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Stress and its management Dr.Shashikant.S.K Snow Mountain Yoga Center
Views of StressEastern philosophies have viewed stress as an absence of inner peace.Western culture has more recently viewed stress as a loss of control.
Chinese medicine men Hippocrates Rene Descartes Galen Robert Koch Hans Selye Rudolph Virchow
Hans Selye, the father of scientific foundation for mind-body medicine, who in the 1950s introduced it as "the non-specific response of the body to any demand for change".10/4/2012
Stress The mental and physical response of our bodies to the changes and challenges in our live Stressor – any physical, social, or psychological event or condition that causes the body to adjust to that situation Adjustment may cause strain or wear and tear on our bodies and minds
S=P>R Stress occurs when the pressure is greater than the resource
Three types of stress Eustress Neustress Distress
The Yerkes-Dodson Curve Maximum PerformanceGood Low performance illness Eustress DistressPoor poor performance poor performance High low moderatre high underaroused- optimally overaroused- bored aroused overwhelmed
8 Interactive Stress Variables Intensity: magnitude (low vs high) quality: insignificant vs significant Duration/frequency: short vs long; high/low Focus of Stressor: vulnerability (high vs low) Extent of Stress: scope of influence (isolated vs extensive) Mental/Physical Status: hardiness (high vs low) Resistance: active vs inactive Perception: reductive vs magnifying
Sympathetic and parasympathetic divisions Sympathetic division Its brings about the emergency reaction, and triggers off the production of adrenaline to keep it going. It is involved in „active“ emotions like fear, anger, or excitement. Parasympathetic division It operates later to correct the balance and to restore body functions to normal operation. It is involved in the „quiet“ emotions, like depression or sadness, when we are not really active at all.
Hypothalamopituitary adrenal (HPA) axis Immune Stress system:Circadian altered rhythm Hypothalamus Muscle: CRH Net loss of amino Posterior Acids (glucose) Anterior Pituitary Gland Pituitary Gland Liver: (-) Deamination of proteins into amino ACTH acids, gluconeogenesis Glucocorticoids, Adrenals Catecholamines, etc.. (glucose) Fat Cells: Free fatty acid Kidney mobilization Heart rate: Increased
The Story of the Cave Man and the Saber-toothed Tiger10/4/2012
Picture this scene a million years ago. You come out of of your cave. The sun is up and the birds are chirping. Your heart rate is normal.10/4/2012 www.yogamaarg.com
All of a sudden you hear a twig snap. Off to your right you see a large saber-toothed tiger. You have two options. What are they?10/4/2012 www.yogamaarg.com
Or flight10/4/2012 www.yogamaarg.com
To fight that tiger or run away fast, the body prepares by releasing stress hormones Cortisol increases blood sugar and speeds metabolism Epinephrine supplies extra glucose Norepinephrine speeds up your heart rate and raises your blood pressure10/4/2012 www.yogamaarg.com
There is no longer a tiger to kill orrun away from!10/4/2012
The Body’s Response to Stress General adaptation syndrome (GAS) – an adaptive response where our bodies move from homeostasis to crisis: Alarm phase “Fight or flight” response Resistance phase Exhaustion phase
Alarm Phase The cerebral cortex – region of brain responsible for higher mental functions – interprets nature of event (stressor). The sympathetic nervous system is triggered. Hypothalamus – interprets the body’s needs for more energy – triggers the pituitary gland to release ACTH (adrenocorticotropic hormone) ACTH acts on the adrenal gland to release stress hormones – cortisol, epinephrine and norepinephrine These stress hormones trigger the muscles and liver to release glycogen (glucagon) into glucose (energy) Heart rate, blood pressure and respiration increases The body’s resources have to be prioritized! Activities of the body that are important – but not urgent are put on “hold”, such as digestion.
Resistance Phase The body is actively trying to reverse the actions that transpired during the alarm phase. During the resistance phase the body is under the control of the parasympathetic nervous system. The body’s vital functions such as heart rate, blood pressure, respiration, digestion, spleen function, vision, bladder function, glucose level, saliva and mucous, endorphins and hearing return to normal functioning. Remember – the body is trying to reach Homeostasis as a defense mechanism. The body wants to survive!
Exhaustion Phase Long term exposure to a stressor or stressors can result in overload. When the body is over-taxed and there are no recovery periods illness can result. This is a depleted state that has been the result of an ineffective balance of the alarm and resistance phase.
The General Adaptation Syndrome
The GeneralAdaptationSyndrome:AlarmPhase Figure 3.2
3 components of Stress Frustration Conflict Pressure
Aetiology of Physical Stress Disorders (3) Personality Friedman & Rosenham Strive to Achieve/Competitive Type A Time Urgency/Impatience Hostility/Aggression ‘Chilled’/Relaxed Type B Less time concerned Less aggressive NB: Type A behaviour linked to CHD & hypertension
Stress affects the whole person in allhuman dimensions : Physical Emotional Intellectual Social Spiritual
How do your feelings impact your health?Depressed Normal BlissUnhappy EuphoricDistressed
Stress: Short-term (Immediate)consequences Physical Signs/Symptoms sleep disturbances irregular heartbeat, palpitations back, shoulder or neck pain asthma or shortness of breath tension or migraine headaches chest pain upset or acid stomach, cramps, sweaty palms or hands heartburn, gas, irritable bowel cold hands or feet syndrome skin problems (hives, eczema, constipation, diarrhea psoriasis, tics, itching) weight gain or loss, eating disorders periodontal disease, jaw pain hair loss reproductive problems muscle tension immune system suppression: more fatigue colds, flu, infections high blood pressure growth inhibition
ABC STRATEGY A = AWARENESS What causes you stress? How do you react?
ABC STRATEGY B = BALANCE There is a fine line between positive / negative stressHow much can you cope with before it becomes negative ?
ABC STRATEGY C = CONTROL What can you do to help yourself combat the negative effects of stress ?
Stress Management Techniques Change your thinking Change your behaviour Change your lifestyle
Change your Thinking Re-framing Positive thinking
Re-framing Re-framing is a technique to change the way you look at things in order to feel better about them. There are many ways to interpret the same situation so pick the one you like. Re-framing does not change the external reality, but helps you view things in a different light and less stressfully.
Positive Thinking Forget powerlessness, dejection, despair, failure Stress leaves us vulnerable to negative suggestion so focus on positives; Focus on your strengths Learn from the stress you are under Look for opportunities Seek out the positive - make a change.
Change your Behaviour Be assertive Get organised Ventilation Humour Diversion and distraction
Be Assertive Assertiveness helps to manage stressful situations, and will , in time, help to reduce their frequency. Lack of assertiveness often shows low self - esteem and low self - confidence. The key to assertiveness is verbal and non - verbal communication. Extending our range of communication skills will improve our assertiveness.
Equality and Basic Rights1) The right to express my feelings2) The right to express opinions / beliefs3) The right to say ‘Yes/No’ for yourself4) Right to change your mind5) Right to say ‘I don’t understand’6) Right to be yourself, not acting for the benefit of others
7) The right to decline responsibility for other people’s problems8) The right to make reasonable requests of others9) The right to set my own priorities10) The right to be listened to, and taken seriously
Being Assertive Being assertive involves standing up for your personal rights and expressing your thoughts, feelings and beliefs directly, honestly and spontaneously in ways that don’t infringe the rights of others.
Assertive People Respect themselves and others Take responsibility for actions and choices Ask openly for what they want Disappointed if ‘want’ denied Self - confidence remains intact Not reliant on the approval of others
Assertive Skills Establish good eye contact / don’t stare Stand or sit comfortably - don’t fidget Talk in a firm, steady voice Use body language ‘I think’ / ‘I feel’ ‘What do you think?’ ‘How do you feel ?’ Concise and to the point
Benefits Higher self-esteem Less self-conscious Less anxious Manage stress more successfully Appreciate yourself and others more easily Feeling of self-control
Get Organised Poor organisation is one of the most common causes of stress. Structured approaches offer security against ‘out of the blue’ problems. Prioritising objectives, duties and activities makes them manageable and achievable. Don’t overload your mind. Organisation will help avoid personal and professional chaos.
Time Management Make a list What MUST be done What SHOULD be done What would you LIKE to do Cut out time wasting Learn to drop unimportant activities Say no
Plan your day Set achievable goals Don’t waste time making excuses for not doing something
Ventilation ‘A problem shared is a problem halved’ Develop a support network through friends or colleagues to talk with. It’s not always events that are stressful but how we perceive them. Writing a diary or notes may help release feelings but do not re-read what has been written.
Humour Good stress - reducer Applies at home and work Relieves muscular tension Improves breathing Pumps endorphins into the bloodstream - the body’s natural painkillers
Diversion and Distraction Take time out Get away from things that bother you Doesn’t solve the problem Reduce stress level Calm down Think logically
Benefits of Exercise Uses up excess energy released by the ‘Fight or Flight’ reaction. Improves blood circulation Lowers blood pressure Clears the mind of worrying thoughts Improves self image Makes you feel better about yourself Increases social contact
Sleep Good stress reducer Difficult to cope when tired Wake refreshed after night’s sleep Plenty of daytime energy
Leisure Interest Gives you a ‘break’ from stresses Provides outlet for relief Provides social contact
Is a pill dissolving in your stomach more effective than a healing thought dissolving in your mind?
Some common specific phobiasAcrophobia HeightsAlgophobia PainAstraphobia Thunderstorms & lightningClaustrophobia Enclosed placesHydrophobia WaterMonophobia Being aloneMysophobia Contamination or germsNyctophobia DarknessOchlophobia CrowdsPathophobia DiseasePyrophobia FireZoophobia Animals, or some particular animal