By Dr Kieran Allen
Medicine is demanding, and stress is a normal response to those demands. Left unchecked, stress can lead to disillusionment, errors and ultimately, declining mental health. Recognising and responding to stress early is essential – not just for your health, but for your patients, your performance, and your long-term career. Here are strategies for understanding, recognising, and managing stress effectively.
What is stress?
Stress is the body's response to any demand or pressure it perceives as challenging or threatening. It can be triggered by external events like work, relationships and financial worries or internal ones, like negative self-talk or fear of the future.
Acutely, stress may be useful in sharpening focus and driving action but often evokes unpleasant physical sensations like shortness of breath, racing heartbeat and an impending sense of doom.
Chronic stress is a prolonged state keeping the body in a hyper aroused mode, which can precipitate burnout, anxiety states and a deterioration in physical health.
How to recognise and manage stress (pro tip: catch it early!)
Trying to solve stress in a hyper aroused state is extremely difficult.
De-escalate – De-escalation is an important first step. Removing oneself from a stressful situation may not always be possible, so learning coping strategies to adapt to the stress in the moment provides a buffer until we can address things from a calmer place. Grounding techniques, such as counting down from five to one, deep exhalation through pursed lips or noticing the immediate environment through each of the five senses can help bring down the volume.
Understand why you’re stressed – Spending time to reflect and work out what the worry is and more importantly, why it matters is critical to being able to manage and move beyond stress. When your body has calmed down from that initial stress response, you can delve into what those underlying fears might be. Some people find this easier to do in therapy or with the support of a colleague. Essentially, we are seeking to ask WHY? Why am I feeling so stressed? Am I scared of a procedure going wrong because it'll harm a patient, or I could get in trouble? Am I scared of looking bad, or not getting a job next year? Am I scared a patient might get upset with me? Our fears do not exist in isolation. We can look as deep as we like to find the answer. Why does getting in trouble matter to me? Why do I care?
Stress clouds our thinking and shortcuts our rationality. We make decisions fast to escape the feeling, rather than in a considered and careful manner. Learning to recognise and manage your stress early can not only prevent things getting worse but can make you a better doctor.
Dr Kieran Allen is a Psychiatry Registrar at Monash Health and a Doctors’ Mental Health Advocate.