Washington, DC — America’s Stress Capital

Washington, DC and its surrounding metro areas are home to a diverse workforce of government and military contractors, government employees, private-sector executives, lawyers, and other professionals whose work lives can be exceptionally demanding. Whether self-driven to climb the organizational ladder or simply doing what it takes to maintain high-paying jobs that support the high cost of living, many of the area’s professionals work more hours than usual and are under tremendous pressure to succeed.

Unsurprisingly, the nation’s capital and its surroundings frequently rank high on lists of the most stressful areas in the country. In 2018, the Movoto real estate blog ranked the District the most stressful city overall—it wasn’t the first time. 

“Our nation’s capital is home to countless politicians and their staff who, all jokes and jeers aside, actually do have pretty stressful jobs when you really think about it. However, the city is also home to countless normal people just going about their normal-profile lives, working at normal jobs, and, as it turns out, being exposed to supernormal levels of stress.”

One of the categories was “hours worked.” 

“For all the cracks about politicians never really working, it turns out that the more than 601,000 people who call DC home are putting in plenty of hours on the job. The city came in third for this category, with residents working an average of 40.1 hours a week. That’s not even the top-end, but the average.”

Commute time was another big factor in DC’s placement at the top of this ranking. The rest of the stats were all consistently high enough for the city’s average score to put it on top as America’s stress capital.

Consultants, executives, lawyers, medical doctors, and other professionals usually embrace a strong work ethic that can easily escalate into perfectionism and workaholism.

“Workaholism, which describes working both excessively and compulsively, is associated with negative mental and physical health outcomes such as depression and sleep disorders. Workaholism is also known to be associated with both perfectionism and narcissism,” wrote Eric Dolan last year on PsyPost

“Workaholics … are obsessed with their work performance and hooked on an adrenalin-high. Bent on self-aggrandizement, these ego-driven folks reach one goal and immediately set another more ambitious one,” wrote Barbara Killinger, Ph.D. in Psychology Today in 2011.

The controller-type workaholic craves “the kind of power that allows them to always be in control. These independent and proud individuals are often arrogant and intense but can be most charming, witty, and appear sociable when it serves their purpose,” wrote Dr. Killinger. “They can be impatient, impulsive, and demanding, and tend to be strong thinking-type personalities who are usually found in top management positions or are self-employed. Controllers, comfortable in goal-directed activities but less so in social situations, find personal friendships hard to maintain. Many have business-related acquaintances, but few intimate friends.”

The global COVID-19 pandemic has added another layer of stress for professionals. A study by FlexJobs and Mental Health America (MHA) revealed that 37 percent of executives now work longer hours than they did before the pandemic (and remember, they already worked longer hours in DC than elsewhere), and more than 75 percent also report job-related mental and physical health concerns. Chronic stress, overwork, and anxiety may contribute to burnout, defined by the World Health Organization as a syndrome resulting from extreme, unchecked workplace stress. 

In May, US Surgeon General Vivek Murthy sounded the alarm on health worker burnout and resignation: “Health workers, including physicians, nurses, community and public health workers, nurse aides, among others, have long faced systemic challenges in the health care system even before the COVID-19 pandemic, leading to crisis levels of burnout.” 

Relentless stress, anxiety, perfectionism, and workaholism are detrimental to both physical and mental health and major drivers of substance use disorder (SUD). Rates of anxiety, depression, suicidality, and substance use disorders have been increasing in recent years — even before the pandemic. According to Kaiser Family Foundation reporting, people in Washington DC report slightly higher rates of depression and anxiety than the national average, and more than eight percent of adults experienced a major depressive episode in the last year. Many people who regularly endure high stress, anxiety, and other mental health conditions attempt to self-medicate the symptoms of these disorders with substances. At 9.4 percent of adults reporting alcohol use disorder, the capital has a significantly higher rate of adult alcohol misuse than the rest of the nation.

Steffanie Kelshaw, LPC, CSAC

Steffanie Kelshaw, LPC, CSAC, is a New Paradigm clinician who sees intersections between highly stressful lifestyles, work-life imbalance, and a substance-accepting local culture in developing behavioral health problems among the program’s clients. “Despite the notion that ‘three-martini’ lunches and ‘power-dinners’ are things of the past, it is still quite common for DC-area executives to consume alcohol or other substances while doing business. For some people, drinking during work-related events is a social lubricant that makes it easier to talk to strangers and feel like you are fitting in. For others, substances simply become a crutch used to endure intensely stressful workdays. In either case, the regular and accepted use of alcohol and other substances can easily lead to developing substance use disorders. This process can be pernicious, and people can develop problematic use or addiction before they realize that they have lost the ability to discontinue using voluntarily.”

Behavioral health conditions affect every aspect of life and can have far-reaching implications, including physical health effects, dysfunctional family relationships, risk of physical harm and injury, and even increased risk of trauma. Some individuals are capable of remaining highly functional professionals while experiencing a substance use disorder. Countless elite physicians, athletes, executives, and policymakers can perform exceptionally in the workplace while experiencing abject failure in other aspects of their lives due to untreated substance use disorders.

“We treat many highly successful people who excel in every way in their chosen careers but whose home lives are in complete disarray. It can become easy for some people to use career demands and expectations as an excuse to endure substance use and mental health problems. Some people come to believe that their substance use is a necessary means of doing what it takes to succeed and that its effects on marriages, health, and other areas of life are the costs of financial success or recognition,” says Kelshaw. “What they often miss is the fact that in the long run, untreated substance use is unsustainable and progressive, and they are likely to not only lose the career that provides them with their sense of identity and motivation but the people and things that make their lives meaningful.” 

Kelshaw and her colleagues at New Paradigm Recovery understand that their clients’ lives and stress-inducing careers can be intertwined and complex. The practice takes a pragmatic approach and uses highly personalized psychotherapy, psychiatry, mindfulness skills development, wellness training, and support groups to address underlying issues. “We know that most of our clients cannot change their workplace or significantly reduce some of their biggest stressors. However, we can help them recognize the ways that they can make changes in their own lives and perceptions, how to be healthier and more productive by creating appropriate boundaries in their work and home lives, and teach them vital skills that help them reconceptualize and respond to these issues and self-regulate without using substances,” says Kelshaw. 

New Paradigm also takes the time needed to get a full client history, incorporates identified family members in the treatment process when possible, and offers extensive case management services to ensure that all aspects of a client’s continuum of healthcare are coordinated around the goals of recovery. 

Located in the Tyson’s Corner area, New Paradigm is an exceptional and comprehensive intensive outpatient resource for individuals and families with substance use and mental health disorders who live and work in and around the capital. As a private practice, the program can apply the clinically-recommended level of therapies and provide more freedom for clients and clinicians than providers required to adhere to in-network insurance reimbursement policies. The program is especially effective for individuals for whom previous treatment providers could not apply the individualized focus, time, and coordination to gain a sustainable foothold in recovery.  If you or a loved one would like to learn more about our program or discuss treatment, please call us anytime at (703) 214-5888.

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