Caroline Kamau and Asta Medisauskaite :
In a large study of physicians in the United Kingdom [1], we examined the many problems that doctors struggle with: 44% of doctors binge-drink and 5% meet the criteria for alcohol dependence. 8% have a binge-eating disorder, 20%-61% have some type of sleep problem with 12% having severe or moderate insomnia, 69% have fatigue and 19%-29% experience other types of ill health.
We found that physicians with signs of occupational distress are at greater risk of these problems. For instance, 55% of physicians have burnout and burnt-out physicians have nearly double the risk of insomnia and binge-eating.
People often express frustrations about work by saying that they are stressed – but work-related stress can also harm your health. Our research on physicians in the United Kingdom shows that what people call “work-related stress” is actually best defined as a syndrome consisting of many symptoms, includes burnout, work-life imbalance, job strain, and others. We believe that our research about physicians has implications for everyone. Burnout involves feeling emotionally exhausted from work, being cynical, or treating colleagues or customers poorly. A work-life imbalance involves spending more time on work than you should, leaving little time for rest, pursue your hobbies, exercise, or spend time with your family or friends. Job strain consists of an imbalance in which the psychological costs of your job exceed the rewards you expect. This is why we have coined the term “occupational distress,” which we define as a syndrome comprising any possible symptoms of psychological anguish or impairment caused by work.
We aim for research that makes a positive difference in society [2]. Our research includes a study of 417 physicians in the United Kingdom [1] that shows that physicians with occupational distress are more likely to experience health problems-including frequent headaches, stomach upsets, acid indigestion, heartburn, eye strain, ear ringing, and diarrhea. Our research also shows that physicians with occupational distress are more likely to suffer from insomnia and other symptoms of disordered sleep-including difficulty falling or staying asleep, with sleep problems impairing daily functioning.
As well as this, suffering from occupational distress can raise the risk of physicians engaging in unhealthy behaviours such as drinking too much alcohol, relying on legal drugs as a way of coping, or disordered eating. This can include consuming a large amount of food when one is not physically hungry, feeling upset by uncontrollable eating, and feeling disgusted, depressed, or guilty with oneself after binge-eating. We have found that the risk of a physician having a binge-eating disorder is higher if they are suffering from occupational distress.
What can people in any profession learn from our research?
1. Occupational distress is harmful to physical health
If you frequently suffer from clinically unexplained stomach upsets, heartburn, headaches, diarrhea, eye strain, and fatigue, this might be a sign of work-related stress. Consult your health professional and tell them whether you are experiencing stress from work, burnout, work-life imbalance, or job strain. Your health professional will be in the best position to determine whether or not these things are contributing to your health problems. If they are, your health professional should refer you to appropriate support services, including support from a trained therapist.
The idea that occupational distress raises the risk of health problems makes sense because research suggests that distress affects physical health by weakening the immune system, making people more susceptible to infections [3]. Other research [4] suggests that distress disturbs the body’s homeostasis by increasing something called “allostatic load,” making people feel exhausted and overloaded during the early or “alarm” phase or after finding it difficult to adapt to the distress. In fact, the field of psychosomatic medicine is dedicated to understanding how mental distress affects physical health and people’s susceptibility to illness [5].
2. Occupational distress raises the risk of alcohol, drug, or food misuse
That includes hazardous or frequent drinking of alcohol, smoking, and use of legal or illegal drugs as a way of coping with distress. Our research supports other studies in the field [6,7] showing that occupational distress raises the risk of disordered eating. The lesson is that, if you find yourself drinking too much alcohol, eating too much, or resorting to medication, this might be a sign that work-related problems are having a negative impact on you.
Reflect on your current employment. Is it too demanding, stressful, or challenging? What can be done about it? If you have no power over the things that are stressful at work or you cannot make a job change, consult with your health professional about alternative coping strategies.
3. Occupational distress harms sleep
It can increase your risk of insomnia and reduce the quality of your sleep, making you more likely to have difficulties falling or staying asleep or to worry about work as you try to fall asleep. Studies show that sleep disturbances have long-term health consequences such as reducing immunity, raising the risk of cardiovascular health problems [8] and raising the risk of suicide [9].
If you are suffering from work-related problems and you also suffer from sleep problems, consult with your health professional to rectify the problem. Although short-term fixes like sleep medication can be useful, we suggest that a long-term solution must address the underlying work difficulties.
4. The different signs and triggers of occupational distress
It is important to figure out what triggers your distress or its impact on your health. Are you burnt-out? What caused your burnout? For example, working for a boss who shouts at you or working with rude customers may force you to put on a brave face and pretend that you are fine. However, this creates something called “emotional labour” through suppression of real emotions [10] and, ultimately, this can contribute to burnout [11].
Are you working in a job that places too many demands on you or a job that is unrewarding? Having a mismatch between job demands like tight deadlines, and job resources like lacking autonomy can create job strain. This can lead to burnout, according to the job demands-resource model [12]. Putting a lot of effort into your job without matching rewards in pay, positive feedback, or recognition can also be a problem, according to the effort-reward imbalance theory [13].
5. Avoid self-blame and confide in someone
Our research suggests that self-blame is a risk factor for sleep problems, substance abuse, and binge-eating. It may be better to vent about your frustrations to a trusted colleague, spouse, friend, physician, or therapist. Be open about the difficulties. Or join an online forum dedicated to people in your profession; ask for advice or a listening ear from the comfort of anonymity.
Do not keep quiet about work problems that your employer can change, such as bullying, an unreasonable workload, or poor rewards (apply for promotion at the next opportunity). Do not ignore symptoms and do not try to cope alone. You will quickly learn that occupational distress is surprisingly common and realising this can help you cope with it. In a randomised-controlled trial, we tested interventions encouraging physicians to see occupational distress as something common and a normal reaction to challenging situations [14]. This awareness itself reduced levels of burnout and anxiety.
If you are experiencing work problems outside your control, do not blame yourself. If you are suffering unexplained symptoms, speak to your health professional. Be self-compassionate and take action to protect your health.
(Caroline Kamau, Ph.D., is in the Department of Organisational Psychology, and the Birkbeck Centre for Medical Humanities, at Birkbeck, University of London. Asta Medisauskaite, Ph.D., is in the Research Department of Medical Education, University College London Medical School, London).
In a large study of physicians in the United Kingdom [1], we examined the many problems that doctors struggle with: 44% of doctors binge-drink and 5% meet the criteria for alcohol dependence. 8% have a binge-eating disorder, 20%-61% have some type of sleep problem with 12% having severe or moderate insomnia, 69% have fatigue and 19%-29% experience other types of ill health.
We found that physicians with signs of occupational distress are at greater risk of these problems. For instance, 55% of physicians have burnout and burnt-out physicians have nearly double the risk of insomnia and binge-eating.
People often express frustrations about work by saying that they are stressed – but work-related stress can also harm your health. Our research on physicians in the United Kingdom shows that what people call “work-related stress” is actually best defined as a syndrome consisting of many symptoms, includes burnout, work-life imbalance, job strain, and others. We believe that our research about physicians has implications for everyone. Burnout involves feeling emotionally exhausted from work, being cynical, or treating colleagues or customers poorly. A work-life imbalance involves spending more time on work than you should, leaving little time for rest, pursue your hobbies, exercise, or spend time with your family or friends. Job strain consists of an imbalance in which the psychological costs of your job exceed the rewards you expect. This is why we have coined the term “occupational distress,” which we define as a syndrome comprising any possible symptoms of psychological anguish or impairment caused by work.
We aim for research that makes a positive difference in society [2]. Our research includes a study of 417 physicians in the United Kingdom [1] that shows that physicians with occupational distress are more likely to experience health problems-including frequent headaches, stomach upsets, acid indigestion, heartburn, eye strain, ear ringing, and diarrhea. Our research also shows that physicians with occupational distress are more likely to suffer from insomnia and other symptoms of disordered sleep-including difficulty falling or staying asleep, with sleep problems impairing daily functioning.
As well as this, suffering from occupational distress can raise the risk of physicians engaging in unhealthy behaviours such as drinking too much alcohol, relying on legal drugs as a way of coping, or disordered eating. This can include consuming a large amount of food when one is not physically hungry, feeling upset by uncontrollable eating, and feeling disgusted, depressed, or guilty with oneself after binge-eating. We have found that the risk of a physician having a binge-eating disorder is higher if they are suffering from occupational distress.
What can people in any profession learn from our research?
1. Occupational distress is harmful to physical health
If you frequently suffer from clinically unexplained stomach upsets, heartburn, headaches, diarrhea, eye strain, and fatigue, this might be a sign of work-related stress. Consult your health professional and tell them whether you are experiencing stress from work, burnout, work-life imbalance, or job strain. Your health professional will be in the best position to determine whether or not these things are contributing to your health problems. If they are, your health professional should refer you to appropriate support services, including support from a trained therapist.
The idea that occupational distress raises the risk of health problems makes sense because research suggests that distress affects physical health by weakening the immune system, making people more susceptible to infections [3]. Other research [4] suggests that distress disturbs the body’s homeostasis by increasing something called “allostatic load,” making people feel exhausted and overloaded during the early or “alarm” phase or after finding it difficult to adapt to the distress. In fact, the field of psychosomatic medicine is dedicated to understanding how mental distress affects physical health and people’s susceptibility to illness [5].
2. Occupational distress raises the risk of alcohol, drug, or food misuse
That includes hazardous or frequent drinking of alcohol, smoking, and use of legal or illegal drugs as a way of coping with distress. Our research supports other studies in the field [6,7] showing that occupational distress raises the risk of disordered eating. The lesson is that, if you find yourself drinking too much alcohol, eating too much, or resorting to medication, this might be a sign that work-related problems are having a negative impact on you.
Reflect on your current employment. Is it too demanding, stressful, or challenging? What can be done about it? If you have no power over the things that are stressful at work or you cannot make a job change, consult with your health professional about alternative coping strategies.
3. Occupational distress harms sleep
It can increase your risk of insomnia and reduce the quality of your sleep, making you more likely to have difficulties falling or staying asleep or to worry about work as you try to fall asleep. Studies show that sleep disturbances have long-term health consequences such as reducing immunity, raising the risk of cardiovascular health problems [8] and raising the risk of suicide [9].
If you are suffering from work-related problems and you also suffer from sleep problems, consult with your health professional to rectify the problem. Although short-term fixes like sleep medication can be useful, we suggest that a long-term solution must address the underlying work difficulties.
4. The different signs and triggers of occupational distress
It is important to figure out what triggers your distress or its impact on your health. Are you burnt-out? What caused your burnout? For example, working for a boss who shouts at you or working with rude customers may force you to put on a brave face and pretend that you are fine. However, this creates something called “emotional labour” through suppression of real emotions [10] and, ultimately, this can contribute to burnout [11].
Are you working in a job that places too many demands on you or a job that is unrewarding? Having a mismatch between job demands like tight deadlines, and job resources like lacking autonomy can create job strain. This can lead to burnout, according to the job demands-resource model [12]. Putting a lot of effort into your job without matching rewards in pay, positive feedback, or recognition can also be a problem, according to the effort-reward imbalance theory [13].
5. Avoid self-blame and confide in someone
Our research suggests that self-blame is a risk factor for sleep problems, substance abuse, and binge-eating. It may be better to vent about your frustrations to a trusted colleague, spouse, friend, physician, or therapist. Be open about the difficulties. Or join an online forum dedicated to people in your profession; ask for advice or a listening ear from the comfort of anonymity.
Do not keep quiet about work problems that your employer can change, such as bullying, an unreasonable workload, or poor rewards (apply for promotion at the next opportunity). Do not ignore symptoms and do not try to cope alone. You will quickly learn that occupational distress is surprisingly common and realising this can help you cope with it. In a randomised-controlled trial, we tested interventions encouraging physicians to see occupational distress as something common and a normal reaction to challenging situations [14]. This awareness itself reduced levels of burnout and anxiety.
If you are experiencing work problems outside your control, do not blame yourself. If you are suffering unexplained symptoms, speak to your health professional. Be self-compassionate and take action to protect your health.
(Caroline Kamau, Ph.D., is in the Department of Organisational Psychology, and the Birkbeck Centre for Medical Humanities, at Birkbeck, University of London. Asta Medisauskaite, Ph.D., is in the Research Department of Medical Education, University College London Medical School, London).
