Stages of Stress: What You Need to Look Out For

Life is full of debilitating stress that can feel relentless and unavoidable. If you’re a physician, it can be worse because your career puts you in high demand. The interesting thing is that you aren’t always aware of the level of stress you’re enduring - particularly if you’ve been in that state for a prolonged period. 

Globally, we are encouraged to work harder and harder to reach unrealistically ambitious goals and reject reasonable rest and personal boundaries. Often doctors face these pressures even more so. Add to that long work hours, decision fatigue, and the high-stakes nature of practicing medicine, and you can see why physicians are suffering burnout in record numbers.   

Related:  How to Deal With Overwhelm in 2021  

What are Stress Triggers

We aren’t all triggered to feel stressed by the same conditions, and physicians may have a higher stress tolerance. But no one is immune to its dire effects. Here are some general situations that may trigger stress:

• Facing change
• Excessive pressure to perform
• Being unable to control a situation’s outcome
• Times of uncertainty
• Not having enough work or activities in your life
• Having too much responsibility
• Having an overall lack of control in your life 

What are the Emotional and Physical Signs of Stress?

It’s essential that you recognize the signs of stress so you can protect yourself. Here are a few general signs of stress:

• Irritable and aggressive
• Overwhelmed 
• Depressed
• Anxious
• Nervous
• Afraid
• Racing thoughts
• Lack of joy and fulfillment
• Dread
• Lonely
• Restless
• Irregular eating habits
• Avoidance
• Lack of focus
• Overly emotional

The Stages of Stress

If you are under stress, it is vital for you to know it. If left unchecked, stress can cause physical and emotional damage or even trauma. Following are the five stages of stress as you may experience them - alarm, resistance, recovery, adaptation, and burnout. You won’t necessarily go through every stage in any particular order, but at least you can recognize where you are and discover positive actions to regain peace and control. 

Alarm

This stage could also be called an acute stress response. It occurs after a circumstance has triggered you, and you experience a fight or flight reaction when your heart rate and blood pressure increase and adrenaline is boosted.  

At this stage, you may encounter the following physical signs:

• Dilated pupils: allowing more light to enter the eyes and improve vision.
• Dry mouth: as blood flow and saliva are decreased in the mouth and digestive system.
• Sweating: your body’s attempt to cool you down.
• Cool skin: as blood flow moves toward your brain, eyes, ears, nose, arms, and legs, it moves away from the skin.  

Related:  Physician Burnout: Everything You Need to Know 

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Resistance

The physical signs of your stress will become easier to cope with at this stage. Here, your body is trying to return to a healthy state by releasing anti-inflammatory hormones to calm and settle your body. The adverse effects of stress can become worse if the pressure continues. Following are some strategies you may employ to move through this stage. 

• Recognize the source of your stress. Try to pinpoint precisely what situations or circumstances are causing you the stress. The calm from the hormones should help you with thinking things through.
• Do something about it. Deal with your stressors as positively and directly as you can.
• Make a plan for a less stressed future. Think about how you can remedy your current situation and also how you may prevent it or deal with it better next time.   

Coping

The most crucial stage is this one. It’s about moving toward equilibrium and recovery. This could happen as the situation or circumstance completes itself. For instance, a family issue is resolved, a long-term project finishes or a busy period in your medical practice comes to an end. 

You can even begin to experience recovery just by getting away from the problems for a time. Here are a few things you can do to start recovery even if the offending situation isn’t resolved.

• Eat a healthy, well-balanced diet. Proper nutrition will go a long way in ensuring your mental and physical well-being.
• Exercise. This releases endorphins in the body, which will lift your mood and make you feel better.  
• Get consistent sleep. Don’t underestimate the crucial role sleep plays in your overall health. Keep a regular sleep schedule.   

Adaptation

In stressful situations, you can either get out of it or adapt to them. Adaptation might be the result of feeling helpless to change things. Unfortunately, this won’t make things better. You are fixing yourself in a state of stress that will have long-term adverse effects. Low energy, sleep issues, low self-esteem, and emotional instability will become your new normal. 

If you find yourself in stressful circumstances that you can’t immediately do anything about, consider doing any of these things to mitigate the long-term damage.

• Check-in with yourself frequently. Ask yourself questions like, ‘How am I doing right now?’ and ‘Can I handle this any better than I already am?’ 
• Be kind and gentle with yourself. You’re dealing with a lot right now, so cut yourself some slack.
• Consider possibilities you may have overlooked before. Use tools like mindfulness and coaching to find peace and practice positive thinking patterns.  

Burnout

If you cannot extricate yourself from stressful circumstances because you don’t know how or because you’ve unknowingly adapted, you’re in danger of burnout.  

Signs of burnout are:

• Extreme exhaustion
• Emotionally drained
• Negativity
• Cynicism
• Catastrophic thoughts 
• Detachment

Try these strategies:

• Slow your thinking and your body. Find a way to take breaks from all the thinking, worrying, and physical tension.   Even if you can just get away in a quiet place for only 10 minutes, it can be beneficial.
• Reconsider your goals and priorities. Decide what you really want from your work and life. Set new and more reasonable goals.  
• Rest, recover, and reward. As you come through every difficult situation, be generous with yourself. Get all the rest you need to facilitate recovery. And when it’s all over, reward yourself for enduring.  Celebrate every small win and success.   As physicians, we often don’t even take a minute before we are on to the next task or goal.  

Related: What is a Life Coach? What You Need to Know 

You Know What Stage of Stress You’re At - Now What?

The first step in positive action is to understand where you’re starting. When you use the above information to determine what stage of stress you are currently in, you can move toward improvement. If you’re in the acute fight or flight stage or in resistance, commit to recovery. Take the time you need to break from the stress, even if only temporarily, to get rest. Change your perspective if you think that taking ‘me time’ is silly or only for the weak. You deserve to be happy.  It is no longer acceptable to believe “the patient always comes first”.   If we don't’ take care of ourselves we will have nothing left to give to our patients.   Recognizing and satisfying your own needs is a strong and insightful move, not a weak one.  

Take Your Own Advice

Be uncompromising about seeing to your own well-being, much like you would advise one of your patients. Develop the rationale that getting enough sleep and recreation, eating healthily, and doing plenty of physical activity are necessary to your survival. 

Reduce the Stress You Can Control

There is a lot in life that we can’t control, but there is also a lot that we can. As you examine what’s stressing you, consider making changes.  

Learn the power and freedom of saying no sometimes. You don’t have to commit to everything that comes your way. Thank people for the opportunities they offer you, but kindly and firmly let them know that your time is maxed out already with other commitments. Or you may have to back out of things to which you have already agreed. Yes, you may feel awkward and guilty at first. But soon, you will feel empowered by taking control of your own time, energy, and life.  

The Final Word on the Stages of Stress

Stress is an enemy that can sometimes be a friend - a little of it can be motivating. It can also be sneaky. We are constantly dealing with situations that are uncomfortable or even difficult but not necessarily stressful. When we are dealing with stress, we have to know it and be able to combat its harmful effects. As a physician, you know that what affects the mind also affects the body. So knowing the signs of stress and burnout can mean everything to your well-being, your career, and your life.

Are you a physician who is facing burnout? We’re a physician life coach who can help you love your job and life again. Contact Deanna Larson, MD to learn more.