DEALING WELL WITH STRESS

Tom BrownConsultant PsychiatristBiG May 2012

DEFINITIONS

Latin “stringere”- to draw tight Borrowed concepts from physics eg

external forces producing pressure and causing strain.

Other definitions emphasise an individuals response rather than the external pressures.

Results from a misfit between an individual and his/her environment

GOOD OR BAD?

Not always a bad thing

Very personal “One man’s stress may be great fun for him but it may kill another man” (Davies 1988)

COSTS OF STRESS

Illness-heart disease,stroke, psychiatric disorder(30-40% of absences)

Suicide Marital /relationship breakdown Alcohol misuse

SOURCES OF STRESS AT WORK(COOPER) Intrinsic to the job eg environment,

hours,shifts,travel,technology, overload Role in organisation-ambiguity, role

conflicts, responsibility Relationships at work-boss,

subordinates,colleagues

SOURCES OF STRESS II

Career development-training,job security,appraisal

Organisational structure-participation

External pressures eg home/personal life

BURNOUTFREUDENBERGER (1974), MASLACH ET AL (1996)

Emotional overextension and exhaustion

Negative, cynical and detached responses to others

Feelings of inefficiency and reducing personal accomplishment

RISK FACTORS

Job related(see earlier slide)eg time demands,lack of control,poor organisation

Personal vulnerability eg personality traits –avoidant,dependant, anti-social.

3 STAGE MODEL OF RESPONSE TO STRESS Signs of not coping with increased

stress

Burnout

Depression

“DYSCOPIA”

Over engagement Irritability/short temper Anxiety Feeling on edge Increased vigilance Physical symptoms –headache, chest

pain, gastro –intestinal symptoms, breathlessness,aches and pains

BURNOUT

Disengagement Blunted emotions-sad,withdrawn Decreased motivation, negative

thinking Detachment and social withdrawal

DEPRESSION

Pervasive low mood Loss of enjoyment Feeling life not worth living/suicidal

thoughts Self neglect

BARRIERS TO COPING

Inadequate knowledge of symptoms and availability of help and treatment

Unwillingness to take time off work Concerns re confidentiality , job

security, career progression Bad organisational policies eg the

collective bonus

PREVENTION

Target occupational and personal risk factors

Regular supervision Realistic workload,clarity re goals,

ongoing training Required rest periods and vacations Education about causes and treatments Work based access to exercise and

stress reduction programmes

SELF CARE STRATEGIES-BIOLOGICAL

Sleep Rest and relaxation Food Exercise Sex Not ignoring health problems Stay off/reduce hours when ill Substance use-be careful

SELF CARE STRATEGIES -PSYCHOLOGICAL Relaxation Use of guided imagery/meditation/prayer Supervision Peer groups Confidantes Humour Increase self awareness-where are my achilles

heels and how am I going to deal with them? Professional help –if necessary

SELF CARE STRATEGIES-SOCIAL

Look after your key relationships-family/friends

Personal comfort-home/car/bike/work space

Finances Religion-spiritual and social function Hobbies Vacations

WHEN TO SEEK HELP

Signs of “Dyscopia”-act before the burnout stage.

Listen to family/colleagues you trust-ask their opinion

Heed signs of decreasing occupational performance or deteriorating relationships

WHAT HELP?

If you act early you may not need professional help-a trusted friend or partner may help you make adjustments which improve matters

By the burnout stage you should probably be seeing your GP

WHAT KIND OF HELP?

Loads of excellent self help books/websites(see list at end)- a good place to start unless you are seriously depressed.

Approaches-cognitive behavioural therapy, interpersonal therapy, mindfulness .

Don’t be “anti drugs” –though for most this is not what the first approach should be-only for moderate to severe depression and some anxiety disorders

SUMMARY

Practice the self care strategies mentioned earlier

Take breaks/holidays Have people in whom you can confide

and trust(preferably at home and work) Don’t delay in seeking help

REFERENCES

Managing Workplace Stress. Susan Cartwright and Cary L Cooper, Sage Press 1997.

Stress:the Challenge to Christian Caring. Gauis Davies. Kingsway Publications 1988.

Manage Your Mind. Gillian Butler and Tony Hope. OUP 2007 Overcoming Depression. Paul Gilbert. Robinson 2000. (there is

a whole series of “Overcoming” books which are all excellent-same publisher ,different authors)

www.lltf.com –free website, Glasgow based author(Chris Williams)