Has cynicism and fatigue replaced the enthusiasm and drive you once had at work? If so, you may be dealing with burnout, a worrisome psychological state that can rob you of your happiness and even your health. Learn more about burnout and take a quick 20 question quiz to find out if you’re experiencing the symptoms of this stress related condition.

Is work becoming a chore? Has cynicism replaced the enthusiasm you once felt and do you wonder if there’s even any point to the work you do?

Could it be that you’re experiencing burnout?

Prolonged periods of high stress can lead to burnout and to corresponding feelings of mental and physical exhaustion, cynicism and even to despair and hopelessness.

But while we rarely fail to notice the stress that leads to burnout, recognizing burnout when it occurs is not always so easy.

And this is problematic, because left unchecked, job-burnout can have serious health and wellness consequences, such as: insomnia, anxiety problems, depression, substance abuse/addiction and many others.

So to beat burnout you need to learn more about the condition and what causes it and be on the lookout for the signs and symptoms that may indicate its presence – and when you recognize the signs in yourself, you need to be ready to make some changes, because no job is ever worth your health and happiness.

Burnout – Who’s Most at Risk?

People who may be more prone to burnout include those who:¹

• Work in health care or teaching professions
• Lack a balance between home and professional life (your work defines you/you spend far more time working than you do socializing or relaxing)
• Lack control over work-life
• Have a very boring job
• Have a perfectionist nature or those who have a pessimistic outlook
• Receive little recognition or reward for a job well done at work
• Take on more than they can handle
• Lack a social support network of close friends²

Signs of Burnout – Burnout Self Test

Ask yourself the following 20 questions based on the typical warning signs of burnout. The more yes answers you rack up, the greater the chances you are experiencing the condition.

1. Do you feel less decisive than you used to?
2. Do you often feel tired, even when you get sufficient sleep?
3. Have you developed sleeping problems – trouble falling or staying asleep?
4. Do you care less than you used to about other people’s problems?
5. Do you feel like your work doesn’t really matter very much?
6. Do you feel unappreciated for the work that you do?
7. Are you less efficient at work than you used to be? Do you fail to meet the goals you set for yourself or that others set for you?
8. Have you lost interest in the work that you do?
9. Are you more forgetful than you used to be?
10. Do you have mostly negative feelings about your work?
11. Do you get more headaches or unexplained aches and pains than you used to?
12. Do you drink or use more drugs than you used to? – Or are you smoking more cigarettes or overeating?
13. Do you work more than 10 hours per day and do you lack at least one full day completely off from work a week?
14. Do you have more trouble concentrating than you used to?
15. Do you feel unable to do a good job on work you are assigned?
16. Are you more easily frustrated and or irritated by minor annoyances than you used to be?
17. Do you feel like most of the people you work with do a poor job at work
18. Do you avoid spending time with friends or family or find that you don’t enjoy the time you do spend with those closest to you?
19. Do you feel sad?
20. Do you feel like you are being ‘used’ at work?

Answer yes to many of the above questions? If you did, then you probably need to make some changes to your professional life.

Career change can be one way to overcome burnout, but it’s not the only or even always the best way forward. Sometimes, making a few small changes to your work routine or responsibilities, getting more support at work or simply managing your expectations and attitudes is all that’s needed to really turn things around.

Think you may need to make a few changes – then read Overcoming Burnout – Ways to Beat the Blahs.

Image Copyright: Stephen Poff

The 12 Steps of AA provide opportunities for healing, self discovery, and spiritual growth... even for individuals who never experienced addiction.

Unless we're part of a 12-Step community, we're likely to remain unfamiliar with the vast amounts of wisdom contained in their literature and practices. I recommend the 12 Steps of AA even to folks who have never experienced addiction because they provide opportunities for healing, self discovery, and spiritual growth.

I encourage folks to notice that only the first step makes mention of alcohol. Replace "alcohol" with the things that negatively impact your life. Example: "I admitted I was powerless over (earning approval from my family of origin)..." I also urge folks not to get hung up on the concept/wording "God." Religious ideas or deities can be limiting. Change this to whatever works for you.

Wonderful examples of a Higher Power folks have shared with me:

• Love
• Connection
• Community
• Family
• the Universe
• Goddess
• Nature

Adapting the Steps with the Buffet Approach (Take what you like and leave the rest):

Step 1

We admitted we were powerless over ____, that our lives had become unmanageable.

Powerlessness is not hopelessness or helplessness. It simply means we have no control over something. I joke with folks that I am only powerless over nouns (people, places, and things). The only person I need to be in control of is me.

Having a manageable life requires three things:

• acceptance of powerlessness,
  
• rigorous honesty with self,
  
• and the support of good people.
  

When we resolve the aspects of our lives that are unmanageable, the life we most want becomes possible.

Step 2 and 3

Came to believe that a Power greater than ourselves could restore us to sanity.

Made a decision to turn our will and our lives over to the care of God as we understood Him.

This is the choice to believe in something - anything, that can improve our lives. It doesn't require a doctrine or religiosity. If Love can restore us and we consciously choose to be more loving in order to be healthier, that is a great step in the right direction.

Step 4 and 5

Made a searching and fearless moral inventory of ourselves.

Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

A "moral inventory" can be as simple as the untold stories, secrets, and other sources of shame that we continue to carry. If we choose to write these out, we externalize what we've fought to keep from the light of day. If we can share even some of these with trusted others, it lightens our load. The mission of postsecret.com is a powerful example of the liberation folks experience, even in telling their stories anonymously.

Step 6 and 7

Were entirely ready to have God remove all these defects of character.

Humbly asked Him to remove our shortcomings.

Instead of continuing to hide our flaws, let's expose them. Let's share the things we don't like about ourselves and work together to change them. When we don't share our goals we most often disappoint ourselves. When we allow others to support us and hold us accountable, lasting change becomes vastly more attainable.

Step 8 and 9

Made a list of all persons we had harmed, and became willing to make amends to them all.

Made direct amends to such people wherever possible, except when to do so would injure them or others.

Here again is an opportunity to take stock. Each of us lives with regret. Are there apologies to be made? Can we make an effort to right our past wrongs? Even a card or a letter in which we take responsibility for mistakes or hurtful actions can be liberating to those we wronged.

Step 10

Continued to take personal inventory and when we were wrong promptly admitted it.

Taking a personal inventory can be as simple as reflecting on your day. What went well? What still needs improvement? Introspection is the key to continued growth and affords us a safeguard against complacency.

Admitting our mistakes is an ongoing lesson in humility. It prevents resentments from being formed and promotes harmony. This is not a lesson so much as a reminder.

Step 11 and 12

Reduced to pure spirituality:

Having had a spiritual awakening... Sought...to improve...and to practice these principles in all our affairs.

We are free to live with intention and to accept that being a "work in progress" means that we continue to strive toward ideals. Incorporating spiritual practices and consciously choosing our focus for the day allows us to have a life "second to none."

Listen to your body to quickly diagnose a stress reaction... and quickly regain your calm with 2 easy stress-busting techniques.

Not many of us think of stress as something to be appreciated, but the truth is, stress reactions fire us up for peak performance in moments of crisis and danger and increase our probability of survival in life and death situations.

Unfortunately, the stress reactions that make a lot of sense when hunting (or running from!) a large animal don’t offer much of an advantage when lineups at the DMV get your heart rate pounding or when a business meeting has you wanting to jump up and bolt.

Uncontrolled stress does more harm than good in most modern lives, but we still need adrenalin spikes for moments of legitimate danger. Fortunately, if we learn a bit more about how stress works and about what’s going on in our bodies during a stress response, we can learn to outsmart stress when it’s not needed and minimize its negative impact on quality of life.

To beat stress we need to:

1. Understand stress and be able to recognize the physical signs of a stress response
2. Counter or exhaust the physical processes associated with a stress response

Do You Know What Stress Feels Like? Learn to Recognize the Physical Signs of Stress

So you’re at the office and a coworker’s sloppy work is putting the success of your morning presentation in jeopardy... You start feeling some stress. You don’t know it yet, but your body has gone into fight or flight mode and is marshaling physiological resources to either flee or attack.

But while you may want to attack your under-performing colleague, you probably shouldn’t or won’t – so really, you’re building up a surplus of emergency energy that has nowhere to go.

So what’s happening and why?

• Heart – Your heart rate increases, arteries constrict to increase blood pressure and your veins expand to accelerate the return of blood to the pump. More blood is pumped to the muscles of the extremities for quick or powerful actions.
• Lungs – Breathing simultaneously quickens and deepens as the throat and nostrils also expand to allow for greater air flow. All to get more oxygen into the blood traveling to the muscles.
• Energy – Your liver produces sugar energy and bodily fat stores are transformed to sugar for an energy surge in the bloodstream.
• Digestive Processes – Processes involved in the digestion and excretion of food slow or stop and less blood travels to the kidneys, stomach and intestines. You may experience dry mouth or a need to urinate/defecate as a result.
• Sensory processes – Your senses heighten as you prepare to run or fight. Pupils dilate to improve vision, the hairs on your skin stand erect to improve your sense of touch and your brain releases endorphins to improve your focus and to reduce sensations of pain.
• Skin – You start sweating as a prophylactic cooling method and your skin vessels tighten to reduce blood loss in the event of an injury¹

So as your stress response builds you start sweating, your heart pounds, your breathing intensifies and accelerates and a host of other processes combine to make you into the fastest runner or fiercest warrior you’re capable of being.

But that’s not much help at the office, so what are you supposed to do when you recognize the physical signs of stress?

2 Ways to Overcome Stress – "Burn It Off" or "Soothe It Down"

Too much stress does bad things to the body and definitely affects overall quality of life. You’ll never eliminate stress from your life, but you can learn techniques that help you to manage stress a little better and to reduce its impact.

Stressful times are coming, whether you like it or not – but if you can learn to burn off or tame stress in a few minutes, instead of letting stress affect you for hours, you greatly reduce its harmful consequences. Two ways to accelerate your stress recovery are to:

1. Burn it off with vigorous activity
2. Tame it with conscious calming exercises

1. Burn it off – Your body’s stress response readies you for a short burst of intense activity – so why not give your body what it’s looking for and take 10 minutes or so to burn off some energy.

Feeling stressed at the office? Excuse yourself for a few minutes and go for a vigorous walk around the block. You’ll burn off some of the energy you’ve marshaled to ‘fight or flee’ and you’ll calm your mind down enough to arrest the continuation of the stress reaction. Not a fancy solution but an easy and very effective one.

2. Tame It – Sometimes circumstances don’t allow you a brief exercise break. In such situations when you can’t bleed off that extra energy (like during a business meeting, for example) you might try conscious calming exercises as a way to arrest and reverse some of the physiological changes of the stress response.²

Stress causes accelerated respiration and heart rate. By doing deep breathing exercises you can slow your respiration and heart rate and by doing so you signal to your body that any danger has passed and that it can revert to normal functioning.

Try taking a number slow deep breaths and flexing and relaxing the muscles of your stomach and legs and arms. If you can, try counting slowly to 5 as you inhale and again counting slowly to 5 as you exhale.³

Setting boundaries and limits and saying "no" are some of the hardest things for many people to do. Learning to say "no" without guilt, shame or anger is a necessary life lesson in for living an emotionally healthy life. Setting boundaries and limits is about taking care of yourself at least as well as you might take care of anyone else.

The difficulty many people have saying “NO” has been the subject of numerous books, articles, lectures and issues people bring into therapy.

What makes this one word so hard to say without anger, guilt or resentment, and so challenging to stick to?

Why do so many people feel so guilty when they say no that they then have to justify, explain or defend their response?  

When you stop and think about what this one simple word means - and all the emotional energy it carries with it - it’s no wonder so many people struggle with this message.

Do you feel burdened whenever you think about saying “no” to anyone? Do these feelings stop you from saying “no“? Do you feel guilty, or feel that you’ve done something wrong if you finally say it? Can you only say no if you are angry, hurt or upset?

Saying No - Setting a Boundary to Protect Your Needs and Feelings

Saying “no” means you’re setting a limit. You’re setting a boundary, and stating that your needs and feelings matter.  What makes this so difficult for so many people? 

• Were you taught that other people’s needs and feelings had to be considered first?  When you were growing up, did you hear that doing for someone else, even if it inconvenienced you, was better than saying “no” and possibly hurting the other person’s feelings?  Were you given a message in your life that you were wrong, mean or inconsiderate if you said “no”?
  

• Thinking back on that message, how do you feel?--- Where in your body does that message of “you’re wrong, mean or inconsiderate”  sit?--- Where do you tense up?--- 
  

Just allow yourself to be aware of your feelings and the messages that you learned.  Take a deep breath and allow your awareness to give you clarity of your past and the lessons that you learned and have carried forward in your life. When we become aware of our old beliefs and habits, we are then in a position to choose if and how we want to change.

Make a Decision to Respect Your Personal Needs and Feelings

I am not advocating never doing for other people due to the possible threat of inconveniencing yourself.  I am stating that it is important that you also learn to consider your needs and feelings as well.  Take a deep breath and say out loud:  “My needs and feelings are as important to me as your needs and feelings are to you.”--- Let this message resonate within you for a moment before reading on.

This is NOT about selfishness or being inconsiderate; rather, it is about acknowledging that while people have a right to ask for whatever it is they want, you also have a right to decide if giving them what they want works for you.

I am asking you to STOP!  BREATHE!  FOCUS! - and ask yourself what will happen to you and your day if you stop and take care of someone else’s needs.  Just allow yourself to consciously decide what you need or want to do at that point, rather than automatically just saying “yes“, and then feeling angry, resentful, stressed, or even worse, martyred because you said yes. 

Being a martyr really does not make you a better person; usually you end up feeling used and abused and very under-appreciated.  This is not for anyone’s greater good!

As you process the situation, please ask yourself “What is my desired outcome?” - Be honest with yourself about what your needs and feelings really are.  If you find yourself in a position where you want or need to say no, then it really is okay to just say no, clearly and compassionately.  “I’m sorry, but I can’t help you out this time” (then stop and take a deep breath) 

This is a clear and simple answer.  Do your best not to offer an “excuse” because that will trigger your defensiveness, and leave an opening for the other person to “argue” with your excuse causing you only more heartache and stress.   Excuses communicate defensiveness; that somehow without a legitimate reason for saying no, you’re not allowed to do so.  Who’s to say what’s legitimate for you?

Both Men and Women Struggle with 'No' but for Different Reasons

Men and women both have difficulty saying no, but for different reasons. 

Women

Socially, women are taught to be the care-takers, which only further heightens their already innate nurturing styles.  Many young women have been  told that if they say no, the other person won’t like them or will be mad at them.  This message only serves to increase the difficulty of saying no. 

Another message many females get that stops them from saying “no” and setting clear and respectful boundaries is that the other person will be upset and somehow not be able to cope with the disappointment, or that if she says no, she’ll be seen as incapable or selfish.  

Men

Men who have a hard time saying no, often feel like they have to rescue, be the hero, (especially for women) or be the good guy who always comes through in a pinch, etc. 

The bottom line is that all these messages severely undermine one’s self-esteem and belief that “who I am is enough” and “my needs and feelings matter, too”, because the minute you start only taking care of someone else’s needs, you stop taking care of your own.

Choose to Take Care of Yourself

Boundaries are about respecting and taking care of your own needs and feelings while balancing other people‘s as well.  In many situations, someone will be disappointed, hurt, upset, frustrated, etc.  However, you have to realize that it just doesn’t always have to be you.

Learning and practicing to say “no“, to set limits and have respectful boundaries, is about how you feel about yourself, and how you choose to take care of yourself.  It is most essential that you’re willing to, first and foremost, communicate to yourself that you matter, and this in turn will help you to communicate to those around you that you are treating yourself with all the respect that you deserve.

Remember that by treating yourself respectfully, you inherently give permission to those around you to do the same.  After all, if you don’t treat yourself with the love and respect you deserve, how will anyone else know to do that?   When you pay attention to your own feelings and needs with respect and compassion, you are NOT disrespecting anyone else’s feelings, you are simply treating yourself as an equal, and you deserve no less.

Write down the following message and repeat it frequently throughout each day. Start with a slow deep breath and end with a deep breath to really let the affirmation sink in (know that it takes practice, patience and perseverance to change a habit, but always remember that you are worth it!):

“I lovingly and respectfully consider my needs and feelings, and when I say “no”, I do so with compassion and respect for myself and others.”

Image Copyright: Jer Kunz

Feeling stressed out? Want to reduce the negative impact of stress on your health and happiness? Here is an easy 3-part recipe to more serenity.

Feeling stressed out?

Well, you can learn to manage your stress through techniques like meditation or deep breathing exercises, but before you expend a lot of effort to manage your stress – maybe you’d be wise to spend a little time working on identifying exactly what stresses you out… maybe instead of managing some of that stress you can prevent it before it gets a foothold!

Most of us take a reactive approach to stress control - letting stress build and then taking steps to mitigate its effects.

But while stress mitigation is important, it is only the last of 3 steps in a 3-pronged strategy to reduce the impact of life stress.

To really reduce the impact of stress in your life, you need to:

1. Work on identifying exactly what types of situations make you feel stressed - and then modify your behaviors when possible to reduce this stress.
2. Develop a lifestyle that raises your stress tolerance threshold - while you will never be able to eliminate all stressful situations from your life you can reduce their impact by increasing your stress resilience. You do this through changes to diet, physical activity levels, sleep and other lifestyle modifications.
3. Learn to manage your reaction to stressful events that do occur.

Too many of us skip steps 1 and 2 and take a reactive-only approach to stress management with step 3 as our only go-to strategy.

If this describes your approach, try increasing your focus on steps 1 and 2 and see what a difference that might make to your quality of life.

Here are some ideas on how to get started…

Step One: Identify Your Stress Sources

What stresses you out most?

Is it that twice a day commute? Caring for elderly relatives?... That stack of bills on the kitchen table?

Stressors are a part of life and you probably can’t eliminate all, or even most, from your daily routine - that being said, if you focus carefully on exactly what causes you stress in any given situation, you may find that small changes to your routines, behaviors or expectations can do a lot to reduce their impact.

Keep a Stress Diary

To find out what small changes you might make to reduce the stress in your life, consider keeping a stress diary.

For a few weeks, carry a small notebook with you at all times. Whenever you find yourself feeling stressed (or soon afterward) write down:¹

• What you’re doing
• Where you are
• Who you’re with
• The time
• How you’re feeling emotionally
• The kinds of thoughts you’re having
• What you’re doing to cope with the stress
• How you’re feeling physically
  

After a few weeks, take a close look at your diary and search for stress patterns:

• Notice you often feel physically tired before your stress level spikes? ...maybe you need a little more sleep.
• Notice you’re often with a certain person before or during stress episodes? ...maybe you could make some changes that would reduce that person’s stress building impact.
• Notice it’s when running late on commutes that your heart really gets pumping? ...maybe giving yourself an extra 15 minutes in the morning is all you’d need to do.
• Notice that your thoughts are always very pessimistic during episodes of stress? ...maybe learning a few positive self-talk techniques could really help a lot.
• Notice you feel stressed at work when some aspect of your job conflicts with your values or beliefs? ...maybe it’s time to make a significant change at work.

By focusing closely on situations that cause you stress you may find unexpected patterns. Once you can identify what exactly causes your stress you may find that making small changes to your daily routine yields big stress reduction dividends.

Step Two: Make Lifestyle Changes to Reduce Your Stress Vulnerability

You can’t prepare for everything; many stressors are simply beyond your control.

What you can do though, is increase your resilience to stressors. They’ll still come at you - but if you’re resilient, they won’t have as much of an impact on your health and well being.

To increase your resilience to stressors, try:²

• Getting sufficient sleep each night
• Minimizing your use of alcohol, tobacco, caffeine and illicit drugs
• Getting some physical exercise most days
• Eating a healthy diet to keep your energy levels stable
• Not over-committing yourself (learn to say "No")
• Making time for yourself a priority, everyday (give yourself 20 minutes a day to do something relaxing that you enjoy)

Step Three: Get Better at Handling Stress

No matter how you try to eliminate the sources of stress from your life and no matter how you improve your stress resilience you’re still only human and so you’re still going to have to deal with unpredictable stress on occasion.

But while you can’t eliminate stress you can control your reaction to it - and with smarter stress handling you can really do a lot to minimize its negative impact.

So the next time you feel your blood pressure spiking at some frustration or other - don’t let stress run rampage, find your way back to tranquility with one of the following commonly recommended stress management techniques:

1. Walk away or count to 10 -- With a little self-control you can choose not to dive into angry situations sure to amp your stress levels. When you feel yourself getting tense take a moment to calm down before responding to the situation. Try actually walking away for a moment until you feel calmer or counting slowly to 10 before responding.³

2. Try deep breathing exercises -- At a primal level, stress signals the body to get ready to fight or run. Your heart and respiration rate increase and your blood pressure rises and a host of other processes kick into gear to get you ready to move with strength and speed if needed.

However, not many of today’s stressful situations call for physical confrontation or running away…!

Fortunately, you can wrest control from your evolutionary self through conscious efforts, like deep breathing exercises, which signal an end to the stressful situation and result in a calming of physical processes which only serve to heighten our perception of tension and stress.

Try taking a number of deep breaths, making an effort to inhale and exhale for to a slow count of 5 each.

3. Try progressive muscle relaxation techniques -- just as deep breathing exercises signal the body to curtail its stress response, so to do muscle relaxation exercises like progressive muscle relaxation; during which you make a conscious effort to relax all of the muscles of your body – one muscle group at a time.

4. Practice mindfulness techniques -- the present reality of a stressful situation is rarely as bad as we perceive it to be as we intertwine it with all our worries for the future and memories of the past. If you can learn to just focus on the here and now what’s stressing you out often gets a lot less worrisome.

5. Burn off the stress -- Stress gets the body ready to fight or to flee - so give your body what it wants and try 10 minutes of brisk walking or stair climbing or any other form aerobic exercise. After a few minutes of exercise what seemed impossibly stressful can transform into something reasonably manageable.

Could 10 minutes a day save your life? You can’t avoid stress, but if you’re smart, you can use techniques like ‘the relaxation response’ to offset the chronic health consequences. Read on to learn how to get started…

Invest 10 minutes a day on your health and happiness and never get stressed out again.

Stress takes its toll…but with tools like the relaxation response you can limit the mental and physical health consequences of a stress filled modern lifestyle.

Stress triggers the body’s flight or fight response, causing a surge of adrenalin, increased heart and respiration rate, increased blood flow to the muscles and a great many other physiological responses - all of which are quite helpful if you need to fight off a pack of wolves - but not so helpful when you’re infuriated by red tape at the DMV!

And unfortunately, the long term consequences of chronic stress can include conditions like high blood pressure, chronic muscle aches and pains, fatigue, sleeping problems, lowered immune system functioning and an increased risk of anxiety and depression.¹

But it’s not all bad news, if you’re willing to learn techniques like the relaxation response and able to invest a little time for stress reduction each day then you can do a lot to reverse the harmful consequences of a stress-filled lifestyle.

The Relaxation Response 

Stress amps you up – the relaxation response calms you down.

The relaxation response is a state of peace and resting that causes a reversal of many of the physical and mental consequences of stress. During a relaxation response your metabolism slows, your heart and respiration rate decrease, your blood pressure falls slightly, more blood flows to your brain and your muscles relax.

Once in a relaxation response you feel the stress-busting benefits right away, and even better, if you practice the relaxation response regularly you’ll notice that the calm and serenity you feel during the exercise will soon expand across the rest of your day to day activities.²

And that’s not all; research shows that people who make the relaxation response a regular practice can achieve lasting mental and physical health benefits, such as:

• Decreased chronic pain
• Lowered blood pressure
• Lower stress hormone levels
• Better thinking and decision making
• More energy and motivation
• Less muscle tension
• Less fatigue
• Less anxiety
• Less irritability³

In fact, making the relaxation response a daily habit may well increase your longevity. When researchers looked at how the practice influenced things at the genome level they found that people who did regular relaxation response exercises experienced anti inflammatory and anti oxidant changes that protected cells from the toxic effects of chronic stress. ⁴

So, are you ready to invest 10 to 20 minutes a day to feel more calm across all situations, to protect yourself from disease, to feel more energy and decisiveness, and maybe even to live a few years longer?

How to Do It - Achieving the Relaxation Response

Here’s how to do it, as taught at the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital.

Before You Start

1. Think of a phrase, prayer, word, sound or even a muscle movement that you’ll repeat over and over for 10 to 20 minutes. If you can tie this into your belief system so much the better – so if you’re Christian you might use a line from the Lord’s Prayer, for example.
2. Understand that you are going to try to clear your head from any extraneous thoughts while you do your practice. That being said, thoughts are always going to drift into your mind no matter how you try to stop them, so when this happens, you just try to let them float away as you refocus your attention on your repetitive mantra.

Getting Started

• Sit comfortably and close your eyes
• Begin progressively relaxing your muscles. Start with your feet and focus on relaxing them as much as you can, then move to your calves and then thighs and buttocks, to the abdomen and all the up to the shoulders and neck.
• Try to breathe slowly and calmly and start silently repeating your chosen word or phrase on every exhale.
• Don’t worry about how well you’re doing or whether you’re doing it right and when thoughts intrude, just let them flow past and refocus your attention on your word or phrase.
• After 10 to 20 minutes, stop repeating your word or phrase, but continue to sit with your eyes closed for another minute or so as you allow your thoughts to return slowly to your conscious awareness.
• Open your eyes but sit for another minute before getting up
• Do this once or twice a day

Take Some Time for Yourself

You probably won’t find getting into a relaxation response very difficult, and if you can find the time to do it regularly then you’ll experience some great health and wellness rewards, but if you try this method and find that it’s not for you, you can achieve the same types of results through other activities that pull you into a similar state of mindfulness.

Other activities that can induce a similar relaxation response include:

• Mindfulness meditation
• Relaxation with imagery techniques
• Repetitive praying
• Progressive muscle relaxation

Image Copyright: Nattu

For first responders at risk of PTSD and burnout, learn more about: daily habits that protect you, red-flags that warn of an impending problem and adaptive response techniques that safeguard your professional standing.

First responders (fire fighters, police, EMTs, ER staff and others) are recognized as being at significant risk for developing Post Traumatic Stress Disorder. Our risks are increased not only by the potential for experiencing traumatic events but are also due to the extremely stressful and draining nature of our work. Career and personal burnout are often the precursors to these conditions but seem to be viewed as inevitable.

We’re held to higher standards than the general public. What we do can make the six o’clock news and then get reviewed under a microscope. The pressure of such scrutiny is intense. We learn to hide not only our emotions, but also our scars.

Our work is honorable. If we are to honor ourselves, our colleagues, and our loved ones then we must accept these responsibilities:

1. Taking steps to avoid burnout and lowering our risk of becoming overwhelmed on and off the job.
2. Recognizing the red flags that indicate we’re struggling and responding to them adaptively.
3. Identifying and utilizing resources and supports that can be accessed without potentially compromising our professional standing.

Avoiding Burnout

In all my years of clinical practice I’ve consistently found that it’s not generally what we do that causes burn out. It’s what we don’t do. We don’t find healthy releases for the stress we accumulate. Establishing certain daily and weekly routines makes us less susceptible to becoming overwhelmed and developing unhealthy forms of coping.

Daily Habits

• Learn how to leave work at work. Develop a ritual for concluding your workday. Put things in order routinely and with the awareness that work is ending for the day and going home means not continuing to anticipate or plan for the next emergency.
• Learn how to change hats at home. Literally put down the tools of your trade and initiate a routine for what you do when you get home.
  
• Invest in organization. Do mundane things methodically in order to reduce stress in your overall life (plugging in your cell phone).

Weekly Habits

• At least once per week, set aside time to talk with someone who not only gets you but also understands the work you do. We protect those we love from the details of what our work often demands of us.
• Implement at least one activity that provides release both physically and emotionally.
• Make time for the people who matter. Maintaining close ties through shared time and activities sustains you. After all, the biggest fear those of us on the front lines have is the fear of losing those whose love keeps us going.

Recognizing Red Flags

It’s always easier to explain away (rationalize) or ignore signs of cumulative stress. We’re acutely aware of what others need and not aware of ourselves beyond how we perform our duties.

At Risk Signs:

• Chronic fatigue, sleep disturbances, nightmares, frequent waking.
• Having to use excessive amounts of aspirin, antacids, nicotine or caffeine to get through the day.
• Mood instability, being quick to anger, lashing out, low frustration tolerance, impatience.
• Loss of perspective – small annoyances are infuriating, minor stressors seem overwhelming, financial stress or relational problems are at the forefront of our minds and interfere with focusing on the work at hand.
• Decline in quality and quantity of food intake, lowered sex drive, reduced interest in hobbies or pursuits you usually enjoy.
• Difficulty processing verbal or written instructions.
• Feeling overwhelmed by sensory input (sound, sight, smell).
• Hesitation during times of crisis.
• Increased use of drugs and alcohol, using earlier in the day, the feeling of “needing” a drink.
• Decline in self care, loss of interest in things we normally enjoy a great deal, withdrawing socially, isolating ourselves from loved ones.

Responding Adaptively

The importance of support systems cannot be overstated. Having people in our lives that are willing to challenge us and tell us what they’re noticing is vital. Having an eclectic group of colleagues, friends, and family who are supportive of not only our work, but of us as individuals, ensures that we go through no hardship alone.

Maintaining connections means having lifelines during times of need. Accountability is key. Being brutally honest with those we trust allows us to explore options. Two heads aren’t just better than one – they’re a million times better than one.

If Your Job’s on the Line

Unfortunately, the systems we serve often fail to provide the resources and supports we need to maintain the high standards demanded of us. Our “Human Resources” seems aptly named. Too often we’re seen as resources to be used up, not protected.

If reporting traumatic stress, addictions, or other mental health conditions will endanger your professional standing, then manipulating systems is warranted in order to get your needs met. The risks of not getting help are too great.

Support Options

Seek out professionals and paraprofessionals who are not required to report to your superiors:

• Recovery coaches and life coaches are solid options for treatment. Many of us have the same training as therapists and addictions counselors and some of us choose to be both licensed professionals and “coaches.” The importance here is that coaches are not required to maintain documentation of any kind nor are they required to report to any governing body.

Know your rights. If you choose to see a clinician you have the right to confidentiality (exceptions: reporting being homicidal, suicidal, or the abuse of children). Know that your diagnosis will be reported to your health insurance provider. If being diagnosed with PTSD or other serious condition could jeopardize your position, I recommend interviewing your clinician and saying something like this:

• “I cannot admit to having symptoms that would be consistent with PTSD or other significant mental illness. Are you willing to work with me and consider a diagnosis of an ‘adjustment disorder (benign diagnosis) due to my current job stress or would you be willing to refer me to someone who would?”

We must be willing to go to any lengths to protect ourselves and those we serve. Seek out brothers and sisters in your field who have been on similar journeys. Do not go through this alone.

Image Copyright: Thomas Hawk

Living with a person with bipolar is overwhelming. We often neglect ourselves and this can lead to burnout. Here are some tips for caring for yourself when the goal is to help a love one who has bipolar disorder.

If your loved one suffers from bipolar disorder, you suffer too.

When you love somebody you are emotionally connected to that person, so if that person rides an emotional roller-coaster, you are also dragged onto the dangerous and scary ride. It is really difficult to maintain your own stability when the household feels like a tornado. On the other hand, you know that you are the one that needs to be strong to stabilize the family. It just seems like one impossible task.

How You Can Help Most

If you take on the challenge to single-handedly enforce “normalcy” then it's probably an impossible task. However, since very few homes constantly and consistently approximate the ideal of a normal home, that should not be your goal.

So even if strength and stability are what you contribute to the household, you don’t need to force it and be responsible for everybody’s strength and stability.

A more reasonable goal would be to become and remain a beacon of strength and stability that others can learn from.

Avoiding Burnout

Living as a beacon of strength is no easy task! To do this you need to care for yourself, which can feel selfish - and even if you are caring for yourself so you can give to others, your loved one is likely to accuse you of acting selfishly.

None-the-less, it is the best thing you can do for the bipolar sufferer as well as everybody else involved. There needs to be one person who acts as the emotional lightening rod, the grounding force that releases the emotional shocks, the one who can anchor the floundering ship to stable reality. Sometimes that just has to be you. How in the world are you going to do that without “killing” yourself?

You have probably experienced some of the symptoms of burnout, even if you have not yet fallen apart from it.

You're on the verge of burnout if:

• You have ever felt like just escaping because it seems to you that all the effort is useless
• You have felt like you just don’t care anymore
  
• You feel that you need to throw in the towel

However, once you bounce back you realize that those feelings were not “really you”.

You need to act as a source of stability. You can't act this way when on the verge of burnout, so here are some tips for avoiding that overwhelming, burnt-out state of mind:

Tips for Avoiding Burnout

Care for Yourself First

If you’ve ever been on a commercial airline you’ve heard the safety speech: if the oxygen masks deploy, take care of yourself and then help your kids.

It makes sense. If you are going down the drain, how will you help the one you love? So take a look at your life:

• What would you do to have a sense of well-being if you were not caring for anybody but yourself?
  
• What are your own personal goals and priorities?
  
• Have you let that wonderful hobby (dancing, football, gourmet cooking, or whatever) fall to the side because there is just not enough time?
  

It could be that two hours twice a week for a hobby could help you be more efficient during high-stress periods, so in the end, you actually get more done.

Find External Meaning and Purpose

Another tactic to enhance a sense of well-being is to become active in some volunteer organization.

Get involved in something that's bigger than you and your problems:

• It could be a church or other religious group
• It could be a social cause
• It could even be an involvement in something connected to the illness such a joining NAMI or organizing a support group (albeit for some people such activities could have the opposite effect.)

There are other places to look.

• Have you lost contact with a special friend or relative? Put that on your priority list - Make a date for coffee and catch up (but not for coffee and ketchup).
• Have you put off school or training? Think about how to keep yourself in the loop. Refining your skills will make sure that you remain up to date just as you would have been if not for these added challenges.
  

Additionally, you don’t want a feeling of resentment when he or she recovers and your social life or professional life has been sacrificed with nothing to show for it.

Find Social Support

Stigma is scary. We live in a society that punishes people with mental illness in all sorts of subtle and not so subtle ways. Therefore too many of us try to hide that we are dealing with a misunderstood illness.

You need to find at least one other person that you can share your experiences with:

• Somebody you can trust who you know will not take over some of your responsibilities. If you feel that they might take on some of your load you might not want to burden them with your issues.
  
• This is a good goal for therapy if you don’t have an acquaintance that can do the job. Support groups are supposed to serve this purpose also. Join a support group and see how it goes.

Set Boundaries

This deserves an article on its own (see the article “Maintaining Boundaries: How to Say No with Compassion”). Without strong and reasonable boundaries, your other efforts for self-care will be sabotaged. You need boundaries for your time, place, emotions and virtually every area of life.

Take a good hard look and evaluate how much you can do before your begin the burn-out process:

• You need your sleep and other time to achieve your personal goals.
• You might need to place a financial boundary to make sure an attack of mania doesn’t deplete your bank account.
• If you are employed out of the home you might need a rule that your workplace is off-limits.

Most important: once you have the limits in place stick to them!

Manage Your Stress

You will be stressed, but you do not have to be “stressed out.”

Remember that a certain amount of stress can be healthy; it motivates us to get things done. But constant and overwhelming stress needs to be avoided since it will cause all sorts of unpleasant reactions in your body and to your mind. So the goal is to manage your stress – keep it in its place. This topic also deserves an article for itself (see 9 Ways to Deal with Stress).

I would like to point out that there are two ways of thinking that most people have when it comes to stress:

1. Stress vacations
2. Lifestyle management
   

Stress Vacations

In the “vacations” category are those things that people do to escape their stress. Besides actual vacations, this can include taking in a movie, going to a party, or even taking a walk. These are good tools, but they do not significantly change your ability to handle stress. If you’ve ever taken a vacation because of living through a stressful period, you quickly realize that your problems do not go away and the stress returns soon after the vacation is over. 

Lifestyle Changes

Lifestyle changes increase your ability to deal with stress. Examples might be adopting a healthier diet or sleep schedule, or taking up a practice of meditation - or even taking a walk, if it is a regularly scheduled and important part of your daily ritual (whether you need it or not.)

Build a Team

If you have read this far you are probably thinking, “I already had too much to handle before all these suggestions - if I follow them all, I certainly won't have enough time or strength to do everything.”

You’re right. If you could not do it alone before, it will still be difficult after you start taking better care of yourself (even though I’ve seen it become easier, it is never easy to “walk on eggshells” whenever you are home.)

So one more important project in this list of suggestions is to find a partner who can pitch in with you. It could be a relative or a close friend. Sometimes it is worthwhile to consider a friend of the loved one who can help. In American culture we tend to be more isolating than in many other cultures, and can be embarrassed to ask for help. On the other hand, in our culture we tend to give help more easily than in many other cultures. So overcome any embarrassment and reach out, either to a private person or to an organization that can meet some of your needs.

Image Copyright: Lauren Rushing

Need to cut your stress load but not sure where to start? Well, if you live or work in noisy surroundings your environment may affect your physiological stress response in ways you’re not even aware of. Reduce some of the noise pollution from your life and see if you don’t feel a little more of the serenity you’re after!

Feeling stressed but not sure what’s causing your distress?

Could the background noise you live with day in and day out – that noise you think you’ve learned to ignore – be contributing to your overall stress levels? If you’re subjected to regular moderate to loud noise levels, then the answer is probably yes.

Consider the following research studies which illustrate just how noise levels affect our physiological functioning in ways we’re scarcely conscious of.

Research Demonstrating How Noise Contributes to Stress Levels

New Airport Leads to Stressed-Out Kids

Using the opening of a new international airport to model a noise experiment, Cornell University researchers measured physiological stress indicators and other quality of life measures among a sample of 9 to 11 year old children in the period prior to the opening of an international airport and again after its inauguration.

The Results

Among study subjects, resting blood pressure and overnight stress hormone levels (epinephrine and norepinephrine) rose and quality of life indices fell after the opening of the new airport and a corresponding increase in environmental noise levels.¹

In another major airport noise study out of Munich Germany, researchers found that the opening of a new airport caused reading and memory scores to decline among children living in the noise affected area. Children living near a newly closed airport, by contrast, demonstrated improved reading and memory performance.²

Low Level Office Noise Increases Stress and Decreases Performance

Cornell University researchers say that even low noise levels – like those found in typical open plan office environments, can lead to elevated stress and performance deficits.

For their study, the researchers assigned a group of office workers to one of two environments for a three hour work period: a quiet environment or an environment with noise levels typical of open plan offices.

After the three hours were up, the researchers measured urine stress-hormone levels and asked each subject to attempt to solve an unsolvable puzzle.

The Results

Subjects from the ‘noisy’ group had elevated urine levels of the stress hormone norepinephrine

Subjects from the ‘noisy’ group made fewer attempts at solving the unsolvable puzzle before giving up (a test of task motivation)

The researchers conclude that even moderate office noise levels have an adverse effect on stress levels and worker motivation.³

Noisy Wards Make for Stressed Nurses

Researchers at John Hopkins School of Medicine wanted to know how noise might affect stress levels among nursing staff in a hospital pediatric ward. To find out, they monitored a team of nurses, constantly measuring for noise level and heart rate and measuring for perceived stress and annoyance levels every half an hour throughout a shift.

The Results

Nurses experienced tachycardia (elevated heart rate) as noise levels rose. Higher noise levels were also associated with higher self reports of stress and annoyance levels.

Echo in the Classroom Affects Peer to Peer and Teacher Student Relationships

German researchers found that elementary children learning in classrooms with poor acoustics (more echo) performed worse on measures of speech perception and verbal memory than children who learned in classrooms with better acoustics.

Interestingly, poor classroom acoustics affected more than just learning – children in classrooms with greater echo also rated their teachers and peers less positively than students in classrooms with better acoustics. The way the room influenced sound altered the way the students evaluated the people around them.⁴

Reducing Noise to Reduce Stress

You can’t eliminate unwanted noise from your life but making a few small changes may help you to eliminate at least some.

Noise stressing you out? Try:

• Blocking traffic and street noise by switching to double or triple paned windows or through the use of noise muffling/blocking curtains. If possible, you may also try sleeping or working in a room which faces onto a quieter street or area.
• Add insulation and weather striping
• Plant trees, bushes and hedges around your yard – particularly between your house or office and a source of consistent noise – the noise muffling impact of a thick hedge can be dramatic.
• Thicker carpets or drapery like wall hangings (as well as curtains, again) will do a lot to muffle sound which passes through floors or walls.
• Put your ringtone on vibrate only, whenever possible
• Try white noise machines or noise cancelling headphones
• Hold off on running the dishwasher or laundry machine until you’ll be leaving the house. Also, try not to rest noisy vibrating appliances next to dividing walls
• Turn off that background TV or radio, unless you’re paying attention, it’s just noise pollution
• Make sure to buy quieter appliances when replacing your existing machines
• Move home or work spaces. This is a pretty dramatic step but if you can’t get rid of what’s causing you stress, you need to consider how much your stress is affecting your health

Image Copyright: Matt Hintsa

Stressed out and wondering why you’re so forgetful these days? Try stopping to smell the roses for a change and see if your memory doesn’t improve a bit… Learn more about how chronic stress impairs your ability to form and retrieve memories and learn how chronic stress destroys brain cells and leads to accelerated age-related memory loss; and most importantly, learn what you need to do to protect yourself from this type of cognitive decline.

Feeling frazzled from stress and wondering why you’re so scatterbrained these days?

Well stress and memory are more linked than you may realize and though you may think you can learn to live with high daily stress levels, your brain doesn’t really ever get used to it - as is demonstrated by how significantly stress can mess with your memory.

Maybe it’s time to slow down and learn to relax? Is what’s stressing you out worth risking your memories over?  Because though chronic stress can lead to problems with memory formation and retrieval today (where did I put those car keys!) the long term consequences of elevated neural stress hormones can be scary and irreversible, like brain shrinkage in areas of the brain linked to memory and accelerated age related memory loss.

How Chronic Stress Damages Your Memory

While sudden moments of stress can focus your memory (which is why people who go through traumatic experiences sometimes remember everything in too much detail) in general, high stress levels work against the formation and the retrieval of memories. And when you think about why this is, it makes a lot of sense.

For memory formation to occur you need to:

1. Pay attention to something and encode a piece of information as a potential memory
2. Consolidate that bit of encoded memory so that it makes it into longer term memory storage (beyond the very short confines of the working memory)
3. Be able to retrieve that bit of encoded information as a memory at a later date

All of these processes require mental energy, any of these processes can be derailed by stress and if any one of the three steps of memory get derailed – the memory won’t work.

When you’re stressed about something you focus a lot of mental energy at the source of your stress. So if you're stressed about a meeting you just had with your boss you may be replaying the meeting in your head and using up a lot of your potential attention on your internal thought processes.

Encoding Problems - Now imagine you get a phone call from your spouse who gives you a shopping list of items to pick up on the way home. Although you hear the list as it is said to you, your attention is so diverted onto the focus of your stress that you don’t even encode the information as something to be remembered. You might not even remember a need to stop at all on the way home!

Consolidation Problems - Or maybe you do manage to focus on the list for a moment and think you’ve got it, but as soon as you hang up the phone, instead of rethinking about the items you need to pick up, you go right back to stressing about work and that list never gets consolidated into a long term memory. (One main way we consolidate an encoded memory is through repetition…eggs, butter and cheese…eggs, butter and cheese…). On the way home you remember that you’re supposed to buy something, but you have no idea what!

Recall Problems – Even if you manage to stay focused on encoding and on consolidating a memory, stress can still derail things at the last stage, as you try to recall your encoded information. So imagine you’ve got the list in your head and you head into the store and as soon as walk in you see the person you just had a difficult meeting with at work. This spikes your stress level and your attention is once again very diverted to the source of your stress – and you find that when you try to remember what you came in to buy, you can no longer retrieve your memory.

So your brain only has a finite amount of attention to focus. When stressed, you focus a great deal of your attention on the source of your stress. When you fail to focus your attention on the encoding or consolidation of a memory, it can derail the process – just as stress can also derail the ability to access a memory.

If you are under a chronic state of stress, your mind is never able to focus as completely as it should on memory processes, and so chronic stress diminishes your ability to remember.

The Neuroscience of Stress Related Memory Impairment

Chronic stress causes increased levels of the stress hormone cortisol in the brain and cortisol interferes with the normal functioning of neurotransmitters involved in memory processes.

• In the short term, stress causes a spike in cortisol that interferes with memory processes for a couple of hours
• And in the long term, chronically elevated cortisol levels (from chronic stress) are actually toxic to brain cells and can result in shrinkage in areas of the brain essential to memory processes

So chronic stress causes both immediate memory impairment and the potential for lasting damage down the road…

Researchers can observe this cortisol effect in animal model experiments.  In one experiment, rats that had been trained to find their way through a maze were given an electric shock (a stressful event) and then tested on their ability to recall the path through.

• When tested 2 minutes after the shock the rats had no problem finding the path through
• When tested 4 hours after getting shocked the rats had no problems remembering the path
• But when tested 30 minutes after the shock the rats couldn’t remember the way out of the maze

This memory deficit is explained by the rise and fall of cortisol levels in the brain following a stressful event.

1. Cortisol levels do not rise for a few minutes after the event

2. Cortisol levels rise after a few minutes and stay elevated for as long as a couple of hours

3. By 4 hours after the stressful event cortisol levels have returned to normal

When cortisol levels rise memory is impaired. Before and after this rise, memory is unaffected.¹

The Stress Hormone Degenerative Cascade – Once It Starts It’s Hard to Stop

Your chronic stress may be giving you memory problems today – but if you’re smart, you’ll reign in some of that stress now before it has a chance to do lasting and permanent damage.

High levels of chronic stress can cause memory problems in people at any age, but for older people, especially people who have been stressed for a long time, stress levels can lead to a downward spiral of memory-related brain damage called the degenerative cascade.

Here’s what happens:

1. Chronically stress increases cortisol levels in the brain.
2. The hippocampus is the area of the brain which is largely responsible for memory formation and retrieval. The hippocampus is also the area of the brain which controls cortisol levels and which signals for a reduction in cortisol secretions after these levels reach a certain elevated point.
3. High cortisol levels are neuro-toxic and cause brain cell death in the hippocampus. Prolonged elevated cortisol levels (such as from years of chronic stress) can lead to a significant shrinkage of the hippocampus and a decreased ability for the hippocampus to regulate cortisol levels.
4. In time, after years of cortisol damage, the hippocampus is less able to effectively monitor and signal for a reduction in elevated cortisol levels (it can no longer close the feedback loop) and so stress can cause high cortisol levels that stay elevated and do accelerated and continuing damage to the memory areas of the brain.²

Once reached, this stage of ongoing damage (called the degenerative cascade) is very difficult to arrest.

How to Improve Your Memory

If chronic stress affects your memory you might logically want to take steps to reduce your stress level – but beyond this, you can also improve you memory through conscious effort.

To counter the negative effects of stress on your memory, try:

• Focusing – Stress derails memory by diverting much of your mental focus away from what you need to remember. You can counter this by consciously focusing your attention on any task at hand, one task at a time. If you’re talking with someone on the phone, for example, resist the urge to check emails at the same time, as you may find that by the end of the conversation you’ve missed something important.
• Using Mnemonic Tricks – By associating information with easily remembered songs or acronyms you strengthen the encoding and ease the retrieval.
• Repetition – Nothing fancy here ( we all do it when trying to remember a phone number) but mentally repeating information to be remembered increases the odds it’ll get encoded into longer term memory storage.
• Visualization – Tying a memory to more than one form of sensory perception strengthens the encoding and ease of retrieval. If you need to remember a shopping list, visualize each of the ingredients on it, and to further help things along. imagine what each will feel like in your hands and what each will taste like.
• Association – If you can relate new information to information you already have in your memory banks you strengthen the encoding process. So, for example, if you are trying to remember instructions on how to repair your broken bicycle, associate each of the steps with something you know well, such as steps of car repair. ³
  

Image Copyright: Cayusa

The physical, mental and time demands of caretaking coupled with the emotional aspects of the job make burnout an unfortunate end point for too many who take on the important task of caring for a loved one. But it doesn’t have to end that way - Read on to learn 5 risk factors that up your odds of burnouts and see if you can’t make some changes today to protect yourself against the stress of tomorrow.

Caregivers live and work a tough and often thankless job.

You work long hours and you deal with a daily combination of physical exhaustion and the difficult emotions that accompany caretaking for a loved one. Given all this it’s unsurprising that caretakers are at high risk of burnout.

But though all caretakers need to watch-out for burnout warning signs there are some caretakers who may face a higher than normal risk of stress and meltdown.

Are you at high risk of burnout?

Read on to learn more about 5 risk factors that up your odds of caretaker burnout - and if you see yourself described below consider what changes you might want to make to reduce the personal price-tag of your caretaking responsibilities.

5 Factors That Increase Your Risk of Caretaker Burnout...

Feeling Unsure about Your New Role as a Caregiver

Are you a wife to your husband or a nurse for his needs?

Are you a son to your father or the caregiver of an elderly patient?

Caregiving shifts the grounds of previously stable relationships and now that you’ve taken on a caretaking role the way you relate to your loved one probably needs to change.

Resolving this new dynamic to everyone’s satisfaction takes some time and effort but until you do role confusion adds greatly to everyday caregiving stress and increases your risk of burnout.

Being Overly Optimistic

In a lot of caregiving scenarios, there’s no real possibility of improvement - in fact, in many situations, the only probable outcome is deterioration…no matter how well you care and no matter how hard you work.

If you are dealing with a permanent or progressive condition it’s important that you accept – with your head and your heart – that you can’t change the course of fate and that no matter what you do you are going to watch things get worse.

Once you can accept this and accept and own the emotions that accompany this fact you can move forward in a more authentic and eyes-open manner – and authenticity and truth are great protectors against stress and burnout.

Trying to Do It All on Your Own

If you think you’re the only one who can or should care for your loved one then you’re on a fast train to burnout.

Caretaking is a 24 hour a day 7 days a week job and you’re a human being like the rest of us who needs sleep and time off and the company of other friends and family on occasion.

If you can’t learn to say no, set limits and ask for help when you need it then you’re at high risk of burnout – and you’re no good to anyone once the stress wears you down.

Striving for Perfection

When you add on a new full-time job (caregiving) onto to your existing responsibilities you’ve got to learn to cut yourself a little slack every now and again.

It’s not all going to go perfectly. That’s OK – you’ll do the best you can, you’ll learn as you go and you will do right where and when it really matters.

Failing to Educate Yourself about Burnout

One of the greatest risk factors for complete burnout is failing to notice or heed the warning signs as they emerge.

Caregivers risk burnout. It’s just a fact. You need to understand the reality of this serious stress condition and understand that you aren’t immune to it - no matter how strong you might think you are.

Learn more about burnout and look for the warning signs that might indicate its emergence – and if you do see signs of burnout, make sure you make the serious changes necessary to protect yourself. ^{1 2}

Image Copyright: Astragony

Feeling stressed out? Well, if that’s how you feel on a regular basis you might want to think about making some lifestyle changes, before that stress load starts to compromise your health.

In an abstract way you know that your work stress can’t be beneficial to your health – but do you how many medical conditions are linked to excessive stress?

Not sure? Well here’s a short list of 33 stress linked medical conditions. Read on to see if your stress load might already be affecting your health and consider while you’re at it if whatever it is that causes you such stress is worth compromising your health over.

33 Stress Linked Mental and Physical Health Conditions

1. Heart attacks – acute stress can trigger heart attack in susceptible people

2. High blood pressure

3. Arrhythmia – acute mental stress can cause arrhythmia

4. Atherosclerosis

5. Obesity – stress increases levels of the hormone cortisol and elevated cortisol levels lead to increased belly fat storage. Retaining too much belly fat increases your risk factors for cardiovascular disease (more so than fat stored in other areas of the body). Stress may also prompt ‘comfort eating’

6. Reduced immune function – more likely to get colds etc. as well as more serious infections

7. Worsened GERD or peptic ulcer

8. Worsened IBS

9. Alzheimer’s disease – in animal model studies, stress is shown to accelerate the progression of brain lesions.

10. Headaches – stress is a very common cause of headache and the way we tend to tense up muscles when stressed will exacerbate an existing headache

11. Diabetes – stress worsens diabetes by increasing glucose levels. The adrenaline and cortisol release during a moment of stress also cause the release of a burst of glucose in the blood – for instant energy in a moment of crisis.  It may also cause people to engage in other behaviors which worsen diabetes, such as drinking or eating to excess.¹

12. Asthma – stress can lead to shortness of breath which can trigger asthma. Stress may also lead to immunocompromise which can worsen or even cause asthma. ²

13. Sleep problems (insomnia) – Stress can cause hyperarousal and this can make it hard to fall asleep, hard to stay asleep and it can affect the overall quality of any sleep that you do manage to get³

14. Depression – Chronic stress is linked with depression in a number of ways. It can cause reduced levels of neurotransmitters like dopamine and serotonin and elevated levels of stress hormones like cortisol and this can result in a disruption of the regulation of everything from mood, to sleep to energy. Chronic stress can also lead to the adoption of lifestyles, like drinking alcohol to excess, which also increase the risk of depression and other mental illnesses. ⁴

15. Anxiety

16. Muscle tension and pain – Usually in the shoulder, neck and head regions⁵

17. Chest pain

18. Fatigue

19. An increased likelihood of substance abuse and tobacco use

20. A worsening of preexisting skin conditions, like eczema⁶

21. Memory problems – In times of stress the body secretes the stress hormone cortisol. Cortisol interferes with the functioning of neurotransmitters normally used to retrieve memories (which is why your mind can sometimes go blank in very stressful situations) and it also depletes the brain of glucose (the glucose is sent to the body to ready a fight or flight reaction.) This depletion of glucose in the hippocampus impairs the formation of new memories. Excessive cortisol in the brain over a long period of time is also linked to the degeneration of the hippocampus, the brain’s memory center.⁷

22. Trichotillomania – pulling out hair or picking at skin

23. Hair loss/baldness – Stress can cause two types of hair loss: alopecia areata and telogen effluvium. The good news though is that stress-caused hair loss isn’t necessarily permanent, and if you can reduce the stress in your life you might even see hair re-growth in bald areas.⁸

24. Worsened acne

25. Psoriasis

26. Chronic obstructive pulmonary disease

27. Painful menstruation

28. Erectile dysfunction

29. Fertility problems

30. Lower back pain⁹

31. Worsened rheumatoid arthritis – Stress may increase the perception of arthritis pain¹⁰

32. Nausea and Diarrhea

33. Increased Incidences of Herpes outbreaks – research shows that for infected people, prolonged elevated stress is associated more frequent outbreaks. Occasional acute stress is not¹¹

Image Copyright: AldoAldoz

Caregiving, if you’re not careful, often leads to burnout. The hours and the frustrations take a significant toll and unless you’re vigilant, you’ll put your health and happiness at risk. But it doesn’t have to go that way – learn 8 ways to be an effective and compassionate caregiver while still protecting what’s important to you and your family.

If you’re not careful, caregiving can lead to burnout – for no matter how good your intentions and no matter how much you love the person you care for – at the end of the day, month or year…this job can wear you down.

And once you’re at burnout, not only is caregiving compromised, you also put your own health, happiness and relationships in serious jeopardy.

But it doesn’t have to go this way. Caregiving is never going to be an easy job, the hours are always going to run long and you’ll never get the thanks you deserve for all you do; but if you’re careful, you can do this for the long run and do it well, without sacrificing what’s important.

Feeling overwhelmed?

Read the list of burnout warning signs below and check yourself to evaluate whether you might already be in burnout mode.

And whether you’re already in trouble or just hoping to avoid it, take a look at the advice on avoiding caregiver burnout and see whether you might want to make a few changes to your daily routines in the interest of caring for yourself – as you care for others.

Warning Signs of Caregiver Burnout

Some caregiver burnout warning signs include:

• Becoming more easily frustrated or irritated – losing your temper more easily
• Experiencing sudden mood fluctuations
• Worrying all the time – such as about whether you have enough money to keep things going or if you have enough knowledge to do a good job as a caregiver
• Feeling guilty that you can’t do more
• Coming to resent your caregiving duties or the person you care for – starting to care less or even starting to think about harming the person you care for
• Often feeling sad or lonely – experiencing depression
• Losing interest in activities you used to enjoy
• Crying a lot
• Experiencing lowered self worth
• Feeling overwhelmed – becoming less able to stay focused or concentrate
• Forgetting your own self care – failing to take care of your own health problems
• Starting to miss/skip your own appointments
• Becoming more socially isolated – skipping time with friends and family
• Unexplained aches and pains – back pains or headaches
• Having difficulty sleeping well – or sleeping more than you used to/need to
• Initiating or increasing the use of tobacco, alcohol or drugs
• Lowered immune function – you get sick more easily
• Persistent fatigue
• Weight gain or loss¹

Preventing/Dealing with Caregiver Burnout

Whether you’re already experiencing burnout or you’re sensibly planning ahead to reduce your risks of overwhelming stress and exhaustion, there’s a lot you can do to become a more effective caregiver without sacrificing so much of your own health and happiness.

Tips for preventing or dealing with caregiver burnout include:

1. Get Educated

The more you know about the conditions you’re dealing with the more effectively you’ll be able to use your time and resources. Education helps you take back control over the process as you gain enough understanding of this issues to make your own effective choices – and since with more education you’ll make better choices, you can also feel good knowing that your efforts are where they need to be.

Education helps you to understand the situation, take more control over your caregiving responsibilities and be more effective during the time you spend on the job – and these are three highly protective factors against burnout.

In addition to general disease knowledge, you’ll also want to acquire specific caregiving skills which can increase your confidence and which will protect you from injury (from heavy lifting for example) and from overwhelming fatigue. You can learn caregiving skills from books, websites and videos, but you may also want to ask for specific training. If you work at all with an occupational or physical therapist, they may be willing to demonstrate certain techniques that can help you a great deal. ²

2. Set Limits and Learn to Say No

Caregiving can take over your life, if you let it – sweeping away marriages, careers and friendships as it rolls along.

But it doesn’t have to go that way.

You can’t do it all on your own and you don’t have to do it all on your own. Take some time to decide what you are willing and unwilling to do, specifically, and make sure that all family members and medical staff involved in your family member’s care know and respect your limits.

And once you’ve set limits for yourself – stick to them! You don’t have to lose your health, relationships and happiness to caregiving but that’s exactly what you’re risking unless you can learn to say no and learn to achieve some balance in your life.³

And since you can’t do it all on your own you’ll need the assistance of friends and family, so when they offer help, accept it and tell them exactly how what they can do.

3. Find Emotional Support

You can’t do this on your own.

Caregiving can be a lonely thankless job and you need periodic infusions of emotional support to stay sane, healthy and happy.

Find emotional support:

• From regular meetings with friends and family who empathize with what you’re dealing with
• From caregiving support groups – these are not only an excellent source of emotional support, they are also great places to find important caregiving information on topics like finding affordable or subsidized respite care. You may also want to look into online ‘support groups’ or virtual caregiver communities as another source of emotional support, understanding and ideas.
• From a counselor or therapist – a counselor can help you work through the emotions like grief, anger, frustration, sadness and others that invariably accompany the caregiving experience.

4. Make Full Use of Available Respite Services

Caregiving hours are long and you need all the breaks you can get. You need at least a half a day off once a week (more is better) and periodic longer breaks from your duties.

Make full use of all the community respite services you are allotted/can afford. Some respite services to consider include:

• Having a health aid or companion come to the house so that you can have some time to yourself
• Enrolling your loved one in an adult day care service
• Having your loved one stay in a nursing home facility for a few days and nights once in a while so you can take a few days to get away

In some cases you can learn more about what’s available in your area by contacting a local health advocacy group, such as the Alzheimer’s foundation or local or national Parkinson’s, cancer or other disease groups.

5. Take Care of Yourself

You are in a marathon, not a sprint, and you’ll never reach the finish line unless you take care of yourself as well as you take care of your loved one.

Remember to:

• Make and keep doctor’s and dentist’s appointments for yourself
• Eat well
• Take care of your mental health through relaxation techniques or meditation
• Exercise – keep your immune system ticking along as you bust down caregiving stress with vigorous exercise
• Treat yourself – A caregiving life can be demanding but life still needs to be pleasurable, so remember to keep things fun with regularly scheduled time for yourself - Treat yourself to a massage or a regular day at the gym or a poker night a week with the guys. Buy yourself that new gadget you’ve been eying or schedule some time for yourself to just unwind and get into a good book.

6. Get More Sleep

For caregiving you need your rest, but because of caregiving, it’s hard to get it.

Caregiving responsibilities don’t stop at the end of a 9 to 5 day, and for a lot of people, frequent overnight wake-ups are a too unfortunate reality.

You need your rest. Here are some tips that may help you get a little more.

• If you need to get up frequently to help your loved one use the bathroom, talk to his or her doctor about medications that may be causing night waking and discuss strategies to increase periods of sleep. Also see if you can minimize liquid intake in the hours prior to bedtime.To maximize the hours you do get, minimize caffeine in the evening and try to make sure you get a little physical exercise each day (be wary of exercising too close to bedtime however, as this can increase alertness).
• Have a friend, outside caregiver or relative take the night shift so you can get an uninterrupted sleeping break.
• Modify the physical environment to make it possible and comfortable for your loved one to get up and use the bathroom without requiring your assistance. Modifications to consider include grab bars, a raised toilet seat, strong night lighting, emergency call intercom or a bell that can be rung in case of a need for assistance.

7.  Get Organized

When you’re already exhausted, keeping track of all those appointments, recommended home health care procedures and prescriptions can be overwhelming.

Take some time to create a system for keeping track of all the paperwork and scheduling and you’ll feel your stress burden ease slightly.

8. Stay Social

When you add together caregiving’s constant pull and the energy required to do a good job it’s no wonder that too many caregivers experience increasing social isolation as a result of their at home duties.

But your life is more than just your duties at home and you owe it to yourself to stay connected with the people, places and activities that matter to you.

You’ll go crazy unless you can get out and have some fun with friends or family on a regular basis. It’s not a luxury it’s a necessity, so schedule social time in and don’t let it get derailed.

Image Copyright: Linda Kronin

Work tedium, a negative attitude, a lack of challenge or variety…just a few examples of workday factors that can lead to dangerous burnout. Sometimes you can change jobs and sometimes you can’t. Here are 8 ways to learn to love the job you’ve got when leaving just isn’t an option.

Feeling unsatisfied at work; stressed out or stuck in a rut?

Well, if so, it’s worth taking a moment to evaluate what’s causing your dissatisfaction and maybe coming up with a few ideas on how you might improve things on the job.

After all, you likely spend a significant portion of your waking hours at work, so liking what you do is inherently preferable, but more than this, job dissatisfaction can lead to energy-sapping burnout and studies even show that people who are happier at work stay healthier than their less satisfied co-workers.¹

Often the best remedy for job dissatisfaction is simply changing jobs, but when that’s not possible, practical or advised, sometimes you can reshape the current job you loathe, into a future job you’ll love (or at least like).

So with that in mind, here are 8 easy (and some not so easy) changes to consider - find any one that works for you and you might find even find yourself on a Sunday evening looking forward to getting into work for the long week ahead.

8 Ways to Increase Job Satisfaction (To Reduce Stress and Burnout)

1. Ask for a Written Description of Your Job’s Responsibilities

You can’t do it all…

Taking on too much and/or feeling like you’re never able to meet a job’s requirements take you on a fast track to stress and burnout, but are you really responsible for all that you’ve got on your plate?

Talk to your manager/supervisor or someone in HR and ask for a written description of your job’s responsibilities. With this in hand you can focus your attention on what you need to be doing and push away what’s beyond your sphere of responsibility.

You’ll perform better at your ‘actual’ job and you’ll feel less overwhelmed by extraneous tasks that aren’t yours to worry about.

2. Don’t Bring It Home with You

Studies show that people who can leave work at the office and mentally detach from the workplace once at home for the night are more satisfied and more productive workers over the long run.

Although you may think that obsessing about work after hours increases your performance, research shows that people who don’t detach from work at home become less engaged workers as time goes by.²

So leave work at work. It’ll lower your stress, increase your job satisfaction and you’ll be a better worker for it.

3. Sign Up for Additional Training

Studies of workplace satisfaction consistently show that workers who get more and better training are more satisfied on the job than those with less training.³

Job training leads to greater work competency and new ideas and approaches which can reduce boredom – and beyond all that, it just feels better to be really good at your job than to just get by each day.

Is there any skill-set at work you need to improve on? Does your workplace offer training courses or are such courses available at local colleges or universities?

Improve yourself – get better at your job – feel more satisfied at work.

4. Take a Vacation

Skip a vacation or two this year and you greatly increase your risk of job burnout⁴ and studies show that people who take more vacation time report higher levels of job satisfaction.⁵

You can only take the days you have but there’s no excuse for failing to use all that you’re given. Take a step back from work whenever you can and you’ll come back a better and more satisfied worker.

5. Add a Potted Plant and a Window View

Seriously.

This one’s an easy one, but according to researchers, adding a few plants and some sunshine to your working environment pays off with a surprisingly high job satisfaction dividend.

In a study of office workers in Texas and the Midwest, researchers found that 82% of workers who had plants and windows in their work environment reported feeling very happy at work, 69% of workers with plants but no windows reported feeling very happy at work and 60% of workers with no plants but windows reported feeling very happy. Among workers with no windows or plants in their work environment, only 58% reported feeling very happy at work.⁶

6. Be Yourself at Work

Be yourself – making an effort to hide your true nature or authentic self results in lower levels of job satisfaction and higher levels of perceived discrimination.⁷

Being authentic at work may increase job satisfaction as it is associated with better work relationships and friendships.

7. Add Variety to Your Job

Tedium, unsurprisingly, leads quickly to job dissatisfaction.

If you’re stuck in a rut at work consider ways to add variety to your daily work routine.

Consider:

• Volunteering to sit on a committee
• Mentoring a junior colleague or asking a talented co-worker/superior to mentor you in some area
• Transferring to a different division within the company
• Volunteering for new responsibilities
• Getting involved with social activities at work (company softball team etc.)

8. Add Exercise to Your Work Day

Shake up your lunch-time routine with an invigorating walk or run – or try commuting by bike instead of driving in by car.

Although there’s a lot you can’t control about your work environment, you can control your attitude - and the way you approach each day goes a long way toward influencing how much you enjoy your on-the-clock time.

Incorporate a little aerobic exercise into most days and you’ll find that the stress relieving and mood buoying effects of getting moving will do a lot to improve the attitude you bring to the job – and that’ll do a lot to improve your overall work satisfaction level.

Image Copyright: Toni Blay