Jerrin MathewRN, BSN
Writing/Seeking care

When work becomes your coping mechanism

Sometimes busy is busy. Sometimes busy is a way of not being alone with something.

Work can be genuinely meaningful. It can also be a way of not being alone with something, and the two are difficult to tell apart from outside — or, frequently, from inside.

For some professionals, staying occupied prevents them from noticing what they feel. If the day never has a gap in it, there is no interval in which anything difficult has to be confronted.

The diagnostic question is about absence

The useful test is not how much someone works. It is what happens when the work stops.

Consider a genuinely empty Sunday. No deadline, nothing owed to anyone, nothing that needs doing.

Does something arrive? Anxiety, restlessness, low mood, loneliness, a sense of pointlessness, an urge to find something to fix?

If removing the work makes distress appear immediately, the work was doing something other than producing output.

This is also why holidays are so revealing, and why some people find them genuinely unpleasant in a way they cannot explain to anyone.

What it looks like

The behaviours are indistinguishable from conscientiousness, which is the entire difficulty.

The accomplishments produced are real. The promotions are deserved. The underlying arrangement can still be unhealthy, and the external rewards make it substantially harder to examine.

What tends to be underneath

Work is unusually well suited to this role, which is why it is chosen so often. It provides structure, immediate feedback, a sense of competence, social contact without intimacy, and complete social approval.

What it is frequently managing includes grief that was never properly given time, a marriage that has quietly deteriorated, depression that has never been named, anxiety that only quiets when the mind is fully occupied, or a sense of worth that has become entirely contingent on output.

That last one is the most common in high performers and the most self-concealing, because the strategy works. Achievement does produce a sense of worth. It simply expires quickly and has to be renewed, which is why the volume has to keep increasing.

Why it eventually stops working

Avoidance strategies tend to require escalation. The amount of work needed to stay ahead of the feeling grows, and the capacity to produce it does not.

Sleep goes first, then health, then relationships — and the deterioration of relationships removes the main alternative source of the thing the work was substituting for. The strategy erodes its own alternatives.

Work is not the enemy

The conclusion is not that you should work less, and advice framed that way tends to be dismissed for good reason. Many people in this pattern genuinely love their work and would be miserable without it.

The question is not how many hours. It is whether work has become load-bearing for emotional stability — and if it has, what would need to be addressed for it to stop being the only thing holding the structure up.

Someone who works long hours because the work is absorbing and meaningful is in a different situation from someone who works long hours because stopping is intolerable. Only the second one needs anything.

Medical disclaimerThis article is educational and is not medical advice. High work involvement is not automatically unhealthy, and this article cannot determine whether any individual's behaviour reflects a psychiatric condition. Persistent distress should be discussed with a qualified professional.
References
  1. National Institute of Mental Health. Health topics and publications. https://www.nimh.nih.gov/health/publications
  2. American Psychological Association. Work in America 2025. https://www.apa.org/pubs/reports/work-in-america/2025
  3. National Institute of Mental Health. Depression. https://www.nimh.nih.gov/health/topics/depression
  4. National Institute of Mental Health. Anxiety disorders. https://www.nimh.nih.gov/health/topics/anxiety-disorders

Published August 2026 · Reviewed for accuracy against the sources listed above.

About the author

Jerrin Mathew, RN, BSN

Registered nurse with a clinical background spanning emergency medical services, long-term acute care, cardiac telemetry, and neurocritical care at a Level I trauma center. Currently completing graduate education in psychiatric-mental health nursing, with an expected graduation in 2027.

Writing here focuses on the intersection of psychiatric illness and demanding professional life — what gets missed, what gets mislabelled, and what is worth taking to a clinician.

More about my background →