Passing the stress test: Gulliver’s travails

Dr Abbie Lane is a consultant psychiatrist who specialises in the treatment of stress. She tells Donal Lynch that despite the ‘epidemic’ of stress-related illness, some stress is good and that we can make it work for us

WE seem to have gone on something of a journey with stress. Twenty years ago the notion of the strains of life and work being a possible cause of illness was still something of a taboo. It wasn’t possible in most industries to take time off work for stress alone — there had to be a ‘cover’ illness — and the nascent mental health services had barely begun to address the problem. In the intervening years there has been something of a revolution in terms of attitudes.

Stress was first mentioned in the 2005 Safety At Work Act, giving employers certain statutory responsibilities to deal with the stress-related problems their staff face. A number of clinics opened in Ireland, which specialise in the treatment of stress. And, as some of the stigma around mental health slowly gave way, stress suddenly installed itself as the No.1 amateur diagnosis for life-related angst. Whether you had a bad back or a bad mood, you could rely on the fact that someone, somewhere would advise you that it was “probably stress”.

But have our perceptions kept pace with reality? Abbie Lane, a Dundrum-based psychiatrist and stress expert, says that the sudden rise of awareness in the link between stress and health is based in solid research. “When I started to work in this area over 20 years ago, stress wasn’t considered a real cause of illness,” Dr Lane explains. “It was considered something that everyone experienced and just needed to get on with. We now have firm evidence of the link between stress and physical and mental illness. It is known to be related to anxiety, fatigue and burnout, mood disorders and suicide, cardiac illness, obesity, gastro-intestinal illness, inflammatory disorders of the bowel, joints and skin, and even some cancers may be aggravated by stress. The World Health Organisation refers to stress as the ‘Health Epidemic of the 21st Century’ and predicts that by 2020 five of the top diseases worldwide will be stress related.”

Dr Lane says she has seen a lot of cases in recent years related to the economic downturn and financial pressures people have come under. “However, even during the boom we would have seen a lot of stress-related issues, some to do with pressures to perform or keep up with perceptions. The current uncertainty is not good for people’s stress levels.”

Not all stress is bad, however. While excessive stress is toxic, under-stimulation or boredom can lead to rumination, which itself can contribute to problems like anxiety and depression. “There is a direct relationship between the amount of stress or pressure we come under and our performance. Too much or too little and we do not function, like an over-stretched piece of elastic,” Dr Lane says.

“Each person has an ‘optimum’ level of stress where the level of pressure they come under activates them and they perform well. This is called being ‘in the zone’, like the athlete before a race — finding this balance is what’s meant by making stress work for you. Equally, like an athlete you must also give yourself proper time to recover after you become activated.”

After decades working as a psychiatrist and specialising in stress, three years ago Dr Lane founded the Gulliver Stress Clinic in Dundrum, so named because “even the very mightiest of us can by dragged down by our worries”, (think of the image of Gulliver being tied down by all the little Lilliputians). There she and her team undertake a thorough assessment of each case and tailor an individual care plan, which may include therapy, life changes and medication, to individuals. “We can inherit a vulnerability to stress, for example some people are ‘born worriers’ and may experience stress easier than others,” Dr Lane says, “but the biology and genetics of stress is a small part of the overall picture. A lot of stress is very individual, the way we think or cope, our resilience levels, our approach to life, the supports around us and our general health — these things are very important.”

Stress can be devastating for men and women but they tend to deal with it differently with some studies showing that women become more social in reaction to stress, as they reach out for help, and men becoming more self-centred. Dr Lane says this broadly parallels the greater likelihood that women will seek help for any kind of ailment.

Dr Lane grew up in Roscommon and has been working as a consultant psychiatrist since 1996. She gives expert advice to a number of organisations such as An Garda Siochana and Healthcare in Practice for the Irish College of General Practitioners and the Medical Council. She says that particular professions, including those where there are high levels of responsibility and public repercussions for mistakes, are inherently more stressful and those who work in them need to be vigilant for signs that stress is wearing them down. Interestingly, she includes psychiatry in this. “The rate of illness and suicide has increased among all health professionals and psychiatrists, in particular.” The key, no matter what area you work in, is knowing yourself and your limits. “There is, of course, a value in optimism and just getting on with things if you can,” she explains. “But if we can’t function we are no good to anyone, ourselves included. Stress is a very real thing, feeling constantly overwhelmed can cost people their life and their health, so my message would be: whatever you do, don’t ignore it.”

For more information, go to www.abbielane.ie