Beating America's number one health problem requires balance between work and family.

Is it any wonder veterinarians feel stress? In the best of times, they work long hours. During calving season, however, they embark on two frenzied months in which they forget what sleep is like.

A vet's home life is often chaotic. They strain to pay student loans that can top $60,000. The work is very dangerous. And, when the ranch and farm economy sours, they may not even get paid.

Stress is a fact of life for many Americans. Large animal veterinarians probably get much more than their share. But, some veterinarians find ways to handle the pressures that crush their colleagues, while others actually thrive in the pressure cooker that large animal vets work in.

"Every vet gets stressed," says David Horn, a veterinary practice consultant based in Greenwich, NY. "Whether they handle stress right is another question."

A handful of factors seem to separate those who survive from those who suffer failed marriages, financial drain, depression and poor health. One of the most important is the ability to balance work and personal lives.

"Veterinary medicine is a way to make a living that allows you to live the rest of your life," says Horn. "It should not be your life. Everybody needs a balance between work and play and family. Doing that will go a long way toward relieving stress."

"I go to the gym four days a week," says Jeff Tyler, head of the food animal section at the University of Missouri's College of Veterinary Medicine. For a hobby, he buries himself in books. "For somebody else, it might be hunting or fishing," he says. "Everybody needs down time."

Frank Gary, coordinator of the Integrated Livestock Management program at Colorado State University, plays hockey. "When you get done playing, you feel you're exhilarated.

"Five or six years ago, I had to step back because I was really getting burned out," he recalls. "I felt over committed. It's very bad to get to the point where the next phone call ticks you off.

"I started learning to say `no.' I developed a better appreciation of priorities. I became very conscious when somebody asked me to do something; I would ask, `will it conflict with my family and other priorities?' I would say, `it's Sunday and I will not do professional work unless it's an emergency.'"

Another stress eliminator is laughter. Humorist Karyn Buxman, Hannibal, MO, makes her living bringing the art of humor to doctors and other professionals. "We're now able to document the positive side of humor and laughter on the by-products of stress."

Laughter helps to drain tension from the body, and it works its magic quickly. Anybody who has been lifted from the doldrums by a joke knows you can't laugh and be depressed at the same time.

Put Life In Perspective But, there are other techniques. One of them is to put events into perspective, says Buxman. "Ask if this problem is going to make any difference 10 years, 10 days, 10 hours or even 10 minutes from now. Ask yourself how this could be worse. Take the problem and exaggerate it again and again and again. Then when you look at the original problem, it's a no brainer."

Still, it's hard for people who are wracked by stress to put their lives in perspective.

"It's like a treadmill," says the University of Nebraska's Ron Hanson, who helps farm families cope with financial and family stress. "Once you get on it, you can't get off. You ask, `how am I going to be able to do this, how am I going to pay for that?' It seems like everything is going against you."

Often, the victims of stress will attempt to bury the problems. "I encourage individuals to ask for help. Don't be afraid to let somebody know you have a problem. Most people try to work it out themselves. They withdraw. They say, `I can't go home and talk to my wife and tell her the veterinary practice is really struggling.'

"They get to that mentality of feeling isolated and alone. Next thing you know, that leads to a state of depression. That's the real danger. Then everything falls apart because you don't have any enthusiasm; you don't have any energy. You don't want to go to work. You have all those bills you can't pay. You just give up," Hanson says.

The solution, Hanson adds, is to address the problem, find someone to talk to and put events in perspective. "Life doesn't always work out the way you want it to. You just have to go on.

"I've seen families go through the toughest of times and still stay together because that was their priority. That was the most important thing when they started, and that is what's most important today," Hanson says.

People get caught up in capitalistic things and forget about relationships, he says. "Many farmers think if they lose the farm, they've lost everything. It's the same with vets. If that's their attitude, they're going to have a problem with their hearts."

If you suffer from stress, you're not alone. The American Institute of Stress calls stress the nation's number-one health problem. It's not hard to see why.

Stress is believed to be a cause of a host of illnesses, including heart and lung disease, cancer, back disorders, ulcers, colitis, cirrhosis of the liver, depression and diminished functioning of the immune system. Stress doesn't just make you feel lousy; it can make you sick. Overall, the institute estimates 1 million workers are absent on the average workday because of stress-related complaints.

Stress also costs us money. The institute puts the national financial toll at $300 billion from lost workdays, lost productivity, employee turnover, industrial accidents, and higher medical, legal and insurance costs.

In particular, claims for stress-related illness help raise health insurance rates. That's important for vets since they often have to buy their own health insurance.

And finally, stress can wreck personal and working lives. Stress has been linked to job burnout, irritability, anger, marital discord and divorce.

Some sources of stress go with the job. To cope with these, a vet must learn to handle the stress. A $100,000 student loan that will take 20 years to pay is an example.

But, many other sources of stress are readily solvable. For these, the solution is to solve the problem, says veterinary practice consultant David Horn. Here are three examples of problems and possible solutions:

- Too little income. "If you're an associate, you need to negotiate with the clinic owner for a better pay package," says Horn. However, that might mean more work, he adds. If you own the practice, Horn says, there are probably areas to improve profitability through better collection of accounts receivable, inventory management and pricing.

- Too much work during calving season. Work with another vet so you can get some time off, even if it's just a day or an afternoon.

- Difficult clients. In some cases, drop the client, Horn suggests. In others, he says, vets should sit down with the client and try to resolve matters.