The link between Stress, Pain and Burnout

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Hello and thanks for joining me today to explore some of the fascinating research on stress and immunity. The ways our bodies can either adapt in the face of challenges, or instead become dysfunctional and make us unwell. And what we can do when our body starts saying no.

You will also look at stress and burnout in the context of the workplace, and what can be done to effectively target it to maintain physical and mental health of employees. In fact, I think the term stress in the context of the workplace has become so overgeneralised that it almost now lacks any meaning or impact.

There are also numerous complex forms of workplace adversity or psychosocial risks, which have a detrimental effect on our wellbeing. And the workplace can be as much of a source of support as it is a deterrent to mental health or physical health. Also, in the context of health in Western culture, sickness is often seen as bad luck or a statistical misfortune or the fault of genetics.

Instead of looking at how we live, in a working world where stress and burnout are prevalent and sometimes normalised, working under a lot of pressure and competition, striving for productivity all the time without often addressing the needs of being human.

Sometimes we can become ill at work for various reasons that stem from our own personal circumstances as well as systemic issues in the workplace. We can, for example, overwork ourselves by having a lack of personal boundaries or having difficult relationships with colleagues or management, or it can be a toxic work environment that leads us to excessive stress.

Or you could be feeling isolated from remote work and spend too long each day focusing on your tasks and deadlines without breaks to properly recharge. Work-related illness can present as burnout, breakdown, health problems, having low motivation, difficulty switching off and enjoying home or leisure time.

Physically, however, it can present as insomnia or chronic pain, headaches, and in severe cases, cardiac problems such as stroke. But how do physical challenges impact our bodies? According to research, our brain and body have trouble distinguishing between real threats such as fire and perceived danger from too many work demands.

This results in a rush of hormones and chemicals in a way that’s not really sustainable, being hyper-vigilant most of the time and unable to properly unwind and recover. And to tackle this, not only do we need to prioritize our mental and physical health, we need to also voice our concerns in the workplace to help make changes and improvements to our culture and systems.

From an organizational perspective, burnout happens when the demands of our work exceed our resources. So when we’re constantly battling the to-do list hopping from deadline to deadline, and then our resilience and coping mechanisms falter and break.

As already mentioned, work demands can include toxic work relationships, high performance expectations or persistent tight deadlines, high workload or high stress environments. Think for example, working in a hospital, especially during COVID, would be considered a high demand job.

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Or working in a busy restaurant serving customers would be considered a high demand job, but with low control over how their work is done. There are high standards and expectations for customer service. In fact, research has identified that the high demand low control combination is the most detrimental to our health.

On a positive note however, there are buffers at work that can help reduce this impact.

Some examples of buffering job resources include having supportive work colleagues, people you get on with that make the day easier, have a bit of a laugh with when things get tough, or having a great manager that helps you to prioritize projects, helps support and work process improvements, encourages you most importantly, to switch off at the end of the day so we can recover and sustain productivity over time.

Job resources can also include your own resilience and adaptability. But most importantly, it is the culture of a workplace that mostly affects our wellbeing.

You can have meditation and yoga classes, but at the end of the day, being in a work environment where you can report any wellbeing challenges, or confide in your manager about work-related ill health or mental health concerning either yourself or others, and whether our colleagues and leadership embody this sense of wellbeing is what really matters.

If you would like to know more about what your organization can do to help create a supportive culture of wellbeing, please contact one of our team at hello at sevohealth.com for further information. So moving on to now the link between stress and illness and why we get sick after challenging times.

Have you ever heard of someone passing away soon after a loved one or someone going through financial or relationship trouble, also suffering with chronic pain or from high blood pressure, or even something as simple as going on holiday after a very stressful period, or need to come down with a cold or a flu when you should be having fun after all your hard work.

We can see that psychological distress affects our health and our immunity. However, one of the leading speakers on the link between stress and disease, Dr. Gabor Maté, notice how the Western medicine approach to disease as disorder of cells and physical systems was limiting, separating the illness from the person who was considered a victim of genetics, bacteria or viruses.

However, this perspective leaves little consideration for the social, psychological, or behavioral influences on health, with mind and body being seen as separate. But to give an example of a couple of studies, a study in the US in 2018, demonstrated that the more incidence of racism someone experienced, the higher the risk for asthma.

Also, the gender ratio for MS in the 1920s and 30s was one-to-one, one man for every woman. Nowadays, three and a half women to every man. Therefore, we can assume it may be not genetic and it really can’t be about diet or climate, considering the vast gender differences.

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So what is going on? With both of these immune-related diseases, inflammation is treated with stress hormones such as cortisol and steroids, but it is possible stress may have caused the onset of the illness. In the case of racism causing asthma attacks, emotional factors must be playing a role, and there may also be social and economic factors to consider.

In 1977, a new biopsychosocial approach to health was developed, yet it wasn’t even new then. Even the physician Galen of Roman times found that women who were depressed were more likely to get cancer, and now we have studies to support these claims. Therefore, it appears we cannot separate the mind from body and we can’t separate the individual from environment.

However, despite the evidence for this now in the research, Western medicine does not really take this into account.

Few doctors will ask about traumatic experiences, relationships, although some might ask about stress and work, and only now we’re seeing medical developments into autoimmune disorders and dysfunctions of immunity that it’s really still at early stages, though throughout history we’ve seen this mind-body connection.

However, when looking after palliative care patients, Dr. Mati identified what he calls the disease-prone personality. He found that they tended to prioritise the needs of others while ignoring their own. As the saying goes, good people die young, and they often do, working until their last day while ignoring the needs of themselves.

He also noticed that repressed anger can lead to premature illness, and we know now that repressed anger suppresses the immune system. In fact, research has shown that the greater the repressed emotion, the less cigarette intake it takes to develop lung cancer, which is fascinating, and there’s so much research out there to support his clinical experiences since.

We now know that stress can lead to illness through inflammation. For example, studies show that negative stressful childhood experiences and trauma can lead to greater numbers of inflammatory markers in their bloodstream as adults. Even stress has been shown to shorten our DNA telomeres, making us chronologically older than we are.

Interestingly, on the other hand, mindful meditation actually increases DNA telomere length, likely due to stress reduction. However, there are many other mechanisms by which stress can impact health, which we’ll discuss.

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Stress is something we all experience, but not all of us manage stress as well as we would like. Being able to effectively deal with stress is important for our own mental wellbeing. ZevoHelp, leaders in workplace wellbeing, provides stress management training to support your team to handle daily stressors.

Our training provides employees with the necessary practical skills to cope with everyday stressors, to allow them to be more productive and happy, both inside and outside the workplace. Contact us today to inquire about stress management training for your organisation www.zevohealth.com

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Stress depends on how you perceive a stressor, how we react to it and our physiological responses such as the release of adrenaline and cortisol, but mostly it’s our unconscious internal processes that affect its impact. We can respond with anxiety or depression based on past experiences or stories that run our lives increasing stress hormones in the body.

An interesting study by health psychologist Kelly McGonigal showed that stress only impacted health negatively if stress is seen as a bad thing at rest and suggests that we should treat stress as something positive, treated more like an ally, which may be easier said than done. In fact Dr. Maté suggests that illness may be an opportunity to learn instead of something to battle against.

The point is not to reject Western medicine, instead we need to have more agency in what’s going on for us and to try to be more curious exploring with compassion why we may be reacting in certain ways or becoming distressed over small matters.

Hans Salle, an endocrinologist who coined the term stress said that in the modern world stress is mostly emotional and the biggest stress of all is trying to be something other than you are, so the lesson here is to get to know who you are and be who you are.

The role of emotions in general is to keep what you don’t need, what is toxic at bay and welcome in what you do need, what is healthy to allow that in. The role of the immune system is the same thing, the nervous system, the gut, emotional processing are all connected so if you suppress any part of it including your emotions it affects other parts as well.

So now let’s explore some of the impacts of stress on autoimmune disorders. Have you ever woken up after a nine hour sleep and feel like you were out all night and got hit by a bus on the way to bed? It could be because you picked up the flu but it could also be as a result of a disordered immune system.

The human immune system is incredibly complex and has evolved to recognise itself as safe and outsiders as unsafe. In this way it can then fight off infections from bacteria or viruses for example. However we know in some cases the messages get confused. Take for example with autoimmune conditions, here the body starts to attack itself no longer recognising its own cells or tissue as safe.

Autoimmune disease can cause pain from inflammation as well as chronic fatigue. Some of the better known conditions include rheumatoid arthritis, MS and type 1 diabetes but there are so many different variations out there and not enough is known about them. Emotional stress or trauma can be the initial trigger of this or make symptoms worse.

Diagnosis can be devastating and the symptoms debilitating as well and I’m sure many of you listeners have or know someone with an autoimmune disorder. Personally I have family with rheumatoid arthritis and I’ve seen how disheartening it is for them to try cope with advancing pain and disability and trying to maintain quality of life with so much pain going on.

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It has such an emotional impact because it’s such a degenerative disease and not enough is known about it or how to treat it. But it can be managed with medication, stress relief and trying not to do too much on good days as well. Though I’ve noticed that those who have it go above and beyond helping others and now find themselves needing to slow down and ask help from other people.

In fact my own health has been impacted by an immune disorder and it can be frustrating some days to try and understand why I feel so tired and wake up with pain and we’re only beginning to learn what autoimmune disorders are, what diet or medication can help. But it’s also a journey for me, a lesson in doing too much maybe and learning to listen to my body and rest when needed.

Is it my body being attacked or is it telling me to just slow down and stop being so busy all the time? Which I think can be tricky when our minds are so busy doing tasks and distracted by technology all of the time. So to reflect on your own experience of stress or repeated illness, what do you think your body might be telling you or what’s going on for you?

Are there any practical changes at work that you could make to make your life easier? Do you need to make more time for a casual chat with your colleagues or take more breaks? Or do you need to stop doing everything at home for your partner or family or to search yourself more with others?

It’s important to take ownership of our own health, as well as seek medical or psychological support to understand what’s going on for us, what might need to change, what needs balancing, what’s not working out for you right now. It reminds me of what psychoanalyst Carol Young once said, until you make your unconscious conscious, it will direct you and you will call it fate.

Thank you so much for listening today. I hope you found it interesting and helpful Bye for now.