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Tom Brown Consultant Psychiatrist BiG May 2012. Dealing Well with Stress. 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.
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Tom Brown Consultant Psychiatrist BiG May 2012 Dealing Well with Stress
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 Definitions
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) Good or bad?
Illness-heart disease,stroke, psychiatric disorder(30-40% of absences) Suicide Marital /relationship breakdown Alcohol misuse Costs of Stress
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 at work(Cooper)
Career development-training,job security,appraisal Organisational structure-participation External pressures eg home/personal life Sources of Stress II
Emotional overextension and exhaustion Negative, cynical and detached responses to others Feelings of inefficiency and reducing personal accomplishment BurnoutFreudenberger (1974), Maslach et al (1996)
Job related(see earlier slide)eg time demands,lack of control,poor organisation Personal vulnerability eg personality traits –avoidant,dependant, anti-social. Risk factors
Signs of not coping with increased stress Burnout Depression 3 stage model of response to stress
Over engagement Irritability/short temper Anxiety Feeling on edge Increased vigilance Physical symptoms –headache, chest pain, gastro –intestinal symptoms, breathlessness,aches and pains “Dyscopia”
Disengagement Blunted emotions-sad,withdrawn Decreased motivation, negative thinking Detachment and social withdrawal Burnout
Pervasive low mood Loss of enjoyment Feeling life not worth living/suicidal thoughts Self neglect Depression
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 Barriers to coping
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 Prevention
Sleep • Rest and relaxation • Food • Exercise • Sex • Not ignoring health problems • Stay off/reduce hours when ill • Substance use-be careful Self Care strategies-Biological
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 -psychological
Look after your key relationships-family/friends Personal comfort-home/car/bike/work space Finances Religion-spiritual and social function Hobbies Vacations Self care strategies-social
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 When to seek 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 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 What kind of help?
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 Summary
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) References