Transcript Dealing Well with Stress

Tom Brown
Consultant Psychiatrist
BiG May 2012
DEALING WELL WITH STRESS
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
BURNOUT
FREUDENBERGER (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 Blunted emotions-sad,withdrawn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
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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)