STRESS

1. STRESS

2. Stress • an estimated 75-90% of visits to primary care physicians are for stress- related issues and problems • job stress is a major source of stress in adults • children, teenagers, students, and the elderly are also feeling more stress

5. Stress • what causes you stress? • identify your major stressors • what happens when you are under stress? • what is all this stress doing to you?

6. Types of Stressors • psychological issues • environmental concerns • poor nutrition • role conflict/ambiguity, multiple roles • sociological, political, ethnic, cultural issues • physical illness/disability • biomechanical (repetitive strain) • developmental issues

7. FIGHT OR FLIGHT • contemporary stress more pervasive, insidious, and persistent • this reaction stems primarily from psychological rather than physical stress and causes ingrained and immediate reactions that were originally designed to help us in emergency situations

8. The Stress Reaction • heart rate and blood pressure increase • there is also increased blood flow to the brain for decision-making activity • blood sugar level increases for more energy (glycogen released) • blood is shunted from G/I tract to large muscles for strength to fight or take flight • clotting occurs quickly to prevent blood loss

9. The Stress Reaction • adrenaline, cortisol and other stress hormones are released into the bloodstream • the mouth becomes dry • the immune symptom is dampened • the skin is cool due to sweating • the scalp tightens

10. The Stress Reaction • this reaction is fine when confronted with a sabre-tooth tiger, but in the modern world is not adaptive • today, most of our stress is psychological and not physical in origin (for example, getting stuck in traffic or taking an exam)

12. JOB STRESS -occupational pressures are responsible for:30% of workers suffering from back pain-28% complaining of "stress"-20% feeling very fatigued-17% experiencing muscular pains-13% with headaches

14. Workplace Stress • damages relationships • reduces job satisfaction • reduces productivity

15. Work Stressors • lack of participation in decisions affecting you • unrelenting/unreasonable demands • poor communication & conflict resolution • lack of job security • long hours & lots of time away from home • office politics and conflicts • wages don’t equal level of responsibility

16. Physiologic Effects • inability to adapt to stress is associated with depression & anxiety • stress may disrupt serotonin (well being) levels • acute stress associated with higher risk of heart arrhythmias & heart attacks • fat released into bloodstream & increases cholesterol levels • chronic stress in women may reduce insulin levels • muscle and joint pain

17. Conditions Increasing Susceptibility to Stress • poor early nurturing • personality traits • genetic factors • immune system diseases can impair response to stress • the longer and more intense the stress, the more harmful

18. Those At Higher Risk • in the young and the elderly, stress may go unnoticed or be ignored • women more than men • working mothers encounter more stress due to greater and more diverse work load • divorced or widowed people • the unemployed • urban dwellers more than suburbanites

19. ELDERLY • often exposed to major stressors • medical problems • loss of spouse and friends • change in living conditions • financial worries • loss of control

20. CAREGIVERS • of physically or mentally disabled families face chronic stress • spouses of disabled partner have more stress-related problems

21. ANGRY PERSONALITIES • less emotionally stable or those with high anxiety may “catastrophize” • there is an association between anger, irritability, hostility and narrowing of the arteries • also being self-conscious in public and suppressing anger • combined with low social support, the situation is worse

22. Strategies to Help Deal with Stress • a healthy lifestyle, good nutrition/exercise • cognitive-behavioral therapy • identifying stress and learning to relax • attitude– “grant me the serenity to accept the things I cannot change, courage to change the things I can, and the wisdom to know the difference.”

23. SELF-EFFICACY • efficacy is the capacity to accomplish tasks • self-efficacy is the perceived ability to handle problems & overcome hardship • stress is minimal when you can look upon problems as opportunities to overcome adversity & gain experience

24. Perception & Assessment • keep it in perspective • ask yourself, “what is the worst that can happen? • can we look for an unexpected benefit? • assess the situation, consider past experience • problem-solve (take action) • make a decision regarding action vs acceptance of the situation

25. Risk for Burnout • having lofty ideals • getting impatient/annoyed frequently • only your ideas areright • blaming yourself (“shoulds”) • tendency to blame others • feeling you have to do everything yourself • equally upset about minor hassles • feeling you have more to do and less & less time

26. Burnout Stages • Stress Arousal Stage • Stress Resistance Stage • Severe Exhaustion Stage

27. Stress Arousal Stage • persistent irritability and anxiety • bruxism and/or insomnia • occasional forgetfulness and /or inability to concentrate

28. Stress Resistance Stage • absenteeism or tardiness at work • tired & fatigued for no reason • procrastination & indecision • social withdrawal & cynicism • resentful, indifferent, defiant • increased use of coffee, alcohol, tobacco, etc.

29. Severe Exhaustion Stage • chronic sadness or depression • chronic mental & physical fatigue • chronic stress related illnesses (headache, stomach ache, bowel problems) • isolation, withdrawal, and self-destructive thoughts