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Will a heavy workload always cause a mental health issue?

I don't think that is by any means a given. It would much depend on how the individual was coping with life at the time. Heavy workloads can be well-managed but I think there needs to be an end in sight to them. I don't think they can be constant. People cope with them in very different ways and some people will look for help, but others don't recognise how heavy the workload has become and work more and more frantically to try and achieve what they feel they are meant to achieve. And some goals just are not achievable. I think it is recognising when it is becoming too much for you or someone else pointing out to you may be that it is. And it is knowing that you are able to say that to your line manager, that it is too heavy, that is a key to managing it well.

Maybe sometimes it is not necessarily the volume of the workload but it can be may... Is it possible that if people are given incompatible jobs to do?

Yeah, and some people are asked to do things that are beyond their capabilities or then they have a very high self-expectation or a false self-expectation of what can be achieved and when it is obvious that that is not being achieved, I think that is when the workload becomes too much for them.

At what point should an employee seriously consider going and talking to their manager to let them know that they may be struggling with the workload?

The first thing to do would be to have that awareness that things were becoming too much and that you were struggling with it and it was affecting how you live your life and how you do your job. Then you would need to ask to speak to whoever your line manager is. Maybe speak to a colleague first if that's easier, an easier route to it, but your line manager is the person to handle this. As an employer, you may become aware that your employee is not performing as usual, seems stressed with what they do, maybe hiding the symptoms of stress and anxiety. So, you would make it easier for that employee to come and talk to you about the workload being too much for them, and it would have to be done in a way that that employee was not made to feel worthless, that it was the workload that was causing the stress, and not them as a person.