Eustress vs Distress
Stress, in its most simply stated form, is nothing more than the response of an object, structure, person, or even ecosystem, to pressure, strain, or tension. Stress is not inherently positive or negative, but just a fact – all interactions, whether they are physically demanding or emotionally fulfilling, put stress on a system. Bones need the stress of gravity to develop fully and healthily. Muscles grow strong with regular exposure to the stress of weight-bearing activity. But when stress becomes too great, negative consequences also occur – knees give out from overuse, passion for a job becomes burnout.
This is where the concept of eustress vs. distress comes in. When the stressor enhances adaptability, growth, creative response, and excited engagement, the stress, even perhaps when quite high, is still “eustress”, or a positive and healthy form. However, when the stressor becomes overwhelming, putting pressures on a person or situation that cannot be creatively or meaningfully adapted to in realistic amounts of time or with reasonable amounts of expended energy, the stress becomes distress, and systems and persons lose effectiveness, begin to function aberrantly, and can ultimately fall apart.
While stress is a normal part of life, and while experiencing some degree of stress from one’s workplace is expected and even necessary, over the last few decades, workplace stress has moved increasingly toward the “distress” side of the stress equation. In particular, these increasing levels of workplace stress are strongly correlated with the sense that the workplace continues to place high levels of demand on its workers, without giving them the means to be effective at meeting those demands – specifically, the psychological sense of having no control over outcomes, but being held responsible for those outcomes, is growing.
It is a classic case of having responsibility but no authority, wherein one is held accountable for results without being given the authority, and often even the opportunity to act with enough latitude, to make those results attainable. These burdens are not “in the head”, however, as people placed in situations like these have been shown to be at a significantly higher risk for cardiovascular disease.
Statistics on Workplace Stress
A report from the National Institute for Occupational Safety and Health (NIOSH) presents a number of telling statistics:
- 40% of workers report their jobs as being more than just stressful, on into categories of very and extremely stressful
- 25% of workers state that workplace and job-related stress is the single greatest stressor in their lives
- 75% or better of workers believe that contemporary experiences of workplace stress are greater than in previous generations
- Over 25% experience themselves as often, and even very often, burned out by stress at work
- Even family stress and direct financial stress are not as strongly correlated to health complaints as is workplace stress
A survey from Attitudes in the American Workplace IV reports the following statistics:
- 80% of workers report some degree of unwanted stress on the job
- Almost half report a need for help with coping strategies and stress management techniques for ongoing workplace stress
- 42% report that they believe their coworkers need help like this as well
From a 2000 Integra Survey:
- Almost one in five respondents had left a previous job because of workplace stress
- Over half of the respondents reported regularly working 12-hour days to meet workplace demands
- A similar number reported routinely working through lunch for the same reasons
- 65% of workers reported workplace stress had caused significant difficulties in their lives beyond the workplace
Immediate Effects of Workplace Stress
I am defining an immediate effect of workplace stress to be any worker-reported condition that is experienced during the stress event, or following it within hours or days. Common conditions are neck pain, painful eyes and hands, difficulty sleeping, and absenteeism due specifically to stress avoidance.
From the same 2000 Integra Survey:
- 62% of workers routinely experience stress-related neck pain by the end of the day
- 44% report painful and weary eyes
- 38% report distinct hand pain
- 34% report insomnia related to worrying and thinking over job stress
- 12% report having called in “sick” over job stress
Other surveys and statistics from a combination of sources suggest that job-related stress is responsible for:
- Back pain in 30% of workers
- Generalized complaints of stress from 28% of workers
- Feeling generally fatigued from 20% of workers
- Headaches for 13% of workers
Long-term Effects of Workplace Stress
Here I am describing “long-term” effects of workplace stress to be those changes to quality of life, and even to morbidity statistics, induced by job-oriented distress. These include the detrimental effects on relationships, sense of personal fulfillment or purpose, on into elevated risks for chronic and ultimately life-threatening diseases.
The following are baseline statistics compiled from a number of sources suggest that workplace stress has impacted their lives in the following ways:
- 54% report interpersonal conflicts with those near to them based on emotional outlet or overflow from workplace stress
- 60% report that they would prefer to leave behind their whole career, not simply change jobs or specific workplaces, if it meant lowering their stress level
- 87% feel a sense of emotional disconnect from their workplace, leading to lower levels of productivity and personal fulfillment
These costs are not simply to the worker – there is an estimated $300 billion lost every year to both immediate and long-term workplace stress effects, whether from absenteeism, illness, or impaired productivity.
Dangerously, both anxiety and depression are triggered and exacerbated by high levels of stress, particularly workplace stress. These dysphoric emotional responses have their own patterns and difficulties beyond the stress that may be inducing or exacerbating them, and have the potential to set up difficult-to-escape cycles, wherein anxiety or depression are made worse by the stress, which in turn situates the person to be less likely to bear up under stress, perhaps especially unrelenting levels of stress that never seem to alleviate in the modern workplace. The American Psychological Association (APA) itself suggests that over two-thirds of Americans rate workplace stress as the leading cause of stress in their lives, up 15% in 2007 over the year prior.
The healthcare costs of stressed-out workers are 46% higher than others, and in many workplaces, 60% to possibly as high as 90% of health-related complaints that find their way to a doctor’s office are stress-related in nature. These are not “hysterical” emotional reactions that have no firm physiological grounds, either. Moderate-to-high levels of stress are routinely correlated with increased risks for chronic illness, like cardiac disease, diabetes, and even some cancers.
Acupuncture and Stress
Acupuncture has long been recognized, if often via self-report of those receiving it, to be a powerful way to lower stress levels, and to find ways of coping with ongoing and unavoidable stressors. Acupuncture is known to release endorphins, natural pain relievers, which, despite perhaps not being a full explanation of its mechanism of action, is a window into how acupuncture may help the mind-and-body to deal with stress.
While not wholly the same as workplace stress, anxiety is regularly bound up with people’s experience of stress. The Anxiety and Depression Association of America (ADAA) has stated that “evidence for the use of acupuncture… to treat anxiety disorders is becoming stronger”. Similarly, a study in the UK involving over 750 people with depression ranging from moderate to severe noted that, when studying both counseling and acupuncture in the treatment of depression, while both modalities benefitted one another, acupuncture was statistically correlated with depression relief as much or more than counseling when the two were compared.
There has not been a broad enough investigation of acupuncture and stress in humans to report specific scientific findings. However, recent research done in mice is promising. The study made use of four groups of mice – one which was a control group, exposed to no stress (cold). The other three groups were exposed to stress (cold), but differed in “treatment”. The study examined the effects of acupuncture performed on mice at a point (ST36) known to relieve stress responses, vs mice that received no acupuncture, and mice that received “sham” acupuncture on their tails.
The results were encouraging – by performing acupuncture on the mice, then subjecting each to the same stress-inducing experiences, and measuring the stress-hormones present in the blood afterwards, they were able to reliably determine that the non-sham acupuncture significantly outperformed both sham acupuncture and non-treatment in terms of finding lower stress hormone levels in the blood. Whether this research is applicable to humans is of course up for debate, but it is a worthwhile enough study to merit subsequent research.
Oriental Medical Theory
Oriental medical theory has long described “stress” in terms of a Zangfu pattern diagnosis called Liver Qi Stagnation. In these terms, the Liver is responsible for the smooth flow of Qi through the channel system, allowing the Qi (or functional capacity) of the body to operate smoothly and without obstruction for other tissues and organs. The Liver, in this context, is expected to bear up under many of our day-to-day stressors, and provide the force and momentum necessary to overcome obstacles and absorb and defray insults and difficulties, allowing us to remain functional, capable of living our lives, performing our duties, etc. Clearly, then, within these terms, stress – physical, emotional, or otherwise – will take some toll on the Liver. When the smooth flow of progress forward is impeded – emotionally, situationally, or physiologically – it is the Qi of the Liver that becomes obstructed. In the short term, this can produce anger or frustration, but also creative response strategies to work around unexpected obstacles. However, workplace stress is an example of an ongoing, unrelenting, and often inescapable form of obstruction, that can leave a person psychologically “stuck”, frustrated, tired, and worn thin. In Oriental Medical Theory terms, this would suggest Liver Qi Stagnation that has begun to generate a pathological condition in the energetics of the organ itself. Many people turn to outlets like smoking, drinking, and alcohol consumption to deal with this kind of chronic stress. These are behaviors that fit neatly within the scope of Liver-oriented pathology in Oriental Medical Theory.
Treating this kind of stagnation with acupuncture can be remarkably effective, in my clinical experience, as well as the clinical experience of many practitioners. Moving Liver Qi allows the breath to return to a steady and deeper rhythm, which allows the parasympathetic nervous system to take over for what is often a hyperactive sympathetic nervous system. Many classical herbal formulas and point combinations are specifically indicated for this kind of pattern, and when properly diagnosed and applied, show significant clinical and empirical results. Statistical work studying these effects is still in its infancy, but even preliminary work looks hopeful.
Lifestyle Strategies and Cultural Values
Working fewer hours and finding a way to experience and value one’s identity and self-worth outside of the workplace are two core strategies for handling workplace stress. This is, of course, much more easily said than done. Who we are is so regularly bound up with what we do, that these often come together in the same breath when we introduce ourselves to someone new. Meditation and “mindfulness” are currently en vogue, and the research on these does look promising in terms of re-orienting obsessive thought processes and intensely unpleasant emotional content. As a practitioner of Acupuncture and Oriental Medicine, as well as personally having a long-standing meditation practice, I do fully acknowledge and firmly believe in the benefits of meditation and mindfulness strategies as a way of coping with stress, anxiety, depression, and other associated psycho-emotional hazards.
However, with that said and fully owning my situated position as an acupuncture physician and meditator, I do find there to be a serious problem lurking within these kind of “mindfulness” strategies for stress management, up to and including acupuncture. The problem is one of potentially shifting the responsibility for stress – its experience, expression, and resolution – to the individual person, the worker or employee, rather than looking for the more structural causes of stress that may be operating at a higher level in an organization. Indeed, there is a danger of “blaming the victim”, wherein the person who is experiencing the stress is told to find strategies to manage and thereby bear up under the stress, rather than changing structural problems like unreasonable outcomes, unpaid overtime, mandatory long hours, and the like. As a person and practitioner deeply committed to health and wellness on many levels, I do have troubling concerns with the “wellness” movement, which in some ways silences a critique of corporatist greed and the exploitation of workers, quietly reinforcing a life- and work-style that has the potential to be mentally, emotionally, and even physically destructive.
This is not to say that we should not do what we can, and what is in our power, to live fully, in the lives we have, at this moment, using whatever strategies we can to do so. Acupuncture – perhaps especially when combined with other techniques like meditation, yoga, or counseling – can be a wonderful resource for dealing with stress, and the often attendant anxiety and depression. I have clinically witnessed this to be the case more times than I can count. And yet, our goal should be to live fully in the whole of our lives, not simply to bear up as best we can under unreasonable pressures. Our stress can be a reminder to us to look into what matters for us – personally, spiritually, and on – and into the structure of the socio-political and economic world around us, to find ways of living that can help us where we are, and reach out to change the world around us for the better.