What exactly is stress at the workplace? The definition may be elusive, but the feeling certainly is not. Impossible deadlines, long work hours, taking work home, and high-intensity management tussles are more the norm than the exception. While most people take it in their stride, a vast body of clinical research shows that continuous exposure to stress can lead to a startling number of diseases: depression and anxiety, of course, but also cardiovascular diseases, musculoskeletal problems, impaired immune responses, even cancer.
A 2012 study that followed 197,473 people in eight European countries for almost eight years found the risk of cardiovascular diseases to be 23% higher for people facing stressful conditions at work, despite taking into account other factors such as lifestyle, age, gender and socioeconomic status. The work, which also involved meta-analysis of previously published and unpublished research on the subject, was published in the journal Lancet, and defines work stress as a situation where high demands are made on an individual who has very limited freedom about how and when to do the work.
Monica Chib, senior consultant psychiatrist at Indraprastha Apollo Hospitals, New Delhi, says that despite the very real risk of disease, most people accept daily stress as a part of the job, and take no preventive or alleviating measures.
“People don’t even realize that something may be wrong till they have a breakdown or have already burnt out,” she says. At least 35% of her patients come to her with work-stress related problems, most at a stage when professional help is a necessity.
“Or they come to get treated for the somatic results of their stress—high blood pressure or diabetes—and when the doctor asks them for their history, it is revealed that the underlying cause is work stress,” Dr Chib says.
Stress affects the body and mind in a number of ways. The body’s first response to a stress trigger, say an approaching deadline that you are going to miss, is a natural biological process called “fight or flight”. In this state, blood flow is redirected from the skin and internal organs to the muscles and brain, and glucose and fatty acids are released into the bloodstream for energy.
When this response occurs frequently or over prolonged periods, it suppresses the immune system, leading to an increased risk of illness and disease, and a range of psychological and behavioural problems.
“All of this, of course, means that your productivity at work, and your personal life, both suffer,” says Dr Chib.
For families where both husband and wife have stressful work conditions, things can get very challenging. “Neither of them will be able to use the home as a place to recharge and rest, and the stress can just keep building,” Dr Chib says. “And the commonest thing I see is that people are either spending very long hours at work, or they are bringing work home.”
Sameer Malhotra, head of department of mental health and behavioural sciences at Max Healthcare, New Delhi, says the new work culture of staying connected through smartphones and tablets at all times has intensified the problem.
“The balance between personal life and work is being broken rapidly,” Dr Malhotra says. Handling stress at work on a daily basis triggers a curious vicious cycle according to psychiatrists. The more under pressure you are to produce work, the less productive you are likely to get. The less productive you get, the more you put yourself under stress. “And then you burn out,” says Dr Malhotra. “The obvious thing to do here is to distance yourself from work the moment you feel that you are working very hard but not getting results. Relax. Take time off. Sometimes what helps my patients most is the simplest advice—‘it’s not the end of the world’ or ‘no one can take your expertise and skills away from you’.”
The treatment for people affected by work strain, like all other mental problems, is a completely individualized process. But there are some common threads. One of the first things psychiatrists try to find out is if the patient is over-perceiving stress levels.
“Different people react differently to stress,” says Dr Chib. “Some amount of stress is good for everyone, it keeps them on their toes. But there are some who respond badly to the slightest strain.”
Counselling is dependent on what the problem at work is—difficult bosses, bad relations with colleagues, too much work, or all these combined.
“One of the big things is to improve sleep patterns,” says Dr Malhotra. “A lot of these people are chronically underslept, and strung out on tea or coffee, which makes the situation much worse.” Time management, so that work issues are left at the workplace, is a critical tool, as is regular exercise. “Taking a couple of minutes out to do simple stretching exercises at work is a great stress-buster,” says Dr Malhotra. “Or start yoga classes.” Dr Chib advises a quick outdoor walk, or listening to a relaxing song in the middle of the workday, or keeping the lunch-break sacred, where you sit and eat a proper meal without thinking of or continuing to work.
“Also identify the muscles that are tensing up when you get stressed,” Dr Chib says, “and focus on relaxing them. This can immediately relieve the tension.”
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Feel at ease
Looking for ways to feel relaxed? Then try these.
Therapists use a variety of relaxation techniques to help their patients, including yoga and autogenic relaxation, where the patient is taught to use visual imagery, body awareness, and repeat words or suggestions in their head to enter a state of calm.
All relaxation techniques need consistent practice—they are an acquired skill—before they start being really effective. Be patient, calm and accepting towards the practice. Don’t worry about distractions or your performance, just remember that with each practice, your ability to relax will keep growing.
Here are the basic contours of a technique called “progressive muscle relaxation”, in which you systematically relax the major muscle groups by briefly flexing your muscles and then releasing the tension.
Find a quiet, comfortable place with minimal distractions.
Wear loose clothes and no shoes and sit straight on an upright chair. For each body part, tense the muscle for 4-5 seconds, but not so hard that it hurts. Then slowly release the tension and relax the muscle over 10 seconds.
u The right hand and arm: Make a tight fist. Release. Make a fist, bend from the elbow to bring your forearm to your right shoulder, flexing the bicep tight. Release.
Repeat with the left hand and arm.
u Head: Raise your eyebrows as high as they can go. Release. Squeeze your eyes shut tight. Open slowly. Open your mouth as wide as you can. Relax the shoulders, and then use your neck muscles to move your head up, to look towards the sky or ceiling. Then slowly bring your head down till the chin touches your chest. Move your head from side to side.
u Shoulders/back: Squeeze your shoulder muscles up towards your ears. Relax. Push your shoulder blades towards each other, pushing your chest out.
u Chest/stomach: Breathe in deeply, lifting your chest as
u Hips and buttocks: Clench your butt muscles hard.
u The right leg and foot: Clench the thigh muscles. Release.
Pull your toes towards you and hold. Release. Curl your
Pull your toes towards you and hold. Release. Curl your
Repeat with the left leg and foot.
At the end of the sequence, just sit and breathe calmly and deeply and be aware of your body for a few minutes.
—Dr Malhotra, Dr Chib, and Centre for Clinical Interventions, Northbridge, Western Australia.