Stress Management in Adolescents

Stress Management in Adolescents V.Sivaprakasam M.D.,D.C.H.,PGD-AP State President , IAP Tamilnadu 2012 E.B.Member National IAP Nataraja Children’s Hospital Chidambaram Tamilnadu

Managing Stress in Adolescents • Adolescence is the period of heightened Stress • This Heightened Stress is the basis for psychopathology and Suicidal Behaviour • Adolescence is the most common Time of Life for psychiatric illness to emerge • Anxiety Reaches its Lifetime Peak • Suicide is the fourth leading cause of death

Managing Stress in Adolescents Why adolescence is the period of heightened Stress & Turmoil ? Limbic System(where Amygdala is seated) develops earlier than prefrontal control regions The imbalance between the activities of amygdala & ventral prefrontal cortex is the main reason for the heightened emotional behaviour in adolescence

case scenario • +2 student S/o Nephrologists committed suicide for Low marks in +2 • LD student Says Traffic Jam in his brain and not able to read letters It Looks as though Jumping- Now in Kilpauk Mental hospital for Major Psychosis • One 10 th Student Stressed for her irregular Periods by her mother :u r doing sex with some one

FOUR TYPES OF STRESS 1. General Stress: • Everyone has this kind of stress • It resolves itself within a day or two • No intervention is necessarily required

FOUR TYPES OF STRESS 2. Cumulative Stress: • Stress builds up in your body • It becomes more difficult to alleviate your symptoms • You may have more serious physical symptoms • You may have more serious mental anguish

FOUR TYPES OF STRESS 3. Acute Traumatic Stress: • Critical Incident Stress • Produces considerable psychological distress • A normal reaction to abnormal events

FOUR TYPES OF STRESS 4. Post Traumatic Stress: • Severe stress produced by severe psychological trauma • Created by unresolved Critical Incident Stress • Produces lasting changes

General Adaptation Syndrome • Stage I - Alarm Reaction • The “fight or flight” response which causes you to be ready for physical activity • However, it decreases the effectiveness of the immune system which makes you more susceptible to illness

General Adaptation Syndrome • Stage II – Stage of adaptation • If stress continues, the body adapts to the stressors it is being exposed to • If the stressor is starvation, the person experiences a reduced desire for physical activity to conserve energy, and the absorption of nutrients from any food intake is maximized

General Adaptation Syndrome • Stage III – Stage of Exhaustion • Stress persists for a long time • The body’s resistance may be reduced or collapse quickly • People who experience long-term stress may have heart attacks, severe infections, or chronic pain or illness

How to handle • Take appropriate history • Varied Symptoms may not directly indicate Stress • Ask him to write it down .What causes Stress • How he suffer, How he is able to manage • Identify the Stressor • Individual counseling

Counseling • Write down the problem • What is the trigger factor (Stressor) • What Coping Technique he Adopt • How he feels • How frequently he is Stressed • Whom do he wants to Communicate

How to Proceed • Stress is common in every Adolescent • When it Increases _Distress • It affects –Cognitive Function • Emotional Function • Socialization • Behavor

Who all involved • Concern Adolescent • Family • Friends • Therapist • Occupational Therapist • Child Psychiatrist • Adolescent Physician

Therapist How to proceed • Adolescent aware of the Problem • Accept the Problem & suffering • Willing to come out of the Problem • His life can be lead by himself

Assessment • Is there a problem? • What is the problem? • What is the extend of the problem? • What is the cause of the problem? • What could be done to Solve the problem? • Who should do it? • How to do it?

What Therapist Decide • How many sessions ? • How long? • Strength & weakness of the Adolescent. • How to Approach the problem?

Non Pharmacological Therapy • Individual Psycho Therapy • Group Psycho Therapy • Family Therapy • Cognitive Behavioral Therapy

Pharmacological Therapy • Anti Depressants • Anxiolitic Agents • Anti Psychiatric Drugs

Stress • Stress –The way our body and mind react to life changes • Adolescents and stress ? Teens are under more stress Since adolescence is a period of significant changes physical, emotional, social, and academic changes many than at any other time of life.

Is STRESS good or bad for us ?: • EUSTRESS” Some amount of stress is essential for us to excel in life. This is good stress • DISTRESS ““ when stress is too much then it reduces performance . This is bad stress

Stress in Adolescents • Deteriorating school performance • Inability to sleep or excessive sleep • Losing or gaining weight • Feeling low or tired all the time • Mood swings : crying, getting angry Not wanting to talk to anybody

Managing Stress in Adolescents Identifying Major Sources of Stress “ When demand exceeds readily available energy, we rely on stress to force our system to meet the circumstances”

Managing Stress in Adolescents Three steps in Managing Teen Stress • Identifying Major Sources of Stress • Recognising the warning Signs of Stress • Controlling the Gate Keepers

Managing Stress in Adolescents Recognising the warning signs of stress a) Beware of constant fatigue I feel Tired all the time(wear your outlook down) b) Beware of nagging discomfort I worry and ache all the time (can Hurt) c) Beware of Burnout I have lost caring for what I usually cared about(depressing) d) Beware of Breakdown I cant seem to get myself going any more ( debilitating)

Effects of stress • stress causes you be to live with. Fatigue • makes you feel negative • can cause you to become critical. • Discomfort that makes you oversensitive can cause you to act irritable. • Burnout that makes you insensitive can cause you to act nonresponsive. ‘ • ‘breakdown that makes you stop functioning can cause you to act unavailable. So if you come home or end the day feeling Stressed • Talk it out by explaining and don’t act it out

Managing Stress in Adolescents Controlling the Gate Keepers A) Goals B) Standards C) Limits

Goal • with how much she wants to accomplish for herself. • This is the problem of ambition. If she is committed to becoming a cheerleader, working extra • trying out for the lead in the high school play, she is creating a very high demand life for herself, • one that has a high likelihood of stress.

Standards • have to do with how well she must perform all the time • . This is the problem of perfection. • If she is determined to maintain a 4.0 grade average, • to win all competitions, and to never make a mistake, • stress is more likely to come her way.

Limits • respond to the wants of others. • must satisfy all that others desire • must not displease or disappoint anyone, • must not turn anyone down, then • social relationships can become extremely stressful.

Family Life Education • Body image Not happy with the way you look • self-conscious feel everyone is staring at you • Color, short stature, White Discharge • Breast Size, Penis size, Beauty,

Life Skill Education • Abilities for adoptive and positive behavior that enables individuals in making informed choices in the face of complex life situations

DIFFERENT TYPES OF LIFE SKILLS (WHO) • Self awareness • Empathy • Interpersonal relations • Effective Communication • Critical thinking • Creative thinking • Decision making • Problem solving • Coping with emotions • Coping with stress

Be more assertive • Deal with problems head on, doing your best to anticipate and prevent them. • If you’ve got an exam to study for and your chatty roommate just got

Stress and Performance: • Dealing more effectively with stress improves performance and the quality of life It is like salt and pepper to life • So all efforts should be to convert all stresses into EUSTRESS –This can be achieved by stress management techniques All stresses can be GOOD

Stress Management • Stay positive to help friends and family cope with stress. • Let others know you're feeling overwhelmed and tell them how they can help. • Allow yourself to simply say "no" to friends and family when you know you cannot meet their demands without becoming overwhelmed.

Time Management • Be prepared for unexpected problems such as traffic, a lost pet or a family emergency. • Prioritize. • Take control of your "to do" list by deciding what's really most important on your list.

HEALTHY LIVING • Learn to manage your anger • Anger affects your health • Anger causes you to over react to many situations

Write down feelings of sadness, frustration or anger to get a clearer perspective of your emotions

Alter the situation • : Alter the situation If you can’t avoid a stressful situation Express your feelings instead of bottling them up • If something or someone is bothering you, communicate your concerns in an open and respectable way, try to alter it • Be willing to compromise. When you ask someone to change their behavior, be willing to do the same

: Adapt to the stressor • If you can’t change the stressor, change yourself • You can adapt to stressful situations and regain your sense of control by changing your expectations and attitude. Reframe problems. • Try to view stressful situations from a more positive perspective. Rather than fuming about a traffic jam

Focus on the positive • . If you see good things about yourself, you are more likely to feel good • Eliminate words such as "always," "never," "should," and "must." • These are telltale marks of self-defeating thoughts. • Do what you can, with what you have, where you are.

: Accept the things you can’t change • . You can’t prevent or change stressors such as the death of a loved one, a serious illness, or a national recession. • The best way to cope with stress is to accept things as they are. • . Don’t try to control the uncontrollable (Behavior of other People)

Look for the upside • .” When facing major challenges, try to look at them as opportunities for personal growth. • . Share your feelings. Talk to a trusted friend or make an appointment with a therapist. • Expressing what you’re going through can be very cathartic, even if there’s nothing you can do to • . Learn to forgive. Accept the fact that we live in an imperfect world and that people make mistakes. Let go of anger

Exercise • . Exercise on a regular basis helps to turn down the production of stress hormones and associated neurochemicals. • Thus, exercise can help avoid the damage to our health that prolonged stress can cause. In fact, studies have found that exercise is a potent antidepressant, anxiolytic (combats anxiety), and sleeping aid for many people

HEALTHY LIVING • Exercise: • At least twenty minutes, five times a week • break a sweat, to release endorphins

Stress Management- Diet • Have healthy eating habits never skip breakfast • Reduce sedentary activities like TV Video games etc. • Eat healthy nutritious food. • Avoid Junk food . Avoid excess caffeine intake eg tea coffee chocolates and cola drinks

Sweets, oils, fats Milk Meat Fruits Vegetables Cereals, legumes, roots, tubers FOOD PYRAMID There is a saying that the total amount of food one eats in his/her life time is the same. Only that some eat it so early and become ill and others spread it over the whole life time!

8hrs of Sleep

Stress Management in Adolescents