Stress and Burn Out

James J. De Santis, Ph.D.
Post Office Box 894, Glendora, CA 91740-08943
(818) 551-1714

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What is stress?

Stress is any demand placed on the body. Stress is the pressure you feel
when faced with circumstances that are unfamiliar, unpleasant, or
threatening. It is an automatic "fight or flight" reaction.

What are factors that contribute to modern day stress?

Three main factors contribute to modern day "Hurry Sickness": (1)
unpredictability, or partial control, (2) inordinate responsibility, and (3) less
reliance on traditional support from family and the community.

"Stressors" are the environmental sources of stress. They include financial
problems, legal problems, health problems, business readjustments, family
conflict, and changes in living situation.

What are signs of stress?

There are four domains in which stress expresses itself--physical, emotional,
psychological, and behavioral. Each domain includes a number of possible
symptoms: (1) physical: fatigue, muscle tension, restlessness, nightmares,
appetite change, rapid pulse, (2) emotional: nervousness, depression, easily
upset, (3) psychological: ambivalence about decisions, excessive worry,
forgetfulness, and (4) behavioral: snapping at people, avoiding tasks,
trouble concentrating, withdrawing from others.

How would you distinguish "stress" from "burn-out"?

The "stressor" is the source of stress. "Stress" is the actual wear-and-tear
on a person from stressors. "Burnout" is what happens when stress does not
stop. Burnout is "hitting the wall." There are three stages to the
development of stress.

(1) The Alarm Phase is our initial response to a stressor. This stage can
often feel good. We can feel motivated, energized, and invigorated.
Adrenalin flow and blood pressure increase. We remain calm under pressure,
our perception sharpens. Activity accelerates, we become particularly
efficient and productive. We rise to meet the challenge and want to
succeed.

(2) The Resistance Phase occurs when the stressor continues, we begin to
experience "fuel shortage," and we begin to try to conserve resources. We
may increase our consumption of quick energy foods like sugar and caffeine.
We may begin to feel some irritation and dissatisfaction that increases to
negativity and pessimism. Sleep and appetite may be disrupted. We may
become preoccupied and have trouble concentrating or remembering things.
Mounting fatigue may contribute to decreasing performance, including
lateness, inefficiencies, and errors at work. We may experience feeling out
of control or panic. A sense of loss of control may contribute to
indecisiveness and self-doubt may surface. We may procrastinate or escape
into avoidant behavior including substance abuse. Personal relationships are
apt to deteriorate. One sometimes begins to seriously consider changes in
career or personal life at this point.

(3) The Exhaustion Phase is the point at which a crisis is apt to occur,
when we run out of resources and crash. We can call this burn-out. When
exhaustion strikes, we may feel we have totally lost control over our life.
We may experience overwhelming feelings of helplessness and hopelessness.
Fully developed depression can occur. Psychosomatic illnesses can occur.
Personal relationships begin to collapse. At work we can become
accident-prone or unable to work. Chemical dependency can take hold. We
may even find ourselves contemplating self-destructive actions.

What are some ways people attempt to cope with stress that are
counterproductive?

Increased use of alcohol, smoking, recreational drugs, risk-taking behavior,
avoidant behavior, hurrying more, trying harder, or outright denial of the
problem are all likely to be counterproductive.

How can a person reduce inordinate stress constructively before it
becomes overwhelming?

There are many things you can do to reduce excessive stress before it
becomes overwhelming. Accept what you cannot change. Exercise control
over what you can change. Learn to say "No" judiciously. Evaluate your
thinking for negativity. Find the humor in the situation. Talk worries over
with a friend or loved one. Make free time for music and hobbies. Good
nutrition, enough rest, and adequate exercise are helpful. Reduce caffeine
and sugar consumption.

Manage your time well. Plan ahead. Get organized. Prioritize. Break jobs
down. Group similar tasks. Alternate mental and physical tasks. Focus on
one thing at a time. Designate a time and place to do your work. Minimize
interruptions. Take breaks.

What can commuters do to decrease the stress of the highway?

There are many ways to prevent "road rage." Plan ahead. Equip your car
with good emergency gear. Perform maintenance on your car at
recommended intervals. Allow plenty of time to get to and from work. Alter
your departure time to allow for delays on the road.

Make car a comfortable place to be. Pay attention to seat adjustment and
air temperature and circulation. Reduce clutter in the car. Throw a
comfortable pair of slippers in the back seat to change into. Vary your route
to work. Listen to books on tape. Listen to favorite music.

Modify your driving style. "Flow" with traffic rather than fight it. Avoid trying
to compete with other drivers or to jockey ahead of the next car. Maintain
an attitude of courtesy and alertness. Yield right of way

What can a person do to avoid stress in the first place?

Strive to achieve a balanced, enriched lifestyle. Fill your life with good
relationships, intellectual stimulation, and fun. Follow advice about good
nutrition, exercises, and rest.

Develop a realistic view of life. Yet expect good things to happen to you,
visualize success. Accept yourself the way you are, develop a sense of
self-worth. Nourish yourself daily, take good care of yourself, reward
yourself.

What kinds of work environments are "burn-out prone"?

Work environments that are "burn-out" prone are those where stress is
continuous and unabated. Burn-out environments tend to have a culture
where self-sacrifice is the norm. Hierarchical relationships are enforced to
the exclusion of peer interaction. Perfection is demanded. Promises are not
delivered. Expression of thoughts and feelings is discouraged. Extra effort is
not acknowledged or rewarded. Suggestions to improve productivity or
morale are discouraged. Work is repetitive and boring. Playfulness and
laughter are frowned on. Policies are only made by a few.

What kinds of people are "burn-out prone"?

People who are burn-out prone tend to overload themselves with
responsibilities. They are highly achievement-oriented, need lots of
appreciation, and tend to have unrealistic expectations of themselves and
others. They may get bored easily and seek out intense stimulation. They
tend not to have cultivated many leisure pursuits. Their identity is bound up
in only one role. They have a limited support system of people to talk things
over with.

What can employers and self-employed people do to minimize the
effects of stress?

Decentralize staff authority, encourage a democratic consensus-building
processes. Delegate; and delegate authority with the responsibility. Keep
communication open with subordinates, encourage feedback, listen.
Practice 2-way evaluations with staff. Revise the work schedule, allow for
"down" time in your plans, and sanction "mental health days." Avoid "lunch
meetings." Maximize pleasant physical surroundings.

Are there any simple techniques people can use on their own to lower
tension?

Try deep breathing or "one-breath Zen." Progressive muscle relaxation,
where you systematically flex and relax each muscle in your body can be
helpful. Visualization of pleasant surroundings like the beach or a meadow
can be helpful.

When would a person know it's time to seek professional help?

The most common time that people under stress will seek professional help
is when they are experiencing symptoms of "fuel shortage," or the
Resistance Phase of a stress reaction. People also seek help when they
have reached the Exhaustion Phase, but treatment is much easier if they
seek it sooner rather than later.

Who can we consult if stress starts to get out of hand?

A number of professionals can assist in the treatment of stress, including
your family physician, hospitals that run stress management programs,
mental health centers in the community, employee assistance programs in
the workplace, clergy, and mental health therapists.

What methods do psychologists use with clients to treat their stress?

Many methods are available to treat stress. The most fundamental is talking
about feelings. Techniques that change a person's perceptions of the
stressor can be used, including altering negative "self-talk," developing
self-acceptance and self-esteem, and communication and assertiveness
skills. Therapy may also address time-management as well as considerations
about making changes one's career or personal life.