In onze huidige maatschappij en werkcultuur staat efficiëntie en streven naar efficiëntie op de eerste plaats. Alles moet vooral efficiënter. Maar wat doet dit met mensen? Leraren, verpleegkundigen, artsen, managers, werknemers in grote en kleine organisaties. Van hoog tot laag heeft bijna iedereen te maken met de meet en controle manie die onze maatschappij in haar greep lijkt te hebben. De werkdruk is hoog en trekt een wissel op steeds meer mensen.
Veel, heel veel, mensen raken opgebrand, geestelijk en lichamelijk uitgeput. Hoe efficiënt is dat?
In 2003 kwam ik contact met het werk van Phil Maffetone.
Naast het begeleiden van ultra-atleten schrijft Phil veel over de gevolgen van stress en burn-out. Voor mij is hij al jaren een bron van inspiratie op het gebied van ultra-lopen en vitaliteit.
Onderstaand artikel deel ik graag met jullie omdat je mijns inziens je niet bewust genoeg kunt zijn van de effecten, die veelvuldig onder druk staan en moeten presteren, hebben op je lichaam en geest.
By Phil Maffetone, bewerkt door Johanna van der Schaft
The who, what, when, where, why and how it can happen to anyone from health practitioners, to teachers, students, athletes, mothers and fathers, you and me.
Everywhere you look, a lot of people are stressed out or, correspondingly, burned out. It’s not just those in high-pressure jobs or weathering a personal crisis. It’s an epidemic among people from all walks of life.
Consider the following testimony:
“I gradually became physically and mentally exhausted. Exercise, socializing, sex, even getting through a typical work day was now a serious struggle. I would stand outside the exam room door sometimes for 10 minutes, pretending to read the chart, trying to generate the energy to walk in and hear the patient’s complaints. Not only could I not deliver good care, it eluded me personally. Fighting to stay awake while driving home, I couldn’t sleep at night, feeling just as bad each morning. Medicating with more morning caffeine no longer helped, nor did more evening alcohol, nor did days off. I saw no way out of the nightmare.” —Anonymous health practitioner.
Burnout is a function of stress. More specifically it’s the accumulation of excess stress we don’t recover from. It’s been referred to as exhaustion, nervous breakdown, and in those who exercise as overtraining. Whatever term we use, it significantly impairs health and fitness — the physical, biochemical, and/or mental-emotional body breaks down.
Two new studies with an accompanying editorial in the Journal of the American Medical Association didn’t help the reality of what virtually everyone in healthcare already knows — very high numbers of practitioners are impaired due to burnout. So are many patients, and healthcare students. While the JAMA articles claim no consensus on a definition of burnout, concluding that “more research is needed,” while the problem everyone knows about, including an understanding of its physiology, goes untreated.
While the research indicates that many doctors are miserable and depressed, researchers wonder whether burnout is even the right word. The result is the elephant in the room goes ignored — despite the thousands of published studies on the topic known as stress, another term for burnout, over the past century. The problem is so prevalent it was referred to by a surgical journal as “an undiagnosed pandemic.” Not only are these practitioners not being cared for, but the quality of care they are delivering is questionable too, with many patients suffering as a result.
While there is an overwhelming burden of paperwork and time spent on the electronic medical records, with less time treating patients, the quality of patient care is a serious concern too, just as much as the practitioner’s own health. Excess stress exists everywhere in healthcare.
A look at the bigger picture makes matters even worse: the problem of burnout in healthcare practitioners is only the tip of a very big iceberg. It includes, potentially, everyone else on earth.
The Stress of Life
We are constantly exposed to many kinds of stressors, categorized as physical, biochemical, and mental- emotional. These can come from exercise, or lack of it, sleep, food, pollution, drugs, and from our own thoughts. However scary this sounds, for most people the road to recovery is clear.
Normally, we adapt to these stressors through the process of recovery, especially by resting and specifically, a good night’s sleep. Adaptation to acute stress involves the brain sending messages, through hormones and nerves, to the body to adjust itself, compensate, or better deal with the stress. The adrenal glands make more stress hormones to accomplish this, and the sympathetic nervous system goes on high alert. After the wave of stress passes, we typically return to normal.
Stages of Excess Stress
Poor adaptation, however, is the result of too many stressors, not enough recovery, or, typically, a combination of both. By not adapting, stress continues to have an adverse effect on us each day. This is referred to as the first stage of excess stress. Fortunately, recovery from it can be relatively quick — it could take only days if we merely reduce the stress and rest. This is actually how exercise and training work to make us stronger.
Without adaptation, however, when we don’t recover from this acute stress, it can become chronic and we enter a more serious second stage of stress.
The range of warning signals can be seemingly benign or extensive. Early in the process, people may complain generally of “just not feeling right.”
Excess fatigue or hunger, reduced creativity, feelings of depression, anxiety, blood-sugar problems, poor sleep, muscle soreness, pain, higher heart rate, daytime sleepiness, cravings for sweets or caffeine, memory loss, and others are not uncommon.
Reduced immunity, with vulnerability to infections, and intestinal dysfunction causing mild to more severe symptoms are also typical. Signs and symptoms can worsen to include poor posture and gait, chronic inflammation, waking in the middle of the night and being unable to quickly fall back to sleep, increasing body fat (and weight), hormone imbalance, reduced physical and mental performance, or chronic pain.
Recovery from the second stage of stress takes longer, typically weeks, and only when we reduce enough stressors and recover with better sleep quantity and quality.
Without recovery from the second stage of stress, we can go into stage three; a chronic disabling condition that takes a long time to recover from, and that usually requires help from a healthcare practitioner(s).
The earliest condition of burnout appears during the first stage of stress and is more obvious by the second and third stages.
Three specific lifestyle factors play a primary role in stress adaptation, allowing the brain, hormones and the rest of the stress-adaptation mechanism to function well.
Without these we can’t recover well.
• Enough sleep
• Physical activity
• Healthy diet
While other lifestyle factors may help such as meditation, mindfulness, yoga, the three above are a prerequisite.
Many people deny that stress adversely affects them, feeling too proud, wanting to avoid the image of being mentally weak, embarrassed or ashamed. This is due to the myth that stress is strictly psychological, and we should somehow be stronger than that.
Without understanding there are many other (controllable) stressors bombarding the brain and body, people keep pushing on — more work, more money, more commitments and responsibilities, etc.
And, of course, this also usually means less time for fun — another way to help adapt to and prevent the excess accumulation of stress.
Excess stress is not an easily determined condition. Burnout also is not so definitive. Yet, depression, anxiety, fatigue and other symptoms, along with a variety of signs such as increased levels of the stress hormone cortisol and increased sympathetic activity that can raise resting heart rate and blood pressure, are quite clear. In reality, excess stress can affect us in so many ways.
The initial clues that we’re not adapting include fatigue, hunger, intestinal distress, poor immunity, cardiac and hormonal problems, poor sleep and others.
There is no doubt that the risk of burnout has haunted humans from the beginning. For a long time, it was simply survival from day to day, protecting the children, or avoiding being chased and eaten by a ferocious furry creature. So, what’s so different today?
Today, humans don’t balance their accumulated stresses with healthy food and physical movement. In short, we don’t adapt as well to the stress of life, despite or in spite of, the luxuries many have. Recovery from a day’s stress often goes undone, and the next day we accumulate more of it.
While high levels of acute stress are inevitable in some situations, such as an intense work period in emergency medicine, a crisis for heads of state or corporate executives, or natural disaster, crossing the line from chronic stress to burnout, is, for the most part, preventable.
Our bodies have all it takes to deal with stress effectively
No matter what type of stress you encounter during your life journey — be it physical, chemical or mental/emotional — your body has an efficient mechanism for coping:
The adrenal glands-
On the top of each kidney, these small glands work with the nervous system to regulate the important coping mechanisms, including the “fight or flight” reactions.
The adrenal glands accomplish their work through the production of certain hormones, making them not only essential for stress coping and optimal human performance, but also for life itself.
These hormones help with stress regulation, sex and reproduction, growth, aging, cellular repair, electrolyte balance and blood-sugar control.
The nervous system also helps in coping with stress.
This occurs through messages sent throughout the brain and nervous system, and through two other important stress hormones, epinephrine and norepinephrine.
Cortisol is the key adrenal stress hormone, and commonly measured by simple blood and saliva tests. When your body is under high stress, cortisol levels can increase dramatically, and when the stress passes it returns to normal levels.
In chronic stress states — the continuation of stress without relief — high cortisol levels can become dangerous. This can adversely affect the brain, especially memory, create blood sugar problems, reduce fat-burning, suppress immune function, lowering the body’s defence against not just cold and flu but any infections, and cause intestinal distress.
Long-standing stress can result in a “burning out” of adrenal function, with a serious loss of normal hormone production. In this state, cortisol levels become dangerously low, along with other hormones made by the adrenals.
The General Adaptation Syndrome
Our knowledge about stress and adrenal function began in the early 1900s, when famous stress-research pioneer Hans Selye began to piece together the common triad of signs resulting from excess adrenal stress. They include adrenal-gland enlargement, depressed immunity and intestinal dysfunction. Selye eventually showed how the adrenals react when confronted with excess stress. This General Adaptation Syndrome has three distinct stages.
Stage 1: The first stage begins with the alarm reaction, in which there is an increase in adrenal hormone production. This is an attempt by the adrenals to battle the increased stress. If it is successful, adrenal function returns to normal. During this stage, a variety of mild symptoms may occur: spotty tiredness during the day, mild allergies or even some nagging back, knee or foot pain. If, over time, the adrenals fail to meet the needs of the body to combat the stress, they enter the second stage, called the resistance stage.
Stage 2: During this period, the adrenal glands themselves get larger through a process called hypertrophy. Since the increased hormone production of the first stage couldn’t counter the stress, the glands enlarge in an attempt make even more cortisol to do the same. During this stage, more advanced symptoms may occur, including fatigue, insomnia and more serious back, knee or foot pain. Most people with stress problems are stuck in this stage. But if the stress persists and is still not controlled, the adrenals eventually can enter the third stage, called exhaustion.
Stage 3: If a person enters this stage, they are exhausted. The adrenal glands are unable to adapt to stress and are unable to produce adequate levels of hormones, including cortisol.
The person is usually quite dis-eased, physically, chemically or mentally.
Are You ‘Stressed Out’?
Excess adrenal stress — or an insufficient adrenal response to adapt to stress — is a common problem. It is often the result of chronically overstimulated adrenal glands, in some cases to the point of exhaustion. We say “you’re stressed- or burned-out” If you’re an athlete, it’s called “overtraining.” Whatever the name, it’s essentially the same problem of adrenal dysfunction, with serious implications for fitness and (mental)health that can seriously reduce quality of life.
Some common symptoms of adrenal dysfunction are listed below. They can be caused by other imbalances in the body. But taken together, they make up the most common symptoms of adrenal dysfunction.
Low energy. This is common especially in the afternoon, but could happen anytime, or all the time. The fatigue can be physical, mental or both. When the adrenals are too stressed, the body uses more sugar for energy, but can’t access fat very well for energy use. This can significantly limit your energy.
Dizziness upon standing. Standing up from a seated or lying position can make you dizzy because not enough blood is getting to the head quickly enough. Check your blood pressure while lying down, and then immediately after you stand.
Eyes sensitive to bright light. Adrenal stress often causes light sensitivity in your eyes. You may need to wear sunglasses or have difficulty with night driving because of the oncoming headlights. You may even misinterpret this as having bad night vision.
Asthma and allergies. Whether you call it exercise-induced asthma, food allergies or seasonal allergies, they are similar symptoms of adrenal dysfunction.
Mechanical imbalance. Problems in the low back, knee, foot and ankle are often associated with adrenal problems. These areas can become mechanically unstable and produce symptoms such as low-back pain, sciatica and excess pronation in the foot, leading to foot and ankle problems.
Stress-related syndromes. The problems referred to as burnout, stressed-out, overtraining and nervous breakdown are almost always the result of adrenal exhaustion. While occasionally these problems become serious enough to warrant medication or hospitalization, adrenal dysfunction occurs long before this point.
Blood-sugar-handling stress. With adrenal dysfunction, the body is unable to properly control blood sugar. Symptoms include constantly feeling hungry, being irritable before meals or if meals are delayed, and having strong cravings for sweets or caffeine.
Insomnia. Many people with adrenal dysfunction fall asleep easily (often because of exhaustion) but wake in the middle of the night with difficulty getting back to sleep. This may be due to high levels of cortisol occurring at the wrong time (levels should be low during sleeping hours). Many people say they wake up in the night to urinate. But it’s usually the adrenal problem that awakens them, and then they get the urge to urinate.
Recognizing the above symptoms of adrenal dysfunction can be useful in preventing getting burned-out
Beware of the signals your body and mind give you.
Dare to slow down and make appropriate lifestyle changes to restore your balance.
Read my ebook that you can download on this website.