August 2014

Stress at Work #3

Stress In The Work Place #3
Physical, Mental and Emotional Costs of Stress


Stress-Related Disorders

While the more dramatic problems, those that cost money, reduce profit and create legal problems often takes the spot light, the fact is that everyday stresses' often lead to loss of joy of living, lowered self-value, marital problems, physical, emotional, mental and spiritual illness. Illnesses which are directly caused by or are worsened by stress I refer to as Stress-Related Disorders (SRD's). These conditions, SRD's, are very important to us as they can reduce vitality, joy of life and even lead to illness and death. On a dollar basis, stress costs each of us in the form of increased health insurance, doctor bills, medications, sick days, loss of productivity, mistakes, errors and injuries. On the personal level, stress can make working a chore, it can take your family from you, lead to divorce, alcoholism, illness, emotional and mental disease and spiritual decay.

Stress-Related Disorders (SRD's) refer to a large number of medical and psychological conditions, symptoms and illnesses that are either triggered by stress, caused by stress or made worse by stress. In the early stages SRD's are often easily resolved, however, because the signs and symptoms of these conditions generally do not appear to be directly related to stress they are not always recognized or treated correctly. When the practitioner is unaware that stress underlies a specific condition (an SRD), he may only treat the symptoms and signs and entirely miss the cause. Without resolving the cause, treatment and resolution may be extremely difficult. Under these condition it is not unusual for medical treatment to be arduous and expensive.


SRD's Are Often Missed

One reason that SRD's are so often missed entirely or mistreated by the medical profession is that medical doctors are taught very little or even nothing at all about stress. Many medical doctors don't take stress seriously beyond telling their patient to get rid of the problems that cause their stress and giving a prescription for a medication to relieve their stress symptoms. Unfortunately this medication often reduces the patient's desire to find out the reasons or causes for their stress. This means that the problems which underlie it do not get solved and the process is allowed to progress over many years. Those few doctors that do take stress seriously, either do not have the time to treat it or rely on psychological counseling which is expensive and long term. Worst of all, if you or your employees belong to a managed health plan, stress reduction and psychological treatment is frequently not a provided benefit.


Which Illnesses Are SRD's?

It has been reported that 70% to 80% of all illnesses seen in medical offices are caused by stress or made worse by stress. High blood pressure, anxiety, panic, depression, ulcer and other gastrointestinal diseases, headaches are well known even to the medical profession. However, many illnesses which are SRD's are not considered by the medical profession to be related to stress. Illnesses and conditions such as recurrent colds and flu's, bronchitis, allergy, cancer, diabetes, asthma, skin disorders, multiple sclerosis, injuries, accidents, chronic fatigue syndrome, low back pain, neck pain, abdominal pain, recurrent vaginal infections, bladder infections, alcoholism, drug addiction, smoking along with many other illnesses and diseases which we do not have space to mention are often directly or indirectly related to stress.

There are also many stress-related problems affecting job performance which are not medical problems. For example, situations such as low self esteem, poor coordination, poor learning, making mistakes, inability to work with people, poor cooperation, poor work habits, sloppiness, loss of temper do not necessarily cause medical problems but may cause stress which ultimately affects the individual's ability to do their job. In the past when I have presented physicians the long list of conditions which are related to stress, I often get immediate arguments. I am frequently told that many of the conditions could not be stress-related. This disbelief on their part of these physicians further demonstrates how little many members of the medical profession still know about stress.

Stress, as I have defined it earlier, is the physical, psychological (mental and emotional) and spiritual response to the difference between the way we want our world to be and the way it actually is. Such a situation is created when we create an image, which we believe to be in our best interest, of the way we want the world to be. When the events of life turn out as we want them to turn out then we feel good, happy and positive. When, on the other hand, we don't get what we want we feel disappointed, reduced and diminished. When these feelings of loss are interpreted by the mind as a threat (to what we want, who we are, or to our perceived well-being) they may invoke the natural protective mechanisms of the body, the Fight or Flight Mechanism which is also known as the Stress Mechanism.

This occurs whether these feelings are directed internally or externally. Therefore, it makes no difference whether we blame our self or see ourselves as the problem or we blame our job, boss, manager or a fellow employee. It should be clear that it is never the event or "stressor" that is the problem but rather what we believe about it. This should make it clearer as to why several people can be involved in the same event yet not all react to it in the exact same way.


Chronic Stress

When stressful situations occur only once in a while and they are resolved, no significant problem may be created. But if there is a string of events or a particular situation or group of situations recur over and over again and is more often then not left unresolved and if the conflict is important enough to the inner self Chronic Stress may be created. Often most people think of stress as occurring only when important issues are involved or left unresolved. This is not entirely true, for stress can occur even when relatively minor issues are involved. All that is necessary is that they in some way disagree with the picture we hold of our self. If such a conflict is left unresolved for months or years and this ongoing conflict is left to act on us, significant physical, emotional, psychological or spiritual problems can arise. While stress itself is normal and a natural part of life, chronic stress is not. Chronic stress is the lowest level of a series of unhealthy conditions that can ultimately lead to illness, disease and even death.

Since chronic stress relates to our perception of our wants and needs then the greater difference between picture we hold of our wants and needs and the realities of life the more significant the reaction. At some point recurrent chronic stress will create a feeling (conscious or unconscious) of Dis-Stress, this is the first level of meaningful distortion of the threat to the Self. This raises the level of the stress reaction. The physical body responds with physical, mental, emotional and spiritual symptoms: anxiety, confusion, feelings of hostility, alienation, loneliness, aggression, headache, indigestion, abdominal pains, chest pain, the blood pressure may go up "just a little," there may be weight gain or lose. The individual may begin taking over the counter medications Tums, Maalox, Excedrin, laxatives, Pepto Bismol, etc.

These symptoms are what the physician usually considered normal aches and pains of life and may not be directly related to stress or any specific causes. If the individual is involved in a traumatic situation of some kind, the physician would immediately tell him he was suffering from a stress reaction. However, when this reaction occurs in response to things not going the way the individual wants them to go or when he is not able to get something he really desires the resulting symptoms may appear totally unrelated to these events and he may never even think of telling the physician about these events or his feelings.

If the symptoms are caused by general unhappiness, marriage problems, life style conflicts, children, mortgage or even inability to fulfill his own image of being a provider, the individual may find his true desires unacceptable. In order to survive the inner self may feel forced to repress these feelings and desires deep into the subconscious. The result of this is often a nonspecific stress which may later be converted to specific stress which appears directly related to his job.

As time passes conflict may build, if it is not resolved in a healthy way, it eventually becomes a festering sore, unseen but quite real. Since the unconscious mind wants resolution it brings the specific conflict up again and again, however, if the conscious mind is unable or unwilling to make the appropriate changes, solve problems or take risks, the knowledge and awareness of the conflict is pushed down again and again. The body responds inappropriately and the process advances to the next level Dis-Ease.


Dis-Ease, The Earliest Stage of the Disease Process

In the Dis-Ease stage the symptoms are somewhat more defined and the individual sees his medical doctor or chiropractor more frequently. His complaints are still relatively generalized in nature and similar to those of the Dis-Stress Stage, however, they are now more frequent, more defined, more severe and more of a problem. Time may be lost from work, depression increases, anxiety worsens, the individual may now be told that his stomach pains are "probably due to an ulcer" but none is found when diagnostic testing is done; his blood pressure may be "somewhat higher"; he may be having episodes of upper or lower respiratory infection, skin rashes, diarrhea, constipation, allergies, his headaches are now "Migraine-like"; he may be gaining or losing weight and he may experience episodic or persistent fatigue. The physician who is unaware that stress is the cause will likely feel that more tests are indicated and x-rays, blood tests and other diagnostic tests are taken often again and again. More potent medications may be prescribed. He may now need medications to relieve his anxiety and tension as well as medications for recurrent infections, stomach pain, headaches, and other problems. He may need medications to "calm down" so that he can get to sleep. He may drink coffee continuously to keep him awake, and if he smokes, he is now smoking more than ever. He may now be drinking two (or more) martinis with lunch, and may require a few "quick ones" after work each night "to let down" or "relax him." He may be losing his interest in sex or cheating on his wife, he and his wife are likely also having "significant" marital problems. His children notice a change and often his fellow employees do as well.

If the underlying conflict is identified and resolved all of these symptoms are reversible, but usually no one recognizes their relationship to stress. Since the conflict is not being resolved, and new conflicts are being added, the process progresses to the next stage, the Disease stage.


The Stage of Disease

Once he reaches the stage of Disease, the pattern becomes localized and fixed. Specific organs are now involved and definite diagnoses can be made. His upper GI now shows a definite ulcer; his chest x-ray may now demonstrate characteristic changes of bronchitis; his electrocardiogram is now positive. Laboratory tests are now positive. He now needs relatively dangerous medications (many side effects and risks) to control his blood pressure, lower his cholesterol, control his heart, eliminate his angina, etc. Now the physician is telling him he must cut out drinking and smoking, he must be on a diet, he may finally be referred for marital or psychological counseling. He needs more medication to reduce his anxiety which now can become so great that he can hardly control it.

Generally, however, besides the prescriptions of medications little or nothing is being done for him to help him find the cause of his situation, hence the process may continue to worsen. Eventually the symptoms become more severe, tests more abnormal, complications set in, he may need surgery for a bleeding ulcer, or for his back, bypass surgery, or removal of part of his intestine for ulcerative colitis. He may have a heart attack or a nervous breakdown. He may become an alcoholic or drug addict. He may have significant side effects from the medication. If he is not divorced already, it is likely his partner will either divorce him or begin to get sick herself or maybe she has been sick all along and the stress has been shared. The final stages of this process are Chronic Disease and Death.

The most unfortunate aspect of this situation is that all along the way, at least until the process reached the stage of a Chronic Disease, it has been fully reversible. If only someone had identified it as related to stress and treated the underlying causes, he wouldn't have had to go through all of this. Look around you, see how often this happens. See how many people suffer from stress and how commonly it is missed. This recognition may create a dilemma for you. You may find yourself face to face not only with the stress of others but your own stresses as well. You may find, as I myself have, that too often SRD's are entirely missed and ignored. In the past you may not have known what to do about it. But now you do, now you can help yourself, your family, your friends and your employees. Now you know where to go and what needs to be done.

The natural end result of chronic disease is death. Generally, death under these circumstances is painful, and dehumanizing. It may take many years or it may occur suddenly without warning. For many it means multiple hospitalizations, surgeries, prolonged stays in convalescent hospitals and even spending the last part of your life in an old age home. Loss of independence and loss of humanity.


How Much Does this Cost Us?

In the end, everyone pays. For the employer the cost of doing business in dollars, as well as mentally, emotionally, physically and spiritually, increases. The employees are seen as adversaries and may have to ultimately give up benefits, lose pay raises or even lose their jobs. And we the general public, we pay the tab with higher prices and lower quality. You now have the opportunity to work with us to assist you in understanding your stresses and learning how to recognize them before it becomes a problem to you, your family or your employees.

In the next section we will learn how easy it can be to treat stress and how successful stress reduction training can be.