'This Job Is Killing Me'

From the WebMD Archives

Dec. 13, 2000 -- Every weekday, Gilda T. wakes up at 5 a.m. to start getting ready for work. She leaves the house a little after 6 a.m. and doesn't return again until after 8 p.m. Sometimes she is so busy throughout the day that she forgets to eat.

Unfortunately, her salary barely reflects the time and energy she puts into her job as an insurance producer. "Sometimes I get so stressed out at work, I can hardly breathe. It's like my whole chest tightens up," she says. "People are always wanting things from me, and I am constantly having to answer to this person or that person for one thing or another. It can make your head spin."

Sound familiar? For many reasons -- including the booming economy -- many of us work more and harder than ever before to keep up with the Joneses or to make ends meet. That's why most of us can relate to Gilda's plight. And a recent article in the Journal of Cardiovascular Risk reports that work-related stress, including long hours, low reward, a hectic pace, and a lack of social support in the workplace, can actually increase a person's risk of heart disease.

Study author Christopher Tennant of the department of psychological medicine at Sydney University and the Royal North Shore Hospital in St. Leonards, Australia, reviewed several studies on work stress and heart disease published from 1990 to 2000. In one study, bus drivers who worked in high intensity traffic areas were found to be more likely to die from heart disease than those whose routes were less hectic. And in six of nine studies, excessive hours also increased the risk for heart disease. Other factors that were shown to raise risk of heart disease included poor social support, job insecurity, inability to relax after work, and lack of decision-making authority.

"There is a broad range of environmental and job characteristics that have various impacts on mental and physical processes -- some are good and some are not so good," says Peter L. Schnall, MD, MPH, director of the Center for Social Epidemiology and an associate professor of medicine at the University of California, Irvine.

"Working is not necessary bad for folks," says Schnall, who is editor of the recently published book The Workplace and Cardiovascular Disease.

But certain factors in the workplace, including stressful relations with co-workers and superiors, social isolation, and even physical factors such as heat, cold, noise, and excessive physical labor, may have a negative effect on health, Schnall says.

For example, he tells WebMD that people in jobs with high demand and low control are 3-5 times more likely to have high blood pressure, which is a major risk factor for heart disease.

"Jobs where they spend a great effort and don't get a great reward have a very negative impact on the physiologic system," says Schnall, who points out that the length of the average American work week is now 48 hours.

People in stressful jobs may be more likely to smoke, drink alcohol, engage in unhealthy eating habits, and lead sedentary lifestyles.

That's exactly what Gilda does. "I smoke on my way to work and coming home from work. I rarely have the time or energy to exercise and find that my treadmill is just another place to keep my belongings," she says.

"There are dozens of different strategies [to improve the work environment]. So the question is whether management is interested enough to make the necessary changes," says Schnall.

For example, bus drivers' stress levels may improve if there was adequate staffing of buses, more breaks, and bus lanes to help avoid traffic, he suggests.

But it's not just the management who has the power to make change. Employees can also help themselves.

"People who come in with job stress issues are suffering from anxiety, fatigue, anger, and other things that up blood pressure and cause health problems," says Jennifer Feeley, MFT, a therapist in San Francisco who specializes in job stress and other issues. "We look at what's going on in the workplace, [and] if the client is up for it, we do a search for a job that might be more suited to their temperament."

But if changing jobs is not an option because of money or other factors, "we look at ways that they can balance their personal life to get what they need," she tells WebMD. "Learning how to meditate or relax through breathing exercises are ways to take their minds off immediate trigger moments so that they have a chance or a choice to respond in a different way."

Feeley says that she sees a lot of people who suffer from job stress and strain. "The more the economy booms," Feeley says, "the more chances there are for people to make money and upgrade their lives. And this is the trade-off."