stress stress. stress an estimated 75-90% of visits to primary care physicians are for stress-...

STRESSSTRESS

StressStress

• an estimated 75-90% of visits to an estimated 75-90% of visits to primary care physicians are for stress- primary care physicians are for stress- related issues and problemsrelated issues and problems

• job stress is a major source of stressjob stress is a major source of stress

in adultsin adults

• children, teenagers, students, and the children, teenagers, students, and the elderly are also feeling more stresselderly are also feeling more stress

StressStress

• what causes you stress?what causes you stress?

• identify your major stressorsidentify your major stressors

• what happens when you are under what happens when you are under stress?stress?

• what is all this stress doing to you?what is all this stress doing to you?

Types of StressorsTypes of Stressors

• psychological issuespsychological issues

• environmental concernsenvironmental concerns

• poor nutritionpoor nutrition

• role conflict/ambiguity, multiple rolesrole conflict/ambiguity, multiple roles

• sociological, political, ethnic, cultural issuessociological, political, ethnic, cultural issues

• physical illness/disabilityphysical illness/disability

• biomechanical (repetitive strain)biomechanical (repetitive strain)

• developmental issuesdevelopmental issues

FIGHT OR FLIGHTFIGHT OR FLIGHT

• contemporary stress more pervasive, contemporary stress more pervasive,

insidious, and persistentinsidious, and persistent

• this reaction stems primarily from this reaction stems primarily from psychological rather than physical stresspsychological rather than physical stress

and causes ingrained and immediate and causes ingrained and immediate reactions that were originally designed reactions that were originally designed to help us in emergency situationsto help us in emergency situations

The Stress ReactionThe Stress Reaction

• heart rate and blood pressure increaseheart rate and blood pressure increase• there is also increased blood flow to the there is also increased blood flow to the

brain for decision-making activitybrain for decision-making activity• blood sugar level increases for more blood sugar level increases for more

energy (glycogen released)energy (glycogen released)• blood is shunted from G/I tract to large blood is shunted from G/I tract to large

muscles for strength to fight or take flightmuscles for strength to fight or take flight• clotting occurs quickly to prevent blood clotting occurs quickly to prevent blood

lossloss

The Stress ReactionThe Stress Reaction

• adrenaline, cortisol and other stress adrenaline, cortisol and other stress hormones are released into the hormones are released into the bloodstreambloodstream

• the mouth becomes drythe mouth becomes dry

• the immune symptom is dampenedthe immune symptom is dampened

• the skin is cool due to sweatingthe skin is cool due to sweating

• the scalp tightensthe scalp tightens

The Stress ReactionThe Stress Reaction

• this reaction is fine when confronted this reaction is fine when confronted with a sabre-tooth tiger, but in the with a sabre-tooth tiger, but in the modern world is not adaptivemodern world is not adaptive

• today, most of our stress is today, most of our stress is psychologicalpsychological

and not physical in origin (for and not physical in origin (for example, getting stuck in traffic or example, getting stuck in traffic or taking an exam)taking an exam)

JOB STRESSJOB STRESS

-occupational pressures are responsible for:-occupational pressures are responsible for:30% of workers suffering from back pain30% of workers suffering from back pain

--28% complaining of "stress"28% complaining of "stress"

--20% feeling very fatigued20% feeling very fatigued

--17% experiencing muscular pains17% experiencing muscular pains

--13% with headaches13% with headaches

Workplace StressWorkplace Stress

• damages relationshipsdamages relationships

• reduces job satisfactionreduces job satisfaction

• reduces productivityreduces productivity

Work StressorsWork Stressors

• lack of participation in decisions affecting lack of participation in decisions affecting youyou

• unrelenting/unreasonable demandsunrelenting/unreasonable demands

• poor communication & conflict resolutionpoor communication & conflict resolution

• lack of job securitylack of job security

• long hours & lots of time away from homelong hours & lots of time away from home

• office politics and conflictsoffice politics and conflicts

• wages don’t equal level of responsibilitywages don’t equal level of responsibility

Physiologic EffectsPhysiologic Effects

• inability to adapt to stress is associated with inability to adapt to stress is associated with depression & anxietydepression & anxiety

• stress may disrupt serotonin (well being) levels stress may disrupt serotonin (well being) levels • acute stress associated with higher risk of acute stress associated with higher risk of heart arrhythmias & heart attacksheart arrhythmias & heart attacks• fat released into bloodstream &fat released into bloodstream & increases cholesterol levelsincreases cholesterol levels• chronic stress in women may reducechronic stress in women may reduce insulin levelsinsulin levels• muscle and joint painmuscle and joint pain

Conditions Increasing Conditions Increasing Susceptibility to StressSusceptibility to Stress• poor early nurturingpoor early nurturing

• personality traitspersonality traits

• genetic factorsgenetic factors

• immune system diseases can impairimmune system diseases can impair

response to stressresponse to stress

• the longer and more intense the stress,the longer and more intense the stress,

the more harmfulthe more harmful

Those At Higher RiskThose At Higher Risk

• in the young and the elderly, stress may in the young and the elderly, stress may go unnoticed or be ignoredgo unnoticed or be ignored

• women more than menwomen more than men• working mothers encounter more stress working mothers encounter more stress

due to greater and more diverse work due to greater and more diverse work loadload

• divorced or widowed peopledivorced or widowed people• the unemployedthe unemployed• urban dwellers more than suburbanitesurban dwellers more than suburbanites

ELDERLYELDERLY

• often exposed to major stressorsoften exposed to major stressors

• medical problemsmedical problems

• loss of spouse and friendsloss of spouse and friends

• change in living conditionschange in living conditions

• financial worriesfinancial worries

• loss of controlloss of control

CAREGIVERSCAREGIVERS

• of physically or mentally disabled of physically or mentally disabled families face chronic stressfamilies face chronic stress

• spouses of disabled partner have spouses of disabled partner have more stress-related problemsmore stress-related problems

ANGRY PERSONALITIESANGRY PERSONALITIES

• less emotionally stable or those withless emotionally stable or those with

high anxiety may “catastrophize”high anxiety may “catastrophize”

• there is an association between anger, there is an association between anger, irritability, hostility and narrowing of the irritability, hostility and narrowing of the arteriesarteries

• also being self-conscious in public and also being self-conscious in public and suppressing angersuppressing anger

• combined with low social support, the combined with low social support, the situation is worsesituation is worse

Strategies to Help Deal with Strategies to Help Deal with StressStress

• a healthy lifestyle, good nutrition/exercisea healthy lifestyle, good nutrition/exercise

• cognitive-behavioral therapycognitive-behavioral therapy

• identifying stress and learning to relaxidentifying stress and learning to relax

• attitude– “grant me the serenity to accept attitude– “grant me the serenity to accept the things I cannot change, courage to the things I cannot change, courage to change the things I can, and the wisdom change the things I can, and the wisdom to know the difference.”to know the difference.”

SELF-EFFICACYSELF-EFFICACY

• efficacy is the capacityefficacy is the capacity

to accomplish tasksto accomplish tasks

• self-efficacy is the perceived ability to self-efficacy is the perceived ability to handle problems & overcome hardshiphandle problems & overcome hardship

• stress is minimal when you can look stress is minimal when you can look upon problems as opportunities to upon problems as opportunities to overcome adversity & gain experienceovercome adversity & gain experience

Perception & AssessmentPerception & Assessment

• keep it in perspectivekeep it in perspective

• ask yourself, “what is the worst ask yourself, “what is the worst

that can happen?that can happen?

• can we look for an unexpected benefit?can we look for an unexpected benefit?

• assess the situation, consider past experienceassess the situation, consider past experience

• problem-solve (take action)problem-solve (take action)

• make a decision regarding actionmake a decision regarding action

vs acceptance of the situationvs acceptance of the situation

Risk for BurnoutRisk for Burnout

• having lofty idealshaving lofty ideals

• getting impatient/annoyed frequentlygetting impatient/annoyed frequently

• only your ideas arerightonly your ideas areright

• blaming yourself (“shoulds”)blaming yourself (“shoulds”)

• tendency to blame otherstendency to blame others

• feeling you have to do everything yourselffeeling you have to do everything yourself

• equally upset about minor hasslesequally upset about minor hassles

• feeling you have more to do and less & less feeling you have more to do and less & less timetime

Burnout StagesBurnout Stages

• Stress Arousal StageStress Arousal Stage

• Stress Resistance StageStress Resistance Stage

• Severe Exhaustion StageSevere Exhaustion Stage

Stress Arousal StageStress Arousal Stage

• persistent irritability and anxietypersistent irritability and anxiety

• bruxism and/or insomniabruxism and/or insomnia

• occasional forgetfulness and /or occasional forgetfulness and /or

inability to concentrateinability to concentrate

Stress Resistance StageStress Resistance Stage

• absenteeism or tardiness at workabsenteeism or tardiness at work

• tired & fatigued for no reasontired & fatigued for no reason

• procrastination & indecisionprocrastination & indecision

• social withdrawal & cynicismsocial withdrawal & cynicism

• resentful, indifferent, defiantresentful, indifferent, defiant

• increased use of coffee, alcohol,increased use of coffee, alcohol,

tobacco, etc.tobacco, etc.

Severe Exhaustion StageSevere Exhaustion Stage

• chronic sadness or depressionchronic sadness or depression

• chronic mental & physical fatiguechronic mental & physical fatigue

• chronic stress related illnesses chronic stress related illnesses

(headache, stomach ache,(headache, stomach ache,

bowel problems)bowel problems)

• isolation, withdrawal, andisolation, withdrawal, and

self-destructive thoughtsself-destructive thoughts