Tuesday, September 19, 2006

stress in working placed

Stress is the reaction people have to excessive demands or pressures. You may find it difficult to cope with tasks, responsibilities or other types of job related pressures or you might get anxious trying to meet such demands. It isn't just bad for your work, it could also be affecting your health.

Stress may be caused or amplified by a number of factors including:

Bad relations with other work colleagues

Long and/or irregular hours

Repetitive work/boredom and lack of job satisfaction

Jobs with heavy emotional demands

Poor working environments such as excessive noise, the presence of dangerous materials, over-crowding, poor facilities, or extremities of temperature or humidity

Increased accessibility--the use of mobile phones, pagers and emails means the boss can always chase up work.

The situation can be made worse if there is bullying, conflict, harassment, and indifference to staff needs. Where the organization lacks leadership, work arrangements, deadlines and demands are set without consultation and seem to be inflexible, this leads to a high degree of uncertainty about direction, purpose, objective and job responsibilities amongst staff.

Tuesday, September 12, 2006

stress management : Decrease or Discontinue Caffeine

In terms of "bang for the buck," it is hard to beat this simple intervention. Most patients do not realize that caffeine (coffee, tea, chocolate and cola) is a drug, a strong stimulant that actually generates a stress reaction in the body. I tell patients that the best way to observe the effect of caffeine is to get it out of the system long enough to see if there is a difference in how they feel. Three weeks is adequate for this purpose and all my patients accept this suggestion, especially when I frame it as an experiment. ("If you dont notice a difference, you can go back to it; but if you feel better without it, you will probably want to stay off it.") I would guess that 75% to 80% of my patients notice a benefit. They feel more relaxed, less jittery or nervous, sleep better, have more energy (a paradox, since you are removing a stimulant), less heartburn and fewer muscle aches. Many patients feel dramatically better and cannot believe the difference.

One warning, however. Patients must wean themselves gradually or they will get migraine-type withdrawal headaches. I suggest decreasing by one drink per day until they are down to zero, then they should abstain for three weeks. When they feel better, they will thank you. In fact, you will be a hero because it is such an easy thing to do and delivers a big payoff. Incidentally, I do not believe caffeine is a highly addictive substance. I have never met a patient in 10 years who could not give it up within one week.

copyright © 1995-2005 by Phillip W. Long, M.D.

stress management : For Patient and Physician

Stress is the most common cause of ill health in our society, probably underlying as many as 70% of all visits to family doctors. It is also the one problem that every doctor shares with every patient. This presents physicians with two advantages:
It is an issue we can relate to experientially so we can use ourselves as a reference point.
In studying and better understanding stress, we can derive personal as well as professional benefits.
As my mentor, Dr. Matthew Budd of Harvard University, told me at our first meeting in 1982, "If you want to help your patients deal with their stress, you're going to have to learn to handle your own." Therefore, when I talk to physicians, I invite them to listen on two channels: one for their patients and one for themselves. The material is much more meaningful if you can connect with it on a personal level.

The manifestations of stress are legion. Early in this century, medical students were taught that, "if you know syphilis (the great masquerader), you know medicine." One could say the same about stress. It can contribute to or mimic just about any symptom you can think of. However, the main presentations can be summarized under four headings: physical, mental, emotional and behavioral (see Patient Information sheet.)

The causes of stress are multiple and varied but they can be classified in two general groups: external and internal. External stressors can include relatives getting sick or dying, jobs being lost or people criticizing or becoming angry. However, most of the stress that most of us have is self-generated (internal). We create the majority of our upsets, indicating that because we cause most of our own stress, we can do something about it. This gives us a measure of choice and control that we do not always have when outside forces act on us.

This also leads to my basic premise about stress reduction: to master stress, you must change. You have to figure out what you are doing that is contributing to your problem and change it. These changes fall into four categories: change your behavior, change your thinking, change your lifestyle choices and/or change the situations you are in. By getting to the root causes of your stress, you can not only relieve current problems and symptoms but you can also prevent recurrences. For example, if you keep becoming frustrated over arguments with your children, you might discover that the cause of your upset is not their behavior but your unrealistic expectations. By modifying your standards, you might find the children's actions no longer bother you.

There are many ways to relieve stress, from going for a walk to quitting your job. What follows is a list of 10 practical and down-to-earth strategies which I have found helpful over the years for both myself and my patients. Some are simple and can be implemented quickly; others are a bit more involved. All are feasible and beneficial.

copyright © 1995-2005 by Phillip W. Long, M.D.

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