Retraining the Amygdala
Published: 03 October 2017
Published: 03 October 2017
The healthcare environment can be a particularly stressful place and nurses are frequently faced with time constraints, ethical dilemmas, and a need to perform under pressure.
Each person interprets stress differently which for some may be positive and others could be as a threat (Jennings, 2008). Job-stress is a health concern as well as a workplace hazard (Jennings, 2008).
In 1960, Menzies ‘identified four sources of anxiety among nurses: patient care, decision-making, taking responsibility, and change’ (cited in Jennings, 2008). Whereas job-stress for nurses can relate to ‘physical labor, human suffering, work hours, staffing, and interpersonal relationships’ (Jennings, 2008).
It is thought that job-stress for nurses may be increasing as a result of the increasing use of technology, healthcare cost rises, and disorder in the healthcare setting (Jennings, 2008).
Nursing ‘burnout’ may result from chronic stress; burnout is common to directly interpersonal working roles such as in nursing (Jennings, 2008). Burnout is described as a ‘syndrome characterised by emotional exhaustion, de-personalisation, and reduced personal accomplishment’ (Jennings, 2008).
Unfortunately for nurses, work- and family- life cannot be completely separated and the collective stressors related to multi-tasking between work, raising children as the primary care-giver, and marital relationships can make nurses prone to burnout and stress (Jennings, 2008).
Job-stress and burnout do not only affect the nurses individually, but also the healthcare organisations (Jennings, 2008). Health problems can arise from the physiologic reactions to neuroendocrine stress responses (Jennings, 2008). Evidently, this can lead to absenteeism, staff turnover and subsequently diminished quality of care for clients (Jennings, 2008). Thereby, it is imperative that healthcare organisations transform the working environment to a place that fosters job-satisfaction, client safety, and well-being for all stakeholders (Jennings, 2008).
An interesting perspective was raised by Bergland (2013), in which he highlighted that neuroplasticity is usually discussed in terms of building new pathways, but perhaps it is necessary to consider facilitating the breakdown of negative/unwanted neural pathways in conditions such as anxiety.
Neuro-imaging has shown increased amygdala activation for various anxiety disorders (Shin & Liberzon, 2010). The Calm Clinic (n. d.) describes the amygdala as a ‘set of small, almond-shaped clusters of nuclei near the base of your brain’. The amygdala triggers the fight or flight response when it senses danger due to either emotional or environmental triggers (Calm Clinic, n. d.).
More about the amygdala (Calm Clinic, n. d.):
The Calm Clinic (n. d.) outlines the following example of the chain reaction of anxiety:
Interesting quote by Unlearn Anxiety (2017):
‘Leonardo di Caprio voluntarily walked into OCD for his job. Yes, that’s right. After his role in ‘The Aviator’, Leonardo developed OCD for about a year. To put this in context, it means that he sensitised his own amygdala. That’s how plastic the human brain is. Then, after getting treated with mindfulness, he again re-wired his brain to cure his OCD. He then de-sensitised his amygdala. His experience was like a switch to alter his brain – on-off, on-off. Self-directed neuroplasticity. Conclusion? NEVER tell youself that anxiety is lifelong’
Note: All of the above information should be used for increased understanding, but not for treatment – please seek medical and psychological support and guidance from qualified professionals to manage stress, anxiety and other concerns regarding your wellbeing.
Madeline Gilkes, CNS, RN, is a Fellow of the Australasian Society of Lifestyle Medicine. She focused her master of healthcare leadership research project on health coaching for long-term weight loss in obese adults. In recent years, Madeline has found a passion for preventative nursing, transitioning from leadership roles (CNS Gerontology & Education, Clinical Facilitator) in hospital settings to primary healthcare nursing. Madeline’s vision is to implement lifestyle medicine to prevent and treat chronic conditions. Her brief research proposal for her PhD application involves Lifestyle Medicine for Type 2 Diabetes Mellitus. Madeline is working towards Credentialled Diabetes Educator (CDE) status and primarily works in the role of Head of Nursing. Madeline’s philosophy focuses on using humanistic management, adult learning theories/evidence and self-efficacy theories and interventions to promote positive learning environments. In addition to her Master of Healthcare Leadership, Madeline has a Graduate Certificate in Diabetes Education & Management, Graduate Certificate in Adult & Vocational Education, Graduate Certificate of Aged Care Nursing, and a Bachelor of Nursing. See Educator Profile