StressStress©©

By Abilio Munoz, MDBy Abilio Munoz, MD

September 19, 2007September 19, 2007

ObjectivesObjectives

What is Stress?What is Stress?

What is Too Much Stress?What is Too Much Stress?

Associated Problems Caused by StressAssociated Problems Caused by Stress

Symptoms of StressSymptoms of Stress

Tips to treat your stressTips to treat your stress

Is Stress Good or Bad?Is Stress Good or Bad?

• Hans Hugo Bruno SelyeHans Hugo Bruno Selye “stress is “stress is not necessarily something bad – it all not necessarily something bad – it all depends on how you take it. The stress depends on how you take it. The stress of exhilarating, creative successful of exhilarating, creative successful work is beneficial, while that of failure, work is beneficial, while that of failure, humiliation or infection is detrimental.” humiliation or infection is detrimental.” The biochemical effects of stress would The biochemical effects of stress would be experienced irrespective of whether be experienced irrespective of whether the situation was positive or negative.the situation was positive or negative.

Distress vs. EustressDistress vs. Eustress

• DistressDistress is the most commonly- is the most commonly-referred to type of stress, having referred to type of stress, having negative implications, whereas negative implications, whereas eustresseustress is a positive, desirable is a positive, desirable form of stress. form of stress.

• Both can be equally taxing on the Both can be equally taxing on the body, and are cumulative in naturebody, and are cumulative in nature

Too Much StressToo Much Stress

• common signs that you’ve had too common signs that you’ve had too much excitement and need to slow much excitement and need to slow down include: down include: – Impatience or Edginess Impatience or Edginess – Lack of Enjoyment Lack of Enjoyment – Sleep Problems Sleep Problems – ExhaustionExhaustion

DefinitionDefinition

• Now, the most commonly accepted Now, the most commonly accepted definition of stress is that definition of stress is that stress is a stress is a condition or feeling experienced condition or feeling experienced when a person perceives that when a person perceives that demands exceed the personal demands exceed the personal and social resources the and social resources the individual is able to mobilize.individual is able to mobilize.

Associated ConditionsAssociated Conditions• Anxiety/panic disorderAnxiety/panic disorder

• DepressionDepression

• InsomniaInsomnia

• AngerAnger

• HeadachesHeadaches

• Lack of concentrationLack of concentration

• Lower libidoLower libido

ComplicationsComplications

• High blood pressureHigh blood pressure

• Heart diseaseHeart disease

• StrokeStroke

• ShinglesShingles

• EczemaEczema

• Abdominal pain - IBSAbdominal pain - IBS

SymptomsSymptoms

• Physical – Physical – – HA, HTN, CP, indigestion, magnification HA, HTN, CP, indigestion, magnification

of symptomsof symptoms

• Psychological – Psychological – – depression, anxiety, irritability, depression, anxiety, irritability,

helplessness, sad and sensativehelplessness, sad and sensative

• Behavioral –Behavioral –– Impatience, overeating, procrastination, Impatience, overeating, procrastination,

isolation, poor personal hygiene, isolation, poor personal hygiene, burnoutburnout

MechanismsMechanisms

• Fight or FlightFight or Flight

• General Adaptation Syndrome General Adaptation Syndrome

• The Way We think The Way We think

““Fight-or-Flight”Fight-or-Flight”

• When an animal experiences a threat When an animal experiences a threat or shock, hormones are released or shock, hormones are released which quickly will help escape the which quickly will help escape the problem or deal with shock. problem or deal with shock.

““Fight or Flight”:Only with life Fight or Flight”:Only with life threatening situations?threatening situations?

• Not really:Not really:– recent research shows that we recent research shows that we

experience the fight-or-flight response experience the fight-or-flight response when simply encountering something when simply encountering something unexpected. unexpected.

General Adaptation General Adaptation SyndromeSyndrome

• is response to longer-term exposure is response to longer-term exposure to causes of stress. to causes of stress.

• Three phasesThree phases

Animals React in Three Animals React in Three StagesStages

• First, in the First, in the Alarm PhaseAlarm Phase, they reacted to , they reacted to the stressor. the stressor.

• Next, in the Next, in the Resistance PhaseResistance Phase, the , the resistance to the stressor increased as the resistance to the stressor increased as the animal adapted to, and coped with, it. This animal adapted to, and coped with, it. This phase lasted for as long as the animal phase lasted for as long as the animal could support this heightened resistance. could support this heightened resistance.

• Finally, once resistance was exhausted, Finally, once resistance was exhausted, the animal entered thethe animal entered the Exhaustion Exhaustion Phase, Phase, and resistance declined substantiallyand resistance declined substantially

Normal Life StressNormal Life Stress

• stress is subtle and occurs without stress is subtle and occurs without obvious threat to survival. Most obvious threat to survival. Most comes from things like work comes from things like work overload, conflicting priorities, overload, conflicting priorities, inconsistent values, over-challenging inconsistent values, over-challenging deadlines, conflict with co-workers, deadlines, conflict with co-workers, unpleasant environments and so on. unpleasant environments and so on.

The Way We ThinkThe Way We Think

The way we thinkThe way we think

• How stressed someone feels depends on How stressed someone feels depends on how much damage they think the situation how much damage they think the situation can do them, and how closely their can do them, and how closely their resources meet the demands of the resources meet the demands of the situation. This sense of threat is rarely situation. This sense of threat is rarely physical. It may, for example, involve physical. It may, for example, involve perceived threats to our social standing, perceived threats to our social standing, other people’s opinions of us, our career other people’s opinions of us, our career prospects or to our own deeply held values.prospects or to our own deeply held values.

So you have StressSo you have Stress

• Who cares?Who cares?

You Do. You Do.

• And you will need to take the And you will need to take the appropriate steps to improve it. appropriate steps to improve it.

Examine the Cause of Examine the Cause of StressStress

• Is your job to stressful?Is your job to stressful?

• Are there relationships in your life Are there relationships in your life that are causing stressthat are causing stress

• Family problemsFamily problems

• Financial problemsFinancial problems

• The way you thinkThe way you think

• Do you worry too much about what Do you worry too much about what others thinkothers think

TreatmentTreatment

• Avoid stressorsAvoid stressors

• Change the reaction to stressorsChange the reaction to stressors

• Relieving stress after the reactionRelieving stress after the reaction

Avoid stressorsAvoid stressors

• Learn the power of “NO”Learn the power of “NO”• Set realistic goals and modify your Set realistic goals and modify your

scheduleschedule• Allow plenty of time – make time for Allow plenty of time – make time for

time offtime off• Family time should be relaxing Family time should be relaxing • Avoid Caffeine, enegry drinks, drugsAvoid Caffeine, enegry drinks, drugs• Avoid: ephedra, guarana, synephrine, Avoid: ephedra, guarana, synephrine,

yohimbineyohimbine

Changing the Reaction to the Changing the Reaction to the stressorsstressors

• Exercise: take a pleasure walk. Do a Exercise: take a pleasure walk. Do a repetetive activityrepetetive activity

• Talk to a friend or a love one about Talk to a friend or a love one about day’s event. day’s event.

• Confront interpersonal conflict at workConfront interpersonal conflict at work

• Change your jobChange your job

• Eat healthy/Sleep 8 hrsEat healthy/Sleep 8 hrs

Relieve StressRelieve Stress

• Every once in a while, do something totally Every once in a while, do something totally different and unexpected without prior different and unexpected without prior planning.planning.

• ExerciseExercise

• Listen to musicListen to music

• MassageMassage

• AromatherapyAromatherapy

• Eat healthy/sleep 8 hrsEat healthy/sleep 8 hrs

• If severe, talk to your doctor.If severe, talk to your doctor.

““Don’t” of StressDon’t” of Stress

• Don’t treat by eating, smoking, consuming Don’t treat by eating, smoking, consuming caffeine, alcohol.caffeine, alcohol.

• Don’t cram stress relieving activitiesDon’t cram stress relieving activities

• Don’t do activities that increase excitement Don’t do activities that increase excitement or stress: ie: competitive activitiesor stress: ie: competitive activities

• Don’t procrastinateDon’t procrastinate

• Don’t de-stress by arguing with others.Don’t de-stress by arguing with others.

TipsTips

• Try a repetitive activity – ie vacuuming, Try a repetitive activity – ie vacuuming, shredding paper, mowing the lawn. shredding paper, mowing the lawn.

• If in your car, turns on some tunes. If in your car, turns on some tunes. Clench exercise in your car. Clench exercise in your car.

• Exercise, swimming is greatExercise, swimming is great• Recall a past success. Reflect on how Recall a past success. Reflect on how

you pulled through other stressful you pulled through other stressful situations. situations.

• Back off stressful confrontations. Back off stressful confrontations.

What About Supplements?What About Supplements?

• MultivitaminMultivitamin

• Vitamin C recommended 75 to 90 mgVitamin C recommended 75 to 90 mg

• Calcium: 1500 mg dailyCalcium: 1500 mg daily

• Magnesium: 400 mg dailyMagnesium: 400 mg daily

• Vitamin B complexVitamin B complex