Stress & Burn-Out

James J. De Santis, Ph.D.
138 North Brand Boulevard, Suite 300
Glendale, California 91203-4618
TEL (818) 551-1714

Stress and Burn-Out
by James J. De Santis, Ph.D.

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 you as a psychologist use with clients to treat their stress?

Many methods are available to treat stress. The most fundamental is talking about feelings. A number of techniques can help drain off or block the effects of stress, including progressive muscle relaxation, visualization, diaphragmatic breathing, and meditation. 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.