uses of lemon grass

 

Managing stress as a doctor

What is it about doctors that makes them vulnerable to poorly managing their own health?
Our research at the Doctors for Doctors Unit shows that only one in three doctors would see their GP when unwell, despite almost all being registered with one (which is often simply required for work, insurance and so on). One in eight doctors reported that they use alcohol or drugs to help them cope with work and ill health, about one in four reported knowing of colleagues who do so.
It is probably a combination of factors leading to such problems: the conscientious personalities of doctors, the demands of the job, and the culture and systems around doctors health.

Doctors' personalities

There are traits that typically feature in a doctor's profile that might make us good at being doctors, but not necessarily at looking after ourselves. We are obsessive and perfectionist, overly conscientious, and we seek approval. Doctors need to be in control, but may harbour chronic self-doubt. We also tend to dislike praise and delay gratification or the rewards from the job.
The very definition of the job also creates a fine line that doctors walk. To be a good doctor, one needs to be involved with patients (capable of empathy and humanity); yet to remain objective and survive emotionally, one needs to be detached from their pain and suffering. And higher levels of self-criticism are associated with high rates of depression; yet doctors need to be obsessional and self-critical in order to avoid mishaps. The very traits that are necessary for good patient care may not be good for the doctor's health.

Demands of the job

But there are also external factors that cause doctors to burn out. We are giving all day (and night) emotionally, and dealing with physical and emotional distress but who cares for us? For GPs in particular, there is isolation, both psychologically and physically. Doctors are also practising intensively at front line. Long hours lead to poor family relationships/support. Added to all this there is:
* A lack of feedback (except in the form of complaints!);
* Perceived threat of, for example, violence, complaints;
* Insecurity (poor support from management; and NHS reorganisation);

Culture

Comments doctors have given us sum up how there is much collusion allowing the health effects of all these stresses to go unchecked - that doctors are not supposed to be ill, everyone expects a doctor to get on with it and cure himself, doctors with health problems are seen as potential problems and I don't think the avenues are clear enough. There is enormous pressure on doctors not to give in to ill health.
So how do doctors know when these three factors - themselves, the job, and the culture around them have conspired to start causing damage, and what can they do about it?

The symptoms of burn out are identifiable in four areas: emotional, cognitive, behavioural and physical.
Emotional:
Loss of humour;
Irritability/resentment/bitterness;
Depressed mood, apathy;
Feelings of failure/guilt/blame.

Cognitive:
Poor concentration;
Rigidity/resistance to change;
Suspicion/mistrust;
Stereotyping;
Objectification/distancing;
Ruminations (of leaving, revenge, and so on).

Behavioural:
Work avoidance (absenteeism, clock-watching, and so on);
Diminished personal conduct with clients/colleagues;
Inflexible behaviour;
Habitual lateness;
Acting out (alcohol/drugs/affairs/shopping, and so on).

Physical:Tiredness, lethargy;

Sleep disorders;
Increased minor illnesses (headache, backache, and so on).
Many of the ways in which we can help ourselves will read as common sense and are often not too difficult  First and foremost, register with a GP before any problem presents itself. When there are stresses, share problems with family, friends, and colleagues and admit vulnerability. You are a human-being like any of your patients. Set boundaries and make space for yourself; learn to say NO. Try to build in some protection to your spare time so that it doesnt get eaten into. And seek help early if you do develop problems that need further management, and consider options including psychotherapy or counselling.

If you are feel that you are getting symptoms of burn out, keeping a stress diary for just a week can help with identifying the stressors and doing something about preventing further ill effects. Divide the day into hours and record events occurring in each hour. Rate events on a scale of one to ten on two parallel charts one for how stressful the event was and another for how much benefit that same event provided you. After a week, reflect on your ratings and try to alter those events that are causing you high stress for low value. The process of keeping a diary means you will also be paying some attention to time management, which can also help against stress. An example of a time management tool that is quick and easy to use can be found at this web page from Bristol GP solutions [http://www.bristolgpsolutions.org.uk/h4.htm ].
Applying a CBT approach to stressful events can help you identify and manage problems too, simply by thinking about your reactions to situations and asking these sorts of questions:

- Was it stressful and how?
- What was I thinking and how did I react?
- What was the outcome?
- How could I have reacted differently?
- What changes could I make?

Identify your negative thoughts review them rationally and challenge them. Counter what have become automatic negative thoughts - with positive alternatives. Sometimes it can also be helpful to try and see the point of view of those with whom you are in conflict.
A final note is that one of the factors that need not necessarily be out of your control is your colleagues and your particular work set up. GPs in particular should place some importance on finding the right practice or partners as far as possible.
In summary, there is much you are in control of yourself to prevent problems caused by the pressures of the profession. Your personality, what being a doctor demands, and the culture around you are three factors that you can recognise and manage too.

Dr Michael Peters, Head of the Doctors for Doctors Unit of the BMA

5 Ways Relationships Are Good for Your Health

Feb 10, 2011

Fewer mental health problems

Couples may occasionally drive each other crazy — but not literally so. Overall, people in committed relationships experience significantly fewer mental health problems than ((CONLINK|231|single people)), according to a study done by Florida State University in 2010, which observed 1,621 college students.
In fact, the study showed that those not in committed relationships who had more ((CONLINK|228|sexual partners)) also had more physical and mental health problems.
The same trend can also be found in post-college adults. Compared with those in relationships, single men and women have comparatively higher levels of depression, anxiety, mood disorders, adjustment problems, suicidal behavior and other forms of psychological distress, according to a 2002 review in the American Journal of Sociology.
The study also showed that men and women in relationships experience equal benefits in terms of mental health. However, the author acknowledged that mental health is likely both a consequence and cause of being coupled up — those with mental health issues are also less likely to be in a committed relationship in the first place.

Reduced pain

Popular ballads might bemoan that "((CONLINK|609|love hurts))." However, research has shown the opposite is true — love can actually help numb your pain.
A 2010 study published in the journal PLoS ONE examined the relationship between pain relief, feelings of romantic love and activation of reward systems in the brain. Researchers subjected 15 college students who said they were intensely in love to mild pain — they placed a heat block in the palm of the students' hands — while showing them pictures of a loved one or an equally attractive stranger.
The results showed that a picture of their loved one distracted them from the pain, but a picture of another person of equal attractiveness was not as helpful. Images of their brains using functional Magnetic Resonance Imaging (fMRI) confirmed that while looking at pictures of their romantic partner, they experienced increased activity in reward-processing regions of the brain, and decreased activity in pain-processing regions.
The students also performed a word-association distraction task while the heat block emitted moderate-intensity heat. In this case, their pain levels were reduced by an average of 36 percent while they were distracted by doing the task, but decreased by 44.7 percent while they looked at pictures of a romantic partner.

Reduced stress

It's easy to assume that a low-maintenance, drama-free romantic relationship should be relatively free of stress. To boot, there are studies to back that up.
Recent studies have found that single people are more prone to psychological stress than those who are married or in a steady relationship. Relationship status can affect the production of cortisol, a stress hormone, during stressful events, according to a 2010 study by University of Chicago and Northwestern University researchers.
And a 2008 study in the Journal of Family Psychology found that women with supportive spouses experienced less marital strain and in turn, were better at tolerating relationship stresses. The researchers also suggested that partners who are satisfied with their relationship are in a better position to provide support when the other partner experiences stressful events.

Longer life

Longitudinal studies and census data have shown that unmarried adults had a higher probability of early death than those who were married and living with their spouses. A 2000 study by the U.S. Bureau of the Census of 281,460 people over age 45 found that non-married people had a significantly increased risk of death over the study period compared with married people, even after adjusting for other socioeconomic factors. Similar effects have also been shown in Great Britain, Sweden, Denmark and the Netherlands.
In fact, a 2011 study published by University of Pennsylvania researchers in the Journal of Aging and Health found that being continuously married (as opposed to being continuously single or transitioning between separation and divorce) led to longer lives among men with low income and socioeconomic inequalities.
Although the researchers cautioned that it's difficult to assess the causal effect of marital status from observational data, it’s possible that married people, even those who have undergone divorces, have more supportive social networks and children that stimulate continuing family contact than unmarried singles, hence extending their life expectancy.

http://www.myhealthnewsdaily.com/936-5-ways-relationships-good-for-health.html

Happiness

Some ((CONLINK|686|lovesick)) couples seem to revel in showing how happy they are. They can't help it — some of them truly are happier than singles. Studies have shown that when we look at the face of someone that we are truly, madly, deeply and passionately in love with, it engages certain areas in the brain.
Brain images from fMRI suggest that early-stage, ((CONLINK|54|intense romantic love)) can activate certain dopamine-rich areas in the brain, according to a 2005 study in the Journal of Neurophysiology. These areas are associated with reward, desire, addiction and euphoric states. In fact, one of these areas, the anterior cingulate, is responsible for obsessive thinking, cognition and emotion — the characteristics of love.
Interestingly enough, the researchers also said the fMRI images of a brain in love were slightly different than the images of brains that were sexually aroused.
Related: ((CONLINK|940|5 Ways Relationships Are Terrible for Your Health))