Managing Stress in a Workplace Full of Risks

Pharmacy work can be highly stressful, and pharmacists who are under extreme stress are at risk for more errors, said Henry Cobb, PhD, MD, BS, CDM, Clinical Associate Professor, University of Georgia College of Pharmacy, Athens, Georgia.^[11] Pharmacists need to identify their own personal stress triggers and anticipate their responses to stress. He presented 5 questions that could be used for such self-analysis:

• How do you know whether stress is a problem for you?
• What is causing most of your stress?
• Is your supervisor aware of the problem?
• How do you deal with stress?
• What can you do to reduce the impact of stress?

Cobb described 3 ways that most workers deal with stress on the job. The active-cognitive person draws on past experience, taking one thing at a time. He or she considers several alternatives, looking for the positive side, and is able to step back and be objective. The active-behavioral person finds out more about the situation and takes positive action. He or she may talk with a friend or spouse, exercise more, or talk with a professional in order to find a solution. The person who practices avoidance keeps feelings to himself or herself, prepares for the worst, takes out frustrations on others, and eats or smokes more to reduce tension.

Identifying the phases of stress can be helpful. Phase 1, or the warning phase, includes vague anxiety, depression, and apathy. Phase 2, or mild stress, includes sleep disturbances, muscle aches, and irritability. Entrenched stress, or phase 3, includes alcohol abuse, depression, ulcers, withdrawal, and marital discord. Phase 4, or severe stress, includes asthma, heart problems, severe depression, violence (or suicide), paranoia, and uncontrolled anger. It is important to note that professional help is needed for phases 3 and 4.

To reduce stress on the job, Cobb presented this list of quick strategies:

1. Discontinue caffeine;
2. Engage in regular exercise (30 minutes 3 times weekly);
3. Practice relaxation-breathing exercises (20 minutes 2 times weekly);
4. Get adequate sleep (try going to bed 30 minutes earlier than usual);
5. Nurture your leisure time, engage in hobbies;
6. Set realistic expectations and avoid perfection;
7. Reframe your outlook to be optimistic, not pessimistic;
8. Eat right;
9. Maintain a sense of humor;
10. Talk and vent;
11. Write down your thoughts;
12. Avoid unhealthy habits (such as alcohol);
13. Set limits (learn to say "no"); and
14. Get help from a professional.

In some cases, however, a person who is in a job that does not match his or her personality and preferences may need to switch to another role or job, Cobb added. That may be a much better stress-reduction technique than any other.

These folks are terrific. I really enjoyed being a guest on their radio show.

I’m very fortunate to have been able to share my message with them and their listeners.

It’s Friday the 13th so I thought we ought to start the show tonight by talking about bad luck and how to avoid it with your doctor!Join me at 8 pm Central (6 p.m. Pacific, 9 p.m. Eastern), won’t you?Terrie

I had a wonderful interview today with Mr. Carl Ames of WIBA in Madison, Wisconsin today!

Turn off the BlogTalkRadio show by hitting the pause button (you’ll have to scroll down) and hit play on the interview!

Terrie

Here’s a replay of my interview by Sherry Anshara of Conscious Healing. We had a great talk on the 14th of March 2007. She even liked the book. 

Sherry is a medical intuitive and you can tell just from listening to her that she has the exact combination of understanding and compassion to help bridge the gap between the "traditional" medical community and the "alternative" side. I am sure you’ll enjoy listening to her and then visiting her QuantumPathic website. I know I was impressed - and not just because she was interviewing me. Anyone who knows me knows it takes alot to impress me.

Here’s the recording (with the breaks edited out) of my hour long interview with Sue Vogan on the "In Short Order" radio show! Enjoy.

Well, even if you don’t ask, I’m gonna tell you!

I’ve been sick - imagine that, a doctor, sick. But it’s been a very positive experience for me and will be the source of serveral blog entries.

I had a respiratory infection with first some days of just feeling cruddy (that’s not the word I actually used but it would have been censored). Then I had to fly to Washington, DC for a business meeting. By the time I got to DC, my throat was totally RAW and worse than I ever remember it being. But, here’s a good plug - the Hall’s MAX sort throat lozenges are phenomenal but I don’t think there are any more since I probably bought them all that week.

The morning after I arrived in DC, my throat was horrible but the bad part was that i couldnt breath while walking. This just got worse and worse so that any type of exertion had me really breathing hard.

By the time I flew home on Thursday I was too scared that this might be my heart to even take my migraine medication - and that’s being pretty darned scared. I arrived back in San Antonio at about noon, called and made an appointment and drove to the hospital and got admitted about 10 hours later. They ruled out a heart attack and a blood clot (pulmonary embolus) but weren’t sure what was really going on.

But that’s not important, I’m much better now. But as I was sick and really unable to do much for the last few weeks, including talk (thus no audio blogs for a while), I had much time to reflect on my life. I came up with the appropriate diagnosis and it began with an "S" - no, not that "S" word.

STRESS

As I looked back over the past year, it’s been a whirlwind and great year but it’s also been crammed full of stress. Stress that I have either created or allowed to build. We don’t have enough electrons to go into that but if you’d like a sleep aid, email me and I’ll tell you all about it - just kidding.

Seriously though, I understood it before but I firmly believe now that we  have to address stress in our life - or better yet, how to eliminate it. And a few good friends have given me advice - don’t let things I have no control over bother me. and even though that’s not easy, it’s certainly something we all should strive for. And the other is to ask ourselves "how can I have the most fun at this precise moment?" I think that’s the best of all and intend to try to work with that as much as possible. I can think of scenes for a sitcom perhaps or stories for a stand up comedian. Anything that will make things fun.

I had to turn my life around and know that there’s a bunch of stuff going on but it’s not stressful UNLESS I MAKE IT STRESSFUL.

Please take heed of this. Stress adversely impacts our immune system and without our immune system, we’re in big trouble.

There are some other "alternative" medicine things I’ve been exposed to also in the past few weeks that I may eventually share depending on my results. But combatting stress in whatever way you can is essential.

So, bottom line is that I’m back now and I’ll be posting away again. It’s good to be back and I appreciate all my readers!

Terrie

If you are or know of someone who is a Patient Advocate, I’m interested in hearing your experiences dealing with doctors from a more objective perspective than how we each deal with doctors when we’re having a problem.

Terrie

Boy is this a pertinent quip from Medical News Today .

In today’s world of very educated patients, most would be insulted if the physician even mentioned anything to do with depression. And yet, the universal presence of depression in the U.S. is phenomenal. Many people do not know that that is their diagnosis though. And therefore, they think that there "must be something wrong with me" - something that enough "tests", enough "diagnostic studies" - enough something - would show. The somatic symptoms of depression are multiple. And it should be considered in most scenarios. AND most patients should not be so resistant to the screening process. This resistance is what keeps physicians from even considering it as a diagnosis.

Providing a voice to an often silent disease, Epocrates, Inc. surveyed 500 clinicians to identify trends in depression diagnosis, prevalence and treatment. People dealing with stress, whether in the workplace or at home, should take note; nearly all clinicians identified stress as the leading contributor to depression.

The majority of clinicians reported seeing an increase in depression in the past five years, and believe this increase may be driven by greater disease awareness, and ultimately more patients seeking help. However, clinicians reported that many more patients may be experiencing symptoms that are going undiagnosed. More than half of survey respondents felt that physicians are hesitant to diagnose depression, primarily due to resistance from patients and lack of societal acceptance. Clinicians also reported uncertainty about diagnosing depression, as patients may present symptoms differently based on gender and ethnicity, or may be a product of another medical illness.

"In today’s digital age, the increasing pressure to get it done yesterday can lead to more stress and potentially depression. Early recognition and intervention are important to prevent the loss of jobs, damage to relationships or suicidal thoughts," said John Luo, MD, Assistant Clinical Professor of Psychiatry at UCLA Semel Institute for Neuroscience and Human Behavior.

The vast majority of clinicians reported recommending prescription therapies for their patients experiencing depression. Beyond pharmacotherapy and psychotherapy, 60 percent of respondents believe lifestyle changes such as diet, exercise and meditation may also be helpful in treating depression, depending on the patient’s individual situation.

Additional key survey findings include:

– Gender makes a difference when diagnosing depression

– Thirty percent of clinicians reported being less likely to discuss depression with men.

– Clinicians reported it is often more difficult to treat men because they are less "open" than women, and symptoms such as anger or addiction may not be immediately linked to depression.

– Clinicians may be more likely to experience depression

– More than 50 percent of clinicians reported experiencing depression at some point in their lives, which compared to the National Institutes of Health data, could make them more than twice as likely to experience depression as the general public.

– Additionally, 12 percent of clinicians reported missing work because they felt depressed. Clinicians are not alone-a national study revealed that depression is the leading cause of missed work days, and lost productivity due to depression is estimated at $83 billion a year.

For more about depression, including a podcast with UCLA psychiatrist Dr. Luo, clinicians’ comments and comprehensive survey results, please visit http://insights.epocrates.com/depression. Comprehensive dosing and drug interaction information for anti-depressants can also be found at http://www.epocrates.com.