Heightened anxiety

If you still have a job, you're lucky indeed. But sometimes it just doesn't feel that way.

Survivor guilt has been replaced by survivor stress.

Early in this recession it was not unusual for people to feel a twinge of remorse when co-workers were laid off and they weren't. But two years of layoffs, buyouts, furloughs and general downsizing have taken their toll on the employees left standing.

They're working longer hours, doing the work of two or three people and often getting less pay.

And with everyone from the chairman of the Federal Reserve on down saying it's going to be a while before companies hire again, there's little hope of relief anytime soon.

Is it any wonder more people are going to their doctors with stress-related problems like depression and anxiety?

During the past two years, Dr. Jeffrey Childers, a psychiatrist with WakeMed, said he has seen more people with job-related stress.

But Childers says stress is not always a bad thing.

"People who are stressed out can actually function very well," he said. "But when it impairs your ability to be productive, they should maybe start think about seeking help."

For many people, the stress has accumulated slowly, building over time as more responsibilities were added to their daily duties.

When Allison Kerwin first started working at Eye Care Associates in Cary, she handled the front desk. Now she takes care of some of the company's marketing operations, updates its Facebook page and also sees upward of 40 patients some days for contact lens fittings and other appointments.

"Within the last year, we've seen some changes in our office - people either calling out sick, being on vacation, finding other opportunities," she said. "We haven't always replaced everybody. ... I'm not going to lie. I have my moments."

Still, she said, the added responsibilities and stress are just part of being employed these days.

Her best stress-relieving tactic is to leave the office for lunch, something she said she does every day no matter what.

"If we're busy, I might take a shorter lunch, but I make sure I get outside and see some light," said Kerwin, 28. "We're open 9 to 7, so in the winter, sometimes it's dark by the time you get out."

Other stress-relievers: going to the gym and going out with friends for her favorite Mexican food.

But, "if it's the gym or Mexican food, I'm going to pick Mexican food."

Getting out of the office and having an outlet for stress is key to managing the current work environment, Childers said.

"It is 100 percent important," he said. "Everyone needs some way of coping with stress. Life is about coping. The best way is to laugh a lot, to exercise, to do things that are healthy, productive that can distract you from a certain stressor."

Managing stress

Companies and executives need to be particularly aware that workers are under stress from many sources these days, said Larry Zucchino, one of five principals of JDavis Architects in Raleigh.

His firm has gone through a 40 percent staff reduction in the past two years, though Zucchino said it hasn't had any layoffs in the past eight months.

To ensure that its employees are looking after their own health, JDavis has introduced a health and wellness program. A registered nurse from Evolve Wellness visits the office once a month to offer medical screenings and health tips. Employees can also e-mail the nurse with questions anytime they like. In addition, last year, the firm offered after-work yoga classes and may do so again this year.

Zucchino said the firm encourages open communication as a way to reduce anxiety. Managers are involved in more daily discussions about projects, and any big changes are discussed with employees so that everyone is aware of what's happening with the company.

"People who work in these environments want to know what's going on, good and bad," he said.

Billie Redmond, CEO of Coldwell Banker Commercial TradeMark Properties of Raleigh, said she knows her 70 employees are working more than ever to keep up with the workload.

"So you run the risk eventually of people just working at a level that's not sustainable," she said. "And yet, if business economics have not improved, there are few options about how to really modify that."

Redmond said she has to watch people to make sure they are not overreaching.

"We're in the middle of flu season," she said. "I've got a bad cold. Half the people in the company have a bad cold."

So she finds herself telling people, "You need to go home. You need to take a break. You need to have a rest."

Tension all around

Bosses, too, are under even more stress than they used to be - whether they run a major operation or a small shop.

Daniel Stratton is the manager of the Dairy Queen/Orange Julius store in Raleigh's Brier Creek Commons. He said he makes it a priority to work out and also to spend Sundays with his wife - the only day the two of them both have the whole day off.

"I don't run errands on Sunday, my wife doesn't run errands on Sunday," said Stratton, who lives in Fuquay-Varina. "We sit, we have a nice dinner together. It's the recharge we need."

Still, sometimes duties at work will force him to break that schedule.

"It gets difficult," Stratton said. "Right now I'm working 10 days straight. I have an employee who is flying home to Ohio. But I'm doing that for her so that when she comes back she feels like I do on a Monday."

Though it's hard for some people, Childers suggested doing something like Stratton's Sundays off. Look for areas of your schedule where you can be flexible and take some time for yourself. Most importantly, leave your iPhone or BlackBerry at home.

"You have to train yourself to do it," he said. "It's maybe not a natural thing for people to do. Leave it at home and do some things that are cathartic."

Staff writer David Ranii contributed to this report.