By RODOLFO FURLAN DAMIANO*
We are witnessing a silent revolution in the way Brazilian society views mental health
1.
In 2024, Brazil recorded an alarming number of 472.328 absences due to work-related mental disorders, representing a significant increase of 68% compared to the previous year. This data is not just a cold statistic, but the reflection of a real crisis faced daily by thousands of Brazilian workers.
As a psychiatrist, I observe daily in my consultations the profound impact that the work environment has on people's mental health. However, this increase in absences has two interpretations: on the one hand, it indicates the worsening of working conditions; on the other, it reveals an important advance in social awareness about the importance of mental health, with people more willing to recognize their limits and seek professional help.
The increase in absences due to psychological reasons is not restricted to Brazil. Absences due to mental disorders increased by 134% in the last two years, rising from 201 cases in 2022 to 472 in 2024. Among the cases related to mental health, absences due to reactions to stress (28,6%), anxiety (27,4%), depressive episodes (25,1%) and recurrent depression (8,46%) stand out.
In Latin America, the situation is equally worrying, with countries such as Argentina and Chile recording significant increases in cases of absence due to mental disorders in the last three years. According to the World Health Organization (WHO) and the International Labour Organization (ILO), an estimated 12 billion working days are lost annually due to depression and anxiety, costing the global economy almost a trillion dollars.
This significant increase can be understood from two complementary perspectives. The first refers to the real worsening of working conditions, especially after the Covid-19 pandemic. Many workers began to face financial insecurity, fear of unemployment and overload due to the forced adaptation to remote work without adequate support. The boundary between professional and personal life has become increasingly blurred, leading to what experts call “permanent availability” – the feeling of always being on call, always connected.
Today, we live in a hyperconnected world, where digital technologies that were supposed to make our lives easier have ended up creating an infinite extension of the work environment. WhatsApp messages from bosses and colleagues arrive at any time of the day or night, emails are checked during weekends and holidays, turning our homes into real offices with no closing time. This permanent connectivity has created the implicit expectation of constant availability, eliminating the spaces for rest and recovery that are so essential for our mental health.
This reality has particularly affected women, who often combine professional and domestic responsibilities. It is no coincidence that they account for 64% of cases of absence due to mental disorders in Brazil. The average age of workers on leave is 41 years, precisely the period in which family and professional demands tend to be most intense.
2.
The second perspective points to a positive cultural shift: we are witnessing a silent revolution in the way Brazilian society views mental health. What was once taboo is now a topic of open conversation. Conditions such as anxiety, depression and burnout have come out of the shadows, allowing people to recognize their symptoms and seek help without the stigma that once accompanied these diagnoses.
From a medical perspective, chronic stress at work goes far beyond simple tiredness or irritability. Studies conducted by the National Institute of Mental Health in the United States show that prolonged exposure to stressful work environments literally alters brain biochemistry, affecting areas responsible for emotional regulation and decision-making.
When a person is constantly under pressure, their body maintains high levels of cortisol, the so-called “stress hormone,” which in excess can damage brain structures such as the hippocampus and the prefrontal cortex. This biological change reduces our emotional resilience and ability to face new challenges, creating a harmful vicious cycle.
In my clinical practice, I have observed a particularly worrying phenomenon among younger professionals. The new generations that are now entering the job market seem to have lower tolerance thresholds for work-related stress, becoming ill more quickly when exposed to pressures that previous generations endured for longer periods. This does not mean, as some erroneously point out, that they are “more fragile” or “less committed” – it is a generation that grew up in different social and educational contexts, with less exposure to frustrations and more aware of their rights and personal limits.
The Occupational Health and Safety Observatory, linked to the Ministry of Labor, identified that health, education and public safety professionals have the highest rates of absence due to mental disorders in Brazil. In particular, nurses and nursing technicians lead the ranking, followed by basic education teachers and hospital attendants. call center.
The characteristics of these environments include high emotional demands, low autonomy and often insufficient resources to perform the work properly. As noted by professionals in the field, “lawyers are trained to ‘think’ like lawyers and not to ‘feel’. This leads to a distancing from their own emotions and values, generating anxiety, dissatisfaction and emotional imbalance”. These environments are conducive to the development of conditions such as Burnout Syndrome – professional exhaustion characterized by exhaustion, cynicism and reduced effectiveness.
3.
In my clinical practice, I have found that effective treatment of work-related mental disorders requires a multidisciplinary approach. The first and most important step is a specialized assessment, performed by qualified mental health professionals, such as psychologists and/or psychiatrists. Only an accurate diagnosis can correctly guide the therapeutic plan, determining whether or not medication, psychotherapy and even temporary leave from the workplace are necessary.
When a mental disorder is identified, it is essential to establish individualized treatment. Psychiatric medication may be necessary in moderate to severe cases, but it should rarely be the only intervention. Psychotherapy, especially cognitive-behavioral therapy, has shown excellent results in managing symptoms related to work-related stress, helping patients modify dysfunctional thought patterns and develop more effective coping strategies.
At the same time, psychosocial interventions play a crucial role in recovery and prevention. Implementing lifestyle changes – such as regular physical activity, a balanced diet, sleep hygiene and relaxation techniques – contribute significantly to improving the condition. Mindfulness and meditation techniques have proven to be valuable tools, helping patients develop greater emotional resilience and self-regulation skills.
It is also essential to promote changes in the work environment itself, with the adoption of healthier organizational practices: regular breaks, clear definition of priorities, setting limits on working hours and availability outside of working hours. Gradual exposure to work-related stressors, under professional guidance, allows for controlled resensitization and the development of adaptive resources.
Returning to work after a leave of absence represents another critical moment that requires specialized attention. This process must be gradual and carefully monitored, ideally with adaptations in the work environment to avoid relapses. Here, the partnership between the mental health professional, the occupational physician and the company's managers is essential to ensure successful reintegration. Unfortunately, many organizations still lack adequate protocols for this delicate moment, which often results in new absences and chronicity of staff.
Finally, we cannot forget the role of primary prevention. Mental health education programs in the corporate environment, early identification of risk factors, preventive psychological support and development of stress management skills are essential initiatives to reduce the incidence of these disorders and promote healthier and more productive work environments.
Addressing this problem requires a coordinated response from different sectors of society. Companies need to go beyond talking about well-being and implement concrete changes in their organizational cultures, such as establishing clear boundaries for work outside of working hours, training leaders to identify early signs of psychological distress, and creating safe channels for employees to express their difficulties without fear of retaliation.
The government also has a fundamental role to play, strengthening the monitoring of working conditions and expanding access to mental health services in the Unified Health System. A new rule that will come into effect in 2025, through the update of Regulatory Standard No. 1 (NR-1) promoted by the Ministry of Labor and Employment, will require companies to assess risks to the mental health of their employees. This regulation provides for the inclusion of the assessment of psychosocial risks in the Occupational Health and Safety management process, representing an important step forward in recognizing the causal link between certain working conditions and mental illness.
*Rodolfo Furlan Damiano is a doctor, post-PhD student in psychiatry at USP.
Author, among other books, of Understanding Suicide (Manole Publisher). [https://amzn.to/4iZ35Mr]
References
Brazil Agency. Mental health: absences double in ten years and reach 440 thousand. March 2025.
Brazil 61. Absence from work due to mental disorders exceeded 400 thousand in 2024. February 2025.
International Labor Organization. SmartLab Decent Work Series 2025: only 46% of Brazilian municipalities have policies or programs to assist people with mental disorders 2025.
Ministry of Labor and Employment. Workers' mental health is the focus of Canpat 2023. May 2023.
Occupational Health and Safety Observatory. Statistics on work absences in Brazil. 2024
CNJ Portal. Data from the Occupational Health and Safety Observatory is worrying. May 2023.
Earth. Mental health at work worsens in 2023: absences increased by almost 40%. January 2024.
Regional Labor Court 13th Region – Paraíba. Mental disorders are the third biggest cause of absence from work in Brazil. January 2023.
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