Overwork  Overwork is the expression used to define the cause of working too hard, too much, or too long. It can be also related to the act of working beyond one's strength or capacity, causing physical and/or mental distress in the process. Compulsory, mandatory, or forced overtime is usually defined as hours worked in excess of forty hours per week “that the employer makes compulsory with the threat of job loss or the threat of other reprisals such as demotion or assignment to unattractive tasks or work shifts." Voluntary overtime is work which the employer may ask the worker to do but which the worker is not required to work unless he agrees at the time to do so. Compulsory overwork is that where the individual has no choice but to work more than their capacity. In other words, compulsory overwork is the lack of control that workers exercise over the boundary between work time and private time. Forced overtime, heavy workloads, and frenetic work paces give rise to debilitating repetitive stress injuries, on-the-job accidents, over-exposure to toxic substances, and other dangerous work conditions. Nevertheless, some studies are beginning to show the costs of compulsory overwork. Reg Williams and Patricia Strasser, professors of nursing at the University of Michigan, estimated in the journal of the American Association of Occupational Health Nurses that the total cost of depression at work was as high as $44 billion. They pointed out that healthcare workers have focused much attention on the workplace risk factors for heart disease, cancer, obesity, and other illnesses, but little emphasis on the risk factors for depression, stress, negative changes in personal life, and difficulties in interpersonal relationships. Annual average work hours for Americans have risen from 1,679 in 1973 to 1,878 in 2000. This represents an increase of 199 hours—or approximately five additional weeks of work per year. This total work effort represents an average of nine weeks more than European workers. Therefore, it is within this logic of working more to gain more that workers are living a very hectic and tiring time to provide their families. The result in reality is an excess that does not often translate into high salaries. There are categories of workers where the work and the environments are unhealthy turning the most vulnerable workers and sentenced to fatigue and even living less. The emotional impacts of overwork can vary, depending on the amount of work, levels of pressure and competition in the work space. Employees who worry about not getting work finished and keeping up a fast pace can feel like they are drowning in their workload, a feeling that manifests itself in chronic stress and anxiety, which can hebetate the spirit and create tension in personal and work relationships.