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Coping with stress: the curse of the strong

Mental ill-health in the profession has never been higher. But you can beat the stress, writes Dr Tim Cantopher of the Priory Hospital

Stress, depression and alcohol misuse are ‘the curse of the strong’, the high
price overachievers pay for giving 110% in all aspects of their lives,
particularly at work.
People in high-stress jobs run twice the risk of suffering serious depression or
anxiety as those in lower-stress occupations.

Time pressure ­ working to deadlines in an environment where failure is
publicly visible ­ is one of the most important causes of stress.

A key measure of job stress ­ lack of support from co-workers and supervisors
­ is also related to depression and can lead to alcohol abuse. The statistics
for men and work stress are particularly shocking. One in three use alcohol to
relieve work stress, while 17% have been to a doctor about stress levels and
more than 25% suffer from exhaustion as a result of stress.

’ might have a reputation for helping celebrities with their
addictions issues, the reality is that these types of hospital provide a wide
range of services to professionals who have taken the brave decision to seek
help for their mental health problems.

The main irony surrounding mental illness is that the sufferer is seen as
weak by those around others, and themselves.

Yet many mental health issues are an affliction of those who are too capable
­ people who are strong, diligent and reliable and have a strong conscience and
sense of responsibility but are sensitive, vulnerable and whose self-esteem is
easily dented.

Strong people go on and on, constantly striving, way beyond the point that
the body is designed for. Eventually the wheels begin to fall off and symptoms
appear, yet those who are strong can’t stop ­ they keep on going until
eventually the fuse blows and they are in crisis.

Toxic stress

Your workplace may be toxic. Some employers really care for their workforce,
while others merely pretend. If you feel abused by your employer, look at your
You may assume you don’t have any choices, with all the financial demands upon
you ­ but you do. You won’t die if you downsize your house, your children won’t
perish from changing school. And are your two cars or two annual holidays worth
risking your health over?

If people can make you ill, the worst culprit can be yourself. Patients tend
to criticise themselves a lot, applying a standard to themselves that they never
would to others. Would you say to a friend suffering from a mental health
problem: ‘You’re pathetic, stop loafing around and just get on with it!’? No.

If you are in meltdown, be as kind to yourself as you are to others.
Recognise that you need to make some positive changes in your life that may be
difficult at first:

• Re-examine your financial commitments: what lifestyle elements do you need
to maintain and what can you relinquish?
• Eat healthily: so many office workers exist on rubbish and wonder why, after
snacking on salty and sugary foods all day, they feel ill.
• Exercise at least four times a week: this can be as simple as going out for a
twenty-minute walk at lunchtime.
• Reduce your alcohol consumption.
• Ensure you get eight hours’ sleep a night.

There is another option ­ get help before it is too late. Your GP may be able
to help or refer you to a healthcare professional who can provide the
understanding and specialist service. You need to regain control of your life.

The demon drink

Depression and alcohol misuse are typically ‘the curse of the strong’ and
many people in high-stress professions like accountancy suffer from both mental
health issues concurrently.

Working harder isn’t the answer, nor is alcohol. The issue of self-medicating
­ of using alcohol to fill the ‘hole in the soul’ created by depression, fear,
loneliness, trauma, low self-esteem and other mental health issues ­ is
critically important. Research conducted by the Priory Group has shown that
nearly 25% of adults, or almost 12 million people, drink when they’re depressed.

Alcohol is generally the first drug that people take. It is socially
acceptable, ubiquitous and relatively inexpensive, all of which contribute to
today’s widespread misuse. It is also dependable ­ it produces a consistent mood
change that some people rely on to help them deal with the emotional
rollercoaster of life. Unfortunately, alcohol addiction is progressive,
generally developing along a continuum, with experimentation leading to
enjoyment, which becomes drinking to cope, then drinking to survive. Alcohol
reverses its own effects in the long term; the drink which you take regularly to
alleviate depression and anxiety eventually makes them worse.

More than one ‘yes’ to the CAGE test, below, is usually an indication that
someone has issues with alcohol that need to be addressed:

• Have you ever felt you should cut down on your drinking?

• Have people ever annoyed you by criticising your drinking?

• Have you ever felt bad or guilty about your drinking?

• Have you ever had an eye-opener ¬a drink first thing in the morning to
steady your nerves or get rid of a hangover?

Again, depression is often the underlying cause of alcohol misuse; if you are
suffering from clinical depression, you may experience the following ‘loss of:
sleep; appetite; energy and enthusiasm; concentration; confidence and
self-esteem; sex drive; enjoyment; patience; feelings; optimism; and almost
anything else you can imagine. Pretty much everything goes.

Dr Tim Cantopher is a consultant psychiatrist at the
Priory Hospital

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