Ready to snap? Sort out toxic stress before it sorts you out

[ magazine@irishtimes.com ]

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

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

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

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

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

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

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

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

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

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

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

If you feel you are suffering from burnout, discuss the problem with your GP. The charity Aware (1800 80 48 48) provides support on mental health issues

Toxic Stress by Dr Harry Barry, from Orion Publishing. mhouston@irishtimes.com. Twitter: @muirishouston.