Working Smarter

Happy 2014, everyone! I hope it’s a great one for you. One way to help make it that way is to use that precious window of openness we have at the beginning of the year when we are receptive for a nanosecond to new things  and resolve to do something different this year: not take stress but turn off the danger signals that drive it.

Hiding in plain sight, this toxic saboteur can ruin your work and health with a trip to the ER and a sinkhole of medical bills. You may think you're handling it, but that's usually an illusion, supplied by the adrenaline released by the stress response, which masks the damage to your body by giving you a sense you're powering through it.

Brian Curin, 39, thought he was managing risk well as president of footwear retailer Flip Flop Shops, which has more than 90 locations. Yes, he had pressure, but he exercised and ate well. He could handle it. He did feel a little off, though, and had a faint ache of something resembling heartburn.

Curin decided to pay his doctor a visit. Blood work, a resting EKG and a respiration test were negative, but a stress test and an angiogram turned up a big problem: four blocked arteries, one of them at 100 percent—not what Curin expected at his age. Without open-heart surgery, he could have been dead within weeks.

"I was extremely lucky," says Curin, whose wake-up call prompted him to start a campaign, The Heart to Sole: Creating a Stress-Free America, to lobby for stress-testing at all companies and to support the American Heart Association's My Heart, My Life program. "If something doesn't feel right, it's probably not. Get it checked out."

Because the human brain's fear central, the amygdala was built for life-and-death scenarios 100,000 years ago, it doesn't know how to process the social stressors of the modern world. As a result, we react to stressful events as life-and-death before we think and become easy prey for chronic stress, which compromises the immune system, increases the bad cholesterol and decreases the good kind. Bravado and busyness can keep us in denial mode until the paramedics arrive.

You're not much good to your work and family from six feet under. This year, let’s make a vow to keep the sirens at bay with these essential stress-reduction strategies.

1. Pay attention to your body. Insomnia, heart palpitations, anxiety, bowel issues--they're trying to tell you something. See your doctor.

2. Make stress-testing as routine as dental checkups.

3. Cut stress by reducing time urgency. Every minute is not life or death.

4. Identify the story behind the stress and reframe it from catastrophic to a new story: "Yes, I've got 300 e-mails, but I can handle it."

5. Build stress-relief techniques into your schedule—meditation, progressive relaxation, exercise, a hobby.

6. Set boundaries. Sixteen hours of work a day is not sustainable. Find the "just enough" point in a given day or project.

7. Check email at designated times. Four times a day is the most productive email checking schedule.

8. Delegate or get help. Doing it yourself can cost well more than the price of a helping hand.

9. Step back. Brains have to reset every 90 minutes. Breaks increase mental functioning and interrupt stress.

10. Get a life. The best stress buffer is a life beyond work. Remember that?

If you would like to get yourself and/or your organization off to a great start for 2014, a stress management program can be one of the best investments you make all year. Our stress reduction tools pay off many times over in dramatically less medical costs and higher productivity and engagement. Click below for more information and prices.

To the outside world, Catherine Thompson England seemed to be handling the pressure of her job as a caseworker for abuse victims well. Though she had told her boss that stress was mounting, it didn't appear to be a problem, since she was getting the job done. But the Pennsylvania social worker was staying late and working at home to do it, a growing trend in a world of tight budgets and understaffing.

Things weren't going well at all. One day the pressure exploded and Thompson England had a breakdown. She was hospitalized for 10 days.

"People don't want to hear about stress, because everybody has it," says Thompson England, who has a five-year-old son. "You will deal with a lot of stress before you reach out, because it's not taken seriously."

Stress has become such a normal part of the day-to-day that it has become a kind of adrenalized wallpaper. Bringing up the subject is to point out the obvious—or that you are a wimp, unable to take it in a bravado world that feigns invincibility. Fear of being wimpy, though, leads to real weakness—physically, since stress plays a role in five out of the six leading causes of death, and financially, since stress costs the nation a boggling $1 trillion a year.

Chronic stress triggers conditions that kill more people every year than cancer and nicotine combined, but it's treated as if it's no more serious than excess gas or bloating. Take a pill and deal with it. Americans certainly do, consuming $16 billion worth of antipsychotics each year and $11 billion in anti-depressants.

There's a disconnect between stress and the conditions it sets off—hypertension, stroke, coronary artery disease, diabetes, insomnia. Many of us watch our cholesterol, get exercise, keep sugar under control, and yet don't do anything to manage the switch linked with the diseases we're otherwise trying to prevent: stress. That's because we've never been taught to take stress seriously—until a heart attack or burnout.

I come across this every day in my work as a stress management educator. There was the manager at a government security agency who had a stroke in his 40s. The real estate agent with panic attacks. The CEO leveled by a heart attack. 

Unlike more exotic bugs and conditions, there is a cure for stress: knowledge. Science knows how to prevent and manage it. The stress response is activated when a perceived threat overloads ability to cope with the danger. It's an early warning system that worked well in hunter-gatherer days when threats to life and limb were frequent, but it doesn't know how to compute the social stressors of the modern world. A number of proven stress management processes can turn off the false alarm of stress. Once the danger signal has been shut off, the stress stops in four minutes.

Job stress is serious business for business leaders who want to cut medical costs and absenteeism, increase performance, and maybe save lives, including their own. Brian Curin, president of Flip Flop Shops, which sells sandals and a casual lifestyle at 80 stores around the country, discovered that he took too casual of an approach to his own health. Though he exercised and ate well, years of stressful business-building had taken a hidden toll. Curin failed a treadmill stress test, and a follow-up angiogram revealed that his heart was starving for oxygen. He had four major blockages, one of them 100 percent—at the age of 38.

"It was years of running as fast as I could go at the speed of business," said Curin. "It really shows the effect that stress can have on you. They said if I had had a heart attack, they wouldn't have been able to help me."

He had to have a quadruple bypass to repair the damage. Curin was so shaken by the experience he decided to do something about it. His company started an initiative with the American Heart Association, My Heart, My Life, to advocate for stress tests at companies and educate customers on stress prevention.

Stress testing, whether by exercise test, ECG, blood pressure testing at work (one out of five people have elevated readings at work but not at home) or other modalities, has to become as routine as dental or cholesterol checks to identify people like Curin, who are unaware of the problem, or England Thompson, who fear reaching out might mark them as a wimp or burden to others.

England Thompson learned she has to speak up more, set boundaries, and share the load with others. "We need to normalize the fact that stress is a very real thing and you don't have to deal with it on your own," she said.

Stress testing, coverable mental health counseling, and social pressure to change macho attitudes can make it acceptable to get help and overcome the shame, bravado, and willful ignorance that feed the chronic disease mill of stress.

Most of the research on job stress has looked at men, but a new study of women finds the stress process very democratic in its toll on the old ticker and its supporting systems. The study, from Brigham and Women’s Hospital in Boston, found that women who report high job demands and stress levels are 67% more likely to have a heart attack and 38% more likely to have a heart problem—stroke, high blood pressure, coronary artery disease—than women with low stress.

It’s another sign that work stress is not a trifling case of nerves, but a health hazard, one that requires stress management skills few of us are taught. The belief is that we can live with stress, that it’s just part of the professional territory—and that we can’t discuss it or try to resolve it or we'll be a wimp.

We do live with a lot of stress. Life is chock full of it, but not all of it is a threat. When demands are low, or high but you have some measure of control over them, events can be perceived as challenging or exciting. But when demands are high and you don’t have control over them, it’s another story—which is why more than two dozen studies show the connection between work stress and heart problems. That’s the kind of stress that is risky to live with.

Chronic high strain triggers the stress response. It creates a sense of not being able to cope, which is misinterpreted by the ancient hub of our emotions, the amygdala, to be a life-and-death threat. Off goes the stress response and a flood of hormones that suppress the immune system, increase blood pressure, and can lead to cardiovascular problems and a host of medical issues, from insomnia to irritable bowel disease.

The study followed 22,000 women in the healthcare field for 10 years and found the high-strain group (including managers, who were high risk) with an elevated risk for heart problems. Lifestyle issues—smoking, weight, etc.—accounted for only one-quarter of the increased risk. The research supports data found in a Finnish study of 48,000 women, which found that job stress can double the risk of cardiovascular disease.

If you or your organization fall into the chronic, elevated strain category, stress management strategies are crucial to prevent the toll on health, decision-making, productivity, and pocketbooks. Since the stress beast runs on knee-jerk reactions and “explanatory style”—what we tell ourselves about stressful events—changing the response to stress can change everything and lead to vastly improved work-life balance.

The stress process is so ingrained it takes a concerted effort to retrain the brain to react differently than autopilot fight-or-flight. Our stress management programs reframe stress so it can be cut off before it spins out of control into chronic activation that takes bodies and businesses down with it.

A two-pronged approach is needed, tools that we can use to put out the fires as stress pops up—both mental and physical techniques—and then stress management strategies outside the job to counter amygdala activation and release the tension. It's part of the body's natural work-life balance system, the parasympathetic system of recovery restoring the body to rest and maintenance.

Study co-author Michelle Albert singled out the importance of having ways to unwind after work. Regular recreational and exercise outlets are essential to relieve work stress, or it continues to fuel anxiety, muscle tension, and cortisol release. That requires planning, a different skill-set than the work mindset, and the right motivational strategy—all of which are part of our training program.

One of the hallmarks of stress is obsessive thinking about the perceived crisis of the moment. Pastimes and aerobic exercise buffer stress as well as increase positive mood and confidence, which helps switch off the false emergency signals in the brain and create the vitality to perform better on the job.

It's all about coping with demands. If they push us beyond our ability to cope and nothing is done to increase coping resources, non-android bodies and performance pay the price. The good news is that coping strategies can become the best parts of the day, from relaxation techniques to recreation after work—if we can override the "I'm too busy" mental block fueled by stress to take care of ourselves, that is.