COPING WITH STRESS & BURNOUT

Stress is inevitable. There are many demands in modern day society, and the fast pace of daily life can wear people down. Occasional Stress is inevitable and can even give people a boost of energy when they need it (for example, meeting a deadline). However, prolonged or extreme Stress can take a toll both mentally and physically. In fact, research has shown that early-life stress can be particularly harmful and may predispose the brain to Depression and PTSD.[1]

Prolonged Stress can lead to Burnout, and although they sound similar, they are different. Someone who is stressed will typically feel overwhelmed and unable to keep up or cope with the demands of life. Stress is a result of trying to keep up with demands and the body naturally activates the innate Fight and Flight system, through adrenaline and cortisol hormones, in order to give you the energy and motivation to take action. On the other hand, Burnout involves feeling defeated and disengaged and having low motivation. Someone who is burned-out likely experienced so much stress that they have given up on trying to accomplish difficult tasks (the Freeze system).

Burnout is defined as a sustained response to chronic stress and symptoms include:[2]

  • Emotional exhaustion
  • Loss of energy, general weakness
  • Negative attitudes/feelings towards recipients of the service
  • Feelings of low accomplishment/professional failure

One area of life where Burnout is common is at work. Once Burnout takes place in one aspect of someone’s life, such as work, it tends to also impact other areas of life, such as with family life or socially. Burnout is commonly seen among professionals that focus on helping others, such as nurses, psychologists, educators, and human resource professionals.2 Burnout has been linked to lower job satisfaction and Depression. People who are overly stressed reported as many depressive symptoms as clinically depressed patients.[3]

Canadian Statistics:

  • In 2010, 27% of Canadian workers described their lives as highly stressful on a daily basis.[4]
  • Forty-six percent of Canadians reported being “a bit stressed” on a daily basis.4
  • Sixty-two percent of workers who described their mental health as “less than good” reported being highly stressed.4
  • Workers in management, professional, and clerical occupations were more likely to report being highly stressed than those working blue-collar jobs.4
  • Workers who were divorced had a greater likelihood of being stressed.4
  • Three-quarters of workers who reported being highly stressed had a college or university education.4
  • The rate of daily stress was higher for females compared to males in all age groups except for those aged 35 to 64 years old. In the latter case, men reported higher daily stress as compared to women.4
  • Two-thirds of highly stressed workers who identified family as their main source of stress were women.4
  • In 2014, 23% of Canadians ages 15 and older reported that most days were “quite a bit” or “extremely stressful.[5]
  • Between 2003 and 2014, females were more likely than males to report that the majority of their days were “quite a bit” or “extremely stressful.”4
  • Seniors who reported having low levels of stress were twice as likely to be in good health as were those with high stress levels.[6]

Behaviours associated with Stress & Burnout:

  • Eating to avoid thinking about an upcoming deadline at work. (Stress)
  • Drinking alcohol at the end of each day. (Stress)
  • Yelling at your children for minor things after a stressful day at work. (Stress)
  • Screaming at people while driving. (Stress)
  • Calling out of work because you could care less about your job (Burnout).
  • Ignoring phone calls and not returning work emails (Burnout).

Feelings associated with Stress:

  • Anxious
  • Irritable
  • Sad
  • Restless
  • Overwhelmed
  • Angry

Feelings associated with Burnout:

  • Apathetic
  • Unmotivated
  • Empty
  • Hopeless
  • Frustrated
  • Exhausted

Thoughts associated with Stress & Burnout:

  • “There’s no way I can possibly get this all done today. I guess I’ll be pulling another all-nighter.”
  • “If I don’t get this essay/project done today, I will surely fail/get fired.”
  • “I wish I could escape my children and my job.”
  • “I hope I get fired.”

Stress, Burnout, & the Body:

  • Studies have shown that chronic work stress can increase the chances of Coronary Heart Disease by 50%.[7]
  • Stress, even in the short term, can cause headaches.[8]
  • Chronic interpersonal stress can worsen the symptoms of Rheumatoid Arthritis.[9]
  • Stressful life events are associated with the onset of chronic Insomnia.[10]
  • People with high amounts of work stress are more prone to having high blood pressure.[11]
  • Work stress has been linked to both weight loss and weight gain.[12]

Stress and the Brain:

The physical and emotional reactions to Stress begin in the brain. There are multiple areas of the brain that are highly involved in reactions to Stress, including the Prefrontal Cortex (PFC) and the Amygdala. The PFC plays a large role in regulating behaviour, thoughts, memory, and emotions. In relation to Stress, studies have shown that exposure to even a mild stressor can impair the working memory functions of the PFC.[13] Overwhelming stress has also been shown to weaken self-control, which is modulated by the PFC. While Stress can weaken the PFC, it has the ability to heighten the Amygdala’s ability to remember traumatic and or stressful events.8 This means that reminders of trauma or stressful events can trigger the body’s stress response system (the Fight/Flight/Freeze reaction), even when it is not an appropriate response.8

Does Psychology Work?

  • Cognitive Behavioural Therapy (CBT): CBT for stress reduction focuses on challenging negative thoughts and ending behaviours that worsen Stress and/or Burnout. Studies of the effects of CBT on work-related stress show that it is a more effective treatment than other interventions, such as organization-focused therapies.[14] Additionally, research has shown that CBT can help reduce stress for parents who have a child with developmental disabilities.9 People struggling with serious medical conditions, such as HIV and spinal injuries, have also responded well to CBT interventions for Stress reduction.9 Post-Traumatic Stress Disorder (PTSD) is a Stress and Trauma-related disorder that has also been successfully treated with CBT.[15]
  • Mindfulness Therapy (MT): The tendency to avoid and distract oneself from painful, stressful, and uncomfortable feelings makes it difficult to solve problems. Mindfulness Therapy helps people learn how to be more accepting of their emotions, bodily sensations, and situations so that they can effectively deal with the things that are causing stress. Multiple studies have shown that MT is an effective treatment for reducing both stress and psychological distress.[16] More specifically, Mindfulness-Based Stress Reduction (MBSR) has proven to be a highly effective treatment for reducing stress, even in the months following the cessation of treatment.[17]
  • Somatic Therapy (ST): Stress has many physical effects on the body. When confronted with stress, the body reacts with what is known as the “fight or flight” response. Extreme stress can leave the body in a “frozen” state, as often seen in people with trauma. Even minor trauma can affect one’s bodily state long after the stressful event has passed. When the body remains in a heightened, reactive state, stress hormones are continuously released. People often try to avoid these anxiety provoking thoughts and sensations and thus they remain stuck in it. As discussed earlier, these hormones can have negative effects on the body. Somatic Therapy has proven beneficial in treating the physical symptoms of multiple mental health issues.[18] Early studies of ST suggest that it can help reduce some of the physical symptoms associated with trauma by encouraging participants to connect with their physical discomfort rather than avoid it.[19]
  • Eye Movement Desensitization and Reprocessing (EMDR): EMDR is a common treatment for trauma, and has proven to be effective in multiple research studies.[20] While EMDR traditionally focuses on treating extreme forms of trauma, it can also be used to reduce symptoms associated with more minor stressful and traumatic events. Whether or not an event is considered “traumatic” depends on the effects it has on the individual. For example, while bullying may not cause PTSD, it may leave a victim with a negative perception of themselves for years afterward.
  • Emotionally Focused Couple and Family Therapy (EFT): The effects of stress on an individual can drastically impact a relationship. Stress can leave individuals feeling irritable and overwhelmed and people either lash out at their loved ones or avoid and ignore them. EFT has shown to be an effective treatment for improving couples’ abilities to resolve conflicts and emotionally support one another.[21] With improved communication skills, individuals can learn how to express their stress in ways that are less detrimental to their relationships. EFT can also be used to strengthen relationships and decrease tension between family members.[22]

Tips to Manage It

  • Aerobic Exercise: Although starting to build exercise into your routine can be challenging, getting into better shape can have positive effects on both the body and the mind. Regular exercise can help reduce blood pressure, which is often raised by stress. The more intense the exercise, the more potentially beneficial the effects on blood pressure.[2
  • Recognize The Things You Can Change: Stress can be overwhelming, and people may feel at the mercy of external factors that are seemingly causing all the stress. There are some things in life that one cannot control, but there are others that can be proactively dealt with. Making a list of your stressors can help you identify areas of your life that can be changed, and others that you must learn to accept.
  • Set Boundaries: Sometimes, Stress and Burnout can be caused by having an overwhelming amount of responsibilities. Feeling the need to say “Yes” to too many things can pile on stress that could otherwise be avoided. Recognize if you tend to do this, and focus on declining unnecessary responsibilities or projects.

Stress and Burnout can be destructive forces to both the body and the mind. While some people are able to manage stress effectively, others need guidance to learn new coping strategies. At Hopewell Psychological, we understand that your life comes with a unique set of stressors. Even if you do not have a Stress-Related Disorder, learning how to manage daily stressors can have significant, positive impacts on your mental health. Hopewell Psychological offers multiple treatment options to address your stressors and lead you towards a more peaceful life. We offer treatments for individuals as well as families, couples, and groups looking to improve their interpersonal relationships. Stress is inevitable, but a decline in health is not. Hopewell Psychological can help empower you to take control over your life and well-being.

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*Psychologists are covered under Insurance Companies in Canada. You will need to check with your insurance company about the specific details regarding your coverage.

References

[1] McEwen, B.S. “Central effects of stress hormones in health and disease: understanding the protective and damaging effects of stress and stress mediators.” European Journal of Pharmacology 58.2-3 (2008): 174-185.

[2] Ogresta, J., et al. “Relation between burnout syndrome and job satisfaction among mental health workers.” Croatian Medical Journal 49.3 (2008): 364-374.

[3] Bianchi, R., et al. “Is it time to consider the “Burnout Syndrome” a distinct illness?” Frontiers in Public Health 3.158 (2015).

[4] “What’s stressing the stressed? Main sources of stress among workers.” Statistics Canada. Statistics Canada, 27 Nov. 2015. Web. 22 May 2017.

[5] “Perceived life stress, 2014.Statistics Canada. Statistics Canada, 27 Nov. 2015. Web. 22 May 2017.

[6] “Perceived life stress.” Statistics Canada. Statistics Canada, 28 Sep. 2016. Web. 22 May 2017.

[7] Kivimaki, M., et al. “Work stress in the etiology of coronary heart disease: A meta-analysis.” Scandinavian Journal of Work, Environment, and Health 32.6 (2006): 431-442.

[8] Martin, P.R., et al. “Stress as a trigger for headaches: Relationships between exposure and sensitivity.” Anxiety, Stress, and Coping 20.4 (2007): 393-407.

[9] Davis, M.C., et al. “Chronic stress and regulation of cellular markers of inflammation in rheumatoid arthritis: Implications for fatigue.” Brain, Behaviour, and Immunity 22.1 (2008): 24-32.

[10] Basta, M., et al. “Chronic insomnia and the stress system.” Sleep Medicine Clinics 2.2 (2007): 279-291.

[11] Vrijkotte, T.G.M., et al. “Effects of work stress on ambulatory blood pressure, heart rate, and heart rate variability.” Hypertension 35.4 (2000): 880-886.

[12] Heraclides, A.M., et al. “Work stress, obesity and the risk of Type 2 Diabetes: Gender-specific bi-directional effects in the Whitehall II Study.” Obesity 20.2 (2012): 428-433.

[13] Arnsten, A.F.T., et al. “The effects of stress exposure on prefrontal cortex: Translating basic research into successful treatments for Post-Traumatic Stress Disorder.” Neurobiology of Stress 1(2015): 89-99.

[14] Hofmann, S.G. “The efficacy of Cognitive Behavioral Therapy: A review of meta-analyses.” Cognitive Therapy Resources. 36.5 (2012): 427-440.

[15] Olatunji, B.O., et al. “Efficacy of Cognitive Behavioral Therapy for anxiety disorders: A review of meta-analytic findings.” Psychiatric Clinics of North America 23 (2010): 557-577.

[16] Fjorback, L.O., et al. “Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy: A systematic review of randomized controlled trials.” Acta Psychiatrica Scandinavica 142.2 (2011): 102119.

[17] Chiesa, A. and Serretti, A. “Mindfulness-Based Stress Reduction for stress management in healthy people: A review and meta-analysis.” The Journal of Alternative and Complementary Medicine 15.5(2009): 593-600.

[18] Röhricht, Frank. “Body oriented psychotherapy. The state of the art in empirical research and evidence-based practice: A clinical perspective.” Body, Movement and Dance in Psychotherapy 4.2 (2009): 135-156.

[19] Price, Cynthia J., et al. “Mindful awareness in body-oriented therapy for female veterans with post-traumatic stress disorder taking prescription analgesics for chronic pain: a feasibility study.” Alternative therapies in health and medicine 13.6 (2007): 32-40.

[20] Davidson, Paul R., and Kevin CH Parker. “Eye movement desensitization and reprocessing (EMDR): a meta-analysis.” (2001): 305-316.

[21] Makinen, Judy A., and Susan M. Johnson. “Resolving attachment injuries in couples using emotionally focused therapy: Steps toward forgiveness and reconciliation.” Journal of consulting and clinical psychology 74.6 (2006): 1055-1064.

[22] Palmer, G., and Efron, D. “Emotionally Focused Family Therapy: Developing the Model.” Journal of Systemic Therapies 26.4 (2007): 17-24.

[23] Hamer, M., et al. “The effect of acute aerobic exercise on stress related blood pressure responses: A systematic review and meta-analysis.” Biological Psychology 71.2 (2006): 183-190.

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