STRESS MANAGEMENT COOPING STRESS DEPRESSION

1. DR. MOHIT BANSAL
PGT-2
Dept of psychiatry
Katihar medical college
STRESS MANAGEMENT

2. Objectives of session
• Define stress , including its positive and
negative aspects.
• Discuss health impact of stress.
• Discuss spectrum of various risk taking
behavior and ways to manage.
• Learning various stress management
techniques.

3. Defining Stress
• Stress is defined as pressure experienced by a
person in response to life demands.
• These demands are referred to as stressors .

4. IS STRESS ALWAYS BAD ??

5. Is Stress always Bad?
• Not necessarily !
• Moderate levels of stress may
actually improve the performance
and efficiency
• ‘Necessary for survival’ : fight
/flight response
• Inverted U-shaped curve
• Stress can be a blessing(dhoni)

7. TYPES OF STRESS
• EUSTRESS (Positive stress)
• DISTRESS/STRESS (Negative stress)

8. Types of Stress

9. Types of stress
• Frustration
• Conflict
• Change
• Pressure

10. Concept of stress
Demands >
Resources
• Like the ‘weight on a bridge’, various
sources of stress act in a similar manner
on our body and mind
• It may continue ‘bent and strained’ or, after
a certain threshhold, it may ‘break apart’

11. Stress-performance curve

12. • When is stress experienced as bad?
• Why same stressor evoke different
reactions in different people ?
• Why different people are affected
to a varying degree with same
stressor?
Among other individual factors, the
role of perception is very important

13. To illustrate…

14. Role of perception

15. Role of perception

16. Role of perception
At times, the way in which an event is
perceived, leads to stress, rather than
the event per se
“PERCEIVED STRESS” is often more
important than the actual stressor

17. Common sources of
stress
What’s Your Experience of Sources
of Stress?

18. Stress in medical students
• Being in new environment
• Greater academic demands
• Frequent examination
• High parental expectation
• Peer pressure
• Long duty hours
• Financial problems
• Relationship disharmony

19. • Numerous studies have been reported that
medical students suffer from higher perceived
stress compared to students in other
academic fields and general population.

20. Stress And Risk Taking Behavior In
Medical Students
• Behavior that may lead to violence or injury
( Being in fight , bullying ,carrying a weapon, being bullied)
• Substance abuse (M>F)
• Unsafe driving or riding
• Self harm behavior ( act with an non fatal
outcome)
• Poor self care
• Unsafe sexual behavior

21. Common Stressors

22. Causes of stress
 Environmental
(physical
surroundings)
 Family and
relationship
problems
 Work-related (e.g
dissatisfaction,
overload,)
 Social stressors (e.g.
financial constraints)
 Uncertainty or worries
 Pessimistic attitude
 Self-criticism
 Unrealistic expectations
or beliefs
 Perfectionism
 Low self-esteem
 Excessive or unexpressed
anger
 Lack of assertiveness
Extern
al
Interna
l

23. EFFECTS OF STRESS
STRESS CAN EFFECT -
• BODY
• MOOD
• BEHAVIOR

24. Physical Symptoms
• Fatigue
• Headache
• Elevated blood pressure
• Sweaty palms
• Tightness of chest
• Aching neck, jaw and
back muscles
• Chest pains
• Stomach upset
• Nausea
• Weakened
immunesystem
• Sleep disturbance
• Tiredness
• Susceptibility to minor
illness
• Itching
• Easily startled
• Forgetfulness

25. EFFECTS ON MOOD
• Anxiety
• Restlessness
• Irritability
• Sadness
• Depression
• Low self esteem & self
confidence.
• Lack of attention and
concentration.

26. Behavioral
• Aggression
• Catharsis
• Learned helplessness
• Displacement
• Social withdrawal
• Indulging oneself
• Over eat or under eat

27. Burn-out
• State of emotional, mental, and physical exhaustion
caused by excessive and prolonged stress.
• As the stress continues, one begins to lose the motivation
that led to take on a certain role in the first place.

28. Dealing with stress
TIP 1
• Identify source of stress in your life
Look closely your habits, attitude and excuses.
Work (dead lines)
Studies
Relationship ( in laws , friends , maid , boyfriend , girl friend …

29. Start to keep a stress journal
• What caused you stress (make a guess)
• How you felt (physically / emotionally)
• How you acted upon it
• What you did to make yourself feel better.

30. • TIP 2 – Practice 4As of stress management.
Avoid
Alter
Adapt
Accept

31. • How to Avoid
a) Learn to say no
b) Distinguish between should and must
c) Avoid people who stress you out
d) Try to make a balance between family and work

32. Alter the situation
a) Express your feelings instead of bottling them up
b) Be willing to compromise
c) Alter environment
d) Create a balanced schedule

33. • Adapt to the stressor
a) Reframe problems
b) Adjust your standards
c) Practice gratitude
 Look at your positive qualities
 See the one behind you
 Perfectionism is major source of stress

34. ACCEPT
• Accept the things you can’t change
Aiims ,Pmch,kmch
• Learn to forgive
• Share your feelings

35. EMOTIONAL TECHNIQUES

36. Ventilation
• तकलीफ बाटने से कम होती है...छु पाने से नहीीं !
• Develop a support network (through family
members and friends) and talk about all your
emotions
• It’s not events always which are stressful but how
we perceive them. Others emotional support helps
us to gain better perspective over the stress
• Maintain a journal and express your emotions
regularly

37. Build Up Daily Positive Emotions
• Regularly engage in activities that evokes
positive emptions in you
• Don’t keep hobbies for weekends or some
imagined breaks
• It can be as simple as listening to music, going
to a park, drawing or playing with your child
etc.
• Find “Your Time” everyday

38. Relaxation training
• Breathing techniques
– Deep Breathing Exercise (Exercise 5)
• Progressive Muscle relaxation
– Tense and relax you muscle groups one-by-one by
which we learn to feel the difference between
tension and relaxation and release muscle tension
when we feel it. I
• Use Imagery/ Visualization
– Imagining yourself in a pleasant or a successful
situation to help reduce stress.

39. Mindfulness Meditation

40. 40
Overcoming Stress

41. What You Must Have Known By
Now
1. Healthy eating habits
2. Getting regular exercise
3. Maintaining sleep hygiene
4. Thinking Positive

42. BEHAVIORAL TECHNIQUES

43. ANGER MANAGEMENT
• Know the difference
between anger and
aggression.
• Anger is an emotion. It is
ok to be angry.
• Aggression is acting out
inappropriately and is not
ok. Learn to check your
aggression and express
your anger appropriately.

44. When you are ANGRY and UPSET
Remember…
1-2-3-4 TURTLE

45. 1 – Go inside your shell
Take a “Time Out”

46. • Time to RELAX
• Calm yourself down
2 – Take 3 Deep Breath

47. • Think of a good solution
3–Think

48. 4– Come Back and Talk About It
But Skillfully

49. Remember…
• You cannot change others as easily as you
can change yourself
• Expectation breeds frustration. Frustration
breeds anger.
• Never reply to a letter/ email when
you are angry.
• Accept what you cannot change & change
what you cannot accept
• Organize your mind and organize your desk
for 5 minutes every hour
• Don’t have to hold on to my anger…TALK
about it..!!
• No BLAME GAME

50. Say NO- The Art of Assertiveness
Skills

51. • Assertiveness is a skill regularly referred to in
social and communication skills training.
• Being assertive means being able to stand up
for your own or other people’s rights in a calm
and positive way, without being either
aggressive or passively accepting wrong .

52. 3 Steps of Assertiveness
1. Acknowledge other’s opinion
rather them refuting them.
2. Give your opinion on how
the situations impacts you
3. Mutually Agree For a
Solution

53. Time Management
• Effective time
management
- keeps us organized
- helps us manage the
daily schedules
effortlessly
- reduce the work-
related stress and hurry
- frees up personal time
/time for relaxation etc

54. Organizational
Skills
• It is defined as
the ability to use your
time, energy, resources,
etc. in an effective way
so that you achieve the
things you want to
achieve
• Learning to prioritize
is the key

55. OTHER TECHNIQUES

56. Self-Gratification
• Many scientific studies
have shown the
importance of realistic
self reinforcement,
meaning to recognize the
positive in us instead of
seeing only the negative.
• This increases motivation,
decreases emotional
tensions and helps us
develop a feeling of inner
security.

57. Maintain Work-
Life Balance
• It is defined as a fine
balance maintained
between work and life
such that each doesn’t
adversely impact the other
and you are able to enjoy
both

58. Thank
You
• “Grant me the courage to
change the things I can
change, the serenity to
accept those that I cannot
change and the wisdom to
know the difference”