Sort out your toxic stress be­fore it sorts you out

The Irish Times - Tuesday - Health - - Front Page - Muiris Hous­ton

Burnout is an evoca­tive term. It con­jures up im­ages of an en­gine flam­ing out. But rather than be­ing some­thing you wake up with out of the blue, burnout is an in­sid­i­ous process, creep­ing up on us over time. Burnout is ac­tu­ally the end point of chronic stress. I like the term “toxic stress”, which was coined by Dr Harry Barry, and is the ti­tle of a book to be pub­lished next month. It ex­plains the back­ground to and of­fers so­lu­tions for deal­ing with burnout.

Ac­cord­ing to Barry, burnout is where we ex­pe­ri­ence the phys­i­cal and psy­cho­log­i­cal con­se­quences of per­sis­tent, chronic toxic stress. When in the throes of fully devel­oped burnout, we are un­able to func­tion ef­fec­tively on a per­sonal or pro­fes­sional level. But there are early warn­ing signs we can look out for.

Here are some typ­i­cal phys­i­cal symp­toms of toxic stress: dif­fi­culty sleep­ing; per­sis­tent ten­sion headaches; tummy pains; sweat­ing, pal­pi­ta­tions, short­ness of breath; mus­cle ten­sion; re­cur­rent bouts of vi­ral ill­ness; loss of li­bido; and rest­less­ness.

Psy­cho­log­i­cal symp­toms in­clude: feel­ing ex­hausted most of the time; frus­tra­tion and in­tol­er­ance; feel­ing anx­ious; feel­ing help­less or hope­less; poor de­ci­sion-mak­ing; and a re­duc­tion in short-term mem­ory.

And then there are some char­ac­ter­is­tic un­healthy be­haviours to watch out for, such as not ex­er­cis­ing, not eat­ing prop­erly, and the overuse of stim­u­lants such as cof­fee or en­ergy drinks to com­bat fa­tigue.

Hav­ing iden­ti­fied these symp­toms, Barry sen­si­bly ad­vises a trip to your doc­tor to rule out any phys­i­cal or psy­cho­log­i­cal ill­ness which may ac­count for your dis­tress. In the ab­sence of a spe­cific ill­ness, you are prob­a­bly ex­pe­ri­enc­ing toxic stress as a re­sult of your body re­leas­ing the three stress hor­mones- adren­a­line, no­ra­drenaline and glu­co­cor­ti­sol.

Glu­co­cor­ti­sol in par­tic­u­lar is re­leased in large amounts in chronic stress, and is re­spon­si­ble for the men­tal and phys­i­cal symp­toms which ap­pear when stress be­comes toxic. Its ef­fect on the im­mune sys­tem is espe­cially rel­e­vant. Nor­mally we pro­duce higher lev­els of glu­co­cor­ti­sol dur­ing the day­time and lower lev­els at night, but this is dis­rupted at times of chronic stress. Dur­ing the day, our im­mune sys­tem tends to neu­tralise viruses and bac­te­ria, and at night it helps de­stroy can­cer cells. But high lev­els of glu­co­cor­ti­sol for a pro­longed pe­riod of time dis­rupt these func­tions.

So what can you do about toxic stress so that it doesn’t trig­ger burnout? In his book, Barry out­lines an ef­fec­tive ap­proach based on: iden­ti­fy­ing stres­sors and our in­ter­pre­ta­tion of them; chal­leng­ing our un­healthy be­liefs and the de­mands we place on our­selves; and ac­knowl­edg­ing the emo­tional, phys­i­cal and be­havioural con­se­quences of such be­liefs and de­mands.

He uses the ABC sys­tem (prac­tised by CBT ther­a­pists and cre­ated by the psy­chother­a­pist Al­bert El­lis) as a tem­plate for tack­ling toxic stress. A is for ac­ti­vat­ing event and rep­re­sents the stres­sor plus our in­ter­pre­ta­tion of why it is both­er­ing us. B stands for be­liefs, rep­re­sent­ing our in­ter­nal be­lief sys­tem/de­mands. C is for con­se­quences – the emo­tional, phys­i­cal and be­havioural con­se­quences which oc­cur in re­sponse to a par­tic­u­lar stres­sor.

The many case stud­ies in the book show how this ap­proach works in prac­tice for a whole range of stres­sors, be­liefs and con­se­quences. It won’t come as a sur­prise to read­ers who have ex­pe­ri­enced toxic stress to hear that tack­ling the is­sue re­quires you be­ing hon­est with your­self and ac­cept­ing that se­ri­ous changes in many as­pects of your life may be re­quired.

As Barry says, “chang­ing the brain for the bet­ter re­quires sig­nif­i­cant changes to a per­son’s be­hav­iour. If you are not pre­pared to tackle key is­sues, you will strug­gle to deal with toxic stress.”

Toxic Stress by Dr Harry Barry, from Orion Pub­lish­ing

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