Chapter 3Chapter 3

Managing Stress: Toward Prevention and Control

STRESS & STRESS MANAGEMENT

So what is STRESS anyway?

• StressStress is a mental and physical response of our bodies to change in our lives!

• Neither positivepositive or negativenegative

Stressor:Stressor:

A physical, social or A physical, social or psychological event that psychological event that requires us to adjust!requires us to adjust!

Adjustment:Adjustment:

attempt to cope with the attempt to cope with the situation!situation!

THE NATURE of STRESS

• The non-specific response of the body to any demand made upon it

• External - environment, people,situations,

elements

• Internal mental process (worry, fear, happiness)

• Whether real or perceived or physiological (drugs, chemicals, etc.)

It’s not the years it’s the mileage!Strain:Strain:

• wear and tear our wear and tear our bodies and minds bodies and minds sustain as we sustain as we adjust to a adjust to a stressorstressor

STRESS and DESTRESSSTRESS and DESTRESS• Disturbance of the Disturbance of the

Homeostatic BalanceHomeostatic Balance

• Physiological Physiological Equilibrium of the Equilibrium of the bodybody

A Non-Specific ResponseA Non-Specific Response

• All stressors are All stressors are processed the same processed the same way physiologically way physiologically by our bodiesby our bodies

• Fight or Flight Fight or Flight ResponseResponse

THE ROLE of PERCEPTIONTHE ROLE of PERCEPTION• How stress is perceived effects the

intensity of the response

• Physical - nutrition, strength, nutrition, strength, endurance, immune system……,endurance, immune system……,

• Social - people, rejection, - people, rejection, loneliness, arguments……,loneliness, arguments……,

• Intellectual - - burnout, burnout, overload,frustration, sense of selfoverload,frustration, sense of self

• Spiritual - lack of meaning, moral - lack of meaning, moral conflicts, guiltconflicts, guilt

Stress Response• Stress can be positive or Stress can be positive or

negativenegative• Physiological outcome the Physiological outcome the

samesame

• Heart RateHeart Rate• Blood PressureBlood Pressure• Breathing RateBreathing Rate• Perspiration ratePerspiration rate

Freedom from Stress is DeathFreedom from Stress is Death

• We need to make the DISTICTION between the

STRESSOR and STRESS Response

++ ++ ==

Stress and Performance

STRESSSTRESS

PE

RF

OR

MA

NC

EP

ER

FO

RM

AN

CE

THE JOY of STRESSTHE JOY of STRESS

• Hanson (1986)

…… optimal stress loads optimal stress loads result in longevity andresult in longevity and

Peak PerformancesPeak Performances

• Activity vs. inactivityActivity vs. inactivity• Intellectual Health vs. Intellectual Health vs.

Mindless ActivitiesMindless Activities• Challenges vs. Boredom Challenges vs. Boredom

Phase #1Phase #1 The ALARMThe ALARM

• ““Acute stress response” Physiological Signs Acute stress response” Physiological Signs and Symptomsand Symptoms

• Adrenal GlandsAdrenal Glands

• muscles / heart / circulation / respiratory rate / muscles / heart / circulation / respiratory rate / nervous systemnervous system

Fight or Flight - involuntary response toFight or Flight - involuntary response to

actual danger or perceived dangeractual danger or perceived danger

Phase #2 - ResistancePhase #2 - Resistance

• Physical symptoms Physical symptoms disappeardisappear

• Repeated and resistance Repeated and resistance increases above baselineincreases above baseline

• Adaptation - homeostasis Adaptation - homeostasis reduced time to recoveryreduced time to recovery

Phase #3 -Repeated or Phase #3 -Repeated or Sustained StressSustained Stress

• ExhaustionExhaustion results if results if insufficient recovery time insufficient recovery time is availableis available

• Fatigue of the bodyFatigue of the body• Muscles, cognitiveMuscles, cognitive• Function,organs,Function,organs,• Immune systemImmune system

Alarm Stage……brain perceives stressor brain perceives stressor (real or imaginary) as threat, Cerebral Cortex (evaluates (real or imaginary) as threat, Cerebral Cortex (evaluates situation)…………consciously or unconsciouslysituation)…………consciously or unconsciously…...…...

• Autonomic Nervous System(ANS)

• Sympathetic Nervous Sympathetic Nervous SystemSystem

• fight or flight - released several stress hormones

• physiological reactionphysiological reaction• Parasympathetic Nervous Parasympathetic Nervous

System - return to System - return to homeostasishomeostasis

Stress and Homeostasis: A Balance

• Sympathetic and Sympathetic and parasympatheticparasympathetic

• Nervous SystemNervous System• Balance out day to dayBalance out day to day• Unless prolonged stressUnless prolonged stress• then body suffers from then body suffers from

the excessive stressthe excessive stress• Burnout, chronic fatigue Burnout, chronic fatigue

and illness………..and illness………..

The HypothalamusThe Hypothalamus

• Control centre- directs stress Control centre- directs stress response - SNSresponse - SNS

• stimulates adrenal glands - stimulates adrenal glands - epinephrine (adrenaline) epinephrine (adrenaline) heightened F or F responseheightened F or F response

• triggers PITUITARY gland - triggers PITUITARY gland - releasing adrenocorticoticotrophic releasing adrenocorticoticotrophic hormone (ACTH) - triggers release hormone (ACTH) - triggers release of Cortisol - releasing stored energyof Cortisol - releasing stored energy

• endorphins released within brainendorphins released within brain

decreases pain caused by stressorsdecreases pain caused by stressors

The Mind Body Connection: Physiological Responses

• Some Physical and EmotionalSome Physical and Emotional Interactions - BREAK-us down Interactions - BREAK-us down over timeover time

• All Body systems are targets (long All Body systems are targets (long term exposure)term exposure)

• Highly Stressed Individuals - Highly Stressed Individuals - cardiovascular disease, cardiovascular disease, hypertension, frequent colds/viruseshypertension, frequent colds/viruses

• This is why we are concerned …This is why we are concerned …STRESSSTRESS

Psychoneuroimmunology (PNI)

………….. The relationship between .. The relationship between stress and the immune systemstress and the immune system

STRESS

levels of adrenal hormones

White Blood Cells - “natural killer T cell”

T cells chance of illness

many factors are involved …… many factors are involved …… more research is more research is required………!required………!

Adaptation Energy Stores

Mental/physicalMental/physical

foundations to cope with stressfoundations to cope with stress

Two Levels:Two Levels:

• DeepDeep - heredity/ present in each cell

• SuperficiaSuperficial- surrounds deep stores / first defense and renewable

• when deep stores are gone organism dies!

Must Replenish Adaptation Stores

• ExerciseExercise• RelaxationRelaxation• Stress ManagementStress Management• Time ManagementTime Management• HealthHealth• NutritionNutrition• Emotional HealthEmotional Health

• …….you get the idea !!!!!!!.you get the idea !!!!!!!

CNS PATHWAYS and STRESSInvoluntaryInvoluntary • Sympathetic NS pathway • adrenal glands• very fast • increased response / performance

Conscious VoluntaryConscious Voluntary• Cerebral cortex• perception of danger• emotional influence• pituitary gland stimulates adrenal

glands

Psychosocial Sources of Stress……...Psychosocial Sources of Stress……...ChangeChange

• The greater the changechange the

greater the stress!

HasslesHassles• petty annoyances, irritations petty annoyances, irritations

frustrations………..frustrations………..

PressurePressure• work, school, deadlines, goals……..

Inconsistent Goals and BehavioursInconsistent Goals and Behaviours• conflict between goals and behaviours

Continued Psychosocial Stressors

ConflictConflict• most common / job, friends, family etcmost common / job, friends, family etc

OverloadOverload• excessive, time pressure, responsibility, excessive, time pressure, responsibility,

lack of support, expectationslack of support, expectations

BurnoutBurnout• physical and mental exhaustion -caused by physical and mental exhaustion -caused by

overloadoverload

Other forms of PsychosocialOther forms of Psychosocial StressStress• injustice, racism, gender, lifestyleinjustice, racism, gender, lifestyle,

unemployment…………..

REFLEX INVOLUNTARY

• Immediate response to pain

• heat• physical pressure

Psychosomatic Disease• Emotional / psychosomatic originsEmotional / psychosomatic origins• Psychogenic (emotional stress)Psychogenic (emotional stress)• structural & functional disorders structural & functional disorders

such as headaches, ulcers, asthmasuch as headaches, ulcers, asthma• Somatogenic Psychosomatic Somatogenic Psychosomatic

DisordersDisorders• when the body’s resistance is when the body’s resistance is

loweredlowered• CHD, backache, blood pressureCHD, backache, blood pressure• A wide variety of disorders can be A wide variety of disorders can be

attributed to perception of stressattributed to perception of stress

Stress Related Disorders and/orDeath• Cancer

• Intellectual Dysfunction

• Heart Disease• Colds• Flu• stress fractures• Burn out• psychosocial disorders

Personality TypeType A - stress pronestress prone

• aggressive /hostile attitudes & behavioraggressive /hostile attitudes & behavior

Type B - stress resistantstress resistant

• relaxed, easy-goingrelaxed, easy-going

Hardy Personality - stress resistant personalitystress resistant personality

commitment, control and challengecommitment, control and challenge

Anxious-Reactive PersonalityAnxious-Reactive Personality - hypersensitivity - hypersensitivity

to stressors to stressors

• anticipate the worse - initiate stress perceptionanticipate the worse - initiate stress perception

STRESS MANAGEMENT• Negative Stress = DistressNegative Stress = Distress

Positive Stress = EustressPositive Stress = EustressStress ManagementStress ManagementIdentify the stressors, symptoms Identify the stressors, symptoms and triggersand triggers

• Awareness - Awareness - Psychological Psychological Considerations in stress Considerations in stress managementmanagement

• PerceptionPerception

• Perception, Memory, Perception, Memory, Appraisal Process, Emotion, Appraisal Process, Emotion, PersonalityPersonality

Coping Styles VaryCoping Styles Vary• Passive vs.. ActivePassive vs.. Active

• Denial vs.Denial vs.

Thinking/problem Thinking/problem

solvingsolving

• Reflective vs. ImpulsiveReflective vs. Impulsive

• Proactive steps to Proactive steps to dealing with the stressordealing with the stressor

• admitting there is a admitting there is a problem & developing a problem & developing a solution to resolve the solution to resolve the situationsituation

• evaluating how you evaluating how you responded to a stressful responded to a stressful situationsituation

• actions / consequencesactions / consequences

Checklist for Coping with Stress

ID source of stressID source of stress physical responsesphysical responses Evaluate realistically / Evaluate realistically /

avoid or modifyavoid or modify Select appropriate coping Select appropriate coping

mechanismsmechanisms Develop positive attitudesDevelop positive attitudes Improve resistance to stressImprove resistance to stress Cultivate positive lifestyle Cultivate positive lifestyle

habitshabits

COPING COPING BEHAVIOURSBEHAVIOURSthe good, the bad and the uglythe good, the bad and the ugly

• APPROPRIATE• physical activityphysical activity

• relaxationrelaxation

• seeking supportseeking support

• time managementtime management

• reflectionreflection

• positive avoidancepositive avoidance

• professional helpprofessional help

• stress management programsstress management programs

• positive self talkpositive self talk

• INAPPROPRIATE• drugsdrugs

• alcoholalcohol

• foodfood

• smokingsmoking

• physical/verbal abusephysical/verbal abuse

• negative ego defense: denial, negative ego defense: denial, ignoring, suppressing, ignoring, suppressing, rationalization, lashing outrationalization, lashing out

• self bashingself bashing

Essential KeysEssential Keys

• Daily routinesDaily routines• Time ManagementTime Management• RelaxationRelaxation• Goal Determination, Goal Determination,

identification of identification of barriers to goalsbarriers to goals

• setting prioritiessetting priorities• learn to say ‘NO’learn to say ‘NO’• DelegateDelegate

• Break large tasks into Break large tasks into smaller componentssmaller components

• Your human - can’t do Your human - can’t do everythingeverything

• Develop hobbies and Develop hobbies and skillsskills

• Do something new Do something new and differentand different

• Develop support Develop support mechanismsmechanisms

Stress and Exercise

Reduction of acute & chronicReduction of acute & chronic

muscle tensionmuscle tension

• fight or flight mechanism reduces intense muscle tension

• Hormone UtilizationHormone Utilization

• Hypothalamus Controls/Regulates all hormones

• Adrenal medulla epinephrine & norepinephrine Physical Endurance

• Cardiovascular / Muscular Cardiovascular / Muscular

body improves resistance to stress reactions

Endorphins, Norepinephrine,Serotonin and Dopamine

• Naturally occurring chemicals• Sense of euphoria / wellbeing• natural pain blockers• Neurotransmitters located in the brain and

other regions of the body• antidepressants - increase energy and lift

mood• low levels of serotonin and dopamine

associated with depression• all released with sustained exercise

RELAXATIONOPPOSITE of STRESS RESPONSEOPPOSITE of STRESS RESPONSE

• MEDITATION

• IMAGERY

• BIOFEEDBACK

• YOGA

• Tai Chi Chuan

• Hobbies and Distractions

Benefits from Relaxation Training• EnjoyableEnjoyable• decreases stress symptoms - decreases stress symptoms -

headache, nausea, and diarrheaheadache, nausea, and diarrhea• increase levels of physical activityincrease levels of physical activity• ability to handle problems ability to handle problems • improve efficiency and improve efficiency and

performanceperformance• insomnia, depression, pain, drug insomnia, depression, pain, drug

abuse, fear, phobias and abuse, fear, phobias and backachebackache

• lower blood pressurelower blood pressure• increase resistance to stress, help increase resistance to stress, help

prevent overreactions to stress.prevent overreactions to stress.