In recent posts, I have discussed the many factors affecting your level of stress and response to it. Stress is difficult for scientists to define since it is a subjective phenomenon that differs for each of us and we all respond to stress differently. Things that are distressful for some people can be pleasurable for others or have little significance either way.

However, the relationship between stress and heart disease has been recognized since antiquity. The incidence of heart attacks and sudden death have been shown to increase significantly following the acute stress of natural disasters like hurricanes and earthquakes and as a consequence of any severe stressor that evokes “fight or flight’ responses. Coronary heart disease is also much more common in individuals subjected to chronic stress and recent research has focused on how to identify and prevent this growing problem, particularly with respect to job stress.

Findings from the Health Advocate group show that nearly three-quarters of American workers surveyed in 2007 reported experiencing physical symptoms of stress due to work. According to statistics from the American Psychological Association (APA), a startling two-thirds of Americans say that work is a main source of stress in their lives – up nearly 15 percent from those who ranked work stress at the top just a year before. Roughly 30 percent of workers surveyed reported “extreme” stress levels. Whatever the root causes, stressed workers tend to be fatigued, prone to mistakes and injuries, and are more likely to be absent. And most significantly, they incur healthcare costs twice as high than for other employees. The consequences of stress-related illnesses, from depression to heart disease, cost businesses an estimated $200 to $300 billion a year in lost productivity.

While the causes for this stress vary with occupations and positions, most risk factors fall into the following categories:

1. How Work And Tasks Are Designed

2. Management Style – e.g. lack of participation by workers in decision-making; poor communication in the organization;

3. Interpersonal Relationships – Poor social environment and lack of support or help from co-workers and supervisors.

4. Vague Or Changing Job Description – e.g. Conflicting or uncertain job expectations; too much responsibility;

5. Concerns About Employment Or Career – e.g. Job insecurity and lack of opportunity for advancement, or promotion;

6. Environmental Concerns – Unpleasant or dangerous physical conditions in the workplace such as crowding, noise, or failure to address ergonomic problems.

7. Discrimination – Lack of opportunity for advancement or promotion because of age, gender, race, religion, or disability despite legislation designed to prevent this.

8, Violence, Physical And Verbal Abuse – An average of 20 workers a week are murdered and 18,000 are physically abused in the U.S. but the number may be higher since many such crimes are not reported. Workplace violence affects over 2 million Americans and costs an estimated $36 billion a year according to Business Insider.

In many instances, we create our own stress that contributes to coronary disease by smoking, poor diet, substance abuse, and faulty behavioral lifestyles with excess anger, hostility, aggressiveness, time urgency, inappropriate competitiveness and preoccupation with work. These behaviors are characteristic of Type A coronary prone behavior, now recognized to be as significant a risk factor for heart attacks and coronary events as cigarette consumption, elevated cholesterol and blood pressure. Type A behavior was first described by two cardiologists (Meyer Friedman and Ray Rosenman) in a paper in 1959. Friedman and Rosenman were the first to explain why specific behaviors could cause heart attacks and contribute to coronary artery disease. While Type A behavior also can increase the likelihood of these standard risk factors, its strong correlation with coronary heart disease persists even when these influences have been excluded. However, while there are scales to measure Type A proneness, there has been confusion about which is/are the key components. Hostility has been implicated frequently as the most critical risk factor in the Type A cluster. It is noted more often in men than women.

Individuals with Type A patterns exhibit certain characteristic activity patterns, including.

Self-imposed standards that are often unrealistically ambitious and pursued in an inflexible fashion. Associated with this are a need to maintain productivity in order to be respected, a sense of guilt while on vacation or relaxing, an unrelenting urge for recognition or power, and a competitive attitude that often creates challenges even when none exist.
Certain thought and activity styles characterized by persistent vigilance and impulsiveness, usually resulting in the pursuit of several lines of thought or action simultaneously, so called multi-tasking.
Hyperactive responsiveness often manifested by a tendency to interrupt or finish a sentence in conversation, usually in dramatic fashion, by varying the speech, volume, and/or pitch, or by alternating rapid bursts of words with long pauses of hesitation for emphasis, indicating intensive thought.
Frequently unsatisfactory interpersonal relationships due to the fact that individuals with Type A patterns usually are more easily angered, frustrated, or hostile if their wishes are not respected or their goals are not achieved.
Preoccupation with time, so called time urgency. They are frequently hurried and rushed, checking the clock, worrying about getting things done.

Various rankings of the “most” and “least” stressful jobs usually are misleading since job stress is entirely dependent on the person/environment fit as assessed by the perception of having little control but significant demands. In the past, I have discussed employee/job mismatch on a cognitive basis which leads to stress secondary to the employee having to use more brain energy to do that which they do not enjoy. However, some individuals with Type A patterns thrive with pressure, provided they feel in control. The perception of having no control is always distressful. As I have said on multiple occasions, in many respects stress is a choice. Many times we create our own stress because of faulty perceptions. Your attitudes/beliefs about what you see as "stressing" you has much to do with how you feel. Just saying "I'm so stressed out", or "This is stressing me out", which I hear all the time, determines your level of stress response. Stress is an unavoidable consequence of life but there are some stresses you can do something about and others that you can’t hope to avoid or control. The trick is in learning to distinguish between the two so that you don’t waste your time, talent, and psychological/physical energy. The best way to accomplish this is in learning how to identify, challenge, and change your absolutistic beliefs (mindsets) about what you can and can not handle. In so doing, you can focus on changing the circumstances, where you can, surrounding your upset. You also will develop a better sense of control over your activities at work as well as at home. You can use the tools discussed in other posts as well to include meditation, massage, progressive muscle relaxation, increasing your social support (linked also to risk for coronary disease), among others. This will not only improve your quality of life but also help protect you from coronary heart disease and other stress-related disorders. For access to other posts, go to www.successandmindset.com.