Workplace bullying is a common cause of sickness absence. The victims have the same symptoms as those who suffer from posttraumatic stress. (Photo: Colourbox)

Bullying weakens the body

Harassment, social isolation or intimidating abuse in the workplace is not only psychologically destructive – it’s also stressful physically. Symptoms are similar to posttraumatic stress.

Bullying doesn’t just hurt inside – it also causes physical damage by slowing the body's ability to release energy from its depots.

So concludes a Danish new study, which has just been published in the Journal of Psychosomatic Research.

“Our study confirms our suspicion that bullying not only stresses the body mentally but also physically by inhibiting the body’s ability to kick-start the production of the stress hormone cortisol in the mornings, says Professor Åse Marie Hansen, of the Department of Public Health at the University of Copenhagen, who’s also affiliated with the Danish National Research Centre for The Working Environment (NFA).

Hansen and her colleagues believe this is a worrying discovery, given that the body needs cortisol to release energy in the form of fat and glucose into the bloodstream from the body’s depots.

Our study confirms our suspicion that bullying not only stresses the body mentally but also physically by inhibiting the body’s ability to kick-start the production of the stress hormone cortisol in the morning.

Åse Marie Hansen

“The consequence could be that the bullying victims don’t get their daily energy needs covered and thus eventually become unable to solve routine tasks,” says Annie Høgh, an associate professor at the Department of Psychology at Copenhagen University, who was also involved in the study.

Questionnaire combined with saliva samples

Their conclusion is based on a survey from 2006 in which 1010 employees in 55 Danish workplaces took part.

These people were asked individually if, in the past six months, they had experienced being bullied, had bullied others or if they had seen others engaging in bullying. To ensure that everyone agreed on what bullying is, the respondents were given the following definition:

"Bullying takes place when employees are exposed to negative and offensive actions, repeated over an extended period, which the employee has difficulty defending themselves against."

We don’t know yet exactly which long-term consequences the lower cortisol levels have on the body, but one thing is certain: bullied people have more sickness absence from work.

Annie Høgh

The respondents were asked to rate each question on a scale of 1 to 5 (1 = never, 2 = occasionally, 3 = monthly, 4 = weekly, 5 = daily). Those who said they had been bullied were asked to specify how long this had been going on for.

Three saliva samples were also taken from each of the employees. Two of the samples were taken in half-hour intervals in the morning, with the last one being taken in the evening. Based on the responses, the researchers could answer the following questions:

  1. Whether the person had been exposed to bullying
  2. If yes, what kind of bullying? (Social isolation, harassment, intimidating behaviour, demeaning of one’s work)
  3. The degree of psychological stress
  4. The degree of physiological stress, measured by the amount of cortisol in the saliva.


Harassment occurs when one or more colleagues create a bothersome or stressful situation around a particular person or group of persons with the deliberate purpose of causing trouble.

Intimidating behaviour takes place when employees violate a colleague’s personal boundaries and become too intrusive.

Social isolation occurs when a person is being kept outside the community, for instance by the use of unsympathetic body language

The survey showed that all forms of bullying not only induced physiological stress responses in the form of reduced levels of salivary cortisol, but also psychological stress reaction such as discouragement, depression, anxiety and a tendency to withdraw into oneself.

The body can’t keep up in the long run

The discovery doesn’t come as a big surprise because it sits well with the researchers’ hypothesis about what effects bullying has on the victim: it affects some very basic human needs.

  • The need to belong
  • The need to maintain one’s self-esteem
  • The need to feel that one has control over one’s own life
  • The need for a meaningful existence

According to the researchers’ theory, the lack of control over one’s own life plays a particularly important role in the development of stress because it prevents the person from being able to predict how a given situation will unfold.

“The theory is a good explanatory model for how the negative acts in the workplace can affect health: after a while, the bullying victim will automatically start expecting the worst-case scenario, which provokes stress, and that prevents the victim from performing his or her duties optimally,” says Høgh.

First study of its kind

The new study is the first one of its kind, as previous studies have focused on identifying either the physiological or the psychological effects of bullying.

“Our study is special in that we examined both factors at the same time,” says Hansen.

Previous studies have for instance revealed that bullying victims show signs of posttraumatic stress (PTS), while other studies indicate that people with PTS have lower concentrations of salivary cortisol.

"In our study we show that some bullying victims exhibit obvious signs of mental as well as a physical stress, which may indicate a posttraumatic stress reaction in which the person may experience nightmares and flashbacks, where they re-experience what they have been exposed to,” says Høgh.

“We also noticed a tendency to cower in fear, become irritable, have difficulty concentrating and problems sleeping, which in itself can cause problems at work.”

Bullying goes through several phases

The ratio between the two forms of stress depends on what kind of bullying the person has been exposed to: social isolation, for example causes the greatest degree of psychological stress, while harassment and intimidating acts primarily provoke physical stress.

One explanation for these differences could be that bullying usually goes through several stages and matures over time. It begins with social isolation, in which the victim is implicitly excluded from the community. Over time, however, the bullying becomes increasingly overt, aggressive and direct, with the victim for instance being exposed to people’s bursts of anger, humiliation and ridicule.

Many bullying victims go on long-term sick leave

Intitially, the bullying has an acute stress effect on the body, similar to the effects of hard physical training. This causes the body to increase the amount of cortisol for a period in order to counterbalance its increased energy needs.

But when the bullying persists and its character starts to change, the body ends up in a state of chronic stress exhaustion. It reacts by slamming on the brakes and starts to reduce its cortisol production.

”We don’t know yet exactly which long-term consequences the lower cortisol levels have on the body, but one thing is certain: bullied people have more sickness absence from work,” says Høgh.

“A series of studies have shown that bullying creates a greater risk of long-term illness than violence, threats and sexual harassment, and that many of the victims end up leaving the workplace.”


Read this article in Danish at

Translated by: Dann Vinther

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