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Stress Management 02

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					Stress
“….stress is the nonspecific response of the body to any demand, whether it is caused by, or results in pleasant or unpleasant conditions.”
Hans Selye, MD

Stress
“…a sociopsychophysiological phenomenon. It is a composite of intellectual, behavioral, metabolic, immune, and other physiological responses to a stressor (or stressors) of endogenous or exogenous origins. The stressors may involve thoughts and feelings or may be a perceived threat or some other condition such as cold. The response generally serves a protective, adaptive function.
Lindsay, Carrieri-Kohlman, Page

Stress
“…a reaction in your mind and body to an event in the outside world that alarms or arouses you.”
EMS Stress: An Emergency Responder’s Handbook for Living Well

The Good
Get married Have children

Sources of Stress
The Bad
Break a leg
Spouse loses job Kidlet in trouble

Buy a new home
Go on vacation New Job

The Ugly
Nasty car accident
Bankruptcy Divorce

Promotion

Lose wallet
In-laws coming

Loved one dying

Types of Stressors

Injury Emotional

Career Pressures

Environmental

Illness Physical

Mind Body Integration
Body Mind Mind Mind Chocolate

Body Mind
Body

Body
Mind

Body Mind

Why Stress Management?
Stress Related Disorders & Chemical Dependency Cost U.S. Employers Billions $$$$$
– – – –

•

lost productivity increased health care expenses increased absenteeism increased accidents

98.6 pH 7.4 Oxygen 99%

98.6 pH 7.4 Oxygen 99%

The Stress Response is the Body’s 911 System

Autonomic Nervous System
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Sympathetic
– – – – – –

•

Parasympathetic
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Increased HR, BP, RR Muscles tense Brain becomes more alert Liver increases blood glucose level Digestion inhibited Pupils dilate

–
– –

Normalizes HR, BP, RR Muscles relax Energy storage Promotes growth Mediates calm Pupils constrict

CUMULATIVE STRESS
“Any idiot can face a crisis……. Its the day to day living that wears you out.”
Anton Cherkhov

How Can the Stress Response Make Us Sick?
•

Chronically elevated BP
– –

atherosclerosis myocardial ischemia tire more easily

•
•

Constantly using stored energy
–

Blocked insulin secretion
–

higher risk of diabetes

Why Stress Management?
•

Researchers indicate 2/3 of medical visits are for stress related illnesses Stress response contributes to:
– – – – – –

coronary artery disease cancer respiratory disorders unintentional injuries cirrhosis suicide

Physiologic Signs of Stress
•

Immediate Changes
– – – –

–
– –

Increased cardiac output Increased circulation Increased BP, RR Increased sweating Piloerection Pupil dilatation Decreased salivation

– – – – – – –

Decreased gastric motility Hyperalertness Increased blood sugar Use of blood glucose Decreased stored energy Increased fatty acids Increased metabolism

Physiologic Sign of Stress
•

Long Term Effects
– – – –

Increased breakdown of protein Increased blood glucose Increased vascular constriction Decreased inflammatory response

– – –

Decreased immune response Increased fluid volume Increased sodium & fluid retention in kidneys

Emotional Signs of Stress
• • • • • • •

Denial Fear Depression Grief Anger Worry Uncertainty

•
• •

•
• •

•

Hopelessness Helplessness Feeling lost Wishing to hide Anxiety Panic Inappropriate Emotions

Cognitive Signs & Symptoms
• • • • • • •

Difficulty Making Decisions Confusion Difficulty Naming Familiar Items Poor Concentration Blaming Others Memory Problems Replaying Events Over & Over

Behavioral Signs of Stress
•

•
• • • •

•

Withdrawal Suspiciousness Excessive Humor or Silence Increased Smoking, Alcohol or Food Change in Activity Level Angry Outbursts Crying Spells

Negative Self-Talk
• • •

The Worrier Voice - “What if…..?”
–

Make a plan then get it out of your head. Recognize what is really true. There is always something to do to work toward a goal. Assess your unrealistic expectations of yourself.

The Critic Voice - “How stupid…..”
–

The Victim Voice - “I’ll never be able to…..”
–

•

The Perfectionist - “I should……”
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Feeling “on edge” Vague sense of future doom Fear losing control Racing thoughts Detached from self Decreased ability to learn

Physical Symptoms of Anxiety
• •

•
• • • • •

Increased Muscle Tension Dizziness Rapid Heartbeat Shortness of Breath Queasy Stomach Dry Mouth Increased Perspiration Problems with Sleep

Coping Skills to Manage Anxiety
• •

•
• • •

Relaxation Techniques Exercise Examine Self Talk Develop Action Plan Avoid Stimulants
–

caffeine, nicotine, sugar

•

Counseling Drug Therapy

Anger Physical Symptoms
• • • •

•
• • •

Increased HR, BP Increased Muscle Tension & Sweating Restlessness Emotional Symptoms Shattered Beliefs in a Just World Wronged Ready to Fight Defensive

“When angry, count four, when very angry, swear.”
-Mark Twain

Anger Management
•

Anger Intensifying
– – – –

•

Cooling Off Habits
– – – – – –

–
– – –

Yelling Sulking Pouting Hitting Other Violence Competitive Games Accusations Arguing

Abdominal Breathing Count to Ten Non-Competitive Exercise Distraction Humor Empathy for Other Person

Workaholic Behaviors
A person whose desire to work long and hard is intrinsic, and whose work habits always exceed the job description and expectation of others.

Personality Traits of a Workacholic
•

•
•

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Detail oriented Perfectionistic High personal standards Action oriented
• • •

Easily bored Highly dedicated Task oriented

Workaholic Behaviors
•

Impaired
– –

•

Contented
– – – –

–
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No pleasure in leisure Distressed when not working Isolated lifestyle Family in distress

Family accepts work habits Autonomy & variety in workplace Good match between personality & job skills Good health

Suggested Behaviors
• •

•
•

Don’t ruminate over problems Respond to signs of fatigue Don’t self medicate
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ie. alcohol/drug abuse

•
• • •

Take scheduled time off Stabilize domestic situations Develop/maintain friendships Engage in regular exercise Foster sense of humor

Depression
•
• •

Mild Moderate Severe
–

Always requires professional help.

Garbage In = Garbage Out
Cumulative Stress Ugly Health Habits Heart Disease Hypertension Arthritis Headache Stroke Irritable Bowel Cancer Diabetes
Told you so...

Healthy Habits
• •

•
• • • •

•

Nutrition Attention to Symptoms Exercise Sleep Recreation Stretching Balance is Social Support the Key Humor

Physiology of Circadian Rhythms Stages of Sleep REM Sleep Shift Work

Increase Quality of Sleep
•

Do
–
– –

–
– – –

Exercise (early in day) Avoid Caffeine Avoid Alcohol Don’t Self Medicate for Sleep
(some sedatives interfere with deep sleep)

Relaxation Techniques Before Sleep Warm Bath Avoid Rich Foods Before Sleep

“A

person without a sense of humor is like a wagon without springs --jolted by every pebble in the road.”
-Henry Ward Beecher, American clergyman

• • • • •

Causes Deep Abdominal Breathing Increases Circulation Releases Endorphins & Enkyins Relieves Tension Puts Life into Perspective

“Laughter and tears are both responses to frustration and exhaustion . . .I myself prefer to laugh, since there is less cleaning up to do afterward.”
-Kurt Vonnegut

ANTI- STRESS THERAPY

BANG HEAD HERE
REPEAT UNTIL STRESS IS GONE OR YOU ARE UNCONSCIOUS

Relaxation Techniques
Breathing  Active Progressive Muscle Relaxation  Visualization  Self-Hypnosis  Meditation  Music  Stretching  Exercise
 Abdominal


				
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