How to Manage Stress

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Join us for a lecture about stress and how it can affect your behavior. Clinical psychologist Katherine DiDonato, PhD, will discuss cognitive behavioral techniques and other evidence-based approaches to help reduce stress and manage worry for a better life.

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<ul><li> 1. Stress &amp; Anxiety What is it &amp; What can be done about it? Presented by: Katherine DiDonato, PhD, ACT </li></ul> <p> 2. Physical Results of Ongoing Stress Heart disease Diabetes Asthma PMS Obesity Infertility Autoimmune diseases Chronic pain Migraines Ulcers Heartburn High blood pressure Skin problems Irritable bowel syndrome 3. Emotional Results of On-Going Stress Anxiety Depression Insomnia Isolation Conflict Substance Abuse BURNOUT 4. Todays Objectives What is Stress? What is Burnout? What is Anxiety? Stress/Anxiety Management Cognitive Techniques Meditation and Relaxation Social Connection Medication 5. Stress is a normal component of the bodys response to demands that are placed on it. It is characterized by the bodys biochemical changes It can be health-enhancing or health-depleting What is Stress? 6. What is Stress? When demands are in balance with your coping abilities and resources you do not feel stressed. When demands are greater than your coping abilities you feel stressed. 7. Appraisal of Threats and Resources First we evaluate the threat. Is it?... Positive / Negative Controllable / Uncontrollable Challenging / Boring Irrelevant / Important If the answer is negative, uncontrollable, important = STRESS Then we evaluate our resources. Can I handle this stress? If the answer is no = STRESS 8. The Stress Response is the Bodys 911 System 9. Fight or Flight Reaction Productive if you were in a situation where you need to protect yourself 10. It is a Matter of Perception Since we are very rarely attacked by bears our perception of threat has changed Now, a threat can be: Social Emotional Financial Work related 11. Sources of Stress The Good Retirement Get married Have children Buy a new home Go on vacation New Job, Promotion The Bad Break a leg Spouse becomes ill Child gets in trouble Lose wallet In-laws coming The Ugly Nasty car accident Bankruptcy Divorce Illness Loved one dying 12. Who Has Stress? 13. Stress Response = Good in Small Doses Gives you a burst of energy when you need it Increases your motivation to complete tasks Protects you from harm Prevents you from walking down a dark alley way at night 14. Stress and its impact on performance works in a bell curve More stress will help you give an optimal performance The optimal amount of stress is different for everyone Stress is Good in Small Doses 15. Stress Can be Health-Depleting " copyright Mental Health America" 16. Negative Emotional Reactions Feeling angry, irritable or easily frustrated Feeling overwhelmed Feeling nervous or anxious Feeling afraid or worried Feeling helpless or hopeless Desire to hide or runaway 17. Negative Cognitive Reactions Difficulty Making Decisions Confusion Difficulty Naming Familiar Items Poor Concentration Blaming Others Memory Problems Replaying Events Over &amp; Over Thinking the Future is bad 18. Behavioral Reactions Difficulty functioning at work or home Withdrawal Isolation Suspiciousness Working more and being less productive Excessive Humor or Silence Increased Smoking, Alcohol or Food Change in Activity Level Angry Outbursts Crying Spells Sleep 19. What is Burnout? 20. Burnout - A State of Mental Exhaustion Powerlessness Hopelessness Emotional exhaustion Detachment Isolation Irritability Frustration Being trapped Failure Despair Cynicism Apathy 21. Stress Burnout Characterized by over-engagement Characterized by disengagement Emotions are over-reactive Emotions are blunted Produces urgency and hyperactivity Produces helplessness and hopelessness Loss of energy Loss of motivation, ideals, and hope Leads to anxiety disorders Leads to detachment and depression Primary damage is physical Primary damage is emotional May kill you prematurely May make life seem not worth living Stress vs. Burnout 22. What is Anxiety? 23. Anxiety Includes: Fight or Flight Reaction Avoidance Behavior Worry or Concern Concern about the physical reaction or its meaning Concern about the future 24. Anxious Thinking Future-Focused Predictions Future is Bad Reaction is as-if the bad thing is happening or going to happen Avoidance / Safety Behaviors 25. Panic Attack = Fight or Flight Discrete period of intense fear or discomfort in which four of the following develop abruptly &amp; reach peak in 10 minute: palpitations, pounding heart, racing heart sweating trembling/shaking sensation of shortness of breath or smothering feelings of choking Chest pain or discomfort Nausea or abdominal distress feeling dizzy, unsteady, lightheaded, faint derealization or depersonalization fear of losing control or going crazy fear of dying paresthesias chills/hot flashes From DSM-IV-TR Copyright 2000 American Psychiatrist Association 26. Stress Management 27. Stress Management Cognitive Therapy Techniques - Learning ways to evaluate situations clearly. Is there a true threat or not? Is the situation exceeding my coping or am I just thinking it is? If it is exceeding my coping what should I do about it? Stress Reduction &amp; Management Reducing environmental stress Changing your physical reactions Pay it forward helping others Medication 28. Medication Benzodiazepines Xanax Klonopin Ativan Antidepressants Zoloft Lexapro Prozac Paxil Buspar 29. Cognitive Therapy Not simply the events in life that causes problems How we think about those events Take our thoughts to be 100% true Focus on information that confirms them Ignore or bend information that disconfirms 30. Using Cognitive Therapy Identify the stressful, anxious thought Consider the thought to be a hypothesis Not a Fact Use Socratic questioning to evaluate GOAL = Realistic and Useful thinking If needed, experiment to confirm or disconfirm the thought 31. Information Skewed Adapted from J.Beck (2005) Cognitive Therapy for Challenging Problems. 32. Thinking Errors Fortune Telling I know what is going to happen and it will be bad All-or-Nothing Thinking (Black and White) If Im not a total Success, Im a Failure Catastrophizing Ill be so upset I will not be able to function Discounting the Positive I did this project well but I just got lucky Emotional Reasoning Its true because I feel it is 33. Thinking Errors Magnification/Minimization Getting a B proves Im stupid. I got an A+ because the test was easy Mind Reading Hes thinking that I dont know what Im doing Personalization He didnt look at me because he hates me Should and Must Statement I must always do my best. I should never make a mistake 34. Thought Record Situation * Who * What * When * Where Moods What did you feel? (Rate 0 100) Negative Automatic Thoughts What was going thru your mind (thought/image)? (Rate 0-100) Socratic Questions to Evaluate the Negative Automatic Thought Are you using any Cognitive Distortions? Alternative Thought to Counter the Negative Automatic Thought Rate Moods &amp; NATs Now What make me think the thought is true? What makes me think it is not true or not competly true? What is an alternative way to look at the situation? What is the worst thing that could happen and could I live thru it? What is the best thing that could happen? What is most likely to happen? What will happen is I keep telling myself the same NAT over and over? What if I was to change my thinking? What would I tell a friend who was going thru the same exact thing I am going thru? 35. Situation * Who * What * When * Where Moods What did you feel? (Rate 0 100) Negative Automatic Thoughts What was going thru your mind (thought/image)? (Rate 0-100) Socratic Question to Evaluate the Negative Automatic Thought Are you using any Cognitive Distortions? Alternative Thought to Counter the Negative Automatic Thought Rate Moods &amp; NATs Now Working on a project with co-worker. No contact for 2 days even though she had left them a message. Sad Despondent Anxious 85 They think the work I have done on the project is poor They dont want to work on the project with me because they think I dont know what Im doing Im a Failure 90 What make me think the thought is true? What makes me think it is not true or not completely true? What is an alternative way to look at the situation? What is the worst thing that could happen and could I live thru it? What is the best thing that could happen? What is most likely to happen? What will happen is I keep telling myself the same NAT over and over? What if I was to change my thinking? What would I tell a friend who was going thru the same exact thing I am going thru? 36. Testing Your Thoughts Ask yourself: What makes me think the thought is true? What makes me think it is not true or not completely true? What is an alternative way to look at the situation? What is the worst thing that could happen and could I live through it? What is the best thing that could happen? What is most likely to happen? What will happen if I keep telling myself the same NAT over and over? What if I was to change my thinking? What would I tell a friend who was going through the same exact thing I am going through? Now that you have tested your NAT what is a more realistic way to think about your situation? 37. Evidence Supports No contact Had some trouble on the project Not feeling sharp Hx Refutes Has a good relationship No negative comments Presented good ideas Willing to meet Mind Reading Emotional Reasoning 38. Thought Record Situation * Who * What * When * Where Moods What did you feel? (Rate 0 100) Negative Automatic Thoughts What was going thru your mind (thought/image)? (Rate 0-100) Socratic Question to Evaluate the Negative Automatic Thought Are you using any Cognitive Distortions? Alternative Thought to Counter the Negative Automatic Thought Rate Moods &amp; NATs Now Working on a project with co-worker. No contact for 2 days even though she had left them a message. Sad Despondent Anxious 85 They think the work I have done on the project is poor They dont want to work on the project with me because they think I dont know what Im doing. Im a failure 90 What make me think the thought is true? What makes me think it is not true or not competly true? What is an alternative way to look at the situation? What is the worst thing that could happen and could I live thru it? What is the best thing that could happen? What is most likely to happen? What will happen is I keep telling myself the same NAT over and over? What if I was to change my thinking? What would I tell a friend who was going thru the same exact thing I am going thru? I dont know why they have not contacted me and it does not necessary mean they are unhappy with me. If they are unhappy with me then I can try to work it out with them and it does not say anything bad about me as a person. 75 Mood 45 AT 50 39. Coping Cards Written reminders that can be carried Excellent for practicing new way of thinking Succinct responses to your stressful thoughts Best after have uncovered distorted ideas 40. Behavioral Experiments Reduce or eliminate avoidance behavior Test stressful thoughts and assumptions Get evidence for alternative perspectives 41. Stress Reduction &amp; Management Environmental Stress Physical Reactions Pay It Forward 42. Environment Reduce Stressors For example: Excessive temperatures Excessive noise Poor air quality Reduce repetitive work tasking and strenuous movements Alcohol 43. Physical Reactions Increase Exercise Regular and Balanced Meals Socializing Sleep Hobbies and Fun 44. Physical Reactions Relaxation Exercises Will reduce fight/flight reaction Like riding a bike for the first time. It is a skill that takes time and practice to do it effectively! Dont expect much after trying it one or two times Relaxation exercises can seem deceptively simple at first With practice they are very effective 45. Physical Reactions Breathing Techniques Mindfulness Meditation Guided Imagery Yoga 46. Pay It Forward New research suggests oxytocin may speed recovery from major stressors The more we give to others, &amp; the more we get from others, the more oxytocin is released Being connected may protect you from stress Kelly McGonigal: How to Make Stress Your Friend 47. Resources Academy of Cognitive Therapy www.academyofct.org Mind Over Mood Dennis Greenberger, PhD &amp; Christine Padesky, PhD Worry Cure: 7 Steps to Curing Your Worry Robert Leahy, PhD Anxiety Free Robert Leahy, PhD Mindfulness for Beginners Jon Kabat-Zinn, PhD (Audio CD) Wherever You Go, There You Are: Meditation in Everyday Life John Kabat-Zinn, PhD 48. Stress &amp; Anxiety What is it &amp; What can be done about it? Presented by: Katherine DiDonato, PhD, ACT </p>