My previous post about stress was posted here on 28 January. This time, I’m attacking (more accurately, sneaking up on) stress from a different angle. And I’m starting by going back in time. Way, way back to pre-CQC. It seems prehistoric man suffered stress, would you believe? And guess what – we know it from their teeth! In 2010, George Armelagos, an anthropologist from Emory University in the USA, discovered enamel defects in teeth dating back one million years indicating that, ‘During prehistory, the stresses of infectious disease, poor nutrition and psychological trauma were likely extreme.’ This stress reduced life expectancy – remains from Dickson Mounds, Illinois, showed that individuals with teeth marked by early life stress lived 15.4 years less than those without the defects.

So is stress bad then?

Not necessarily; read on. According to the Mental Health Foundation: ‘Some stress can be positive. Research shows that a moderate level of stress makes us perform better. It also makes us more alert and can help us perform better in situations such as job interviews or public speaking. Stressful situations can also be exhilarating and some people actually thrive on the excitement that comes with dangerous sports or other high-risk activities.’ The Foundation does point out that stress is only healthy if it is short-lived.

Stress causes a surge of hormones to better help you deal with ‘fight or flight’ situations. According to NHS Choices: ‘Once the pressure or threat has passed, your stress hormone levels will usually return to normal. However, if you're constantly under stress, these hormones will remain in your body, leading to the symptoms of stress.’

How much stress is normal?

Now we come to the science – specifically the Depression, Anxiety and Stress Scale (DASS). This is a self-report questionnaire whereby you answer questions, add up the score and convert these to severity ratings for depression, anxiety and stress. There are two versions – DASS and DASS 21. The former has 42 questions, the latter 21 (so you multiply the scores by two). Ignoring depression and anxiety for the purposes of this article, the severity scores for stress are:

·        Normal 0-14

·        Mild 15-18

·        Moderate 19-25

·        Severe 26-33

·        Extremely severe 34+

DASS is not a diagnostic tool. If you are feeling anxious, depressed or stressed, you should see your GP – even if you get low DASS scores. However, if you wish to get some idea of how stressed you are and so gauge whether it could be considered healthy, go to https://www.cesphn.org.au/images/mental_health/Frequently_Used/Outcome_Tools/Dass21.pdf for DASS 21 (remember to double your scores for the full DASS severity ratings.

No added stress

In my previous post, I urged you to stop putting stress on others – particularly colleagues and staff in your practice. Now we see that some stress is normal and may well be beneficial. So does that contradict what I wrote before? Not at all. Yes, some stress is normal and healthy but so very few of us lead completely stress-free lives that we need added stress at work. Relationships, health, family obligations, household maintenance, cars, money worries all cause stress. Many of us are also good at getting stressed about things that haven’t even happened yet! So who are you to add to the stress of your colleagues or staff and maybe move them from normal to mild, moderate or severe on DASS?

Stress as a management tool?

Excuse me? Think twice (or more) before you decided to ‘push’ members of your team to make a greater effort. It is far more effective to motivate people to work more effectively or efficiently. People work best through their lunch hour when they don’t hold a grudge at you demanding it but because they genuinely want to get the patient records up to date.

As a manager you should be familiar with the theory of psychological type as introduced by Jung and the Myers-Briggs Type Indicator – so you know how to get the best out of each member of your staff.

This is a topic covered on my courses – come and find out.

Image credit -Bottled_Void under CC licence - not modified.