Stressed out?: Take some advice from this top psychiatrist on how to keep calm in the business world's turbulent waters. (Exec's Corner).

Executive stress is an everyday headache for many upwardly mobile managers, who are increasingly burdened with ever-heavier workloads, higher levels of responsibility and crippling office hours.

With the magnitude and complexity of this problem, a lot of them are now reaching for more than just a bottle of Pepto-Bismol or a stiff drink. Many experiencing the effects of stress on their professional and personal lives are seeking professional counseling now more than ever.

Dr. Francisco Schnass is head of Psychiatry at Mexico City's ABC Hospital. His daily work often focuses on helping stressed-out high-level executives to confront their inner demons. BUSINESS MEXICO took to the doctor's couch to absorb his words of wisdom regarding stress in the workplace.

How do you define executive stress?

Stress is a normal part of life for everybody and it is really the stimulus that produces a response in the human being, or any living being. When we talk about executive stress, however, we are talking about the stress that executives are subject to, due to the type of activities that they encounter in their professional lives. This is not the same type of stress that a housewife or a child going to school would encounter.

How does executive stress manifest itself and what are the early warning symptoms?

You can either have physical symptoms that go all the way from anxiety, insomnia, heartburn, constipation or diarrhea, palpitations, chest pains, muscle aches and headaches, to behavioral symptoms like drinking more alcohol than usual, overeating, not eating enough, taking drugs, or having an affair.

When it comes to executive stress, are there significant differences between men and women?

The way they cope with stress is different. Men in general tend to cope with stress by practicing sports, by doing hobbies and activities that usually have nothing to do with their businesses. Women prefer to get together with other women and go out for lunch, or perhaps go on trips or go shopping, which are different ways of coping with stress. I would say that the symptoms are not very different for executive men and women, but how they cope with it is different.

Do you find that women in top jobs cope with the pressure of stress better than men do?

I don't think so. Let's not forget that we live in a society that is basically run by male ideology and the executive world is set up that way. So women, when they reach executive positions, in a way, have to function very much like men. The percentage of divorced working women in the United States is extremely high. They have a higher incidence of divorce because they have three jobs: being a homemaker, a wife and a provider. And who takes care of them, when the husband is also working and wants to be taken care of? That usually creates conflict, which ends in divorce. Many top executive women have either never married or are divorcees.

We can imagine that an executive coming to you for help has taken a difficult first step, and they may see it as an admission of failure.

Usually the referral comes from a general practitioner or surgeon who is often a friend of theirs. The patient will go to the doctor with all these symptoms trying to find a physical cause, and when the answer is that there is nothing physically wrong and that he or she needs to visit a psychiatrist, it comes as a real shock. Very often they come here looking for a quick fix--the magic pill that will solve their problems, and very few of them really consider changing their lifestyle so that they can learn to cope with stress.

How do you persuade them to make the commitment to change when they probably feel their life is just far too busy?

Usually, I give them enough evidence of what's going on in their lives. First, I give them a questionnaire on stress, and once I have the answers I confront them and tell them that they've been experiencing this and that, and that they are not doing this and that. They are having symptoms of stress because they are not able to cope with stress. They need to change their lives in certain areas, and since these are usually very rational people who are used to finding practical solutions to problems, they accept it.

Are companies demanding too much from their employees these days and piling on too much pressure, stress and workload?

I would agree with that. I've seen it at different levels, not just with people in top management positions. I see it with junior partners of companies and junior employees, with work hours that are really ridiculous. You can see them starting at 8 a.m. and not finishing until 10 p.m. or even midnight. Perhaps they have a quick lunch only a few days a week, because they have to make a presentation and they have to have this project ready--blah, blah, blah. I think that at times companies tend to push the limits of their employees in order to increase productivity, and that's a mistake.

But I'm sure a lot of senior executives say things like "I used to work 100 hours a week, and it never did me any harm. So why shouldn't they do it?"

But it does do harm. In the United States rotating medical internships were reduced to no more than 10 hours a day, after people started to see that interns, after they had not slept well for three nights in a row, were making mistakes that could result in the death of their patients. And they realized that it was all due to fatigue.

Should we be building stress management into mainstream education, so people can learn about it earlier?

Yes, absolutely. I think that as part of the capacity of people to get ahead in life, and to climb up the executive ladder, they have to be able to tolerate stress. This can be achieved by giving them a certain level of understanding and education (about stress management). The next important step is having the stamina to be able to tolerate stress, because people who have high levels of responsibility are accountable for the lives and futures of the employees of the company, where many people have money invested. That is what creates stress: the amount of responsibility you have in making your decisions.

Why do some people cope with stress much better than others?

I think it is a question of stamina. We can say it has to do with your constitution and your psychological makeup. I think that some people just have the luck of having a very good constitution, and having been brought up in such a way that they are tough. For them, the saying "when the going gets tough, the tough get going" really means something.

Is stress a silent killer if it's not treated?

Yes, definitely. Stress is by all means a silent, slow killer. High blood pressure, heart attacks and peptic ulcers are the things most commonly seen. The longevity of women is higher than that of men, and it has been proven that the reason for this is the stress men encounter in being providers wears them out faster than women who stay home taking care of the kids.

How do you yourself cope with stress?

I run five kilometers every morning, I work only four days a week, I play the cello and ride horseback on the weekends. That is the way I cope with stress.

James Blears--who pumps iron to reduce stress--is a Mexico City-based freelance writer and a correspondent for Standard Radio News in Mexico.