STRESS

1. STRESS Chapter 10

2. Stress • Can be defined as the physical or psychological reaction that an individual has to a demanding or threatening stimulus. • The stimulus can take many different forms such as a test, a job interview, a chronic illness, death of a loved one, marriage, money issues. • What is stressful to one person, may not be stressful to another. • Stress occurs when the perceived demands of a situation exceed the perceived capabilities for meeting the demands.

3. Balancing academic, professional and family responsibilities. Money (or lack of it) Power issues (student/instructor) Scheduling various obligations Living Conditions Class management difficulties Interpersonal relationships (social life) Technology problems (learning, availability, support) Partitioning a work space Becoming a competent career professional College Stressors

4. Stress • The absence of all stress is death! • We are not able to live a stress-free life, but the goal should be to deal with stress, actively and effectively. • Stress helps us to reach our goals. If we did not have stress, we would not be as motivated!

5. Stress • Stress is not limited to negative situations, as it is also a response to pleasurable physical challenges and the achievement of personal goals. • Whether stress is experienced as a negative or positive event, depends upon the person and how we perceive stress. • The situations that trigger physical and emotional reactions (stress) are called the STRESSORS. • The physical and emotional reactions we have are called the STRESS RESPONSE.

6. The Stress Experience as a Whole • Physical, emotional, and behavioral responses are interrelated • Symptoms of excess stress • Physical symptoms: dry mouth, excessive perspiration, frequent illnesses, gastrointestinal problems, grinding of teeth, headaches, high blood pressure, pounding heart, stiff neck, aching lower back • Emotional symptoms: anxiety or edginess, depression, fatigue, impulsiveness, inability to concentrate, irritability, trouble remembering things • Behavioral symptoms: crying, disrupted eating or sleeping habits, harsh treatment of others, problems communicating, sexual problems, social isolation, increased used of tobacco, alcohol or other drugs

7. Stress • Eustress – The good stress or short term stress that strengthens us for immediate physical activity, creativity, and enthusiasm. It is easily identified, externalized and positive. Example – Being excited about graduation from college. You have choices and can influence the outcome of the situation. • Distress – A negative or harmful stress that causes us to constantly readjust or adapt. It usually occurs when we feel no control over our outcomes; we see few or no choices, the source may not be clear and it is prolonged over time. The demands exceed our ability to cope. Feelings of tension, pressure and anxiety result.

8. Death of a loved one Divorce Marital separation Jail Term Personal illness or injury Marriage Fired at work Changes in financial status Pregnancy Retirement Change of residence Major catastrophes Top Life Stressors

9. Stress • Some changes and threats are major and some are everyday problems and minor nuisances of life that cause stress. • Daily Hassles – The irritating and frustrating incidents that occur in our everyday life. Example – The printer runs out of ink when you are ready to print your paper. You lose your keys. A flat tire. • The daily hassles, although less intense and serious than the major life events, occur more frequently and may be even a greater source of stress.

10. Physical Responses To Stress • There are two major control systems in your body that are responsible for your physical response to stressors: Nervous System and Endocrine System. • The Nervous System – brain, spinal cord, nerves-in which part is voluntary (tell the arm to reach for a candy bar) and part is involuntary (the digestion of that candy bar). • Involuntary (Autonomic nervous system) – controls HR, RR,BP and many more. It has two divisions: • Parasympathetic – The relaxed state. Digestion takes place, stores energy, promotes growth. • Sympathetic – The emergency, pain, anger or fear state that enables the body to handle an emergency. It commands the body to stop storing energy and instead use the energy resources to respond to the crisis.

11. Physical Responses To Stressors • Endocrine System – A system of glands, tissues and cells that help control body functions by releasing hormones and other chemical messengers into the blood, to help the body respond to a stressor. Activated by the sympathetic nervous system. • Key Hormones released are cortisol and epinephrine. • These hormones trigger physiological changes such as hearing and vision become more acute, HR ↑ to pump more oxygen to the body, liver releases extra sugar for energy, perspiration ↑ to cool the skin, endorphins are released to relieve pain in case of injury. These almost instant physical changes are called the FIGHT-OR-FLIGHT RESPONSE, a survival mechanism. These physical changes may vary in intensity, but occur in response to any type of stressor.

12. Fight-or-Flight Reaction

13. Return to Normal • Once the stressful situation is over, the parasympathetic division takes over and halts the reaction. • The parasympathetic division restores homeostatis, or the state of stability and consistency in an individual’s physiological functioning. BP, HR, hormone levels and other vital functions are returned to normal. This division calms the body down, returning the body to normal functions such as digestion.

14. Personality Types • Type A – Characteristics include competitiveness, time urgency, impatience, anger, hostility, aggression. • Type B – Characterized by greater passivity, lower levels of competitiveness, slow to anger, easy-going, relaxed. • Type A and Type B behavior occurs on a continuum. • Type A tend to act more intensely to stress, find themselves in more stressful situations due to hurried behavior or competitive situations. Strong link between Type A’s and CHD.

15. Stress and Disease • The role of stress in disease is complex, but it is clear that people with too many stressors, or those who handle stress poorly, are at risk for a wide range of problems. • Short -term Risks – Colds, stiff neck, headaches, dizziness, stomach aches • Long-term Risks – CVD, HTN and impaired immune system, possible correlation to cancers and conditions such as chronic headache and asthma. • HTN is probably the most serious long term effect of stress. The continual ↑ in HR and BP during the stress response can damage blood vessels and arteries. HTN is a MAJOR risk factor of CVD.

16. Coping with Stress • Emotion-focus Coping – Controlling the emotional consequences of stress. “Letting off steam”, using distracters, cognitive strategies to reappraise the situation, or acceptance of the circumstances. • Problem-focused coping – Behaviorally oriented. Individual focuses on what they can do to remove or handle the situation. Example – You lose your job, so you rewrite your resume, search for jobs, sharpen skills. • We often use these two types of coping together. • Example – Accepting the job loss and taking a class to learn new skills.

17. Managing Stress • Stress is not going to go away, so we have to learn how to manage stress. • TIME MANAGEMENT – Often feeling stressed is not having enough time to complete the daily demands. Schedule harder tasks during your most productive time. Set realistic goals. Figure out how long something will take and add 10-15% more time. Consolidate tasks when possible. Stop talking and take action. • EXERCISE – Exercise helps to decrease the stress level and the negative aspects of stress such as anxiety, hostility and tension as well as improving the immune system and cardiovascular health.

18. Managing Stress • Relaxation Techniques – Progressive muscle relaxation has been shown to reduce stress. Visualization. • Social Support – Surround yourself with true friends, family members who are supportive. • Eat Sensibly – Limit or avoid caffeine and sugar. Eat balanced meals. Avoid “junk foods”. • Learn to Accept What You Cannot Change – If the source of stress is beyond your control, try your best to accept the circumstances and focus on the positive aspects of your life. • Get Enough Sleep – Lack of sleep makes you more irritable. Strive for 8 hours of sleep/night. • Avoid Self-Medication – Many chemicals such as alcohol and drugs can mask the stress symptoms, but they do not solve the situation. They are habit-forming and cause more stress. The ability to handle stress comes from within, not from external sources.

19. In order to become the winner that you will respect and admire. . .you must have control of the authorship of your own destiny. . .the pen that writes your life story must be held in your own hand. Irene C. Kassoria