stress makes you distracted,stress makes you distracted, distraught, dumb, and dead albert h. eaton,...
TRANSCRIPT
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STRESS makes you Distracted,Distraught,Dumb, and Dead
Albert H. Eaton, Ph.D., M.Div.
Director of Behavioral ScienceFamily Medicine ResidencyColumbus, Georgia
Debi Hinson, MBA, CHC, CHP, CCEP, CHRC
Chief Research and Associate Compliance OfficerColumbus Regional Health
What is my role in this presentation?
I’m here as the real life “example” of what stress does to you …
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My Personality …
Myers-Briggs personality type: ISTJ
“POLAR BEAR”
Motto: I’ll work it out myself
“Perfection” is typically my goal.
Type “A”: competitive, outgoing, ambitious, impatient, high-strung, hard-driving, control freak …
My Personality …As a child,
• Intense & serious, very mature
• Attracted to interest requiring precision & skill
• Learned best by doing
• Valued routine and structure
• Liked to research and become an “expert”
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My Personality …
As a young person,
• Often more adult than the adults!
• Valued independence, privacy & personal space
• Dependable, loyal & responsible.
My Personality …
As a partner,
• Practical
• Loyal & sensible
• Do not like spontaneity
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My Personality …
At work,
• A task finisher
• Good at understanding & applying the RULES
• Over-represented in accountancy, law, uniformed services, surveying, business administration, management & COMPLIANCE!
STRESS makes you Distracted,Distraught,Dumb, and Dead
Who Manages You?
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What is Stress?
• Threat of job change or loss• Job deadlines or difficult boss• Your spouse demands more time• Your child suffers a loss• Your parent dies• You get promoted• You win the lottery
What distresses you?• Talking to a psychologist
• Talking to an administrator
• Talking to a physician
• Talking to a nurse
• Talking to a patient
• Talking to a judge
• Public speaking
• Flying
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Real Stressors!• Our “Customers”
– External/Internal
– Rules, Regulations, Interpretations
• Customer Delight and Outrage– Sloan Management Review, Fall 1999
– Needs Based
– Security, Justice, and Self-esteem
Real Stressors!• Our Physical Environment
– Traffic, Physical threat
– Economics – food, shelter, water
– Weather and landscape
• Our Social Environment– Family
– Work
– Community
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Real Stressors!
• Ourselves– Biology
– Behavioral patterns
– Thoughts
– Feelings
Stress & It’s Effects …
Back to the Compliance Professional’s Story
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Stress…
If your personality is anything like mine,
Think about all the things that irritate you, that cause you stress…
Now,
Think about the various health events in your life.
Stress…
Compliance Officer for around 20 years…High anxiety – Creating Compliance Programs from the ground up, several Qui Tam litigations, 1st OCR
Security Audit.
Sudden death of my father.
… Panic attack on an airplane.
… Panic attacks in traffic.
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Stress & It’s Effects …
May ‘13 New Job – immediate Qui Tam
Feb ‘14 - Hospitalized: Vestibular Dysfunction
Sep ‘14– Hospitalized: Heart Attack
Nov ‘14 – Hospitalized: ? ? Stroke
Mar ‘15 – Diagnosed: Hypoglycemia
… Dr. Eaton
Then, I heard Dr. Eaton’s presentation to our
Leadership
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Sorry, It’s Not Entirely the Event
• Perceptually mediated
• What is “stressful”??
• Perception is your reality
• What you think you are going through and
• What you are actually going through
Stress and Distress
• Some Stress is normal/desirable– Effective homeostasis
– Coping = return to baseline
• Distress is a problem– Ineffective homeostasis
– Dumb
– Dead
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Psychobiology
• Data– 5 senses– emotions– memory
• Outside of consciousness• Mediated by thoughts
Perception• My reality• Biases my future perceptions• An internal process
– Senses– Emotion– Memory– Schemas, models, frames
• Unconscious and Conscious
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Biology
• Hypothalamic-Pituitary-Adrenal Axis– ACTH
– Cortisol
– Epinephrine
– Norepinephrine
• Increased arousal
• Freeze – overwhelmed arousal
DUMBYerkes-Dodson Law
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Biological responses (short list)
Heart Rate
Respiration
Blood Pressure
Sweating
Muscle tension
Blood to Big Muscles
Blood Glucose
Biological responses (short list)
Blood to gut and gut motility
Immune Response over time
Heart rate variability (HRV)
Cellular repair
Hippocampal cells (memory)
Frontal lobe functioning
Shortens telomeres
Inhibits collagen formation
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The Consequences
• Pain, indigestion, muscle tension
• Difficulty sleeping
• Anxiety/worry
• Distraction/poor awareness
• Loss of Pleasure
• Diabetes risk
• Heart attack risk
The Consequences
• Cancer risk
• Difficulty making decisions - judgment
• Impulsivity
• Diabetes risk
• Heart attack risk
• Shorter Life
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Questions?
15 Minute Break !
Please come back, it could mean the difference between life and death!
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Thinking
• What you think counts
• Determines perception– Threat
– Challenge
– Opportunity
• Can lead to physical arousal
The Consequences
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Dysfunctional Coping
• Alcohol (more than 1-2 drinks)• Food (especially high fat and sweet)• Sad or mad• Sleep (more than 9 hours)• Work (loss of balance)• Exercise (dominating your life)• Sex (overindulgence)• Avoidance
Let’s multitask!93-86-79-72-65-58-51-44-37-30-23-16-9-2
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Coping
• Eat better• Exercise• Recreate• Relax• Change your thinking• Good social connections
Negative Cognitions
• I can’t do this …• He always …• I never …• This will be a disaster• I can’t
– Cope– Change
• Your own negative self-talk
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Thought Stopping
• Changing patterns
• Recognize negative attributions
• STOP!
• The illusion of “Don’t”
• Change thoughts to …
Optimistic Cognitions
• This is an opportunity
• I can really grow through this
• A novel solution will present itself
• I will find help where I least expect it
• How can I see this from another angle
• I will do better if I relax
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Questions?
Feeling
• Let yourself feel!
• What do you feel?
• Do Feelings fit Reality?
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Memory
• How do your memories – affect your perception?– influence your mood?– guide your perception?
• Memory changes– Expectation– Satisfaction
The Effects of Stress
A Mother’s Story
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The Effects of Stress
October 30, 2015
The Effects of Stress
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The Effects of Stress
Normal heart
Takotsubo cardio-myopathy
Resulting in Acute Congestive Heart Failure
The Effects of Stress
… sudden onset of congestive heart failureassociated with ECGchanges mimicking a myocardial infarction of the anterior wall …
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The Effects of Stress
Takotsubo cardiomyopathy…
Stress is the main factor in takotsubo cardiomyopathy, over 85% of cases are set in motion by either a physically or emotionally stressful event that prefaces the start of symptoms. Examples of emotional stressors may include grief from the death of a loved one, fear from public speaking, arguing with a spouse, relationship disagreements, betrayal or financial problems. Acute asthma, surgery, chemotherapy, and stroke are examples of physical stressors.
The Effects of Stress
December 28, 2015
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The Effects of Stress
Diagnosis: Breast Cancer
Physiologically
• How relaxed are you?
• How tense are you?
DO YOU KNOW ?
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Breathing
Psychological First Aid
• Overcome denial – stunned
• Be aware of own response
• Breathe to calm down
• Grasp overall picture
• Establish purpose and task priority
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Writing
• Keep a Journal– Activities
– Thoughts
– Feelings
• A Fifty-word story– Great for a specific event
– Beginning, middle, and end
Long-Term Strategies
• Regular Exercise
• Healthy food
• Yoga
• Tai Chi
• Meditation
• Develop relationships
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Questions?