Stress and Burnout

Article Contributed By Dr. Carolyn Ross

Stress is actually a natural and necessary response experienced by both humans and animals. To put it simply, stress is a state of readiness. It can be positive, as in the form of excitement, or negative, as in the form of nervousness and worry. Unfortunately, our modern society provides too many opportunities to heighten stress and too few to deal with it. Unpleasant effects of the natural stress response develop when a person experiences stress all the time.

A long-term high level of stress can lead to burnout. Burnout is a descriptive rather than a medical term, but when it occurs you may experience a variety of symptoms. These include trouble concentrating, constant feeling of fatigue, irritability and insomnia. Long-term stress affects the entire body, causing such problems as headaches, skin irritations, diarrhea, ulcers, indigestion, muscle pain, irritable bowel and many others. You may also be at risk for later developing heart disease, high blood pressure, diabetes or immune system problems.

The effect of too much stress has become a major health problem in our country. Clearly, it is worth understanding and treating. As with any problem, the solution begins with awareness. Following is more about the stress response and some recommendations for professionals and techniques to help you cope.

The Stress Response
The stress response is highly individual because it begins when we perceive a situation to be a challenging or threatening. Thus, one woman could have an extreme response to seeing a snake, while her friend remains unconcerned. In any case, once we perceive a situation as being challenging or threatening, the sympathetic branch of the central nervous system is immediately activated to produce stress hormones. These hormones cause specific bodily changes such as increased heart rate and metabolism and redirection of blood flow to large muscles; all to prime the body for action. When the perceived threat is over, the body has two means of returning to normal. The stress hormones will dissipate over time and be destroyed by other chemicals in the body;
and the parasympathetic branch of the central nervous system can release hormones to calm the body and return it to its normal state.

Too many stress hormones released too frequently are the culprits in burnout. Since the stress response affects most of the body systems, the process takes a lot of energy; leaving you feeling drained at the end of a stressful day. There are two basic ways to deal with stress hormones: decrease their production (not allow ourselves to become stressed by altering our perception of the situation) or eliminate them from the body once they have been released (through relaxation and other techniques). These two mechanisms form the basis of stress management.

Your Physician or Nurse Practitioner
Your physician or nurse practitioner may suspect stress or burnout if you show generalized problems in different parts of the body along with feelings of being overwhelmed. When symptoms come in response to a stressful period in your life, they will rule out an organic cause with a physical exam and blood work. Sometimes medication may be prescribed during an adjustment period to stress. Anti-anxiety medication or mild sleeping agents may be helpful.

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Author of:

Dr. Carolyn Coker Ross received her medical training at the University of Michigan Medical School and completed a residency in Preventive Medicine and a Master's in Public Health at Loma Linda University. She is on the Clinical Faculty at the University of California, San Diego in the Department of Family and Preventive Medicine.

Dr. Ross founded three Women's Integrative Medicine Centers in San Diego between 1993-2000. Her centers offered the best of Eastern and Western medicine, including: chiropractic, yoga, acupuncture, homeopathy, herbal medicine, massage and nutrition counseling.

Dr. Ross has been proactive in women's health in a number of areas: she founded and served as medical director of the Nova Women's Health Network, an IPA of 53 women physicians in San Diego; she is a founding Board Member of the American College of Women's Health Physicians, a group dedicated to the development of a boarded specialty in Women's Medicine. She is a past president of the San Diego Chapter of the National Medical Association.

Dr. Ross served on the Board of the National Association of Professionals in Women's Health from 1995-1997. She is the recipient of the "Matriot Award" presented to women who make a significant contribution to women's health (1997), the "Women Who Mean Business" award (1995), the Who's Who in San Diego Award (1995) and the Young Woman of the Year award (1984).

Dr. Ross served as the on-air medical advisor for the KUSI Morning News Show in San Diego and has appeared on major network affiliates as an on-air medical expert. She is also a published author and a
nationally known speaker.

Dr. Ross currently serves as a medical consultant to several internet-based medical companies and is a freelance writer for Alternative Therapies in Health and Medicine Journal.

Contributors to Stress/Burnout
Carolyn Coker Ross, MD, MPH; Barbara Whiteside, RN, CNP; Johanna Appel, DC; Julie Martin, MS; Dorothy Miller, RN; Connie Saindon, MA, MFCC; Jacqueline Zhang, LAc, MD (China

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