Category: Featured Articles

Taking Steps to Manage Work Stress – Getting Help When You Need It

Coping with Work Stress

Who is Most Vulnerable to Stress at Work

Scroll Down for Dr. Holland's Perspective on this article

Everyone who has ever held a job has, at some point, felt the pressure of work-related stress. Any job can have stressful elements, even if you love what you do. In the short-term, you may experience pressure to meet a deadline or to fulfill a challenging obligation. But when work stress becomes chronic, it can be overwhelming — and harmful to both physical and emotional health.

Unfortunately, such long-term stress is all too common. In fact, American Psychological Association’s annual Stress in America survey has consistently found that work is cited as a significant source of stress by a majority of Americans. You can't always avoid the tensions that occur on the job. Yet you can take steps to manage work-related stress.

Common Sources of Work Stress

Certain factors tend to go hand-in-hand with work-related stress. Some common workplace stressors are:

  • Low salaries.
  • Excessive workloads.
  • Few opportunities for growth or advancement.
  • Work that isn't engaging or challenging.
  • Lack of social support.
  • Not having enough control over job-related decisions.
  • Conflicting demands or unclear performance expectations.

Effects of Uncontrolled Stress

Work-related stress doesn't just disappear when you head home for the day. When stress persists, it can take a toll on your health and well-being.

A stressful work environment can contribute to problems such as headache, stomachache, sleep disturbances, short temper and difficulty concentrating. Chronic stress can result in anxiety, insomnia, high blood pressure and a weakened immune system. It can also contribute to health conditions such as depression, obesity and heart disease. Compounding the problem, people who experience excessive stress often deal with it in unhealthy ways such as overeating, eating unhealthy foods, smoking cigarettes or abusing drugs and alcohol.

Taking Steps to Manage Work Stress

  • Track your stressors. Keep a journal for a week or two to identify which situations create the most work stress and how you respond to them. Record your thoughts, feelings and information about the environment, including the people and circumstances involved, the physical setting and how you reacted. Did you raise your voice? Get a snack from the vending machine? Go for a walk? Taking notes can help you find patterns among your stressors and your reactions to them.
  • Develop healthy responses. Instead of attempting to manage work stress with fast food or alcohol, do your best to make healthy choices when you feel the tension rise. Exercise is a great stress-buster. Yoga can be an excellent choice, but any form of physical activity is beneficial. Also make time for hobbies and favorite activities. Whether it's reading a novel, going to concerts or playing games with your family, make sure to set aside time for the things that bring you pleasure. Getting enough good-quality sleep is also important for effective stress management. Build healthy sleep habits by limiting your caffeine intake late in the day and minimizing stimulating activities, such as computer and television use, at night.
  • Establish boundaries. In today's digital world, it's easy to feel pressure to be available 24 hours a day. Establish some work-life boundaries for yourself. That might mean making a rule not to check email from home in the evening, or not answering the phone during dinner. Although people have different preferences when it comes to how much they blend their work and home life, creating some clear boundaries between these realms can reduce the potential for work-life conflict and the stress that goes with it.
  • Take time to recharge. To avoid the negative effects of chronic stress and burnout, we need time to replenish and return to our pre-stress level of functioning. This recovery process requires “switching off” from work by having periods of time when you are neither engaging in work-related activities, nor thinking about work. That's why it's critical that you disconnect from time to time, in a way that fits your needs and preferences. Don't let your vacation days go to waste. When possible, take time off to relax and unwind, so you come back to work feeling reinvigorated and ready to perform at your best. When you're not able to take time off, get a quick boost by turning off your smartphone and focusing your attention on non-work activities for a while.
  • Learn how to relax. Techniques such as meditation, deep breathing exercises and mindfulness (a state in which you actively observe present experiences and thoughts without judging them) can help melt away stress. Start by taking a few minutes each day to focus on a simple activity like breathing, walking or enjoying a meal. The skill of being able to focus purposefully on a single activity without distraction will get stronger with practice and you'll find that you can apply it to many different aspects of your life.
  • Talk to your supervisor. Employee health has been linked to productivity at work, so your boss has an incentive to create a work environment that promotes employee well-being. Start by having an open conversation with your supervisor. The purpose of this isn't to lay out a list of complaints, but rather to come up with an effective plan for managing the stressors you've identified, so you can perform at your best on the job. While some parts of the plan may be designed to help you improve your skills in areas such as time management, other elements might include identifying employer-sponsored wellness resources you can tap into, clarifying what's expected of you, getting necessary resources or support from colleagues, enriching your job to include more challenging or meaningful tasks, or making changes to your physical workspace to make it more comfortable and reduce strain.
  • Get some support. Accepting help from trusted friends and family members can improve your ability to manage stress. Your employer may also have stress management resources available through an employee assistance program (EAP), including online information, available counseling and referral to mental health professionals, if needed. If you continue to feel overwhelmed by work stress, you may want to talk to a psychologist, who can help you better manage stress and change unhealthy behavior.

This information provided by the American Psychological Association. Learn more here ---> American Psychological Association


Dr. Holland's Perspective

Talk therapy is proven to reduce stress, Increasing confidence, productivity and job satisfaction. Burnout happens when chronic stress and overwhelm starts to reduce your motivation, leadership abilities and confidence in your ability to be successful on the job and help others.

Work Stress and Burnout can happen to anyone, but CEOs, attorneys, doctors, nurses, clergy advisors, etc., are particularly vulnerable because of the weightiness and responsibility of their roles. Working with someone who understands the particular stresses that working professionals face can help keep you effective, motivated and boost your energy to do the job you want to do.
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Dr. Holland can help you to manage work stress and Prevent Executive Burnout and help you to remain an Effective Leader for your team or for your clients. Dr. Holland provides cutting edge, integrative and evidence-based care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss and caring for a parent or loved one during a health crisis or decline. To schedule an appointment call 707-479-2946.

Researchers say girls more vulnerable to harmful effects of bullying

Girls are more often bullied than boys and are more likely to consider, plan, or attempt suicide, according to research led by a Rutgers University-Camden nursing scholar.

Teen girls more vulnerable to bullying than boys

Girls are more often bullied than boys and are more likely to consider, plan, or attempt suicide, according to research led by a Rutgers University-Camden nursing scholar.

"Bullying is significantly associated with depressive symptoms, suicidal ideation, suicide planning, and suicide attempts," says Nancy Pontes, an assistant professor at the Rutgers School of Nursing-Camden. "We wanted to look at this link between bullying victimization, depressive symptoms, and suicidality by gender."

In an examination of data from the Centers for Disease Control's nationally representative Youth Risk Behavior Survey from 2011-2015, Pontes and her fellow researchers conducted analyses of the data and found that more females are negatively affected by bullying.

Pontes says that, in general, girls are more often bullied than boys, and girls are also more likely to consider, plan, or attempt suicide compared with boys, regardless of being bullied or not -- although boys are more likely to die by suicide. In this study, Pontes and her fellow researchers looked at significant associations and not direct causal links.

Using two methods of statistical analysis, the researchers showed the probability of a link between bullying and depressive symptoms and suicide risk, and then compared the results of the two methodologies.

Through the more commonly used multiplicative interactions method, their findings matched the findings that some other researchers have used in previous studies, which showed no difference between males and females being bullied at school and having depressive symptoms or suicide risk behaviors.

However, when using the International Journal of Epidemiology-recommended methodology of additive interactions, Pontes and her team found the effects of bullying are significantly higher in females than males on every measure of psychological distress or suicidal thoughts and actions.

The study, "Additive Interactions between Gender and Bullying Victimization on Depressive Symptoms and Suicidality: Youth Risk Behavior Survey 2011-2015" by Pontes and her colleagues, is published in the journal Nursing Research.

"To our knowledge, our paper is the first in nursing to compare these two methodologies, and to challenge the status quo of analysis in our field," says Pontes.

The researchers acknowledge limitations with the study, such as the nature of its retrospective design and the inability to change or alter the design of the CDC study.

Pontes hopes the results of her team's examination will help draw attention to how researchers conduct analyses of data and how crucial it is to carefully consider which methods are the best fit, or to use both methods and compare them.

Bullying among boys is often physical. Pontes says while many schools are cracking down on physical bullying which people can see, those actions probably are preventing and stopping bullying that's more common among males.

Among females, Pontes says, the bullying is often the kind that's not visible. It's often relational bullying, such as excluding someone from activities and social circles, or spreading rumors about them. The actions are not overt, Pontes explains, so they could go on for a long time without anyone else knowing.

"Our school interventions should understand the differences in bullying and how we might better address females who are bullied," says Pontes.

The Rutgers-Camden nursing researcher believes that preventing bullying should begin at a young age. She says parents should start teaching preschool children that bullying is unacceptable.

"There are parents who see it as a rite of passage," says Pontes. "They say, 'Everyone gets bullied. You have to buck up. Stand up for yourself.'"

She says pediatricians and nurse practitioners should talk about the harmful effects of bullying with parents so that they can intervene early and reduce the victimization that causes adolescents to consider suicide, so they will be able to live happier and healthier lives.

Pontes' co-authors of the study are Rutgers School of Nursing-Camden colleague Cynthia Ayres and Manuel Pontes of Rowan University.

Nancy Pontes, the primary author, recently was honored with the Eastern Nursing Research Society's 2019 Nursing Research Authorship Award at the 2019 ENRS Annual Scientific Sessions held in Providence, R.I. A distinguished fellow and practitioner of the National Academy of Practice, she received her Ph.D. in nursing from Columbia University in 2003, and earned her master of science in nursing from the University of Florida in 1994. She received her bachelor's degree in nursing from Pensacola Christian College in 1985.


Story Source: Rutgers University. "Teen girls more vulnerable to bullying than boys." ScienceDaily. ScienceDaily, 7 May 2019. www.sciencedaily.com/releases/2019/05/190507110457.htm.


Dr. Holland's Perspective

"Boys experiences are often more rooted in the physical and what we can see." Dr. Holland explains. "For girls, everything is internal. Often they become the target of bullying and this persists over a period of time, because it is so insidious, it may not be seen or experienced as such. It is important that we educate our kids about the different kinds of bullying, and what we can do to stop it. We also need to actively teach them how to reach out for help. It is not often enough to tell A girl who was being bullied that you’re always there for them. It is important to come up with a plan. It is important that girls know how to reach out for help and when.

"We also need to give parents a hand in understanding the long term effects of bullying, symptoms that they can watch out for that might indicate their child is struggling, and help them to communicate effectively with their children. Parents can be helped by being made aware of signs of anxiety and depression in tweens and teens. Currently, suicide is the second leading cause of death in individuals between the ages of 10 and 24.Often, we are afraid to ask our kids questions, just in case we might be wrong, or experienced as intrusive. To this I say, “Better a dirty look, then no look at all."

It's important that parents understand the need to be direct with their children. It is my experience that when we ask directly, if they have thought of hurting themselves they feel relieved for being asked, because they don’t have to keep this big secret anymore, or follow through with it."

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Dr. Jenny Holland provides cutting edge, integrative and evidence-based care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss and caring for a parent or loved one during a health crisis or decline. To schedule an appointment call 707-479-2946.

Low serotonin levels thought to influence gut health and spark depression

New study suggests that depression and GI trouble sometimes spring from the same source

For people with depression, gastrointestinal distress is a common additional burden, and a new study suggests that for some, the two conditions arise from the same glitch in neuron chemistry -- low serotonin.The study, conducted in mice, shows that a shortage of serotonin in the neurons of the gut can cause constipation, just as a serotonin shortage in the brain can lead to depression. The study also found that a treatment that raises serotonin in the gut and the brain may alleviate both conditions.

Up to a third of people with depression have chronic constipation, and a few studies report that people with depression rate their accompanying bowel difficulties as one of the biggest factors reducing their quality of life. Severe constipation can obstruct the GI tract and cause serious pain. The condition leads to 2.5 million physician visits and 100,000 hospitalizations each year. Though some antidepressants are known to cause constipation, medication side effects do not explain all cases.

"Ultimately, many patients with depression are faced with limited treatment options and have to suffer with prominent GI dysfunction," says study leader Kara Gross Margolis, MD, associate professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeon.

Similarities between the gut and the brain suggest the two conditions may also share a common cause. "The gut is often called the body's 'second brain,'" says Margolis. "It contains more neurons than the spinal cord and uses many of the same neurotransmitters as the brain. So it shouldn't be surprising that the two conditions could be caused by the same process."

Because low levels of serotonin in the brain have been linked to depression and serotonin is also used by neurons in the gut, the researchers studied mice to determine if a serotonin shortage also plays a role in constipation. The serotonin shortage in the gut, the researchers found, reduced the number of neurons in the gut, led to a deterioration of the gut's lining, and slowed the movement of contents through the GI tract.

"Basically, the mice were constipated," Margolis says, "and they showed the same kind of GI changes we see in people with constipation." (In previous studies, these same mice also showed depressive symptoms).

The treatment -- slow-release drug-delivery of 5-HTP, a precursor of serotonin -- works in part by increasing the number of GI neurons in study subjects. The discovery of this connection between a brain and a gastrointestinal disorder suggests that new 5-HTP slow-release therapies could treat related brain-gut conditions simultaneously. The study is also one of the first to show that neurogenesis in the gut is possible and can correct abnormalities in the gut. "Though it's been known for many years that neurogenesis occurs in certain parts of the brain, the idea that it occurs in the gut nervous system is relatively new," Margolis says.

Neurogenesis may help treat other types of constipation. "We see a reduction of neurons in the GI tract with age, and that loss is thought to be a cause of constipation in the elderly," Margolis says. "The idea that we may be able to use slow-release 5-HTP to treat conditions that require the development of new neurons in the gut may open a whole new avenue of treatment."

An immediate-release version of 5-HTP is available as a supplement, but it has not been proved scientifically to work and physiologically it should not, as it is too short-acting, Margolis says. 5-HTP is the immediate precursor to serotonin. Once ingested, 5-HTP is converted to serotonin, but the serotonin is rapidly inactivated before it can work effectively. The slow-release version of 5-HTP used in the current study produces constant administration of 5-HTP which has been demonstrated to remedy the limitations of currently available immediate-release 5-HTP. Clinical studies are already planned for testing a slow-release 5-HTP drug in people with treatment-resistant depression. Planning for testing a slow-release 5-HTP drug in constipation is in progress.

Story Source -- Read the full article on Science Daily: Materials provided by Columbia University Irving Medical Center. Note: Content may be edited for style and length. Columbia University Irving Medical Center. "A moody gut often accompanies depression: New study helps explain why." ScienceDaily. ScienceDaily, 7 May 2019. www.sciencedaily.com/releases/2019/05/190507080148.htm.


Dr. Jenny Holland provides cutting edge, integrative and evidence-based care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss and caring for a parent or loved one during a health crisis or decline. To schedule an appointment call 707-479-2946.

Sticking to life goals can fend off depression, anxiety, panic disorders

Looking on the bright side also acts as a safeguard, according to 18-year study

People who don't give up on their goals (or who get better over time at not giving up on their goals) and who have a positive outlook appear to have less anxiety and depression and fewer panic attacks, according to a study of thousands of Americans over the course of 18 years. Surprisingly, a sense of control did not have an effect on the mental health of participants across time.

The study was published by the American Psychological Association in the Journal of Abnormal Psychology.

"Perseverance cultivates a sense of purposefulness that can create resilience against or decrease current levels of major depressive disorder, generalized anxiety disorder and panic disorder," said Nur Hani Zainal, MS, from The Pennsylvania State University and lead author of the study. "Looking on the bright side of unfortunate events has the same effect because people feel that life is meaningful, understandable and manageable."

Depression, anxiety and panic disorders are common mental health disorders that can be chronic and debilitating and put a person's physical health and livelihood at risk, according to Zainal and her co-author, Michelle G. Newman, PhD, also of The Pennsylvania State University.

"Often, people with these disorders are stuck in a cycle of negative thought patterns and behaviors that can make them feel worse," said Newman. "We wanted to understand what specific coping strategies would be helpful in reducing rates of depression, anxiety and panic attacks."

Zainal and Newman used data from 3,294 adults who were studied over 18 years. The average age of participants was 45, nearly all were white and slightly fewer than half were college-educated. Data were collected three times, in 1995 to 1996, 2004 to 2005 and 2012 to 2013. At each interval, participants were asked to rate their goal persistence (e.g., "When I encounter problems, I don't give up until I solve them"), self-mastery (e.g., "I can do just anything I really set my mind to") and positive reappraisal (e.g., "I can find something positive, even in the worst situations"). Diagnoses for major depressive, anxiety and panic disorders were also collected at each interval.

People who showed more goal persistence and optimism during the first assessment in the mid-1990s had greater reductions in depression, anxiety and panic disorders across the 18 years, according to the authors.

And throughout those years, people who began with fewer mental health problems showed more increased perseverance toward life goals and were better at focusing on the positive side of unfortunate events, said Zainal.

"Our findings suggest that people can improve their mental health by raising or maintaining high levels of tenacity, resilience and optimism," she said. "Aspiring toward personal and career goals can make people feel like their lives have meaning. On the other hand, disengaging from striving toward those aims or having a cynical attitude can have high mental health costs."

Unlike in previous research, Zainal and Newman did not find that self-mastery, or feeling in control of one's fate, had an effect on the mental health of participants across the 18-year period.

"This could have been because the participants, on average, did not show any changes in their use of self-mastery over time," said Newman. "It is possible that self-mastery is a relatively stable part of a person's character that does not easily change."

The authors believe their findings will be beneficial for psychotherapists working with clients dealing with depression, anxiety and panic disorders.

"Clinicians can help their clients understand the vicious cycle caused by giving up on professional and personal aspirations. Giving up may offer temporary emotional relief but can increase the risk of setbacks as regret and disappointment set in," said Zainal. "Boosting a patient's optimism and resilience by committing to specific courses of actions to make dreams come to full fruition despite obstacles can generate more positive moods and a sense of purpose."

Story Source -- Read this article on Science Daily: American Psychological Association. "Perseverance toward life goals can fend off depression, anxiety, panic disorders: Looking on the bright side also acts as a safeguard, according to 18-year study." ScienceDaily. ScienceDaily, 2 May 2019. www.sciencedaily.com/releases/2019/05/190502100852.htm.


Dr. Jenny Holland provides cutting edge, integrative and evidence-based care, proven effective with depression and anxiety, life transitions; pregnancy, parenting, ageing, loss and caring for a parent or loved one during a health crisis or decline. To schedule an appointment call 707-479-2946.