Explore tools to manage stress of new job

Q: I just started my first post-college job, which I love. Nevertheless, I've been feeling really stressed and anxious. My boyfriend says stress can affect your health. What can I do?

A: First, congratulations on this major milestone in your life. As for finding it stressful, please know that you're not alone. Starting a new job is often overwhelming, and with good reason. Virtually everything — the physical environment, the people, the social culture and the work itself — is unfamiliar.

Your boyfriend is correct that, over time, stress can result in adverse health effects. Acute stress, which we experience in response to a single event or situation, can make your heart race or send your blood pressure soaring. Some people experience headaches, stomach pain, sweating, nausea and bowel problems. Chronic stress, which is long-term exposure to the cascade of hormonal changes that set off the stress response, can lead to depression, sleep disorders, cardiovascular problems, weight gain, systemic inflammation, a weakened immune system and an increased risk of a range of diseases.

You can learn to manage the stress of this transition. First, recognize that sources of stress can be mental, emotional or physical. By taking a detailed mental inventory of your workdays, you can identify the specific situations that result in distress.

On the physical side of things, which is your working conditions, take the necessary steps to be safe and comfortable. Depending on your occupation, this applies to lighting, temperature, ventilation, the ergonomics of the workstation or familiarity with safety procedures.

When it comes to mental and emotional stressors, which pretty much everyone has on the job, focus on coping techniques. Deep-breathing exercises and mindfulness techniques have been shown to reduce stress significantly. You can learn about these techniques by reading books or taking a class. If that doesn't help, seeing a therapist can help.

The next step is to pay attention. Identify the specific triggers that set off your stress response. Maybe it's a tight deadline, a public presentation, someone's management style or even interacting with a challenging co-worker. Once you know your danger zones, you can prepare with your preferred coping technique. Afterward, use the technique again to get centered. As with everything, the key here is practice and consistency.

In small amounts, stress is no big deal. But chronic stress can take a steep physical and emotional toll. The sooner you learn to identify and manage it, the better off you'll be.

Q: I just turned 65, and my doctor wants me to have a bone density test. What is it, and how does it work?

A: A bone mineral density test, or BMD, measures the strength of one's bones. It's an important diagnostic tool for osteoporosis, a progressive disease in which bones become brittle and fragile and can easily break.

Although our bones appear hard and static, they are made up of living tissue. The honeycomb inner framework of a bone is composed of collagen, which is a protein. A mineral known as calcium phosphate provides strength and solidity. Together, these two substances create a strong and flexible structure that successfully withstands stress.

Our skeletons have a dynamic life cycle in which old bone is continuously removed, while at the same time new bone is added. In children and teens, the addition part of the cycle outpaces removal, allowing the skeletal bones to grow in both strength and density. This cycle peaks sometime in our late 20s, at which point bone reabsorption gradually begins to overtake bone formation. Certain hormonal changes that occur in women during menopause further accelerate that imbalance. The result is that old bone may be removed too quickly, new bone may be added too slowly, or both. Over time, the honeycomb framework within the bone grows increasingly porous, while the exterior structure becomes thinner.

All of this leads us back to the scan your doctor has recommended. Known as a DXA test — that's short for dual-energy X-ray absorptiometry — it's essentially the same procedure and technology used in a standard X-ray. A machine delivers low-dose X-rays, which measure the amount of calcium and other bone minerals present in a segment of bone. The proportion of bone minerals to soft tissue reveals bone density.

The DXA test, which is most often used to measure bone density at the hip and the lumbar spine, is used to diagnose osteoporosis. It can also help assess risk of future fractures, and to detect whether a treatment for osteoporosis is working.

The test, which is as quick and painless as an X-ray, is performed on an outpatient basis. It takes from 15 to 30 minutes to complete, depending on the part of the body being scanned. The results of the test, known as a T score, are presented as a comparison between your own bone density and that of a young adult at the peak of bone formation.

A second measurement, known as a Z score, compares your bone density to averages from people your own age, size and gender.

The BMD test is usually recommended for women when they turn 65. It may be recommended earlier than that if a woman has rheumatoid arthritis, low body weight or low vitamin D levels; has used a corticosteroid for three or more months; has a family history of osteoporosis; has experienced bone breaks resulting from a minor accident; has lost height; or is a heavy smoker or drinker. Depending on the results of the initial test, a follow-up test may be needed in one or two years.

• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to

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