Phase 4―Severe/ Debilitating Cumulative Stress Reaction This phase is often considered “self-destructive” and tends to occur after 5 to 10 years of continued stress.
Conflict with team mates and supervisors
Lack of necessary training to perform a task (job)
Mobility fears (phobias) (commuting and travel schedules)
Repetitive thought patterns
Worrying about future events
Unrealistic, and perfectionist expectations
Failing to be assertive
Procrastination or failing to plan ahead
Demands―Employees indicate that they are not able to cope with demands of their job.
Control―Employees indicate that they are not able to have a say about the way they do their work
Support―Employees indicate that they receive adequate information and support from their colleagues and superiors.
Relationships―Employees indicate that they are subjected to unacceptable behaviors, Bullying and harassment at work.
Role―Employees indicate that they don’t understand their role and responsibility. There is role confusion.
Change―Employees complain that the organizations do not carry them along frequently when there is an organizational change.
Career Development―under-over promotion, career development opportunities
Organizational structure/climate―favoritism in a place of meritocracy
Work life balance―career and family (father working, mothe working, their problem taking care of the home front children)
Ridged thinking, lack of flexibility
All or nothing attitude
School and exams
Demands from boss
Demands from spouse
Extended family pressures
Organizational affiliations pressure
Accidents and disasters―land, air, water
Armed robbery attacks
Security force brutality―(police, army)
Task force brutality―(LASTMA, KAI, V.I.O Road safety)
Hoodlums activities―(Area boys, Opc, Agbero)
Protests and strikes
Relocation―wives/husband’s burden during relocation.   
Significant intervention from professionals.