A Presentation for the SOMC Medical Imaging Department Kendall L. Stewart, MD, MBA, FAPA

1. The Portable Mentor Presentation Series Dealing WithStress Some Practical Questions & Answers A Presentation for the SOMC Medical Imaging Department Kendall L. Stewart, MD, MBA, FAPA March 2, 2002 SOMCPress

2. Even the smallest sustained change takes real effort. “Parking the Impala” What’s in this forme? • Stress happens! • Stress can and does diminish the quality of our lives. • You can learn to cope more effectively with stress. • Individualized approaches are the only ones that work. • This presentation may produce some insights that you can use.

3. We are all like balls connected with strings. “Jonathan’s trials as a first year teacher.” What isstress? • A physical, chemical or emotional factor that causes bodily or mental tension and may be a factor in disease causation • Bodily or mental tension resulting from factors that tend to alter an existing equilibrium

4. And we call it women’s liberation. “Claudia gesturing, on phone and pulling away with the door open.” What are some of the common unpleasantstressesin our lives? • Illness • Unemployment • Conflict • Increasing demands • Crime • Death • Information overload

5. A woman won the lottery. She asked the preacher to tell her husband. What are some of the common pleasantstressesin our lives? • Retirement • Vacation • New baby • Moving • New job • New phase of life • Children leaving home • Family visits

6. How are stress andhealthrelated? • More than 200 points on the Social Readjustment Assessment Scale in one year was associated with an increased incidence of • Myocardial infarction • Psychiatric illness • Peptic ulcer disease • Infection

7. Your first day on a new job, look cool. “You look more like one of us.” What are therelative scoresof some common life events?

8. Whatdisordersare negatively affected by stress? • Psychiatric disorders • Cardiovascular disorders • GI disorders • Neurological disorders • Musculoskeletal disorders

9. Denial is a powerful defense. “Your racehorse, Suzy, called today.” What are somepsychologicalresponses to stress? • Irritability • Preoccupation • Difficulty with concentration • Anxiety • Depression • Sleep changes • Avoidance • Psychological defense mechanisms

10. Stress can be very uncomfortable. “Treating a MI patient in the Air Force” What are somephysiologicalresponses to stress? • Increased heart rate • Increased respiration • Increased perspiration • Diarrhea • Tremor • Flushing

11. You can know too much. “We hope to get better speakers next year” What factorsoften distract us from the realization that we are stressed? • Time pressure • Demand for productivity • Emphasis on quantity • Materialism • Competition • Selfish interests • No sense of purpose or meaning • Longer task lists • Resentment

12. Working harder Taking it out on others Withdrawing Ignoring issues Congregating with other miserable people Doing nothing Eating Drinking Using chemicals Indulging in pathologic relationships Ruminating Being a couch potato Forget changing others. Change yourself. “Waiting on my wife” What are someunhealthy strategies?

13. Even ugly pictures look better in an attractive frame. “Reframing on call duties as ministry” What are some healthymental strategies? • Meditation • Healthy distraction • Thought stopping • Ventilation • Reframing • Ignoring • Assertiveness • Prayer

14. Few of us enjoy vigorous exercise. “Combine it with something your do enjoy. What are some healthyphysicalstrategies? • Exercise • Proper diet • Recreation • Avoidance of stressful situations • Lifestyle change • Physical labor • Use of sensory override techniques

15. Celebrate small accomplishments. “Climbing Camelback mountain” What are some suggestednext steps? • Decide whether stress is an issue you want to address in your life. • Decide on your priorities. • Make a commitment. • Identify measures of your success. • Organize your “project team.” • Set incremental goals. • Celebrate all progress. • Be realistic.

16. Whatinsightscan I take away? • Stress happens. • Not all stress is bad. • There are many successful strategies for minimizing the negative impact of stress on our lives. • The most effective strategies are individualized and dynamic. • Dealing more effectively with stress will improve your productivity and the quality of your life.

17. Where can I learnmore? • Stewart, Kendall L, Stress Management: Dealing Effectively with Stress at Work and in Life. A SOMC White Paper, 2002. (Watch for it on http://www.somc.org) • Davis, Martha, McKay Matthew and Eshelman, Elizabeth Robbins, The Relaxation & Stress Reduction Workbook. 5th ed., New Harbinger Publications, 2000. • Carnegie, Dale, How to Stop Worrying and Start Living. Pocket Books, 1985. • Weeks, Claire, Hope and Help for your Nerves. Signet, 1991. • Davidson J. The Complete Idiot’s Guide to Managing Stress, Alpha Books, 1996 • How to Master Stress http://www.mindtools.com/smpage.html

18. How can we contact you? Kendall L. Stewart, M.D. Medical Director Southern Ohio Medical Center 1805 27th Street Portsmouth, Ohio 45662 740.356.8153 stewartk@somc.org www.somc.org

19. Whatquestionsdo you have? Southern Ohio Medical Center SafetyQualityServiceRelationshipsPerformance www.somc.org