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STRESS
BY- Soumya Ranjan ParidaMSC NURSING 1 yr
INTRODUCTION:
In psychology stress is a feeling of strain andpressure. Small amounts of stress may bedesired, beneficial, and even healthy. Positivestress helps improve athletic performance.
It also plays a factor in motivation, adaptation,and reaction to the environment. Excessiveamounts of stress, however, may lead to bodilyharm.
Stress can increase the risk of strokes, heartattacks, ulcers, dwarfism, and mental illnessessuch as depression.
TERMINOLOGY
1. StressIn a medical or biological context stress is aphysical, mental, or emotional factor that causesbodily or mental tension. Stresses can beexternal (from the environment, psychological,or social situations) or internal (illness, or from amedical procedure). Stress can initiate the "fightor flight" response, a complex reaction ofneurologic and endocrinologic systems.
Categories of stress Distress- can threaten health(continual
worries Eustress – good stress (passionate kiss)
financial
Developmental –Associated with life stages (e.g–college ,graduation)
Situational –Random, unpredictable (e.g.Hurricane or accidents)
Physiological – affect body structure /function (diseases or mobility problems
Psychological –arise from life events (e.g workpleasure ,family arguments )
Where does stress come from ?
Stress can come from Inside -–
–
–
–
INTERNAL STRESSOR:-
Body image
Not happy with the way you look
self-conscious feel everyone is staring atyou
Stress can come from OutsideEXTERNAL STRESSOR:-
i.e. surroundings, environment–
–
–
–
–
Family ……..
School ….
Friends /Peers …
Society ….
Others ……
Stresses physical
– Prolonged school
hours
Over-packed class
rooms
Transport
Pollution air, noise
Overcrowding road
Poor ventilation
–
–
–
–
–
–
Stresses psychological
–
–
–
–
Bullies,
Changing schools,
Conflicts with teacher,
Forced
competitiveness,
Falling grades,
Have to present in
class
Learning disorders,
–
–
–
–
Physiological Stress response
Adrenal medulla :-
- Releases norepinephrine and epinephrine
Eye :-
- pupil dilate
-secretion is increased from lacrimal glands
Respiratory system :-
-Bronchioles dilate.
-Respiration rate is increased
Cardiovascular system :-
-Increased force of cardiac contraction
-Increased cardiac output
-Increased heart rate
-Increased blood pressure
Gastrointestinal system :-
-Decreased gastric and intestinal motility
-Sphincters contract
-Decreased secretions
Liver :-
-Increased glycogenolysis
-Decreased glycogen synthesis
Urinary system :-
-Increased ureter motility
-Bladder muscle contracts
-Bladder sphincter relaxes
Skin :-
-Increased secretions
STRESS RESPONSE
Stress mastery
Stress Mastery Stress Mastery is theutilization of coping strategies in theresponse to stressful situations.
Adaptive coping strategies protect theindividual from harm and restore physical andpsychological homeostasis.
Coping strategies are considered maladaptivewhen the conflict being experienced goesunresolved or intensifies
EFFECTS OF CHRONIC
STRESS Increase Gluconeogenisis
Decrease Immune
Decrease inflammatory response
Retention of sodium and water
Decrease in libido, frigidity and impotence
Increase in blood pressure
Psychological adaptation ofstress
Anxiety and grief have been described as two major, primarypsychological response patterns to stress.
A variety of thoughts, feelings, and behaviors are associated with eachof these response patterns.
Adaptation is determined by the extent to which the thoughts,feelings, and behaviors interfere with an individualǯs functioning.
Psychological adaptation ofstressMind and body interaction
2. Anxiety
3. Coping mechanisms
1. Mind body interaction:-
humans react to threats of danger as if they were physiologic threats ofa person perceives the threat on an emotional level& the body preparesitself to either resist the danger or to run away from it. Each personreacts in
Backache
Constipation
Diarrhea
Dilated pupils
Dry mouth
Headache nausea
Sleep disturbances
Psychological adaptation ofstress
Anxiety:
-A diffuse apprehension that is vague in nature and isassociated with feelings of uncertainty and helplessness.
-Extremely common in our society.
-Mild anxiety is adaptive and can provide motivation forsurvival.
Peplau’s four levels of anxiet
Mild – seldom a problem
Moderate – perceptual field diminishes
Severe – perceptual field is so diminished thatconcentration centers on one detail only or on manyextraneous details
CONT...
Anxiety at the moderate to severe level thatremains unresolved over an extended periodof time can contribute to a number ofphysiological disorders – for example,migraine headaches, IBS, and cardiacarrhythmias.
• Extended periods of repressed severeanxiety can result in psychoneurotic patternsof behaving – for example, anxiety disordersand somatoform disorders.
CONT...
Extended periods of functioning at the paniclevel of anxiety may result in psychoticbehavior; for example, schizophrenic,schizoaffective, and delusional disorders.
At the mild to moderate level ,the ego callson defence mechanism for protection .
CONT...
3. Coping mechanism:- DENIAL DISPLACEMENT INTROJECTION PROJECTION RATIONALIZATION REACTION FORMATION REPRESSION SUBLIMATION UNDOING COMPENSATION
Intervention to reduce anxiety
a). Exercise:- Regular exercises help to maintainphysical & emotional health.b). Rest and sleep:- Rest and sleep helps the body to
maintain homeostasis & restore energy levels.c). Nutrition:- It plays an important role inmaintaining the bodyǯs homeostatic mechanisms & in increasing resistance to stress. Obesity &malnutrition are major stressors & greatly increasethe risk of illnessd). Encouraging the use of support system:- Supportsystem provides emotional support that helps aperson identify & verbalize feelings associatedwith stress.
Stress adaptation model
Three main models of stress :
1. Stimulus based model
2. Response based model
3. Transaction based model
1. Stimulus based model:-
Acc. To this model ,stress is defined as astimulus,a life event ,or a set of circumstances thatarouses physiologic and psychologicalreactions that may increase the individuals vulnerability to illness.
Stress adaptation modelcont..2. Response model :-• Hans Selye (1907- 1982) was a
Hungarian endocrinologist, first to give a scientific
explanation for biological stress.
• Hans Selye explained his stress model based on
physiology and psychobiology as General
Adaptation Syndrome (GAS).
His model states that an event that threatens an organism’s well-being (a stressor) leads to a three-stage bodily response:
Stage 1: Alarm
Stage 2: Resistance
Stage 3: Exhaustion
He explained about hypothalamic-pituitary-adrenal axis (HPA axis) system which prepares the body to cope with stress.
Selye also explained about a local adaptation syndrome which refers to the inflammatory response and repair processes occur at the local site of tissue injury as in small, topical injuries, such as contact dermatitis which may lead to GAS if the local injury is severe enough.
Stages
Stage 1: Alarm
Upon encountering a stressor, body reacts with “fight-or-
flight” response and sympathetic nervous system is
activated.
Hormones such as cortisol and adrenalin released into the
bloodstream to meet the threat or danger.
The body’s resources now mobilized.
Stage 2: Resistance
Parasympathetic nervous system returns many
physiological functions to normal levels while body
focuses resources against the stressor.
Blood glucose levels remain high, cortisol and adrenalin
continue to circulate at elevated levels, but outward
appearance of organism seems normal.
Increase HR, BP, breathing
Body remains on red alert.
Stage 3: Exhaustion
If stressor continues beyond body’s capacity, organism
exhausts resources and becomes susceptible to disease
and death.
Stress adaptation modelcont..
3.Transaction based model :-
•Transaction (interaction) occursbetween a person & theenvironment
•Stress results from an imbalance
between (a) demands & (b) resources
•Thus we become stressed when
demands (pressure) exceeds our
resources (our ability to cope &
mediate stress)
•Thus the interpretation of the
stressful event was more important
than the event itself
LAZARUS MODELOF STRESS & COPING
•Considers whether the person has apersonal stake in encounter (are theirgoals thwarted)
•Evaluates the significance of theencounter – which either
1. Has no significance for
person
2. Is a benign-positive encounter(desirable)
3. Harmful/ threatening/
challenging
Primary appraisal –concerns relevance to our
well-being
•Stressful situations are appraised asinvolving
1. Harm/ loss - that has occurred (sofar)
2. Threats – i.e. potential
future harm
3. Challenges – i.e. how can we learn/gain confidence from this experience
PRIMARY APPRAISAL
•Individual will then engage in secondary appraisalto work out how we can best deal with situation &change undesirable conditions•Evaluate internal/ external coping options as wellas more specifically resources to create a morepositive environment.
1. Internal options – e.g. will power, inner strength2. External options – peers, professional health• Thus it may become a reappraisal of stressor and
our coping resources
SECONDARY APPRAISAL
•Used when we feel we have control of thesituation, thus can manage the source of theproblem•Thus our possible strategies could include:
1. Defining the problem2. Generating, evaluating alternative solutions3. Learning new skills to manage stressor4. Reappraising – by reducing our ego
involvement
PROBLEM BASED COPING
•Used when we feel we have little control of thesituation, thus we cant manage the source of the problem•Involves gaining strategies for regulating emotionaldistress – e.g.
1. Avoiding – ͚I’m not going school.2. Distancing yourself from the emotion, I am not
stressed, it does not matter to me.3. Acceptance – ͚I failed the exam but I still have 4 other
subjects.4. Seeking emotional support from your partner5. Selective attention
6. Alcohol
EMOTIONAL BASED COPING
Is STRESS good or bad forus ?
All stresses can be GOODSo all efforts should be to convert all
stresses into EUSTRESS –This can be
achieved by stress management techniques
STRESS MANAGEMENT
MANAGE AT ALL THE THREE LEVEL– PSYCHOLOGICAL LEVEL: MEDITATION,
REASSESSING OUR THOUGHTS &FEELINGS– PHYSICAL LEVEL: EXERCISES,
YOGA,PHYSICAL ACTIVITIES– BEHAVIOURAL LEVEL: RESPONDING WITH
EQUANIMITY .
IF the distress crosses the threshold levelmedical problems like Depression, Anxietydisorders, Hypertension etc. sets in. seekmedical help from a qualified medicalpractitioner
SUGGESTED COPINGSTRATEGIES
• Take life the way it comes
• Stop blaming others
• Develop your own inherent potential
• Live in the present & Work for the future
• Maintain harmonious relation with others
• Learn to be happy & cheerful
SUGGESTED COPINGSTRATEGIES
MEICHENBAUM’SAPPROACH TO STRESS
MANAGEMENT
1. Teaching individuals that negative self-evaluation increase stress
2. Monitoring one’s own self-defeatingstrategies – teaching new cognitivestrategies
3. Teaching new skills like relaxation
4. Providing real life homework assignmentthat become increasingly difficult to carryout
CONCLUSION
• Stress is manageable -It needs efforts
• Engage truthful thinking
• Modulate your behavioral pattern
• Lead a well balanced life of satisfaction.
• Assert control on self in terms of thinking &action
ADAPTABILITY IS THE “MOTHER KEY” TOCONVERT DISTRESS TO EUSTRESS
STRESS MANAGEMENT
TIPS
• Making little changes in your life can really add upto a big feeling of relief.
• Learn to recognize when you are feeling stressedand simple ways you can relax.
• Take a break. Have a cold drink, get some fresh air,or close your eyes for a minute to refocus.
• Stay positive to help friends and family cope withstress.
• Let others know you're feeling overwhelmed andtell them how they can help.
• Allow yourself to simply say "no" to friends andfamily when you know you cannot meet theirdemands without becoming overwhelmed.
STRESS
MANAGEMENT TIPS• Be prepared for unexpected problems such
as traffic, a lost pet or a family emergency.
• Prioritize. Take control of your "to do" list bydeciding what's really most important on yourlist.
• Write down feelings of sadness, frustrationor anger to get a clearer perspective of youremotions.
• Enjoy life's simple pleasures like colorfulflowers, dancing, music, and social outings,etc.
Exercise regularly.
Have healthy eating habits never skip breakfast
Reduce sedentary activities like TV Videogames etc.
Eat healthy nutritious food. Avoid Junk food .
Avoid excess caffeine intake eg tea coffeechocolates and cola drinksDo NOT TAKE QUICK FIX REMEDIES likealcohol tobacco and drugs
‘as they have long term and very harmfuleffects on your body and mind ‘’.
STRESS
MANAGEMENT PLAN
THANKYOU