Expatitis, Part Two: Stress

Teen Depression, Tunnel

Yesterday I introduced the concept of expatitis, a syndrome of expat ill health. I also introduced my uber-expat businessman, Mr Indy Spensible, who was having panic attacks, among other complaints. Let’s focus first on stress, a vastly under-appreciated malady affecting expats.


Let’s face it, doing business in China can be very, very stressful. The demands on some expat jobs are extraordinarily intrusive into a normal life — the hours expected, the evening dinners and networking, the language and cultural barriers to master. I think it’s far too normal and expected that a businessperson misses much of their family’s evening and weekend routines due to work expectations and business trips. These demands also lead to less time for your general health — usually exercise is first to go, as well as a slide in diet choices and a lot more smoking and drinking. This issue of work stress is a hot topic right now, and a new book by Dr John Kennedy, called Healing the Heart of Corporate America, points out how stress leads to heart disease (thanks to Adam Daniel Mezei for the tip).

Stress certainly isn’t expat-specific. If anything, local Chinese workers may have even more health problems due to even more expectations on them — not to mention their relatively less pay. This was detailed quite frighteningly in a recent national survey of Chinese white collar workers:

…80% of the white-collar workers surveyed have irregular sleeping or dining schedules and they feel fatigued during the day; 23.7% of them do not take the time to eat breakfast; over 20% of them often eat fast food; 54.4% of them lack sufficient sleep; and 32.4% of them do not get quality sleep; only 46% of them take even occasional exercise. In addition, over half of the white-collar workers often feel irritated, 20% feel lonely, and over 70% feel a lack of happiness and satisfaction…

Why Should We Care About Stress?

Just suck it up, right? Comes with the territory? Love it or leave it? Well, sure, a bit of stress can be energizing for people and get creative juices flowing. But as Dr Kennedy discusses in his book above, “those with chronic job stress had a 68% higher chance of having a heart attack, developing angina or dying from heart disease.” So stress is not just something you should live with; it could literally be wearing you down — and out. Dr Kennedy goes on:

What’s more, longitudinal studies show those with high workplace stress are more likely to develop blood cholesterol problems and increased body mass index. And increased body mass index is associated with the metabolic syndrome which is a cluster of signs, symptoms and diagnoses including high blood pressure, elevated cholesterol, blood sugar problems, and increased waist size—all known risk factors for cardiovascular disease.

In addition to jeopardizing health, stress leads to decreased company morale increased absenteeism, diminished productivity, employee turnover, and accidents which cost American business more than the annual total net profits of the Fortune 500 companies.

Let’s now learn about good coping mechanisms for that inevitable stress in your job…

What Can I Do To Relieve Stress?

Good question! Fortunately, a lot:

Exercise — Yes, that seems obvious and if you had time you’d exercise more, yes? Well, we all need to stop saying that we have no time, because we only have one life here, and getting used to the concept that business overshadows everything else is simply an unhealthy philosophy — and your body will tell you that, sooner or later. Besides, there is evidence that exercise does indeed help you not only to relax but to deal with stress better. Quite literally, exercise boosts neurotransmitters that help mediate your natural stress response. But this isn’t a one-off event; you need a few weeks of routine exercise to start getting that boost. Exercise also has great benefits on keeping your immune system healthy so you don’t have a productivity-losing cold every few weeks.

SmartPhone Relaxation Apps — Since we’re already staring at our Blackberry or iPhone all day, why not add a couple free apps designed to help you relax? My favorite is Ambiance; it’s a free app that lets you download hundreds of relaxing sounds like waves and rain. To de-stress, you should make a binaural mix: first download the Binaural – Low Alpha sound and mix this with a second sound of your choice — something that transports you instantly into a relaxing childhood memory (a beach? train? I use Rain – Porch) Put the Alpha sound at a low, barely audible level and play the mix any time you feel overwhelmed. It’s best to be in a quiet space; also focus on slow breathing while listening. Just close your office door for fifteen minutes, lower the shades, close your eyes and work on slow breathing while listening to your mix. You are getting very sleepy, very sleeeeeepy…

There’s very little good research on binaural beats, but one well designed (randomized and controlled) study in a hospital showed less anxiety in patients preparing for general surgery. No matter what you think of binaural beats, listening to relaxing sounds certainly does no harm, and it’s free. What may be just as important a message is the idea of a time out personal break during the day — even 10 minutes can reset you.

There’s also another iPhone app called Stress Check where a quick 20-question survey assesses your current state of mind and gives you tips on how to improve your immediate situation.

Yoga and Tai Chi Breathing Exercises–
I discovered yoga and tai chi in college and I am a firm believer that these can not only keep people fit but provide invaluable secondary benefits in stress relief. It’s not just that wonderful relaxing feeling during the sessions; it’s more the long-lasting benefits from proper breathing, and also that wonderfully peaceful mindset you get during yoga. When I’m stressed and I realize my breath is short, I remember my deep and slow breathing exercises from yoga which I immediately try out, and quickly I’ll relax. It’s as easy as counting backwards from 10 to 1 with each slow, deep breath, and then repeating for a couple minutes until you feel more calm.

And for those “too busy” for a one-hour a week yoga class, you can simply watch a 15 minute yoga video online at the above link from the Mayo Clinic. Your body and mind will thank you!

Counseling – Do not ignore this suggestion! Needing counseling doesn’t mean you’re crazy, or a failure, it only means that things are getting out of hand and you need some help. Psychologists and psychiatrists can specifically treat stress in multiple ways. The best counselors will teach you effective and positive ways to cope with your stress. Each expat clinic has a group of counselors.

Sleep – Yes, again this seems obvious, but research clearly shows that lack of sleep leads to a decreased immune system as well as worsening stress.

Reassess Your Life – A small percentage of you should take that long family vacation you’ve been “too busy” to have for five years, and during those quiet moments really think about whether your job is simply too overwhelming. Take a look at your loved ones and check in with your relationships; are they teetering on a cliff? Really think hard about your life priorities; on your deathbed, are you going to be looking back at your awesome expat job that destroyed your marriage, or will you be suffused in the glow of the wonderful family you raised?

Watch Groundhog Day, Again and Again Until You Get It. OK, this is a strange recommendation, but this 1993 Bill Murray film has a wonderfully deep message of self-enlightenment and reassessment of the important things in life. If you’ve never seen it, you’re in for a treat. Download and watch it on your iPhone on your next red-eye flight.

A Final Word From Mr Indy Spensible…

Case One: Follow-up. Mr Indy Spensible returns to my clinic two months later. He looks tanned and happy. “Doc, I finally took that vacation to Sanya with the family. Yeah, the first couple days I didn’t know what to do with myself, but after I locked my Blackberry in the safe I started to get into it, playing games with the kids, swimming in the ocean. I feel like a new man, doc! My wife and I snuck away for long walks. Oh yeah, she wants me, uh, to ask you, um…can you give me a couple of those blue pills…you know what I mean, doc…”

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4 thoughts on “Expatitis, Part Two: Stress”

  1. Binaural beats are really amazing. However, the thing is that to get the full effect one signal must come in one ear, and the other in the other ear (hence the term binaural, the beat is created from the dissonances). I'm not sure that much will happen from an Iphone unless u have wired earpieces and stereo enabled.

    Hemi Sync is one company specializing in bb music. (There are Alpha, Beta, Gamma, Delta and Theta waves which accomplish different things, some programs have verbally guided relaxation, some are just music). You can download nearly every hemi sync for free off of Vuze (download Vuze at Vuze.com and search for hemi sync or binaural beat).

    Reading, and research on bb is here
    and an introduction to what is it? here

    1. Binaural definitely works on all headphones, so on an iPod/iPhone it’s perfect. I’m glad you like it! And yes there are other wavelengths; I personally use Theta for studying; alpha to destress; beta to relax. Again, there’s not overwhelming evidence but it definitely helps me to focus while in a noisy cafe…

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