To the outside world, Catherine Thompson England seemed to be handling the pressure of her job as a caseworker for abuse victims well. Though she had told her boss that stress was mounting, it didn't appear to be a problem, since she was getting the job done. But the Pennsylvania social worker was staying late and working at home to do it, a growing trend in a world of tight budgets and understaffing.
Things weren't going well at all. One day the pressure exploded and Thompson England had a breakdown. She was hospitalized for 10 days.
"People don't want to hear about stress, because everybody has it," says Thompson England, who has a five-year-old son. "You will deal with a lot of stress before you reach out, because it's not taken seriously."
Stress has become such a normal part of the day-to-day that it has become a kind of adrenalized wallpaper. Bringing up the subject is to point out the obvious—or that you are a wimp. Fear of being wimpy, though, leads to real weakness—physically, since stress plays a role in five out of the six leading causes of death, and financially, since stress costs the nation a boggling $1 trillion a year.
Chronic stress triggers conditions that kill more people every year than cancer and nicotine combined, but it's treated as if it's no more serious than excess gas or bloating. Take a pill and deal with it. Americans certainly do, consuming $16 billion worth of antipsychotics each year and $11 billion in anti-depressants.
There's a disconnect between stress and the conditions it sets off—hypertension, stroke, coronary artery disease, diabetes, insomnia. Many of us watch our cholesterol, get exercise, keep sugar under control, and yet don't do anything to manage the switch linked with the diseases we're otherwise trying to prevent: stress. That's because we've never been taught to take stress seriously—until a heart attack or burnout.
I come across this every day in my work as a stress management educator. There was the manager at a government security agency who had a stroke in his 40s. The real estate agent with panic attacks. The CEO leveled by a heart attack.
Unlike more exotic bugs and conditions, there is a cure for stress: knowledge. We know how to prevent and manage it. The stress response is activated when a perceived threat overloads ability to cope with the danger. It's an early warning system that worked well in hunter-gatherer days when threats to life and limb were frequent, but it doesn't know how to compute the social stressors of the modern world. A number of proven stress management processes can turn off the false alarm of stress. Once the danger signal has been shut off, the stress stops in four minutes.
Job stress isn't weakness; it's a serious business. Brian Curin, president of Flip Flop Shops, which sells sandals and a casual lifestyle at 80 stores around the country, discovered that he took too casual of an approach to his own health. Though he exercised and ate well, years of stressful business-building had taken a hidden toll. Curin failed a treadmill stress test, and a follow-up angiogram revealed that his heart was starving for oxygen. He had four major blockages, one of them 100 percent—at the age of 38.
"It was years of running as fast as I could go at the speed of business," said Curin. "It really shows the effect that stress can have on you. They said if I had had a heart attack, they wouldn't have been able to help me."
He had to have a quadruple bypass to repair the damage. Curin was so shaken by the experience he decided to do something about it. His company started an initiative with the American Heart Association, My Heart, My Life, to advocate for stress tests at companies and educate customers on stress prevention.
Stress testing, whether by exercise test, ECG, blood pressure testing at work (one out of five people have elevated readings at work but not at home) or other modalities, has to become as routine as dental or cholesterol checks to identify people like Curin, who are unaware of the problem, or England Thompson, who fear reaching out might mark them as a wimp or burden to others.
England Thompson learned she has to speak up more, set boundaries, and share the load with others. "We need to normalize the fact that stress is a very real thing and you don't have to deal with it on your own," she said.
Stress testing, coverable mental health counseling, and social pressure to change macho attitudes can make it acceptable to get help and overcome the shame, bravado, and willful ignorance that feed the chronic disease mill of stress.