Leaving a job that’s just too stressful

Traditionally, when an executive has announced his or her resignation “for health reasons,� the office betting pool has offered a straight 50-50 proposition: Either the boss has been stricken by a life-threatening disease, or the boss has gotten sacked.

In early February, however, former L.A. Lakers coach Rudy Tomjanovich upset the bookmakers and gave the “health reasons� euphemism new meaning. Just 43 games into a five-year, $30-million contract, Tomjanovich said he was quitting because the “wear and tear of doing this business� was making him anxious, wrecking his diet and wearing down his immune system.

His job, he said in short, was killing him slowly. And with that, he walked away.

Tomjanovich’s decision flummoxed basketball fans and left type-A personalities everywhere scratching their heads. How, many asked, does a guy who has made it to the pinnacle of the sports world admit he’s been licked by the stress?

But to those who tend to the physical and psychological health of the highly motivated, Tomjanovich may be a hero for an age in which 40% of American workers describe their jobs as “very� or “extremely� stressful.

He is a public figure who recognized the toll that his job was taking on his health, made the necessary adjustments, and called a news conference to acknowledge that, at the age of 56, “maybe I’m an old general who needs to get ... off the front line and do something else.�

“Our culture is so driven by achievement, money and status. I’m delighted that someone had the courage to admit ... that there’s a price� to be paid for getting to the top and staying there, said James W. Gottfurcht, a Los Angeles-based psychologist who coaches individuals and companies about the role of money in their lives.

More typically, added Gottfurcht, the acknowledgment of that toll comes from “people on the other side� -- public figures who have been driven to addiction, exhaustion or illness by the stresses of success.

Although few have been willing to acknowledge it, success (and the stress it brings) does not come cheap. Employees who report that they are stressed incur healthcare costs that are 46% higher -- an average of more than $600 more per person per year -- than employees who are not, according to the National Institute for Occupational Safety and Health, the federal government’s workplace research center.

The New York-based American Institute of Stress estimates that workplace stress costs the nation more than $300 billion in additional healthcare costs, missed days of work and stress-management programs for workers. Although workplace stress is rampant, publicized examples of those opting out “for health reasons� remain scarce.

In announcing his decision to quit on Feb. 2, Tomjanovich said he had probably tried to return to coaching too soon after treatment for bladder cancer that was diagnosed in March 2003. He said that his moods were swinging higher and lower with each Laker victory or defeat, adding that he was frequently sapped of energy and getting sick. He began taking an antidepressant, and when that didn’t seem to help, Tomjanovich said, he was set to switch to “something stronger.�

A recovering alcoholic, the coach said he was concerned about the new medication’s potential for addiction and questioned whether another prescription was the answer to his problems. “I didn’t like the fact that I was going to start taking medication so I could do my job,� Tomjanovich said in announcing his departure. “I never had to do that before.�

Physicians say that Tomjanovich’s symptoms are a classic recitation of the health effects of job-related stress and strain. General internist Benjamin Ansell, who directs UCLA’s Executive Health Program, says that people under constant or acute stress at work often complain of diffuse muscle aches, depression, anxiety, sleep disruptions and a greater vulnerability to minor infections. A closer look at their blood chemistry often reveals other, more subtle tolls of stress, including elevated levels of blood glucose after fasting -- a sign of incipient problems of metabolism.

Warning signs of heart disease, such as high blood pressure or elevated cholesterol levels, are usually more pronounced in executive patient populations than in the broad population of adults first diagnosed with the same conditions, Ansell says.

“Stress is the X factor,� he says. “If you see an individual under a great deal of stress, they’re both more likely to have risk factors for heart disease and more likely to have significant presentation of those than other populations. It’s multiplicative.�

What is unusual, say experts, is Tomjanovich’s response to signs of his stress. To leave a pressure-cooker job is a solution that few high-profile people take. Most workers simply cannot afford to do so. And for those who could afford the financial sacrifice of punching out of a job, there is often little willingness to admit defeat, especially to the forces of stress.

Although Ansell insists “there is no such thing as good stress,� it is a tenet of management bravado that stress motivates and strengthens good executives, it doesn’t kill them.

“For most people we see -- high-level executives with significant amounts of responsibility -- their position is such an intrinsic part of who they are, that talking about leaving it is sometimes an admission of weakness, of defeat,� Ansell says. “They view acknowledgment of stress as a personal failure.�

As a result, Ansell says, physicians are often reluctant to advise their patients to switch jobs or downsize their ambitions as a means of reducing stress. With executives especially, Ansell says, it’s frequently more effective to draw the line between stress and their symptoms and let them plot the solutions.

“Are there areas of your life that you can modify?� he asks. “And every once in a while, I hear ‘yes.’ �

For people who must keep their noses to the grindstone, however, experts say there are many things short of retirement that can help.

Dr. Michael Irwin of the Cousins Center for Psychoneuroimmunology at UCLA says that small steps, such as taking breaks during work and taking vacations once or twice a year, have been shown to reduce the physical strain of workplace stress. Even 20 or 30 minutes of exercise a day -- a brisk walk outside of the office -- can break stress’ hold.

And Irwin urges patients to look at their day’s priorities realistically and winnow when the “to-do� list gets out of hand, as well as to appreciate one’s achievements at work before moving on to the next challenge.

Finally, Irwin warns that self-medicating with alcohol (the most common response to workplace stress) is a losing strategy. Not only will it erode the quality of sleep one gets -- and sleep is an important buffer against stress -- but it can elevate blood pressure and accelerate the cardiovascular consequences of job stress.

“It’s important [for the stressed-out] to take time to leave the office behind and allow themselves to relax in the evening,� Irwin says. “Coming in the door and having several drinks may extinguish the stress immediately. But it does not induce a relaxation response.�