immune system

Stress can be a killer for women too

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Woman&officephoneWe are all aware of how stressful work can be at times. Contrary to popular belief not all of it is caused by the deliberate actions of others but usually because of the way we interpret events. Something that is stressful for one person may not be for someone else. Stress can be caused inadvertently by someone lacking social or management skills, and increasingly rudeness at work is being identified as a major cause.

Common sense tells us that rudeness can affect our mood but it also affects our performance, our problem solving ability, and our willingness to work in a collaborative way – and research shows that even witnessing rudeness can create these adverse outcomes and damage the working climate especially in teams that need to collaborate.

Bullying is another source of stress and it might be on the increase again, fuelled by insecurity since the recession. It also seems that whilst the majority of bullies are men women bullies can be more persistent. There also seem to be gender differences. I’ve found in my work and research that women are more likely to bully using personal attacks whereas men bully under the pretext of performance management.

Now new research has shown that women in high pressure jobs run twice the normal risk of developing heart problems as a direct result of work-related stress. Those reporting work pressure to an excessive degree are also at an increased risk of developing ischaemic heart disease.

The research, published in the Journal of Occupational Health and Environmental Medicine, was based on a 5-year study of over 12,000 Danish nurses aged between 45 and 64. Whilst the link between stress and heart disease is well-established this is one of the first studies on women.

Stressed workers often resort to unhealthy ways of coping such as smoking, eating comfort food, or drinking, which can lead to them becoming overweight and creates a vicious circle. In a study carried out by the author amongst NHS employees nurses had the highest sickness absence rates and also smoked the most. Managers on the other hand rarely took time off but drank more!

A research team at Ohio State University has been studying the effects of stress on health for the last 30 years (psycho-neuro-immunology) and have shown that chronic stress can lead to cardiovascular disease, cancer. stroke, osteoporosis and diabetes. The culprit is stress-induced chronic inflammation as a result of the immune system being in a constant state of high alert. This in turn wears you down and makes your body less able to fight infections and diseases, heal wounds, and develop antibodies. On a less dramatic level it explains why you can’t shake off that cold or persistent cold-sore when you are stressed.

And the latest research shows that children with difficult childhoods, eg through being abused, are especially susceptible to the physical effects of chronic stress and that their immune systems may learn a hyperactive response to stress which kicks in again when they are facing stressful events as an adult.

Some good news is that becoming adept at yoga does lower your stress response.

Updated 2 May 2011: Women with high job strain have a 40% increased risk of cardiovascular (CV) disease compared to those with low job strain, according to research presented at the American Heart Association’s Scientific Sessions 2010. They defined job strain, a form of psychological stress, as having a demanding job, little or no decision-making authority or opportunities to use you creative or individual skills. Their findings were based on a sample of over 17,000 healthy women who participated in the Women’s Health Study. Primarily white health professionals with an average age of 57, they were tracked for 10 years whilst they provided information about job strain and job insecurity.

Job insecurity was associated with risk factors for CV disease such as high blood pressure, increased cholesterol, and excess body weight but not directly associated with heart attacks, strokes and CV death.

The higher CV risks for those who reported high job strain included heart attacks, ischemic strokes, coronary bypass surgery, balloon angioplasty, or death.

The findings that women in jobs with high demand and low control are at risk echo UK research on Civil Servants (The Whitehall studies). The first Whitehall Study compared mortality of people in the highly stratified environment of the British Civil Service over a 10 year period starting in 1967.

It showed that among British civil servants, mortality was 3 times higher among those in the lower grades when compared to the higher grades. The more senior one was in the employment hierarchy, the longer one might expect to live compared to people in lower employment grades. It also found higher mortality rates due to all causes but specifically coronary heart disease for men in the lower employment grade when compared to men in higher grades.

Twenty years later, the Whitehall II study, a longitudinal, prospective cohort study of 10,308 women and men, all of whom were employed in the London offices of the British Civil Service at the time they were recruited to the study in 1985, documented a similar gradient in morbidity in women as well as men. The studies revealed this social gradient for a range of different diseases: heart disease, some cancers, chronic lung disease, gastrointestinal disease, depression, suicide, sickness absence, back pain and general feelings of ill-health.

Companies might not use the S word so much these days , preferring to talk about resilience instead, but the pressure is still there and a source of illness and distress for many employees.

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Smile! 

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Trying to influence or establish contact with people by smiling only works with sociable people, according to research at Stanford University (2002).

Their brains respond and react with positive emotions but smiling has no impact on negative people, introverts, or those more neurotic.

The more extraverted you are, the more you allow yourself to be infected by the other person’s smile.

People make judgements based on your appearance in 1/10 of a second or less, to know whether or not they like you or think you are trustworthy. But after a couple of seconds they are distracted by what you say or do anyway.

Research by UK psychologists for Comic Relief in 2003 found big variations in the way people responded to smiles. In Edinburgh only 4% responded but in Bristol 70% smiled back (Birmingham was 31%). NB Smiling responses probably depend on the setting and the context.

Women smile more than men but it is discounted more as it is expected. 30 years ago researchers thought it was because of status differences between men and women but it may be more about relieving anxiety. Generally men only smile to be sociable.

Smiling is good for you as it lowers your heart rate and improves you immune system eg happier people resist catching colds better than unhappy people.

Cultural differences need to be taken into account too eg in former Soviet Union countries the older generation tend not to smile at strangers, even in shops and customer service settings (Russia, Ukraine, Czech Republic, Lithuania).

There is also a cost to smiling when you are required to do it for your job. Emotional Labour, the so-called “have a nice day syndrome”, is the cost of appearing happy and reasonable no matter how you really feel. Having to fake it for your job eg in medical settings, teaching and call centres, can make you feel exhausted, detached from other people and your own feelings, and can eventually lead to job dissatisfaction. If you want to see how good you are at detecting fake smiles go to: http://www.bbc.co.uk/science/humanbody/mind/surveys/smiles/index.shtml

Regulating empathy in this way is taking management control a step further than requiring staff to behave in certain ways. “You can’t force people to smile, they have to be satisfied with their lives, their jobs and their performance” said the HR Manager at IKEA, Russia.

There are things organisations could do:

  • Recruit extroverts who are generally more optimistic and positive
  • Give people who aren’t, role models to emulate (introverts can learn how to behave in extrovert ways)
  • Help people to get into positive moods through visualisation or by remembering positive events
  • Give people satisfying jobs to do!

If you need an incentive to smile it also looks like people who smile may live longer. http://bps-research-digest.blogspot.com/2010/06/say-cheese-big-smilers-in-photos-are.html

It seems dimples are in fashion (influenced by Cheryl Cole) and a “dimpleplasty” operation – cutting a hole in your cheek and stitching it to your muscles – is now all the rage. The problem is that, unlike real dimples which disappear when you stop smiling, your grin is permanent and as Carol Midgley in the Times magazine says, it might be awkward having a permanent grin when your neighbour tells you the dog has just died.

First posted 2010

How to be happier 

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Despite what England fans might feel right now football competitions can make you happy. But only in the short-term – and only if you are the host country. And even that doesn’t make you as happy as a good marriage.

Married people are happier than single people (of course it could be that happy people get married more easily).

And the 30% improvement in happiness due to being married even counteracts all the negative affects of unemployment but don’t get divorced (the two worst life events are losing a spouse and unemployment).

There are some differences between the sexes and between age groups. For example women look less happy but angrier than they are, whereas men look less angry and happier than they are. Probably because we have cultural expectations that women should be happier than men and men angrier than women and we notice when people display behaviour counter to that norm.

Older people focus more on positive aspects of goods and services because they focus more on emotional goals than young adults.(See “What makes you Happy”). Optimism is associated with happiness, good physical and mental health and longevity. Conversely when we are stressed it lowers our immune system so we are more likely to become ill. Middle aged people who are happy have fewer physical symptoms of diabetes, high blood pressure and heart disease.

Extraverts are happier than Introverts because they spend more time doing enjoyable things. But introverts who are asked to behave as extroverts can be even happier than real extroverts. And we are attracted to happy people because we think we will give good genes to our children.

Happiness IS NOT associated with: wealth (once basic needs are met), education, high IQ, youth (20-24 year olds are more depressed than 65-74 year olds) and watching TV more than 3 hours a day – especially watching soaps.

But it IS associated with: religion (although it may be the community rather than the belief), having lots of friends, and drinking in moderation (compared to teetotallers).

We are not evolved to be happy all the time otherwise we would have nothing to strive for. However 50% of happiness may be due to our genes compared to les than 10% due to our circumstances. We may have a set point or range of happiness to which we return after experiencing ups and downs. So like the football example, winning the lottery may not make us happy forever.

According to Martin Seligman – the inspiration for positive psychology – we can raise our happiness levels by enjoying life’s experiences more eg by savouring sensual experiences, by becoming more engaged with life and by finding ways of making our lives more meaningful.

Sonja Lyubomirsky, author of “The How of Happiness: a practical guide to getting the life you want“, suggests the following programme to raise your levels of happiness:

  • Count your blessings – keep a gratitude journal each week of 3-5 things
  • Practise being kind – both randomly and systematically
  • Savour life’s joys
  • Thank a mentor
  • Learn to forgive
  • Invest time and energy in friends and family – these are more important than work to your happiness.
  • Take care of your body and health
  • Develop strategies for coping with stress and hardship – having a strong belief system helps.

Updated 2 July 2010: Catherine Bennett in the weekend’s Observer (27 June 2010) took a rather cynical view in her piece; “Phew. At last we can ignore the gurus peddling happiness“. Clearly not impressed by the wave of optimism being generated at a time of world-wide problems and austerity at home. She refers to the Movement for Happiness and its founder Lord Layard who said; “… as our society has become richer, our happiness has not risen in step. Despite ever greater affluence, our lives are increasingly stressful. This paradox requires a radical rethink of our lifestyles and our goals”.

Conceding that the strategies proposed by happiness enthusiasts are neither complicated or expensive she also quotes the GREAT approach (advocated by the New Economics Foundation). GREAT stands for: Giving, Relating to others, Exercising the body, Attending to the world around, and Teaching yourself something fresh – but she wonders what good they are to people who have just lost their jobs or never had one.

Well I know that exercise is the best form of anti-depressant, relating to others might help develop networks and reduce self-obsessing, and keeping up-to-date and learning a new skill is a good way to get a new job. Maybe we should just ignore the journalists peddling negativity?