Define the following terms:1.Allostatic load2.Immunocompetence3.Hypothalamus4.Parasympathetic nervous system

5.Psychoneuroimmunology

Pop QuizPop Quiz

Stress and Stress and Stress Stress

ManagementManagementSaniya G. AbirinSaniya G. Abirin

ObjectivesObjectives

»Define stress and examine its Define stress and examine its potential impact on health, potential impact on health, relationships, and success.relationships, and success.»Explain the phases of the Explain the phases of the general adaptation syndrome general adaptation syndrome and the physiological changes and the physiological changes that occur during them.that occur during them.

ObjectivesObjectives

»Examine the physical, emotional, Examine the physical, emotional, and social health risks that may and social health risks that may occur with chronic stress.occur with chronic stress.»Discuss sources of stress and Discuss sources of stress and examine the unique stressors.examine the unique stressors.»Explore techniques for coping Explore techniques for coping with or reducing exposure to with or reducing exposure to stress and using positive stress and using positive stressors to enrich your life.stressors to enrich your life.

DOH Facts about StressDOH Facts about Stress 75-90% of visits to physicians 75-90% of visits to physicians are stress-relatedare stress-related

Stress-related disorders are a Stress-related disorders are a major cause of rapidly major cause of rapidly increasing health care costs.increasing health care costs.

According to the World Health According to the World Health organization (WHO), by year organization (WHO), by year 2020, five (5) of the top ten 2020, five (5) of the top ten medical problems world-wide will medical problems world-wide will be stress-relatedbe stress-related

DOH Facts about StressDOH Facts about StressStress is a major cause Stress is a major cause ofof–Low productivityLow productivity–High absenteeismHigh absenteeism–Misallocation of resourcesMisallocation of resources–Poor morale, which may Poor morale, which may lead to suicide.lead to suicide.

What Is Stress?What Is Stress?

Stress is the nonspecific Stress is the nonspecific response of the body to response of the body to any demand made upon it.any demand made upon it.–Can be external or Can be external or internal.internal.

–May affect a person May affect a person physically, mentally and/or physically, mentally and/or emotionally.emotionally.

Hans Selye: “stress is not Hans Selye: “stress is not necessarily something bad – it necessarily something bad – it all depends on how you take all depends on how you take it. The stress of it. The stress of exhilarating, creative exhilarating, creative successful work is beneficial, successful work is beneficial, while that of failure, while that of failure, humiliation or infection is humiliation or infection is detrimental.” detrimental.”

What Is Stress?What Is Stress?

There are two types of There are two types of stress:stress:

Positive stress, called Positive stress, called EUSTRESSEUSTRESS-This type of stress challenges -This type of stress challenges us to adapt and grow.us to adapt and grow.

Negative stress, called Negative stress, called DISTRESSDISTRESS-This type of stress can deplete -This type of stress can deplete or destroy our energy for life.or destroy our energy for life.

Negative Occupational Consequences of Stress

•Lack of concentration•Lower productivity•Increased frequency of mistakes on the job•Higher rate of on the job injuries•Higher rate of absenteeism•Irritability, conflict with co-workers and supervisors

Positive Stress

•Alleviates boredom•Opportunity for change•Opportunity for personal growth•Sense of achievement, fulfillment, satisfaction, accomplishment

How Stress Promotes How Stress Promotes IllnessIllness

Direct effectDirect effect– Raises blood pressureRaises blood pressure– Impairs immune systemImpairs immune system

Indirect effectIndirect effect– Less positive behaviors Less positive behaviors (exercise, healthy diet, lack of (exercise, healthy diet, lack of sleep)sleep)

– More negative behaviors More negative behaviors (drinking, smoking, unhealthy diet)(drinking, smoking, unhealthy diet)

The Stress Target ZoneThe Stress Target Zone

EUSTRESS (The optimal amount of stress)

BURN OUT

(Distress)

RUST OUT

(Boredom)

Stress ContinuumStress Continuum

Rust Out (Boredom)Rust Out (Boredom)– Fatigue, frustration, dissatisfactionFatigue, frustration, dissatisfaction

EustressEustress– Creativity, problem solving, change, Creativity, problem solving, change, satisfactionsatisfaction

Burn Out (Distress)Burn Out (Distress)– Over-stimulation, ineffective problem Over-stimulation, ineffective problem solving, exhaustion, illness, low solving, exhaustion, illness, low self-esteemself-esteem

What causes stress?What causes stress?

A A stressorstressor is any is any physical, social, or physical, social, or psychological event or psychological event or condition that causes condition that causes the body to adjust to the body to adjust to that situation.that situation.

Types of StressorsTypes of Stressors EnvironmentalEnvironmental

– Heat, noise, crowdingHeat, noise, crowding PhysiologicalPhysiological

– Drugs, caffeine, tobaccoDrugs, caffeine, tobacco ThoughtsThoughts Emotional Emotional (psycho-social)(psycho-social)– Pressures, lifePressures, life

Contemporary Views Contemporary Views of the Nature of of the Nature of

StressStress

Stressor Stress

Appraisal

Outcome

Coping

The Process of Stress

Stressor

High Stress

Low Stress

StressAppraisal

See stressor as a challenge

See stressor as a threat

Appraisal of StressorsAppraisal of Stressors

Responses to StressResponses to Stress PhysiologicalPhysiological

– Increased Heart RateIncreased Heart Rate– Tense musclesTense muscles

CognitiveCognitive– Worry, lack of concentrationWorry, lack of concentration– forgetfulnessforgetfulness

EmotionalEmotional– Anger, sense of dreadAnger, sense of dread

BehavioralBehavioral– Less patient, hurryingLess patient, hurrying

How Do You How Do You Respond to Respond to Stress?Stress?

Click to watch video

The Body’s Response to The Body’s Response to StressStress

Fight-or-flight responseFight-or-flight responseGeneral adaptation syndrome General adaptation syndrome (GAS), characterized by Hans (GAS), characterized by Hans Selye in 1936, has three distinct Selye in 1936, has three distinct phases:phases:1.1.Alarm phaseAlarm phase2.2.Resistance phase Resistance phase 3.3.Exhaustion phaseExhaustion phase

The General Adaptation The General Adaptation SyndromeSyndrome

Copyright © 2010 Pearson Education, Inc.

Alarm Phase (of GAS)Alarm Phase (of GAS)

Autonomic nervous systemAutonomic nervous system (ANS)(ANS) is is triggered when the mind perceives a triggered when the mind perceives a stressor the brain interprets as a stressor the brain interprets as a threat.threat.

Sympathetic nervous systemSympathetic nervous system releases releases hormones that speed heart rate.hormones that speed heart rate.

Parasympathetic nervous systemParasympathetic nervous system counteracts the actions of the counteracts the actions of the sympathetic branch, reaching a sympathetic branch, reaching a balance.balance.

The General Adaptation The General Adaptation SyndromeSyndrome

Alarm:Autonomic nervous systemSympathetic nervous systemParasympathetic nervous

system

Resistance

Exhaustion:Allostatic load

Resistance and Exhaustion Phases (of Resistance and Exhaustion Phases (of GAS)GAS)

Resistance phase: The body tries to Resistance phase: The body tries to return to homeostasis but doesn’t return to homeostasis but doesn’t achieve complete rest.achieve complete rest.

Exhaustion phase: Stress is promoted to Exhaustion phase: Stress is promoted to adaptation.adaptation.– Deep stores of adaptation are preset Deep stores of adaptation are preset by heredity.by heredity.

– Superficial adaptation stores are Superficial adaptation stores are renewable and present the first line renewable and present the first line of defense against stress.of defense against stress.

Effects of long-term stress Effects of long-term stress

On your Cardiovascular System…On your Cardiovascular System…– Increased risk of stroke and heart Increased risk of stroke and heart attackattack

On your Immune System…On your Immune System…– Increased susceptibility to infection Increased susceptibility to infection and slower recovery/healing timeand slower recovery/healing time

On your Brain…On your Brain…– Stress hormones affect memoryStress hormones affect memory– Anxiety, insomnia and depressionAnxiety, insomnia and depression

Coping with StressCoping with StressActive CopingStrategies

Stressorwithin your control

Stressorout of your control

Passive CopingStrategies

Problem-Focused or

Emotion-Focused or

Types of Coping Types of Coping StrategiesStrategies

Active Coping Strategies– AcceptingAccepting– Re-AppraisingRe-Appraising– PrayingPraying– Problem SolvingProblem Solving– ControllingControlling– Seeking Social Seeking Social SupportSupport

Passive Coping Strategies– IgnoringIgnoring– EscapingEscaping– ConfrontingConfronting– RelaxingRelaxing– ExercisingExercising– Seeking Social Seeking Social SupportSupport

You may not be able to smooth out the surf, but you can learn to ride the waves!

Summary of StressSummary of Stress

Managing Your StressManaging Your Stress Building skills to reduce Building skills to reduce stressstress–Assessing your stressorsAssessing your stressors–Changing your responsesChanging your responses–Learning to copeLearning to cope–DownshiftingDownshifting

How to manage StressHow to manage Stress

The 4 A’s of Managing The 4 A’s of Managing StressStress–AvoidAvoid–AlterAlter–AdaptAdapt–AcceptAccept

Managing Social Managing Social InteractionsInteractions

Making the most of support groups Making the most of support groups –Important part of stress managementImportant part of stress management–Members include friends, family Members include friends, family members, and co-workers.members, and co-workers.

–If no close support group exists If no close support group exists for you, there are alternatives: for you, there are alternatives: counseling services, clergy, counseling services, clergy, instructors, mental instructors, mental health clinics.health clinics.

Taking Mental ActionTaking Mental Action Changing the way you thinkChanging the way you think

– Cognitive restructuringCognitive restructuring Managing emotional responsesManaging emotional responses

– Learn to laugh and cry.Learn to laugh and cry.– Fight the anger urge.Fight the anger urge.

» Identify your anger style (e.g., Identify your anger style (e.g., explosive).explosive).

» Recognize patterns in your anger responses Recognize patterns in your anger responses and how to de-escalate.and how to de-escalate.

» Plan ahead (e.g., traffic).Plan ahead (e.g., traffic).» Develop a support system.Develop a support system.» Develop realistic expectations of yourself Develop realistic expectations of yourself and others.and others.

Taking Positive Physical Taking Positive Physical ActionAction

ExerciseExercise– Human stress response is intended to end in Human stress response is intended to end in physical activity.physical activity.

RelaxRelax– As your heart rate slows, your blood pressure As your heart rate slows, your blood pressure and metabolic rate decrease, allowing you to and metabolic rate decrease, allowing you to channel energy appropriately.channel energy appropriately.

Eat rightEat right– Avoid sympathomimetics (e.g., caffeine) that Avoid sympathomimetics (e.g., caffeine) that may cause distress in the body.may cause distress in the body.

Managing Your FinancesManaging Your Finances

Tips to better manage your money and Tips to better manage your money and reduce finance-related stress:reduce finance-related stress:– Develop a realistic budget.Develop a realistic budget.– Take care of bills immediately, and Take care of bills immediately, and consider electronic banking.consider electronic banking.

– Educate yourself about how to manage Educate yourself about how to manage your money.your money.

– Avoid those tempting credit cards.Avoid those tempting credit cards.– Don’t get into debt.Don’t get into debt.

Alternative StressAlternative StressManagement TechniquesManagement Techniques

Yoga, qigong, tai chiYoga, qigong, tai chi MeditationMeditation Breathing techniquesBreathing techniques Progressive muscle relaxationProgressive muscle relaxation VisualizationVisualization HypnosisHypnosis Massage therapyMassage therapy BiofeedbackBiofeedback

Diaphragmatic Diaphragmatic BreathingBreathing

TRY NOW

Developing Your Spiritual Side: Developing Your Spiritual Side: MindfulnessMindfulness

Physical dimension: Interact with the Physical dimension: Interact with the natural environment.natural environment.

Emotional dimension: Focus on Emotional dimension: Focus on positive emotions through self-talk.positive emotions through self-talk.

Social dimension: Listen Social dimension: Listen activelyactively by by taking note of content, intent, and taking note of content, intent, and feelings expressed.feelings expressed.

Intellectual dimension: Use our minds Intellectual dimension: Use our minds for objective reasoning.for objective reasoning.

Quick "Time Out"Quick "Time Out"

Deep breathingDeep breathing Take mind off of problemsTake mind off of problems

Watch VideoWatch Video

Jacobson's Progressive Jacobson's Progressive Relaxation TechniqueRelaxation Technique

Involves alternate Involves alternate contraction and relaxation contraction and relaxation of musclesof muscles

Teaches a person to Teaches a person to identify stress-related identify stress-related tension in the bodytension in the body

Autogenic Relaxation Autogenic Relaxation TrainingTraining

Combines deep rhythmic Combines deep rhythmic breathing with soothing breathing with soothing imageryimagery

Feelings of heaviness and Feelings of heaviness and warmth facilitate processwarmth facilitate process

Visualization

Involves creating relaxing visual images and scenes in times of stress to elicit body and mind relaxation. Meditation-The goal is to clear the mind and block the stressors responsible for the tension.

Click to Meditate

SummarySummary Stress is a Stress is a natural part of natural part of life but with life but with appropriate stress appropriate stress management management techniques you can techniques you can learn to manage it learn to manage it more effectively.more effectively.

BibliograhyAbascal, J. R., Brucato and D., Brucato, L.

(2001). Stress mastery: The art of coping gracefully. NJ: Prentice Hall.

Charlesworth, E. A. and Nathan, R. G. (2004). Stress management. NY: Ballantine.

Boenisch, E. and Haney, C. M. (1996). The stress owner’s manual. CA: Impact Publishers.

Davidson, J. (2002). Managing your time. IN: Alpha.

Davis, M., Eshelman, E. R., and McKay, M. (2000). The relaxation and stress reduction workbook (5th edition). CA: Publishers Group West.