On July 20, 2024, what seemed like an ordinary evening for 26-year-old Anna Sebastian Perayil took a tragic turn. She had returned to her room at the paying guest facility in Pune much earlier than usual. Around 10 pm, she went down to collect the food she had ordered and was climbing to her room on the second floor when she collapsed on the staircase. Despite her roommates rushing her to the hospital, she was declared dead on arrival. Just a month before that, her parents were in Pune to attend her convocation when they found her unwell due to lack of sleep and food. She was taken to a hospital after she complained of chest pain and other difficulties, but the doctors told the family that her main problem was lack of sleep and issues caused by irregular food intake.
Anna was a chartered accountant employed at one of the ‘Big 4’ consultancy firms in the world — Ernst & Young. Her family pointed to an overwhelming workload as a key factor in her declining health, which eventually led to her untimely death. The tragic incident has kindled a discourse on how a culture of overwork can lead to a deterioration in health, even among young adults. TNM spoke to cardiologists, mental health experts and a labour rights activist to understand the impact of chronic stress on overall health and on the mind-body connection, which can unravel under extreme pressure.
While there is no clear definition of the terms ‘toxic work culture’ or ‘hustle culture’, it refers to any workplace situation that denies the basic labour or human rights of a worker. A toxic work environment is where negative behaviours, including manipulation, discrimination, yelling, are intrinsic to the work culture. Some of the common traits that are easily identifiable are micromanagement, lack of personal life-work boundary leading to exhaustion, distrust among workers, no tolerance for errors, and little to no support for personal growth.
Dr Deeyaneswar D, consultant interventional cardiologist at Prashanth Super Speciality Hospital in Chennai, points out that a culture of overwork in any profession can have adverse impact on our health. “Over time, this can lead to poor eating and sleeping habits, and an inability to maintain a healthy social or personal life. These factors contribute significantly to heart health problems,” he says.
Stating that stress can arise from physical factors, such as lack of sleep or acute illness, as well as emotional factors such as workplace tension, natural disasters, pandemics, or the death of a loved one, Dr Pradeep Haranahalli, cardiologist at Manipal Hospital in Bengaluru’s Whitefield, adds that all such situations can contribute to a deterioration in health.
Dr Pradeep says that one of the main challenges with stress-related heart conditions is that there are sometimes no obvious warning signs and anyone can be susceptible to them. However, he adds that a stressful lifestyle combined with underlying factors such as elevated cholesterol, blood pressure, and blood sugar, should be seen as potential causal factors of cardiovascular illness.
Dr Deeyaneswar lists certain early warning signs to look out for: excessive fatigue, reduced enjoyment of work, irritability, aggression, and increased sensitivity. “Seeking professional help or simply talking to others for a fresh perspective can be invaluable at this stage. Physically, signs like palpitations, unexplained chest discomfort, and daily dizziness should not be ignored,” he says.
His piece of advice to those who have to sit for extended periods at work: “Sitting for extended periods can disrupt circadian rhythms and elevate stress hormones. This makes it important to take breaks, declutter your mind, drink water, and move around, maybe take short strolls, to maintain balance.”
Dr Pradeep adds that physical activity plays a crucial role in managing stress and improving heart health. “Regular exercise helps lower blood pressure, cholesterol, and blood sugar levels. It can also act as a stress reliever by breaking up the monotony of daily work life and improving the quality of sleep.”
He emphasises the importance of prioritising sleep. Calling it a “natural, biological reset for the human body”, he explains that sleep regulates vital processes, especially in the brain and hormone systems, allowing us to recharge after a good night’s rest. “Without sufficient sleep, we experience fatigue, irritability, and behavioural problems, which can push people toward unhealthy coping mechanisms like smoking or drinking to manage stress or stay alert. Maintaining quality sleep, along with regular physical activity and balanced living, is essential for both heart and mental health.”
Dr Vidyulatha Ashok, consultant psychologist at Dr Mohan’s Diabetes Specialities Centre, also reiterates the need to prioritise sleep and adds that while there is a common belief that a few hours of sleep is enough or that we can compensate inadequate sleep at night with daytime naps, “in reality, at least six to seven hours of quality sleep is essential for both physical and mental well-being. Short naps during the day cannot replace the restorative power of a full night’s sleep, and disruptions to sleep patterns can upset the body’s circadian rhythm.”
Dr Pradeep explains how stress impacts our health. “Our body releases hormones such as cortisol as a natural response to stress. Prolonged high cortisol levels can raise blood cholesterol, triglycerides, blood sugar, and blood pressure. These are all well-known risk factors for heart disease. Additionally, chronic stress can promote the build-up of plaque in the blood vessels and alter blood clotting patterns, making the blood stickier and increasing the risk of heart attacks. Even minor stress can constrict blood vessels, reducing blood flow to the heart muscle, which can cause severe damage if the heart doesn’t receive enough oxygen,” he says.
Dr Vidyulatha adds that stress can seep into every aspect of life. “When the demands placed on a person outweigh the resources that they have to cope, stress becomes overwhelming, causing burnout, affecting cardiovascular health as well.”
Dr Satish Kumar CR, clinical psychologist at Manipal Hospital, points out that many people wake up with a sense of urgency, planning and organising their entire day before it even begins. “They feel like they’re constantly racing against time, trying to fit everything into a single day. This hustle culture has become the norm, where doing multiple things in a day is seen as productive. Mentally, the cognitive labour involved in managing schedules and completing tasks is draining. Even after work, people are mentally reviewing their day and planning for the next, which leaves little room for relaxation,” he says.
“Hustle culture encourages the belief that being busy equates with being productive. Many feel they must be highly successful, leading to longer working hours and tighter deadlines. Ironically, this results in lower productivity, as fatigue sets in when people overextend themselves. Even when individuals think they are being productive by working long hours, they often aren’t. Erratic eating habits are also common, with long work hours disrupting regular meals and contributing to physical strain,” says Dr Vidyulatha.
She adds that while people overwork for various reasons, including economic necessity, it is often because they simply don’t know how to relax. “Many people tie their self-worth to their professional success, which is part of the problem,” she says and adds that to cope with stress, it is essential to find a balance between work and personal life.
Managing Director and CEO of CIEL HR Services, Aditya Narayan Mishra, says that it is important to find our own sense of balance, recognising that it isn’t the same for everyone. He also adds that we should redefine what success means on an individual level.
The doctors say that even 30-45 minutes of exercise or engaging in meaningful personal activities daily can make a difference. Taking short breaks during work to relax, visualising calming spaces, or simply closing one’s eyes can also be helpful.
Dr Satish further suggests that companies foster healthy work environments by encouraging open dialogue, offering mental health support, and creating policies that allow employees to take breaks when they aren’t feeling well. “Introducing mental health days or recognising the importance of rest over constant productivity would help shift the culture towards a healthier balance,” he says.
Aditya also reiterates the importance of employee-friendly workplace policies, saying, “Progressive companies need to step up and take action. They should prioritise mental health by offering access to counsellors and fostering a culture of honesty and transparency. Employees should feel comfortable discussing their challenges with anyone in the organisation, without fear of judgement.”
Namrata Raju, a labour and public policy researcher, who has worked on an array of labour and policy considerations in South Asia and internationally, points out that these suggestions by medical professionals should actually be put on paper as a policy. “What we really need is for companies to establish clear policies, in writing, about how they will create a healthy work environment for their employees and ensure those policies are implemented. The first step is to ensure compliance at the organisational level,” she says.
Adding that while India has a long way to go in terms of India’s unorganised workforce, she says it’s crucial to have formal policies in place and ensure they are translated into meaningful actions.
Namrata also points out that some companies have introduced "burnout leave," which is telling in itself. “It implies that burnout is common enough to require formal leave. This reflects a work culture where pushing employees beyond healthy limits is normalized. Even when work-life balance is non-existent, it’s often dismissed as acceptable. If employees are consistently working overtime, leading to adverse health effects, this speaks to a toxic work environment. If so many people are burnt out, it’s not just a health issue—it’s a human rights issue, which requires a systemic change,” she says.
