This document provides information on managing stress without stress. It begins by defining stress and outlining the objectives of learning to identify the signs of stress, understand its impacts, and how to manage it. It describes the different types of stress including normal, pathological, acute, and chronic stress. It identifies common stressors like work, family issues, health problems and discusses risk factors. It outlines the cognitive, emotional, physical and behavioral symptoms of stress. It also discusses the complications of stress, different coping mechanisms, social support, relaxation techniques, exercise, time management, anger management, spirituality, psychotherapy and various lifestyle approaches to managing stress without additional stress.

1. WORKINGWITHOUTSTRESS
Dr Chinedu Ibeh
Senior Medical Officer

2. LEARNING OBJECTIVES
How to spot the signs of stress
Impact stress could have on us an
individuals
Understand how to manage stress

4. INTRODUCTION
The entire life of man is characterized by
alternating periods of worries and states of
happiness.
Stress is an integral and indivisible part of man;
like catholic wedding, our marriage with stress
is till death do us part.
It is both an enemy and a friend; while normal
stress is beneficial by enabling us to adapt and
tackle challenges, persistent overwhelming
stress hinders performance.

5. DEFINITION OF STRESS
Stress is the reaction to threat that
has the potential to impair health
when it exceeds the body’s
adaptive capability.
Stress is as a result of conflict
between what you perceive and
how you react to it.

6. TYPES OF STRESS
Physiological/Normal Stress/Eustress-
motivates us to achieve aspirations and goals.
Normal stress that produces the best in people.
Pathological/Abnormal Stress/Distress-
when stress overwhelms the body’s adaptive
mechanism, it causes disharmony in the
synchronous relationship between the mind
and the body resulting in physical and
psychological disorder.

9. TYPES OF STRESS CONTINUES
Acute/Short Term Stress- results
when time is short, and demands are
heavy. Caused by anything that
temporarily throws you off balance.
Chronic/Long Term Stress-builds up
over time and remains persistent while
exerting an unrelenting pressure

10. CAUSES OF STRESS=STRESSORS

11. TYPES OF STRESSORS
Positive-marriage, promotion, appointment
Negative-bereavement, physical injury,
examination failure
Pleasant-pregnancy, lottery, buying a house
Unpleasant-financial crisis, marital conflicts
Natural-flood, fire, weather, tsunami
Artificial-dirty environment, drug abuse

12. RISK FACTORS
Risk Factors-biological Risk Factors-social
Abnormal Personality
Traits
Challenging Occupation
Poor Defense
Mechanism
Overwork/Inadequate
Rest
Pre-existing Psychiatric
Disorder
Excessive Burdens And
Expectations
Genetic Susceptibility Hostile Environment
Abnormal Beliefs
Certain Medical
Disorders
Conflicts[marital,
Financial etc]

13. COMMON STRESSORS
Transportation problems[traffic jam,
bad roads]
Accommodation problem
Financial constraints
Environmental problems[fuel scarcity,
lack of power, pollution]
Social/family/marital conflicts
Emotional illness and physical
injuries

16. SYMPTOMS
4 categories of symptoms:
Cognitive: anything to do with thoughts,
judgment and evaluation.
Emotional : anything to do with feelings.
Physical: any thing to do with bodily
symptoms
Behavioral: any thing to do with
actions/reactions in response with
external/internal stimuli.

17. COGNITIVE SYMPTOMS
Memory loss
Poor judgment
Indecisiveness
Inability to concentrate
Anxious or racing thoughts
Constant worrying
Fearfulness
Seeing only negative.

18. EMOTIONAL SYMPTOMS
Moodiness
Agitation
Restlessness
Short temper
Irritability
Inability to relax
Loneliness
Depression
General unhappiness

19. PHYSICAL SYMPTOMS
Headache
Muscle tension and stiffness
Diarrhea or constipation
Nervousness.
Dizziness
Insomnia
Chest pain
Palpitation
Tremors

20. BEHAVIORAL SYMPTOMS
Eating more or less
Sleeping too much or too little
Isolating oneself from others
Procrastination, neglecting
responsibility
Picking unnecessary fight with others
Using alcohol and cigarettes to relax
Overdoing activities

21. COMPLICATIONS OF STRESS.
 Stress hormones reduce immune response leading to
increased susceptibility to disease
 This makes one more prone to infectious disease
while aggravating the symptoms of chronic stress-
related NCDs such as hypertension, diabetes, cancer,
peptic ulcer, mental illness etc.
 People under stress tend to neglect good health habits
viz. smokes more to ‘ease out’, drink more alcohol to
‘wash out annoyance’, eat less nutritious meals and
gets less sleep, unsafe sexual practices, disregard
medical instructions

22. COPING MECHANISM

23. COPING BEHAVIOR AND DEFENSE
MECHANISMS
Suppression or repression; an individual
subconsciously expel disturbing thoughts or
experiences from his or awareness
Confrontation or self assertion
Humor
Displacement:“Diverting emotional feelings (usually
anger) from their original source to a substitute target.
Rationalization/intellectualization/making excuses
Projection/blame shifting
Denial/refusal to accept reality

24. MANAGING STRESS
Identify your stressors
Recognize your reaction
Change your
response/seek for help

25. RECOGNIZE YOUR REACTION
Physical; sweating, headaches, tight
muscles, rapid heartbeat
Mental; worrying, feeling anxious, not
being able to focus, having a sense of
doom
Behavioral ; yelling, crying, becoming
withdrawn, eating too much or too little,
drinking too much.

26. SEEK EXTERNAL HELP
STRESSORS EXTERNAL HELP
Heavy work load/schedule Employer
Road Traffic Government and its agencies
Dirty environment Neighbors, co-tenants, or landlords
Overcrowding Government/ private developers
Poverty and ignorance Government, private sector and
development partners
Power outage/water scarcity Government and responsible agencies
Inadequate income Employer
Harsh/unfriendly policies Law makers, decision making bodies
Conflict, hate, divide, stigmatization Religious bodies, govt and security
agencies
Armed robbery and violent crimes Security agencies

27. EXPLORE STRESS OUTLETS
 Meditation and relaxation
 Rest and sleep
 Recreation and play
 Aerobic exercise and sports
 Indoor entertainment
 Hobbies and adventures
 Fun and sexual intimacy
 Seeking for spiritual solace

28. SOCIAL SUPPORT
‘The biggest disease today is not
leprosy or tuberculosis, but the feeling
of being unwanted, uncared for and
deserted by everybody’ Mother
Theresa
Research has linked social support to
good health and a superior ability to
cope with stress.

29. RELAXATION AND MEDITATION
Rest and relaxation period is a time to take
a break from all responsibilities and
recharge your batteries.
Meditation helps in achieving subjective
goals such as contemplation, wisdom, and
altered states of consciousness.
Transcendental meditation involves
focusing attention on and repeating a
mantra thought to have particularly
calming properties.

30. REST AND SLEEP
The number of hours you need to sleep each
night [babies-16hrs, 5yrs-12hrs, >12yrs-6-
8hrs]
At night, the body goes through several cycles
of progressively deeper sleep with periods of
lighter sleep in between.
If you do not sleep long enough, you will not
enter the deepest, most restful period of sleep.
Loss of sleep can adversely affect physical
and mental health and possibly lead to
reduction in ones lifespan.

31. AEROBIC EXERCISE
Aerobic exercise is vigorous, sustained exercise of
the whole body for twenty minutes or more. Eg;
walking, running, swimming, and biking’
It can reduce stress and anxiety in people of all
ages.
Studies have shown that people who exercise
regularly have higher self esteem and suffer less
from stress, anxiety and depression than
comparable people who live a sedentary lifestyle.

32. RELATIONSHIP MANAGEMENT
‘A man should keep his friendship in
constant repair’. ‘If a man does not make
new acquaintances through life, he will
soon find himself left alone’ Samuel
Johnson
Know and practice how to get along with
superiors, subordinates, opponents,
friends, business associates and every
one else.

33. RELATIONSHIP MGT. CTD.
John Maxwell[author of The Power of
Influence]
The six most important words; I admit I made a
mistake
The five most important words; you did a good
job
The four most important words; what is your
opinion
The two most important word; Thank you
The most important word; we
The least important word; I

34. TIME MANAGEMENT
Poor time management is a recipe for stress
It is necessary for one to achieve a delicate
balance in different arenas of life such as
family, social career, spiritual and
psychological wellbeing.
Why African time? Time is grossly abused and
wasted in most African organization leading to
stress, frustration and poor standard of living.

35. COMMON TIME WASTERS
Lack of planning
Lack of delegation
Failure to identify priorities
Procrastination
Traffic delays
Telephone calls
Poor record keeping
Incompetent secretary
Lack of procedure for routine work.

36. TIPS FOR MINIMIZING TIME WASTAGE
Proper planning of organization
Prioritization of activities
Delegate some responsibilities to your
subordinates
Avoid distractions and interruptions
Make effective use of ideal time
Use reminder system[secretary, diary,
clip tags]
Keep schedules and appointments

37. FINANCIAL MANAGEMENT
He who works his hand will have abundant food
but the one who chases fantasies will have his
fill of poverty. proverbs 28;19
Apply four PS of planning, patience, prudence
and prioritization in order to be a good financial
manager.
Empower your close family members,
colleagues and dependants economically for ‘ a
rich in the midst of so many who are poor is
himself poor indeed.

38. ANGER MANAGEMENT
Anger could be a manifestation of one’s failure
to cope with fears apprehension resulting from a
stressful situation
Anger management involves
Sitting down, if standing
Going for sports
Appeal to spirituality
Sight seeing
Watching favorite films or channels
Positive confrontation-cool, calm and collected

39. SEEKING SPIRITUAL SOLACE
Come to me, all you who are weary and
burdened, and I will give you rest. Take
my yoke upon you and learn from me,
for I am gentle and humble in heart,
and you will find rest for your
souls. For my yoke is easy and my
burden is light” (Matt 11:28-30)

40. SEEKING SPIRITUAL SOLACE
WHO recognizing the wider dimensions of
health defines health as ‘ a state of
complete physical, mental and social
well-being and not merely the absence
of disease or infirmity
It therefore follows that the attainment of
optimal level of health in an individual is a
product of harmony between his body, soul
and mind.

41. SEEKING SPIRITUAL SOLACE
By appealing to spirituality, people
who are overcome by anxiety, fear,
distress, and dejection receive
succor, serenity and tranquility.
The also find true meaning of life
whenever hope and everything
seems lost

42. STRIVING FOR CLEAR CONSCIENCE
‘Conscience is an open wound, only truth
can heal it’. Sheihk Usman Bn Fodiyo
A thief can escape his pursuers, but
cannot escape his conscience.
In order to obtain clear conscience, we
should always strive to uphold societal
moral values and avoid perversions and
deviations.

43. STRIVING FOR CLEAR CONSCIENCE
Adopt golden rule as guiding principle
Love your neighbor and your country
‘’ There comes a time when a man has to
be honest with himself and his own
nation and face the tribunal of history with
clear conscience ‘’ Francis Mitterand’’

44. PSYCHOTHERAPY AND COUNSELLING
Psychotherapy includes guidance and
counselling, reassurance, environmental
manipulation, behavior modification,
conditioning, psychoanalysis, and all other
forms of treatment in which the major technique
applied is communication rather than drugs or
other somatic agents.
Psychotherapy can lead to change in lifestyles
such as excessive alcoholism, drug abuse,
reckless driving and cigarette smoking.

45. DRUGS USED IN MANAGING STRESS
Drugs are used as an adjunct with other
non drug techniques.
Common drugs include;
1. Anxiolytics for reducing anxiety.
2. Specific drugs for treating stress related
disorders such as hypertension,
depression, and PUD.
3. Antioxidants for provision of synthetic
vitamins and mineral supplements.

46. LIVING WITH INEVITABLE
‘’O Lord, give me the courage to
change the things I can, the patience
to accept the things I cannot change
and the grace to know the difference’’
Anonymous.
People who unnecessarily brood over
things they can neither control nor
change are prone to stress related
disorders.

47. THINGS I CAN CHANGE
Things I can change Things I cannot
change
My income My height
My academic grades My origin
My school My family members
My friends climate
My car Bad roads
My life style My gender
My attitude My genotype

48. FOOD FOR THOUGHT
I'm sorry for people who research
'wealthiest people under 30, 35, 40 etc'
without checking their background.
The Bill Gates and Aliko Dangotes of this
world would not have gotten to where the
are as fast as they did without their family
backgrounds.

49. FOOD FOR THOUGHT
 It's wrong for any motivational or inspirational or
whatever speaker to put young people under pressure
to become another Dangote.
 Wealth or success is built over generations, that is why
we talk about 1st, 2nd, 3rd generation wealth.
 Most of these young wealthy people are of the 3rd,
even up to 5th generations.
 They are not your mate, so don’t unnecessarily
torment yourself by pointing to the success of such
people.

50. FOOD FOR THOUGHT
 Granted there are many who have the
same opportunities but who do not attain
equal success, however, your goal should
not be to become Dangote overnight .
I'm in no way discouraging you from
aiming high, but one attribute of a good
goal is that it must be reasonable and
realistic.
Don't give yourself heart attack because of
other people's success.

51. FOOD FOR THOUGHT
Haven't you noticed that you're not even
on the same level with some of your
friends, classmates, or colleagues.
You may earn the same salary, have the
same revenue, but there's a reason why
company A and B report different Profit .
It's called costs and expenses.
Depending on your background, you're
going to have primary expenditure levels
different from another.

52. FOOD FOR THOUGHT
You may be in the 1st generation of wealth
creators in your family whereas that friend
is in the 5th generation
 Run in your own lane and stop bumping
into another's lane.
Work towards creating a better opportunity
for your children so that they can grow
standing on your own shoulders.

53. FOOD FOR THOUGHT
Just control your appetite for power
and live realistically.
Before you envy another man or covet
his success, consider these things.
Don't increase your stress levels
unnecessarily. I believe this can be
applicable to other areas of life too.

54. MERCI
oThank you for your
attention.
Question/Contributio
n time….