Presenteeism at work: what is it, why it happens, and how to cope

Workplace Wellness

Sep 17

Written By Calm Editorial Team

Clinically reviewed by Dr. Chris Mosunic, PhD, RD, MBA

Still showing up at work when you’re burned out or sick? That’s presenteeism. Here’s how it can affect your health (and productivity) and 10 tips to help you care for yourself.

Do you answer emails when you should be out sick, join back-to-back meetings when you barely slept, or agree to stay late even though you have plans? You might tell yourself it’s just a rough patch, and you’ll push through and catch up on rest later. But later keeps getting farther and farther away. This is presenteeism.

Presenteeism in the workplace isn’t always a dramatic display. In fact, it may look like you’re doing fine. You’re showing up. You’re checking boxes. But, under the surface, you might be depleted in every sense of the word — physically, mentally, emotionally, or all of the above. And because you’re still “functioning,” the exhaustion goes unseen, unacknowledged, and untreated.

This is what makes presenteeism so tricky. It’s normalized in many workplaces, even rewarded. But over time, it can erode your health, your productivity, and your sense of work-life balance. Here’s why presenteeism is so common, and what you can do to care for yourself without guilt.

What is presenteeism?

Presenteeism is the act of working, even though you’re not well enough to. Many times it happens because of physical illness, chronic pain, anxiety, depression, burnout, or exhaustion. Unlike absenteeism, where you’re visibly not there, presenteeism is quieter and harder to spot. You may be physically at your desk, on a Zoom call, or in a meeting, but you’re not really functioning at full capacity.

It’s often misunderstood or overlooked because, from the outside, everything can look “normal.” You’re still getting things done and still showing up. But the cost is internal. You might be struggling to concentrate, making more mistakes, or pushing through with the help of caffeine, adrenaline, or sheer willpower.

Presenteeism can happen in any role, industry, or career stage. It’s not just about being a “workaholic.” It’s often about pressure—whether it’s internal, cultural, or financial—and it thrives in environments where rest and recovery aren’t seen as essential.

Presenteeism isn’t sustainable, and if it’s not addressed, it can lead to mental health issues and other health-related issues, too.

5 causes of presenteeism

Presenteeism doesn’t happen in a vacuum. It’s usually a response to pressure — some of it cultural, some of it personal, and some baked right into the systems we work within. These are some of the most common reasons people keep working even when they’re not well:

1. Workplace pressure and culture: In some workplaces, being “on” is treated like a badge of honor. People who push through illness or burnout might be praised as dedicated or hardworking, while those who take a sick day feel guilty or judged. Over time, this culture discourages rest and encourages presenteeism.

2. Fear of job loss or missed opportunities: When your role feels precarious, or your industry is competitive, it can feel risky to step away. Some people work through illness because they’re worried about job security, and others because they don’t want to miss out on a promotion, a client, or an important project.

3. Financial pressure: Not everyone has access to paid sick leave or supportive policies. If missing work means missing a paycheck, presenteeism can feel less like a choice and more like survival.

4. Internalized expectations: Some of the pressure doesn’t come from your boss or your workplace — it comes from inside. Maybe you’ve always been the dependable one, or you grew up learning that rest was indulgent. These beliefs can make it really hard to stop and take care of yourself, even when you know you need to.

5. Stigma around mental health: It’s one thing to call in sick with the flu. It’s another to say you need the day off because you’re overwhelmed. When mental health struggles aren’t treated with the same weight as physical ones, people inadvertently learn to push through quietly.

What are the effects of presenteeism on your mental and physical health?

Presenteeism can feel like a necessary sacrifice in the moment — just one more day, just one more meeting, just push through. But over time, the cost adds up. Working while you’re unwell doesn’t just delay healing, but it can make things worse. And because it often goes unnoticed, it can quietly become chronic.

When you ignore what your body or mind is asking for, like rest, care, and space, you’re more likely to experience:

Prolonged illness, because your immune system can’t catch up
Increased stress and anxiety
More frequent headaches, stomach issues, or flare-ups of chronic conditions
Difficulty concentrating or making decisions
Emotional exhaustion, cynicism, or disconnection from your work and others

These symptoms can make work harder, but they can make recovery harder too. Instead of taking a day or two off to rest, you might find yourself running on empty for weeks or even months.

Does presenteeism affect productivity in the workplace?

Yes, it does, and more than most people realize. Studies have shown that presenteeism can reduce productivity even more than absenteeism. Why? People who are working while unwell are less focused, more likely to make mistakes, and often need more time to complete basic tasks. It’s like trying to run a marathon on a sprained ankle. You may be moving forward, but it is not efficient, safe, or sustainable.

At a broader level, presenteeism can quietly chip away at team performance. Communication may break down, mistakes slip through, and burnout likely spreads. And because it’s invisible, managers and coworkers may not even realize why things are falling through the cracks.

In short, presenteeism doesn’t benefit anyone. And if it does impact you, it doesn’t mean you’re not capable or committed; it means the system needs to be better at recognizing and supporting human limits.

How to reduce presenteeism: 10 ways to care for yourself

Reducing presenteeism doesn’t mean walking away from responsibility. It means recognizing when you’re not okay and giving yourself permission to respond to that reality with care, instead of pressure. These strategies can help you create more space for rest, recovery, and boundaries without feeling guilty about it.

1. Check in with your body and mind regularly

You don’t need to hit a crisis point to ask, “How am I doing, really?” Create micro check-ins throughout your day before meetings, after lunch, or during your commute. Notice if you’re clenching your jaw, skipping meals, or struggling to focus. These subtle signs are often early clues that your body or brain is being overworked and you need a break.

Try this: You could also try the STOP method by stopping, taking a breath, observing how you’re feeling, and proceeding intentionally. This only takes a minute, and it can really shift the rest of your day.

2. Use your sick days (even for mental health)

If you have access to paid sick leave, use it. Don’t wait until you’re completely nonfunctional to take a day. Needing rest or mental recovery is a normal part of the human experience, so you shouldn’t feel bad when it happens to you. Sick leave exists to support your overall wellbeing, not just to cover stomach bugs and fevers.

If you’ve been having anxiety attacks or can’t focus from sheer exhaustion, that counts. Give yourself the same care you’d offer a friend in your shoes.

3. Set clearer boundaries with your time

If your workday has no edge or if you set your own hours, presenteeism can become the default. To create more balance and rest, implement some structure. You could set a rule with yourself where you don’t answer emails after 7 pm or make a promise to yourself that you will always take at least a 30-minute lunch break, where you step away from your computer and reset.

Try this: Regularly block time off on your calendar as “focus time” or “work block,” even if it’s just to catch your breath or take a short stroll in your neighborhood.

💙 Remind yourself of the importance of setting Boundaries with help from this meditation led by Tamara Levitt.

4. Be honest with your manager

Honesty is the best policy. Talk to your manager about what you’re experiencing if you’re in a workplace that allows for psychological safety. This doesn’t mean you have to overshare. It just means letting them know that you’re not operating at 100% and are taking steps to care for yourself. As a result, they might be able to shift deadlines, reassign tasks, or offer more workplace flexibility.

Try this: You could say, “I’ve been feeling stretched thin lately and could use some space to reset so I can come back focused.”

5. Normalize mental health support

Whether you’re a leader in your company or a teammate, it’s important to model what it looks like to prioritize your wellbeing above all else.

You could mention your therapy appointment (if you’re comfortable with that) or share that you took a mental health day, because you were feeling overwhelmed. Little actions like this can make it easier for others to follow suit and slowly (and safely) shift the culture.

6. Prioritize sleep, nutrition, and hydration

Working through burnout or illness without decent sleep, regular meals, and enough water is like driving on a flat tire. Your brain literally can’t function without fuel — so fuel it.

To make sure you're giving yourself the tools to succeed, keep snacks and a water bottle at your desk. You can also set reminders to stretch or breathe if you tend to skip breaks.

💙 Learn how to fuel your body and mind properly during Dr. Michelle May’s series on Mindful Eating.

7. Identify your personal warning signs

Presenteeism looks different for everyone. For some people, it means losing their cool in meetings. For others, it means rereading the same email three times. Knowing your own early signals can help you catch the spiral before it deepens.

Try keeping a burnout log in your notes app or journal. This can help you track patterns so you know when you’re right on the edge and in need of a break.

8. Build a support system

Talk things out with a friend, co-worker, mentor, or therapist. This can interrupt the cycle of pushing through in silence and make you feel less alone. The goal of this isn’t to fix everything, but rather to have a sense of support so you aren’t flying solo.

9. Don’t wait for rock bottom to rest

You don’t need to prove how bad it’s gotten before you deserve time to heal. If you’re sick, you’re sick. If you’re burned out, you’re burned out.

Early and compassionate action is typically much more effective than recovery from collapse.

10. Reflect on what you’re working toward

If you’re not feeling right but don’t want to take a break, ask yourself what you’re afraid of missing. Is it recognition? Stability? Impact? Also, check in with yourself and ask if you could get there more easily if you were more rested or took some time away.

Most of the time, stepping back is what helps you show up stronger later.

Presenteeism FAQs

What are some common signs of presenteeism?

Presenteeism is often subtle and easy to miss. You could find yourself going through the motions, struggling to focus, or feeling emotionally checked out. Other common signs are working long hours without real output, avoiding taking breaks, and making more mistakes than usual.

Over time, you might also notice increased irritability, declining mental health, and a creeping sense that you’re stuck in survival mode.

How is presenteeism different from absenteeism?

While absenteeism is about not being physically present at work, presenteeism is the opposite. It’s being physically there, but you’re not fully functioning.

The danger with presenteeism is that it often flies under the radar, for both you and your employer. On the other hand, absenteeism is easier to track and respond to.

Why is presenteeism bad for mental health?

It can be bad for your mental health because it encourages a pattern of ignoring your needs, which can deepen struggles like anxiety, depression, and burnout.

Additionally, presenteeism reinforces the message that performance matters more than wellbeing, which can increase feelings of shame and isolation. Over time, this can then erode your self-worth and lead to emotional exhaustion.

How can companies reduce presenteeism?

Organizations can reduce presenteeism by building a culture where physical and mental health are respected and not stigmatized. This means encouraging employees to take time off when needed, offering flexible scheduling, and making mental health support accessible.

Regular check-ins, workload reviews, and psychological safety are also important. When employees feel supported and trusted, they’re more likely to speak up before things spiral.

Is working while sick always considered presenteeism?

Sometimes it is, and sometimes it’s not. If you feel well enough to handle light tasks or check a few emails without pushing your limits, then it’s not presenteeism. The big difference is capacity.

In general, if you’re forcing yourself to perform through pain, exhaustion, or mental distress, then this could be considered presenteeism.

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presenteeism

Calm Editorial Team