning of 2020, the Pakistan health workforce has had to cope with a wide range of crises, leading to job burnout. A recent study from Pakistan indicated that around 46.6% of healthcare workers have left their job due to the pandemic [ 37 ]. Healthcare burnout is an accelerating phenomenon that has raised awareness of the need to find solutions to combat COVID-19 work stress and job burnout [ 38 ]. Bradley and Chahar [ 39 ] found that burnout has drastically increased during the pandemic years, emphasizing the need to provide immediate support.

The emergence of a fourth wave of COVID-19 saw anxiety and stress rapidly increase in Pakistan. The wide circulation of the virus has placed a psychological burden on healthcare workers, causing them to experience an increased level of burnout [ 40 ]. The uncertainty surrounding the outbreak has increased concerns about healthcare workers and their rate of burnout [ 41 ]. Despite the ongoing nature of the crisis, Pakistan still lacks the medical equipment needed to function effectively in this difficult situation. In this regard, medical support for healthcare workers is urgently required to maintain superior quality services [ 42 ], and to ensure employees’ intention to stay in the sector. During the pandemic, the accelerating incidence of burnout has exacerbated the negative effect of healthcare workers’ psychological conditions. In the current period of the pandemic, the public health emergency has caused the healthcare workforce to experience numerous physical and psychological issues, leading to excessive employee burnout. Employee burnout has been the most prevalent negative health outcome observed in the healthcare industry in the past few years. As a result, today, the increasing impact of burnout has caused health professionals to be less focused on their work performance [ 43 , 44 ].

The outbreak of COVID-19 has significantly affected the working lives of healthcare workers. In recent years, these issues have strongly increased the turnover rate. The high prevalence of stress, anxiety, and depression have clearly caused burnout in healthcare employees [ 45 ]. The psychological adversity experienced has influenced healthcare employees‘ job performance, leading some to give up their profession [ 46 ]. Saleem et al. [ 47 ] found that, faced with the excessive burden of the pandemic, pandemic stress and depression have caused healthcare employees to leave healthcare organizations, substantially impeding the ability of these organizations to perform their role.

Healthcare employees have experienced reduced work productivity due to the pandemic, thus leading to a higher turnover rate. One study found that, in the healthcare sector, reduced work performance had elevated the feeling of negativity (e.g., stress, anxiety) in individuals, increasing the overall turnover rate [ 48 ]. Further, in a previous systematic review, it was found that, in the COVID-19 era, health professionals frequently experience burnout with consequent reduced job performance [ 49 ]. Long-term stress and anxiety have become critical factors leading to the increase in the burnout rate among healthcare workers [ 50 ].

2.5. The Mediating Role of Mental Health

In the current pandemic scenario, employees’ organizational performance has been impacted by COVID-19′s effect on individuals’ mental health [ 51 ]. Organizations strive to sustain themselves in this competitive world by empowering employees to perform well. To achieve this goal, organizations emphasize maintaining positive mental health for superior work performance. Satici et al. [ 52 ] state that the negative consequences of the COVID-19 pandemic have created a high level of anxiety, stress, and depression in individuals, thus hindering their healthcare performance.

Arguably, various factors affect the psychological well-being of workers. Among them, stress, depression, and anxiety hold a prominent position in impeding employee work performance. As the pandemic unfolds, numerous mental health problems have been highlighted, demanding researchers’ attention [ 47 ]. An employee’s mental health considerably influences their work performance. During COVID-19, workplace changes have made healthcare employees exhibit poorer work performance. Stress, depression, and anxiety are the most prominent psychological issues that have emerged as the dominant threats to employee well-being and performance [ 53 ]. Mental health issues, such as stress, depression, and anxiety affect the performance of front-line workers, as shown by Lei et al. [ 54 ].

COVID-19-related psychological problems (e.g., distress and depression) threaten healthcare employees’ mental health, and result in poor work performance [ 17 ]. In particular, Lai et al. [ 55 ] showed that, in the nursing profession, the excessive pandemic workload posed a threat to work efficiency and productivity. Therefore, the literature has highlighted the need to analyze the psychological factors that influence mental health and performance in the workplace.

Figure 1 represents the direct and indirect relationships among the study variables (stress, depression, anxiety, job burnout, mental health problems and employee performance).

Conceptual Framework.

3.1. Study Procedure

A quantitative research design using a self-reported questionnaire was used to collect data from healthcare employees of 30 hospitals in Pakistan. A purposive sampling technique was used to gather data from healthcare employees from January to March 2022. The healthcare workers sampled were treating COVID-19 patients. In this study, we considered government COVID-19 treatment facilities located in three major cities of Pakistan (Lahore, Islamabad, and Karachi). To design the online questionnaire, a public platform recommended by Google INC: Google Docs was used, and the survey link was sent to healthcare employees. It was confirmed through a confidential statement that the personal information of participants would be protected and that the responses provided would only be used for research purposes. In accordance with the Declaration of Helsinki, an information letter was provided and an informed consent form obtained from the study participants.

3.2. Common Method Bias

This study addressed common method bias using Harman’s single-factor methodology. The variance extracted using one factor was 20.900% which was less than 50%. This indicated that there was no common method bias [ 56 ].

3.3. Measures

Depression, anxiety, and stress were assessed using seven-item scales adopted from Vignola and Tucci [ 57 ]. Sample items included, “I felt like I was being a little too emotional/sensitive”, “I was intolerant of the things that kept me from continuing to do what I had been doing”, and “I knew my heartbeat had changed even though I hadn’t done anything physically rigorous (for example: increased heart rate, irregular heartbeat)”. In this study, the depression, anxiety, and stress scales had Cronbach’s alphas of 0.896, 0.902, and 0.897, respectively.

Job burnout was assessed using a three-item scale adopted from Ninaus [ 58 ]. Sample items included, “I feel used up at the end of a workday”, and “I feel burned out from my work”. The job burnout scale had a Cronbach’s alpha value of 0.773 in this study.

Mental health problems were assessed on a 15-item scale adopted from Sharma and Devkota [ 59 ]. Sample items included in the questionnaire were, “Have you been less confident than before?”, “Do you use alcohol or other substances that are causing problems in your daily life? and “Have you been anxious, restless, or having multiple worries and doubts in mind more than usual?”. The mental health problems scale had a Cronbach’s alpha value of 0.945.

Employee performance was assessed using a 16-item scale adopted from Ferozi and Chang [ 60 ]. The Cronbach’s alpha value for the employee performance scale was 0.945; the sample items included, “I give advanced notice when unable to come to work”, “I take action to protect the organization from potential problems”, and “I perform tasks that are expected of me”.

3.4. Statistical Analysis

The data was analyzed using the Statistical Package for the Social Sciences (SPSS) and the Analysis of Moment Structures (AMOS) software. In this study, structural equation modeling (SEM) was used to analyze multivariate causal associations. Confirmatory factor analysis (CFA) was carried out to assess the internal validity of the model.

Table 1 shows the demographic details of the study participants. Of 669 collected questionnaires, 311 useful responses were received from the male participants (46.5%) and 358 from the female participants (53.5%). Therefore, the study sample comprised an approximately equal proportion of male and female respondents. In terms of age, 92 (13.8%) respondents were 19–30 years old, 182 (27.2%) were 31–40, 158 (23.6%) were 41–50, 141 (21.1%) were 51–60, and 96 (14.3%) of the respondents were more than 60 years old. Regarding educational level, 130 (19.4%) had an intermediate degree, 216 (32.3%) had a bachelor’s degree, 240 (35.9%) had a master’s degree, and 83 (12.4%) had MPhil/other qualifications. With respect to marital status, 118 (17.6%) of the respondents were single, while 551 (82.4%) were married.

Study participant’s demographic information.

Assessment of Model Fit and Measurement Model

As shown in Table 2 , the results of the model fit indicated that the overall measurement model provided an adequate fit of the data with all 55 items, with Chi-square = 1454.113 and df = 1415. The value of GFI was 0.929; greater than the recommended value of 0.9 as recommended by Hoyle (1995). Based on the CFI, TLI and IFI indices having values greater than the cut-off value of 0.9 (0.998; 0.998; and 0.932, respectively), the model was inferred to represent a good fit of the data [ 60 , 61 ]. The root mean square error of approximation (RMSEA) was 0.006, which was below the threshold of 0.08 recommended by Steiger [ 62 ]. Further, the standardized root mean squared residual (SRMR) was 0.025, which was below the threshold of 0.08 recommended by Hu and Bentler [ 63 ]. Additionally, the relative CMIN/df was 1.028, which, at less than five, indicated a good fit of the model [ 61 ].

Model fit and reliability and validity analysis.

*** p < 0.001.

As presented in Table 2 , the results of an assessment of the standardized factor loadings of the model’s items indicated that the initial standardized factor loadings of all 55 items were above 0.6, as recommended by Hair [ 69 ], ranging from 0.692 (for EP_14) to 0.771 (STR_6).

Each of the constructs was evaluated for reliability after the uni-dimensionality of the constructs was determined. The average extracted variance (AVE), construct reliability (CR), and Cronbach’s alpha were used to evaluate reliability. The AVE results are presented in Table 2 ; all the values were higher than 0.5, as recommended by Nunnally and Bernstein [ 70 ], ranging between 0.52 (for employee performance) to 0.567 (for anxiety).

The CR value, which indicates the degree to which the construct indicators reflect the latent construct, exceeded the recommended value of 0.7 for all constructs, as recommended by Bagozzi and Yi [ 71 ], ranging between 0.773 (for job burnout) and 0.945 (for mental health problems). The Cronbach’s alpha value, which describes the degree to which a measure is error-free, ranged between 0.773 (for job burnout) and 0.945 (for mental health problems), which were above the threshold of 0.7 recommended by Nunnally and Bernstein [ 70 ].

The correlation between the mental health problems scale scores and the employee performance scale scores was -0.601. The correlation between the job burnout and the mental health problems scale scores was 0.681. The data presented in Table 3 highlight that both were less than the threshold of 0.85 [ 72 ]. The results also revealed, as shown in Table 3 , that the value of the off-diagonal items was lower than the value of the square root of AVE on the diagonal. This supported the view that each latent construct measurement was discriminating relative to the others, according to the Fornell–Larcker interpretation [ 73 , 74 ].

Discriminant validity analysis (Fornell–Larcker and HTMT).

Note: Values on the diagonal (italicized) represent the square root of the average variance extracted, while the off diagonals are correlations.

The descriptive statistics of the constructs are also provided in Table 3 . These statistics include the mean and standard deviation. Evaluating the data presented in this table, it is evident that the highest mean value was 3.65, recorded for employee performance, and the lowest mean value was 3.59, recorded for depression. The highest standard deviation value was 0.886, for measurement of burnout, and the lowest standard deviation value was 0.785, for measurement of mental health problems.

In predicting employee performance, stress had a significance value below 0.001, as highlighted in Table 4 . For this relationship, a t -value of −5.541 and a p -value were obtained.

Hypotheses testing—direct effect.

Indicates significant paths: * p < 0.05, ** p < 0.01, *** p < 0.001.

Stress has a negative and significant impact on employee performance.

As shown in Table 4 , H1 was supported because the regression weight for stress in the prediction of employee performance was significantly different from zero at the 0.001 level (two-tailed). A negative relationship was highlighted because the standardized path coefficient was −0.205. So, employee performance decreased by 0.205 standard deviations when stress increased by 1 standard deviation.

Depression has a negative and significant impact on employee performance.

There is a less than 1% chance of obtaining a t-value that is as large as the observed −3 in absolute value. With a standardized path coefficient of −0.123, the effect of depression on employee performance was, thus, negative and significant at the 0.01 level. Following these arguments, H2 was supported.

Anxiety has a negative and significant impact on employee performance.

There is a less than 5% chance of obtaining a t-value as large as the observed −2.897 in absolute value. With a standardized path coefficient of −0.113, the effect of anxiety on employee performance was, thus, negative and significant at the 0.05 level. As a result, H3 was confirmed.

Stress has a positive and significant impact on job burnout.

There is a less than 0.1% chance of obtaining a t-value as large as the observed 9.938 in absolute value. In other words, with a standardized path coefficient of 0.318, the impact of stress on job burnout was positive and significant at the 0.001 level. As a result, H4 was confirmed.

Depression has a positive and significant impact on job burnout.

There is a less than 0.1% chance of obtaining a t-value as high as the observed 11.871 in absolute value. In other words, with a standardized path coefficient of 0.368, the relationship between depression and job burnout was positive and significant at the 0.001 level. As a result, H5 was confirmed.

Anxiety has a positive and significant impact on job burnout.

There is a less than 0.1% chance of obtaining a t-value as high as the observed 8.968 in absolute value. In other words, with a standardized path coefficient of 0.278, the relationship between anxiety and job burnout was positive and significant at the 0.001 level. As a result, H6 was confirmed.

Stress has a positive and significant impact on mental health problems.

There is a less than 0.1% chance of obtaining a t-value as large as the observed 6.950 in absolute value. In other words, with a standardized path coefficient of 0.278, the impact of stress on mental health problems was positive and significant at the 0.001 level. As a result, H7 was confirmed.

Depression has a positive and significant impact on mental health problems.

There is a less than 0.1% chance of obtaining a t-value as high as the observed 7.541 in absolute value. In other words, with a normalized path coefficient of 0.279, the relationship between depression and mental health problems was positive and significant at the 0.001 level. As a result, H8 was confirmed.

Anxiety has a positive and significant impact on mental health problems.

Anxiety had a substantial positive impact on mental health problems at the 0.001 level with a standardized path coefficient of 0.341. Therefore, H9 was supported.

Job burnout has a negative and significant impact on employee performance.

Employee performance was adversely affected by job burnout at the 0.001 level with a standardized path coefficient of −0.195. Therefore, H10 was supported

Mental health problems have a negative and significant impact on employee performance.

The results indicated that the effect of mental health problems on employee performance was negative and significant at the 0.001 level with a standardized path coefficient of −0.183. Therefore, H11 is supported.

The results indicated that the most important determinants of job burnout, mental health problems, and employee performance were stress (β = −0.205), depression (β = 0.368), and anxiety (β = 0.341).

Table 5 shows that the p -values obtained were less than the standard level of 0.05. All hypothesized mediation effect paths were determined to be statistically significant, as shown in Table 5 . Hence, hypotheses H10a, H10b, H10c, H11a, H11b, and H11c, were all supported. The next subsections explain the path analysis findings in relation to the mediation effect hypotheses.

Hypothesis results—indirect effects.

Indicates significant paths: ** p < 0.01, *** p < 0.001.

Job burnout mediates the relationship between stress and employee performance.

The bootstrapping results revealed that the indirect effect of stress on employee performance through job burnout was negative and significant at the 0.001 level (β = −0.062, p < 0.001), the 95% confidence interval (CI) using a 5000 bootstrap sample did not include 0, and the CIs were −0.058 and −0.019. The results indicate that job burnout partially mediated the association between stress and employee performance. Thus, H10a was supported.

Job burnout mediates the relationship between depression and employee performance.

The bootstrapping results revealed that the indirect effect of depression on employee performance through job burnout was negative and significant at the 0.01 level (β = −0.072, p < 0.01, CI = 95%, CI-LL = −0.077, CI-UL = −0.031). The results indicate that job burnout partially mediated the association between depression and employee performance. Thus, H10b was supported.

Job burnout mediates the relationship between anxiety and employee performance.

The bootstrapping results revealed that the indirect effect of anxiety on employee performance through job burnout was negative and statistically significant at the 0.001 level (β = −0.054, p < 0.001, CI = 95%, CI-LL = −0.059, CI-UL = −0.020). The results indicate that job burnout partially mediated the association between depression and employee performance. Thus, H10c was supported.

Mental health problems mediate the relationship between stress and employee performance.

The bootstrapping results showed the indirect effect of stress on employee performance through mental health problems was negative and significant at the 0.01 level (β = −0.051, p < 0.01, CI = 95%, CI-LL = −0.068, CI-UL = −0.027). Mental health problems partially mediated the association between stress and employee performance. Hence, H11a was supported.

Mental health problems mediate the relationship between depression and employee performance.

Table 5 shows the bootstrapping results, which indicate that the indirect effect of depression on employee performance through mental health problems was negative and significant at the 0.01 level; β = −0.051, p < 0.01, CI = 95%, CI-LL = −0.058, and CI-UL = −0.022. Mental health problems partially mediated the relationship between depression and employee performance. Thus, H11b was supported.

Mental health problems mediate the relationship between anxiety and employee performance.

Table 5 and Figure 2 shows the bootstrapping results, which indicate that the indirect effect of anxiety on employee performance through mental health problems was negative and statistically significant at the 0.01 level; β = −0.054, p < 0.01, CI = 95%, CI-LL = −0.071, and CI-UL = −0.021. These results, along with the significant effect of anxiety on employee performance (from Table 4 ), suggest that mental health problems partially mediated the relationship between anxiety and employee performance. As a result, H11c was accepted and supported.

Structural Model.

The value of R 2 represents the proportion of variance in the dependent variable explained by its predictors (see Table 6 ). For mental health problems, job burnout, and employee performance, the three dependent variables in the research model, the R 2 values were 0.619, 0.715, and 0.508, respectively. This shows that the five predictors (i.e., stress, depression, anxiety, job burnout, and mental health problems) accounted for 50.8% of the variance in employee performance. Overall, the R 2 values were found to meet the cut-off value of 0.30 recommended by Sarfraz [ 11 ].

R 2 Values.

5. Discussion

The COVID-19 emergency has heavily affected the psychological condition of healthcare workers. Pakistan’s healthcare industry is at high risk of experiencing COVID-19 vulnerabilities [ 41 ]. COVID-19 has altered employees’ lives by causing them to experience unprecedented health consequences arising from their work. Healthcare employees are an organization’s most critical asset, able to enhance workplace productivity by delivering superior performance. To explain the effect of psychological problems on employee job performance, this discussion offers insights into the current study findings in light of previous literature. As such, the study seeks to provide an understanding of the effect of the COVID-19 emergency on front-line workers in Pakistan.

During the COVID-19 pandemic, organizations have reported negative consequences for healthcare performance. Kumar et al. [ 35 ] showed that COVID-19 induced stress in healthcare workers, inevitably undermining their job performance. Our study findings support previous studies that have demonstrated how COVID-19 stress significantly impacted healthcare performance [ 75 ]. These findings lead us to accept H1. Similarly, during the initial declaration of the COVID-19 pandemic, healthcare employees also reporting feeling depressive symptoms. Hennekam et al. [ 76 ] showed that increasing depression arising from the experience of COVID-19 caused healthcare workers to exhibit poor work performance. Previous research also indicated that COVID-19 intensified anxiety with negative effects on healthcare performance [ 77 ]. These studies support our findings, leading us to accept H2 and H3.

Several studies have illuminated the symptomatology of stress, anxiety, and depression during the pandemic. These psychological issues have deteriorated employees’ mental health and performance. Greenberg et al. [ 10 ] state that COVID-19-related psychological problems (e.g., stress, depression, and anxiety) have exerted unbearable pressure on workers’ mental health, influencing their work performance. A further consequence of the pandemic, and healthcare workers’ increased vulnerability to its effects, has been the growing incidence of burnout affecting healthcare performance. Poor health negatively affects employee performance. In this regard, Dyrbye et al. [ 78 ] found that many healthcare employees decided to quit their jobs due to increasing psychological problems during the pandemic. In the healthcare industry, these psychological problems (i.e., depression, stress, and anxiety) have drastically impeded workers’ performance, and increased the rate of job burnout [ 79 ]. Our study analysis, while supporting previous literature, has highlighted the mediating role of mental health and job burnout on employee performance. Overall, the study findings support the acceptance of all the proposed hypotheses and their assumptions.

This study was limited to healthcare employees working in three major cities of Pakistan, and future research could involve a comparative analysis of female and male healthcare workers’ job performance in public and private healthcare centers. The study employed cross-sectional data, but future research could consider longitudinal data. This study is based on a quantitative approach; in future research, mixed or qualitative approaches could be adopted.

6. Conclusions

In recent years, the negative impact of COVID-19 has altered the professional lives of healthcare workers. The clinical features of COVID-19, including its infectivity, have placed a significant burden on employees’ mental health and performance. It has made front-line workers vulnerable, resulting in an increased level of psychological problems.

The current study explored the extreme toll COVID-19 has taken on the healthcare industry of Pakistan. Significantly, the study results confirm the prevalence of stress, depression, and anxiety in front-line workers. The findings show that increasing COVID-19 stress and depression have caused employees to lose interest in their work tasks, thus decreasing their performance. Similarly, the results showed that COVID-19 anxiety significantly influenced employee performance. In addition, this review of the impact of the COVID-19 pandemic demonstrates that psychological issues (e.g., stress, depression, and anxiety) have influenced employees’ mental health and performance. Furthermore, the study has confirmed a significant mediating role of job burnout in influencing employee performance.

Undoubtedly, the pandemic has made today’s employees vulnerable, and negatively impacted their workplace functioning. The literature shows that the impact of the pandemic drew the attention of researchers to individuals’ mental well-being. The results of the current study suggest that managers should respond to the adversity caused by the pandemic by ensuring superior job performance through improved mental health support. In conclusion, health professionals, practitioners, and policymakers should take steps to improve employees’ mental well-being and job performance.

Funding Statement

We acknowledge the financial support from the National Natural Science Foundation of China (Grant No: 71974102) and from the Philosophy; Social Science Fund of Tianjin City, China (Grant No: TJYJ20-012).

Author Contributions

Conceptualization, M.S. and L.I.; methodology, J.S.; software, M.S.; validation, A.M. and K.I.; formal analysis, M.S.; investigation, J.S.; resources, L.I. and K.I.; data curation, K.I.; writing—original draft preparation, M.S.; writing—review and editing, L.I. and M.S.; supervision, M.S.; project administration, L.I. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

Ethical review and approval were not required for the study on human participants in accordance with the local legislation and institutional requirements.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Conflicts of interest.

The authors declare no conflict of interest.

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