Stress is chief among executives' health concerns

Friday, May 23, 2003

JACKSONVILLE, Fla., May 23, 2003 — Physicians at Mayo Clinic in Jacksonville say an increasing number of executives acknowledge that stress is affecting their job performance, family life and health. Start with a sluggish economy, pressure to maintain profitability and increased responsibilities. Add concerns about travel and workplace security, and you've got a pressure-cooker environment. "It's no wonder that stress is high on the list of executive concerns this year," says Dr. Christian Van Den Berg, chair of Executive and International Medicine.

Not all stress is bad. Whether you're an executive or not, some degree of stress is a necessary part of life. "Stress can be positive when it provides motivation to achieve your goals," Van Den Berg says. "However, when you have too much stress, or it lasts too long, it can be harmful to your health." How do you know if you're experiencing stress overload? Here are some warning signs:

• Headache
• Teeth grinding
• Shoulder, neck or back pain
• Chronic fatigue or insomnia
• Sexual dysfunction, infertility or menstrual problems
• Upset stomach or heartburn
• Sweating
• Irregular or elevated heart rate
• Unexplained pain
• Frequent colds or flu
• Skin problems
• Anxiety or depression
• Anger, impatience or irritability
• Poor concentration or forgetfulness
• Speech or hearing difficulties
• Overeating or not eating
• Increased smoking, drug or alcohol use

Van Den Berg urges people to take a stress inventory. You can't reduce stress until you know what's causing it. Trouble on the job, the death of a loved one and personal injury are obvious, but Van Den Berg says daily hassles and demands are easy to overlook. "Persistent little things like commuting, unproductive meetings, too many commitments and family arguments can wreak more havoc on your health over time than the intermittent big things," Van Den Berg says.

He suggests people keep a stress journal, listing all the demands on their time and energy for one week. Once the stressors are identified, here are four coping strategies:

• Accept the situation
• Avoid the situation
• Alter the situation
• Adapt to the situation

"Focus on changing the things you can and accepting the things you cannot," Van Den Berg says. In addition, try:

• Relaxing
• Relabeling
• Regular exercise
• Humor
• Strengthening or establishing a support network
• Making more personal time

Relaxing can reverse the physical effects of stress and make a person feel better, think better and perform better. Van Den Berg suggests people relax half an hour each day. Here's how. First, clear your mind. Close your eyes. Breathe deeply and mentally focus on one image or one pleasant thought for 10 minutes. Another technique relaxes the muscles. Select major muscle groups beginning at the top of the body and work down. Tense the muscle and notice how it feels. Then, release the tension and notice how it feels. Concentrate on the difference between the two feelings. Do this for 15 minutes.

Attaching negative labels to too many situations makes life seem gloomy. Van Den Berg suggests relabeling situations with a positive outlook. Instead of thinking, "No one communicates," try, "I'll open the channels of communication." Instead of thinking, "It's not going to get better," think, "I'll give it one more try."

Aerobic exercise reduces stress by increasing the body's production of natural painkillers (endorphins). It also increases oxygen to the brain which releasing tension from muscles. Physical activity also provides a time out from stressful situations.

Laughter is an "inner upper," Van Den Berg says. "People should allow themselves to experience moments of joy without feeling guilty."

And don't forget the power of friendships. Studies of people who remain happy and healthy despite many life stresses conclude that most have very good social support.

Activity overload is a source of stress in many people's lives. Carve more personal time out of your busy life. Prioritize your activities and cut out low-priority ones and any that are not necessary, enjoyable or satisfying. The result: more time alone, or more time to do they things you really enjoy.

"You cannot eliminate all the stress in your life, but you can learn to deal with it actively and effectively," Van Den Berg says. "Stop thinking of stress as something that just happens to you. Instead, take charge of your stress and turn it into a positive force in your life."

Because stress can be a factor in a variety of emotional illnesses that should be treated professionally, Van Den Berg says you should talk with your doctor if you are experiencing signs of depression or severe anxiety. Common signs of depression include:

• Persistent lack of energy
• Irritability and mood swings
• Recurring sense of hopelessness
• Feelings of unworthiness or guilt
• Recurrent early morning awakening or other changes in sleep pattern
• Lasting sadness
• Continuing negative view of life
• Overeating or loss of appetite
• Inability to concentrate, poor memory
• Inability to enjoy pleasurable activities

Signs of anxiety disorder include:

• Feeling apprehension, nervousness and a nagging uneasiness about your future
• Rapid heart beat, palpitations, sweating, dizziness
• Headaches
• Insomnia and relentless fatigue

Van Den Berg and his colleagues see about 2,500 executives a year through the Mayo Clinic Executive Health program in Jacksonville. The program offers a comprehensive one- to two-day medical evaluation for busy professionals.

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