stress management 1_
Post on 13-May-2015
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StressStress
““…….stress is the nonspecific response of the .stress is the nonspecific response of the body to any demand, whether it is caused body to any demand, whether it is caused by, or results in pleasant or unpleasant by, or results in pleasant or unpleasant
conditions.”conditions.”
Hans Selye, MDHans Selye, MD
StressStress“…“…a a sociopsychophysiologicalsociopsychophysiological phenomenon. It is phenomenon. It is
a composite of intellectual, behavioral, a composite of intellectual, behavioral, metabolic, immune, and other physiological metabolic, immune, and other physiological
responses to a stressor (or stressors) of responses to a stressor (or stressors) of endogenous or exogenous origins. The stressors endogenous or exogenous origins. The stressors may involve thoughts and feelings or may be a may involve thoughts and feelings or may be a
perceived threat or some other condition such as perceived threat or some other condition such as cold. The response generally serves a protective, cold. The response generally serves a protective,
adaptive function.adaptive function.
Lindsay, Carrieri-Kohlman, PageLindsay, Carrieri-Kohlman, Page
StressStress
““……a reaction in your mind and body to an event a reaction in your mind and body to an event in the outside world that alarms or arouses you.”in the outside world that alarms or arouses you.”
EMS Stress: An Emergency EMS Stress: An Emergency Responder’s Handbook for Living WellResponder’s Handbook for Living Well
Sources of StressSources of StressThe GoodThe GoodGet married
Have children
Buy a new home
Go on vacation
New Job
Promotion
The BadThe BadBreak a leg
Spouse loses job
Kidlet in trouble
Lose wallet
In-laws coming
The UglyThe UglyNasty car accident
Bankruptcy
Divorce
Loved one dying
Types of StressorsTypes of Stressors
EmotionalEnvironm
ental
Injury
PhysicalIllness
Career Pressures
Mind Body IntegrationMind Body Integration
Mind
Body
MindBody
Mind
Body
Mind BodyBody
Mind
Chocolate
Mind
Why Stress Management?Why Stress Management?
Stress Related Disorders & Chemical Stress Related Disorders & Chemical DependencyDependency
• Cost U.S. Employers Billions $$$$$Cost U.S. Employers Billions $$$$$– lost productivitylost productivity– increased health care expensesincreased health care expenses– increased absenteeismincreased absenteeism– increased accidentsincreased accidents
98.6
pH 7.4
Oxygen 99%
98.6
pH 7.4
Oxygen 99%
The Stress Response is the The Stress Response is the Body’s Body’s 911911 System System
Autonomic Nervous SystemAutonomic Nervous System• SympatheticSympathetic
– Increased HR, BP, RRIncreased HR, BP, RR– Muscles tenseMuscles tense– Brain becomes more Brain becomes more
alertalert– Liver increases blood Liver increases blood
glucose levelglucose level– Digestion inhibitedDigestion inhibited– Pupils dilate Pupils dilate
• ParasympatheticParasympathetic– Normalizes HR, BP, RRNormalizes HR, BP, RR– Muscles relaxMuscles relax– Energy storageEnergy storage– Promotes growthPromotes growth– Mediates calmMediates calm– Pupils constrictPupils constrict
CUMULATIVE STRESSCUMULATIVE STRESS
““Any idiot can face a crisis…….Any idiot can face a crisis…….
Its the day to day living that wears you out.”Its the day to day living that wears you out.” Anton CherkhovAnton Cherkhov
How Can the Stress Response How Can the Stress Response Make Us Sick?Make Us Sick?
• Chronically elevated BPChronically elevated BP– atherosclerosisatherosclerosis– myocardial ischemiamyocardial ischemia
• Constantly using stored energyConstantly using stored energy– tire more easilytire more easily
• Blocked insulin secretionBlocked insulin secretion– higher risk of diabeteshigher risk of diabetes
Why Stress Management?Why Stress Management?Researchers indicate 2/3 of medical visits are for Researchers indicate 2/3 of medical visits are for
stress related illnessesstress related illnesses• Stress response contributes to:Stress response contributes to:
– coronary artery diseasecoronary artery disease– cancercancer– respiratory disordersrespiratory disorders– unintentional injuriesunintentional injuries– cirrhosiscirrhosis– suicidesuicide
Physiologic Signs of StressPhysiologic Signs of Stress
• Immediate ChangesImmediate Changes– Increased cardiac outputIncreased cardiac output– Increased circulationIncreased circulation– Increased BP, RRIncreased BP, RR– Increased sweatingIncreased sweating– PiloerectionPiloerection– Pupil dilatationPupil dilatation– Decreased salivationDecreased salivation
– Decreased gastric motilityDecreased gastric motility– HyperalertnessHyperalertness– Increased blood sugarIncreased blood sugar– Use of blood glucose Use of blood glucose – Decreased stored energyDecreased stored energy– Increased fatty acidsIncreased fatty acids– Increased metabolismIncreased metabolism
Physiologic Sign of StressPhysiologic Sign of Stress
• Long Term EffectsLong Term Effects– Increased breakdown of Increased breakdown of
proteinprotein– Increased blood glucoseIncreased blood glucose– Increased vascular Increased vascular
constrictionconstriction– Decreased inflammatory Decreased inflammatory
responseresponse
– Decreased immune Decreased immune responseresponse
– Increased fluid volumeIncreased fluid volume– Increased sodium & fluid Increased sodium & fluid
retention in kidneysretention in kidneys
Emotional Signs of StressEmotional Signs of Stress• DenialDenial• FearFear• DepressionDepression• GriefGrief• AngerAnger• WorryWorry• UncertaintyUncertainty
• HopelessnessHopelessness• HelplessnessHelplessness• Feeling lost Feeling lost • Wishing to hideWishing to hide• AnxietyAnxiety• PanicPanic• Inappropriate EmotionsInappropriate Emotions
Cognitive Signs & SymptomsCognitive Signs & Symptoms• Difficulty Making DecisionsDifficulty Making Decisions• ConfusionConfusion• Difficulty Naming Familiar ItemsDifficulty Naming Familiar Items• Poor ConcentrationPoor Concentration• Blaming OthersBlaming Others• Memory ProblemsMemory Problems• Replaying Events Over & OverReplaying Events Over & Over
Behavioral Signs of StressBehavioral Signs of Stress• WithdrawalWithdrawal• SuspiciousnessSuspiciousness• Excessive Humor or SilenceExcessive Humor or Silence• Increased Smoking, Alcohol or FoodIncreased Smoking, Alcohol or Food• Change in Activity LevelChange in Activity Level• Angry OutburstsAngry Outbursts• Crying SpellsCrying Spells
Negative Self-TalkNegative Self-Talk• The Worrier VoiceThe Worrier Voice - “What if…..?” - “What if…..?”
– Make a plan then get it out of your head.Make a plan then get it out of your head.
• The Critic VoiceThe Critic Voice - “How stupid…..” - “How stupid…..”– Recognize what is really true.Recognize what is really true.
• The Victim VoiceThe Victim Voice - “I’ll never be able to…..” - “I’ll never be able to…..”– There is always something to do to work toward a There is always something to do to work toward a
goal.goal.
• The PerfectionistThe Perfectionist - “I should……” - “I should……”– Assess your unrealistic expectations of yourselfAssess your unrealistic expectations of yourself..
Feeling “on edge”Feeling “on edge”
Vague sense of future doomVague sense of future doom
Fear losing controlFear losing control
Racing thoughtsRacing thoughts
Detached from selfDetached from self
Decreased ability to learnDecreased ability to learn
Physical Symptoms of AnxietyPhysical Symptoms of Anxiety
• Increased Muscle TensionIncreased Muscle Tension• DizzinessDizziness• Rapid HeartbeatRapid Heartbeat• Shortness of BreathShortness of Breath• Queasy StomachQueasy Stomach• Dry MouthDry Mouth• Increased PerspirationIncreased Perspiration• Problems with SleepProblems with Sleep
Coping Skills to Manage Coping Skills to Manage AnxietyAnxiety
• Relaxation TechniquesRelaxation Techniques• ExerciseExercise• Examine Self TalkExamine Self Talk• Develop Action PlanDevelop Action Plan• Avoid Stimulants Avoid Stimulants
– caffeine, nicotine, sugarcaffeine, nicotine, sugar
• CounselingCounseling• Drug TherapyDrug Therapy
AngerAngerPhysical SymptomsPhysical Symptoms
• Increased HR, BPIncreased HR, BP• Increased Muscle Tension & Increased Muscle Tension &
SweatingSweating• RestlessnessRestlessness• Emotional SymptomsEmotional Symptoms• Shattered Beliefs in a Just WorldShattered Beliefs in a Just World• WrongedWronged• Ready to FightReady to Fight• DefensiveDefensive
““When angry, count four, when very When angry, count four, when very angry, swear.”angry, swear.”
-Mark Twain-Mark Twain
Anger ManagementAnger Management• Anger IntensifyingAnger Intensifying
– YellingYelling– SulkingSulking– PoutingPouting– HittingHitting– Other ViolenceOther Violence– Competitive GamesCompetitive Games– AccusationsAccusations– ArguingArguing
• Cooling Off HabitsCooling Off Habits– Abdominal BreathingAbdominal Breathing– Count to TenCount to Ten– Non-Competitive Non-Competitive
ExerciseExercise– DistractionDistraction– HumorHumor– Empathy for Other Empathy for Other
PersonPerson
Workaholic BehaviorsWorkaholic Behaviors
A person whose desire to work long and A person whose desire to work long and hard is intrinsic, and whose work hard is intrinsic, and whose work habits always exceed the job habits always exceed the job description and expectation of others.description and expectation of others.
Personality Traits of a Personality Traits of a WorkacholicWorkacholic
• Detail orientedDetail oriented• PerfectionisticPerfectionistic• High personal High personal
standardsstandards• Action orientedAction oriented
• Easily boredEasily bored• Highly dedicatedHighly dedicated• Task orientedTask oriented
Workaholic BehaviorsWorkaholic Behaviors• ImpairedImpaired
– No pleasure in No pleasure in leisureleisure
– Distressed when not Distressed when not workingworking
– Isolated lifestyleIsolated lifestyle– Family in distressFamily in distress
• ContentedContented– Family accepts work Family accepts work
habitshabits– Autonomy & variety in Autonomy & variety in
workplaceworkplace– Good match between Good match between
personality & job skillspersonality & job skills– Good healthGood health
Suggested BehaviorsSuggested Behaviors• Don’t ruminate over problemsDon’t ruminate over problems• Respond to signs of fatigueRespond to signs of fatigue• Don’t self medicate Don’t self medicate
• ie. alcohol/drug abuseie. alcohol/drug abuse
• Take scheduled time offTake scheduled time off• Stabilize domestic situationsStabilize domestic situations• Develop/maintain friendshipsDevelop/maintain friendships• Engage in regular exerciseEngage in regular exercise• Foster sense of humorFoster sense of humor
DepressionDepression
• MildMild• ModerateModerate• Severe Severe
– Always requires professional help.Always requires professional help.
Garbage In = Garbage OutGarbage In = Garbage Out
Told you so...Told you so...
Heart DiseaseHeart Disease HypertensionHypertension
Arthritis Arthritis HeadacheHeadache
StrokeStroke Irritable Irritable BowelBowel
CancerCancer DiabetesDiabetes
CumulativeCumulativeStressStress Ugly Ugly
Health Health HabitsHabits
Healthy HabitsHealthy Habits• NutritionNutrition• Attention to SymptomsAttention to Symptoms• ExerciseExercise• SleepSleep• RecreationRecreation• StretchingStretching• Social SupportSocial Support• HumorHumor
Balance is the Key
Physiology of Circadian RhythmsPhysiology of Circadian Rhythms
Stages of SleepStages of Sleep
REM SleepREM Sleep
Shift WorkShift Work
Increase Quality of SleepIncrease Quality of Sleep• DoDo
– Exercise (early in day)Exercise (early in day)– Avoid CaffeineAvoid Caffeine– Avoid AlcoholAvoid Alcohol– Don’t Self Medicate for SleepDon’t Self Medicate for Sleep
(some sedatives interfere with deep sleep)(some sedatives interfere with deep sleep)
– Relaxation Techniques Before SleepRelaxation Techniques Before Sleep– Warm BathWarm Bath– Avoid Rich Foods Before SleepAvoid Rich Foods Before Sleep
““A person without a sense of humor A person without a sense of humor is like a wagon without springs --- is like a wagon without springs --- jolted by every pebble in the road.”jolted by every pebble in the road.”
-Henry Ward Beecher, American clergyman-Henry Ward Beecher, American clergyman
• Causes Deep Abdominal Causes Deep Abdominal BreathingBreathing
• Increases CirculationIncreases Circulation• Releases Endorphins & Releases Endorphins &
EnkyinsEnkyins• Relieves TensionRelieves Tension• Puts Life into PerspectivePuts Life into Perspective
““Laughter and tears are both responses Laughter and tears are both responses to frustration and exhaustion . . .I to frustration and exhaustion . . .I myself prefer to laugh, since there is myself prefer to laugh, since there is less cleaning up to do afterward.”less cleaning up to do afterward.”
-Kurt Vonnegut-Kurt Vonnegut
BANGHEADHERE
ANTI- STRESS THERAPYANTI- STRESS THERAPY
REPEAT UNTIL STRESS IS GONE OR YOU ARE UNCONSCIOUS
Relaxation TechniquesRelaxation Techniques Abdominal BreathingAbdominal Breathing Active Progressive Muscle RelaxationActive Progressive Muscle Relaxation VisualizationVisualization Self-HypnosisSelf-Hypnosis MeditationMeditation MusicMusic StretchingStretching ExerciseExercise
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