Empowered Patient is a regular feature from CNN Medical News correspondent Elizabeth Cohen that helps put you in the driver's seat when it comes to health care.
After suffering a heart attack at 37, Helen Smith knew she had to get rid of work-related stress.
ATLANTA, Georgia (CNN) -- When Helen Smith had a heart attack at age 37, she was in shock. She was young, healthy and in tip-top shape. There'd been no warning signs. She had no family history of heart disease.
It was no little heart attack, either. It was a big one, she says, that forced her to take drugs and wear a pacemaker for the rest of her life. What in the world, Smith wondered, had caused the heart attack? And, more important, what could she do to make sure she didn't have another one?
Smith, a forensic psychologist, never got a clear answer to the first question, but she answered the second one on her own: She knew deep down that her stressful working conditions had contributed to her medical crisis. And she knew things had to change if she wanted her heart to keep ticking.
It wasn't easy. "It was a horrible feeling to know that my life's work that I trained 11 years in graduate school for was going up in smoke due to my health," she says.
But a new study says Smith did the right thing. The study, published in the Journal of the American Medical Association, shows you're more likely to have a second heart attack if you work in a stressful job. Other studies have shown you're also more likely to have that first heart attack if your work is stressful.
Smith took a long, hard look at specifically what parts of her job were stressing her out. The first thing to go: her five employees, so she could reduce the stress of managing others. "Some people flourish by dealing with other people. I did not, and I knew my limitations," she says.
Next step: She moved out of her fancy office (and into a home office) so she didn't have to work so hard to make ends meet. With no rent and no payroll, Smith could see fewer patients. As a forensic psychologist, she spent most of her time with violent patients, a high-stress situation in itself. "When I would treat and evaluate patients who were violent, my heart would beat irregularly, and I would feel dizzy and weak," she said. But she couldn't (and didn't want to) stop working altogether. So instead, she found less stressful pursuits: a blog, podcasting and a radio show.
Smith acknowledges that not everyone can rearrange work the way she did. "I am very lucky that I was my own boss," she says.
So what do you do if you're not your own boss? We posed several scenarios -- exploding bosses, back-biting co-workers -- to the authors of "Working with You is Killing Me: Freeing Yourself from Emotional Traps at Work." Katherine Crowley is a psychotherapist, and Kathi Elster is a business strategist.
Elizabeth Cohen: In addition to being authors, you're consultants -- people come to you when they're stressed out about work. What's usually bothering them?
Katherine Crowley: Bosses!
Cohen: OK, so let me throw a few stressful bosses at you. Let's say a client tells you, "My boss doesn't appreciate me."
Kathi Elster: You have to detach and depersonalize. You're not going to turn this person into a caring, loving boss. You have to accept you're not going to change this person.
Crowley: That's right -- the stress comes from expecting something you can't get. If you need appreciation and acknowledgment -- which everyone does -- we suggest you find another way. Get colleagues to band together and acknowledge each other. Find other ways within the company to get this appreciation.
Cohen: Here's another one: How about the boss that explodes -- she just yells and screams.
Elster: This is where people take a lot of medication! You have to detach and depersonalize again. Accept that it's not about you, and watch them scream. Act a little bored. You have to see it as the other person's problem.
Crowley: Also, do a physical activity during your lunch hour or after work that releases the toxins of the other person's behavior. Unhook physically. Take a run, take a bath, get a massage, do yoga.
Cohen: How about the boss that's been in the company forever, has survived every layoff, but doesn't really do anything.
Crowley: We call that the sacred cow. They're your boss, but you have no idea why. We always say, bow down to the sacred cow. The only way they're going to allow you to function is if you give them the credit.
Cohen: Moving away from bosses, let's talk about colleagues. What do you do about the co-worker who's sweet to your face, but stabs you in the back?
Elster: What a back stabber does is cut you out of meetings and conversations. They insert themselves when you're not around. So you're going to have to forge your own PR campaign and let people know the truth. We don't suggest you confront the back stabber -- it won't get you anywhere. But remember, back stabbers think they can't get anywhere on their own, that they have to bring someone down in order to succeed. They'll eventually sink their own ship.
Cohen: So big picture, what can someone do when they feel stressed out at their job?
Elster: Lots of things can be stressful at work, but it's how you internalize the stress that makes the difference. Remind yourself all day long that no one has control over your experience. They have control over your paycheck, but they don't have control over your internal experience.
Elizabeth Cohen is a correspondent with CNN Medical News.