Hi my name is __________________ and I am a psychologist. (Include more information on your background – how many years in practice, areas of specialty, any experience working with people dealing with major illnesses or lifestyle changes.) As a psychologist, I am a member of a professional association called the American Psychological Association. My professional association has developed a public education campaign that is aimed at raising awareness of Mind/Body Health and how people can make lifestyle and behavioral changes to improve and strengthen their mind/body health. Today, I am focusing on a particular topic under the mind/body health topic, stress.
Before we get into stress, I’d like to talk about what mind/body health is. (Engage audience) How many of you have heard this term? What do you think it means? Mind/Body Health is the effective balance of physical and psychological health so that each work to support the other. Poor mental health or poor emotional well-being can have an effect on your physical health. And, it works the other way too. Poor physical health can affect a person’s mental health.
So, let’s focus on stress. What is it? Stress is usually defined as overwhelming feelings of lack of control over our environment and an inability to change things. According to the American Institute of Stress, stress tends to be more pervasive, persistent and insidious because it stems primarily from psychological than physical threats. It is associated with ingrained and immediate reactions over which we have no control that were originally designed to be beneficial such as: heart rate and blood pressure soar to increase the flow of blood to the brain to improve decision making, blood sugar rises to furnish more fuel for energy as the result of the breakdown of glycogen, fat and protein stores, blood is shunted away from the gut, where it is not immediately needed for purposes of digestion, to the large muscles of the arms and legs to provide more strength in combat, or greater speed in getting away from a scene of potential peril. Blood away from the gut might result in some odd feelings in the digestive track, especially after eating. Your body may not digest food as comfortably. Also, blood to the large muscles might result in some feelings of heaviness over time, clotting occurs more quickly to prevent blood loss from lacerations or internal hemorrhage.
Stress is normal up to a point and can be optimal for certain performance related tasks. Stress becomes a problem when it interferes with a person’s ability to do daily life tasks over a period of a few weeks or impacts their health in a dangerous or risky way. When it does become risky, stress can have a negative effect on our bodies and even weaken our health. Research shows that stress can affect the following body systems:. Cardiovascular Circulatory Respiratory Gastrointestinal Endocrine Musculoskeletal Nervous Male Reproduction Immune Female Reproduction
Stress is linked to the six leading causes of death--heart disease, cancer, lung ailments, accidents, cirrhosis of the liver, and suicide 43% of all adults suffer adverse health effects from stress 75 to 90% of all physician office visits are for stress-related ailments and complaints. (American Psychological Association) Lets take a look at what stress can do to some of our body systems.
We’ll start with heart disease which is the leading cause of death in the U.S. (American Heart Association data) A lot of research has emerged over the past decade supporting a link between stress and heart disease. The research shows that Stress has direct effects on the development and course of coronary heart disease through the intervening psychobiological effects of stress and negative emotions. (Source: “Psychosocial influences on the development and course of coronary heart disease: Current status and implications for research and practice” by Smith, Timothy W.; Ruiz, John M., Journal of Consulting & Clinical Psychology. 2002 Jun Vol 70(3) 548-568.) Stress and negative emotions increase heart rate and heart contraction force in both healthy people and those with coronary heart disease. [Source: “Cardiovascular psychophysiology” (chapter) Brownley, K. A., Hurwitz, B. E., & Schneiderman, N. Handbook of psychophysiology (2nd ed., pp. 224–264), J. T. Cacioppo, L. G. Tassinary, & G. G. Berntson (Editors), Cambridge, England: Cambridge University Press (2000)] and [Source: “Ischemic, hemodynamic, and neurohormonal responses to mental and exercise stress: Experience from the Psychophysiological Investigations of Myocardial Ischemia Study” (PIMI), Goldberg, A. D., Becker, L. C., Bonsall, R., Cohen, J. D., Ketterer, M. W., Kaufman, P. G., et al., Circulation, 94, 2402–2409, (1996).] Stress can also affect how blood flows in your body. Researchers found stress affects a variety of factors related to the readiness with which blood coagulates and clots . [Source: “Effects of psychological stress and psychiatric disorders on blood coagulation and fibrinolysis: A biobehavioral pathway to coronary artery disease?” Psychosomatic Medicine, Von Kanel, R., Mills, P. J., Fainman, C., & Dimsdale, J. E., 63, 531–544, (2001).] (NOTE TO PRESENTERS: Audience members may ask questions about normal stress and normal anxiety vs. abnormal amounts of stress and anxiety and poor coping. A basic generic answer might be to acknowledge that yes, stress does have these impacts, anxiety does have an impact, people generally don’t die directly from a stressful episode or a panic attack, but long term, these responses likely do have bad effects on us and make us more vulnerable to disease and illness. Focus on making a direct causal connection but emphasize that rather this increases our vulnerability and risk and as such, psychological interventions are very important in order to reduce risk and have more effective coping strategies.)
Stress also affects the immune system and can weaken physical health. Researchers at The Ohio State University have found that stress can alter levels of certain biochemical markers in the body which play a role in the human immune response. According to research published by scientists from five universities including Ohio State in a --- 1999 issue of the Journal of American Medical Association, stress can lessen a person’s immune response and make him/her more susceptible to infectious diseases. The research paper describes how compounds in our bodies called cytokines are important in regulating the immune response. When a person is experiencing negative stress, hormones balances can be altered which affects the cytokines and can make you prone to infection. (Source: R onald Glaser ; B r uce R abin; Ma r ga r et Chesney; Sheldon Cohen; Benjamin Natelson“Stress-Induced Immunomodulation: Implications for Infectious Diseases?”, JAMA, Jun 1999; 281: 2268 - 2270.)
So we have a general idea of how stress affects your physical health. Let’s look at how it may contribute to poor mental health. Stress can contribute to depression and anxiety. According to the National Institute of Mental Health, 20% of the US population experiences an episode of depression in their lifetime. Anxiety disorders affect approximately 19 million American adults. It’s important to understand the difference between short-term stress or mild anxiety and an anxiety disorder. Everyone feels anxious and under stress from time to time. Situations such as meeting tight deadlines, important social obligations or driving in heavy traffic, often bring about anxious feelings. Such mild anxiety may help make you alert and focused on facing threatening or challenging circumstances. On the other hand, anxiety disorders cause severe distress over a period of time and disrupt the lives of individuals suffering from them. Be aware when symptoms start interfering in your life, when the anxiety no longer motivates you to be more alert or perform better but instead becomes the focus of your concerns and gets in the way of doing things. These are signs of a more serious form of anxiety.
Okay, let’s look at the symptoms people may experience when under a lot of stress. They may feel overwhelmed by a number of things in their lives. They may also feel anxious, mood swings, short temper, rundown and tired. And, they sometimes may experience physical symptoms such as headaches, body aches, tightness in muscles, back and neck pain.
Additional reactions to stress can include: Anger Depression Heart palpitations Irregular menstruation cycles Loss of sexual function Loss of sexual desire
There are a variety of stressors, situations that cause stress. Not all stress is bad. Some stress can act as a motivator for people, such as preparing for and then taking an exam, or meeting a deadline at work. So, what’s going in our lives that may contribute to stress? What are some ordinary life events that can be stressful? (Engage audience.) According to a 2004 survey commissioned by the American Psychological Association (APA), 73 percent of Americans name money as the number one factor that affects their stress level. Work, physical health, and children follow next.
What are some other life situation that can be stressful? (engage audience) Go thru list on slide. Interestingly, a 2004 survey conducted by the American Psychological Association revealed that 73% of Americans name money as the number one factor that affects their stress level. Work, physical health, and children follow next. The same survey found that worries about terrorism are now a major cause of stress in American life and surpass stress caused by intimate relationships Another bit of information from the APA survey showed that work is a greater source of stress than home for Americans . 39% of workers consider their current stress level at work as high. This stress is most frequently attributed to low salaries and heavy workloads. How you manage stress is the key, and whether it is well managed or not can affect your total mind/body health. Unfortunately, people may choose to engage in unhealthy behaviors to deal with stress.
What are some of the unhealthy behaviors people may engage in to help alleviate or deal with stress? Overeating and/or unhealthy eating Not eating Excessive amounts of caffeinated beverages Smoking Use of alcohol or other substances Inactivity Not enough sleep or rest Over scheduling
How many people turn to food for comfort or relief from stress? Eating can serve as a distraction from negative stressors as well as a coping mechanism. If you’re feeling under pressure at work, do you get an urge to go to the vending machine or step out for another snack even though you may not be hungry or have already eaten breakfast or lunch? Do you walk straight to the refrigerator when you get home? Do you sit in front of your TV at night and munch on food beyond what you ate for dinner? I’m sure you have heard that eating too many calories and not getting enough physical activity can lead to weight gain. And being overweight can be a risk factor for physical ailments such a heart disease and diabetes. How much you eat and what you eat can affect how you feel physically and mentally. If you’re eating well-balanced meals and snacks that make you feel energized and healthy, then you will be better able to deal with stress. (Source for statistics: I’d Kill for a Cookie: A simple Six-Week Plan to Conquer Stress Eating , Susan Mitchell, Ph.D., R.D., L.D. and Catherine Christie, Ph.D., R.D., L.D., Penguin Group, 1997, page 19. – Authors are licensed dieticians. Data from survey conducted by Drs. Mitchell and Christie of more than one thousand people.)
Having a cocktail after a difficult day seems like an easy and quick solution to dealing with stress. However, consuming excessive amounts of alcohol or some other substance to cope with stress can be harmful. While some research suggests that small amounts of alcohol may have beneficial cardiovascular effects, there is widespread agreement that heavier drinking can lead to health problems. In fact, 100,000 Americans die from alcohol-related causes each year. Short-term effects include memory loss, hangovers, and blackouts. Long-term problems associated with heavy drinking include stomach ailments, heart problems, cancer, brain damage, serious memory loss, and liver cirrhosis. Drinking problems also have a very negative impact on mental health. Alcohol abuse and alcoholism can worsen existing conditions such as depression or induce new problems such as serious memory loss, depression, or anxiety. According to the National Institute on Alcohol Abuse and Alcoholism, for most adults, moderate alcohol use--up to two drinks per day for men and one drink per day for women and older people--causes few if any problems. One drink equals one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits. Decrease alcohol consumption – if you’re drinking more than two alcoholic beverages at a meal or just consuming alcohol without food, try cutting back to just one drink. Consider one glass of red wine with dinner instead of hard alcohol, beer or several glasses of wine. Cut back the number of times per week that you consumer alcohol. Substitute alcohol with a non-alcoholic beverage Change your home environment – cut back or eliminate the amount of alcohol and beer you keep in your home. Get support if necessary - If you experience a strong need to drink or have problems stopping once you’ve started to drink, or a family member or friend has expressed concern about your drinking behavior, then consider getting help.
What do you do after work and on the weekends? Do you feel so exhausted by stress that you just plop on the couch and channel surf? Watching excessive amounts of TV is another way of suppressing what you feel from stress. It does not give you an outlet to release stress. Another key unhealthy behavior is lack of physical activity. Lethargy and low activity levels, not just TV viewing, but just flopping on the couch and not do anything for long periods of time can sometimes be an unhealthy way of dealing with stress, especially if it’s a way to postpone dealing with responsibilities. One thing about napping or being lazy in the evenings is that people may throw off their sleep schedules, rest a little when they get home and then can’t fall asleep at bed time and go to bed much later than usual. So they don’t get sufficient sleep over night resulting in feeling very tired the next day.
There are a number of things you can do to help reduce and manage stress. Define stress - First thing is to find out what stress means to you? Why a person finds something &quot;stressful&quot; is very important to pin down. Identify stressors in your life – what events or situations trigger stressful feelings? Is it related to work, home, relationships, or something else? Take decisive actions – Act on adverse situations as mush as you can. Take decision actions, rather than detaching completely from problems and stresses and wishing they would just go away. Take care of yourself – Taking care of yourself helps to keep your mind and body primed to deal with stress. Pay attention to your own needs and feelings. Engage in activities that you enjoy and find relaxing. Exercise regularly. Eat healthy. Make sure you get enough rest and sleep. Get support – good relationships with close family members, friends or others are important. Accepting help and support from those who care about you and will listen to you strengthens your resilience and ability to manage stress. If you feel overwhelmed or if the reasons behind stress are emotional, then consider seeking professional help. Psychologists are uniquely trained to understand the mind/body connection and to offer strategies to help people maintain a healthy mind and body.
Let’s look at some healthy behaviors that can release stress and help you better deal with it. Exercise - Just going for a 15 minute walk can make you feel better. It’s a way to clear your mind. There’s plenty of research showing that exercise not only benefits physical health, but also helps mental health. Instead of heading for the couch as soon as you get home, go for a walk. Meditation – can help you relax and get centered. Start with just five minutes and sit quietly. Or listen to a meditation tape or soothing music with your eyes closed. Yoga – another great way to release tension in your muscles, relax and do something good for your mind and body. You could start by using a beginner’s video tape or taking a class once a week. Spiritual Activity – some people find that being active in faith-based activities provides support and helps develop a hopeful outlook. Rest – we all need to sleep and rest. Schedule an hour or two on the weekends to take a nap, or read, or sit someplace calm and nurturing. It could be in your backyard or on your porch or at a park. Reevaluate and re-do schedules – take a look at your schedule and how often you commit your time to others. Block in time to do something good for yourself at least once a week. Get a stress-buster buddy – talk to a family member or friend about teaming up and supporting each other in engaging in activities to release stress and better manage it.
Remember, it’s okay to just start by making one change at a time. And the key is to identify ways that are likely to work well for you as part of your own personal strategy in managing with stress. Let’s look at some additional ways to help better deal with stress. Create a worry-free zone – worry can be a reaction to stress. Give yourself a day off once a week from your worries. Turn off the cell phone 15 minutes of quiet time Take 5 and focus on deep breathing – you can do this at work or home. Close your door or go to a quiet place and just sit straight, hands in lap and focus on your breathing. It’s a great way to calm yourself and get focused. Plan fun time – it’s important to engage in pleasurable activities and hobbies. Planning fun time is a way to give yourself a break. Journaling – some people find relief in writing about their thoughts and feelings related to stressful events.
If you’re feeling overwhelmed, overscheduled and barely have time to take a breather, it’s okay to say “no” to additional work, requests from family and friends or other things. Give yourself a break. Set boundaries. More work assignments? Talk to your boss about how to manage the workload and delegate and share responsibilities. Too many family demands? Talk to your spouse or partner or relatives about sharing errands. Ask for help. You do not have to do everything on your own. Ask for support. If you feel overwhelmed or if the reasons behind stress are emotional, then consider seeking professional help. Psychologists are uniquely trained to understand the mind/body connection and to offer strategies to help people maintain a healthy mind and body. (NOTE TO PRESENTERS : If you have enough time, consider introducing a brief relaxation exercise .)
So, let’s review some tips you can do to make lifestyle changes to help you manage stress. Take care of yourself – Eat healthy, engage in physical activities, relax and rest Identify sources of stress – Take a few minutes and evaluate what’s going on in your life. Pinpoint the things that cause stress. Write them down. Learn how to reduce and manage life stressors – Look at your list of stressors. Seeing them on a piece of paper can help put things in perspective. Beside each listed item causing stress, write down an action. Think about something that would help you reduce that stressor. Keep things in perspective – even when you’re feeling overwhelmed and stretched, try to consider the stressful situation in a broader context and keep a long-term perspective. Avoid blowing a situation out of proportion. Ask for support – turn to family, friends. G ood relationships with close family members, friends or others are important. Accepting help and support from those who care about you and will listen to you strengthens your resilience and ability to manage stress. If you feel overwhelmed or if the reasons behind stress are emotional, then consider seeking professional help. Psychologists are uniquely trained to understand the mind/body connection and to offer strategies to help people maintain a healthy mind and body. (Adapted from “The Road to Resilience,” APA 2002)
(Use this time to take questions, hand out stress fact sheet and other PEC materials. Ask audience to complete evaluation form on program.)
Stress power point
<ul><li>MIND/BODY HEALTH </li></ul>STRESS
Stress <ul><li>Mind/Body Health is the effective balance of physical and psychological health so that each work to support the other. </li></ul>What is Mind/Body Health?
Stress <ul><li>Overwhelming feelings of lack of control over our environment and an inability to change things </li></ul><ul><li>Stress is pervasive, persistent and insidious because it stems from psychological rather than physical threats (American Institute of Stress) </li></ul>Stress
Stress and Your Body Stress <ul><ul><li>Stress is normal up to a point and can be optimal for certain performance related tasks. </li></ul></ul><ul><ul><li>Stress becomes a problem when it interferes with a person’s ability to do daily life tasks over a period of a few weeks or impacts their health in a dangerous or risky way. </li></ul></ul>
Stress <ul><li>Stress is linked to the six leading causes of death--heart disease, cancer, lung ailments, accidents, cirrhosis of the liver, and suicide </li></ul><ul><li>43% of all adults suffer adverse health effects from stress </li></ul><ul><li>("The Stress Solution: An Action Plan to Manage the Stress in Your Life", Lyle H. Miller, Ph.D., and Alma Dell Smith, Ph.D.) </li></ul><ul><li>Two-thirds of all office visits to family physicians are due to stress-related symptoms (American Academy of Family Physicians) </li></ul>The Facts About Stress
Stress <ul><li>Research shows that stress can… </li></ul><ul><li>have direct effects on development of coronary heart disease </li></ul><ul><li>increase heart rate and heart contraction force </li></ul><ul><li>affect blood flow </li></ul>Stress and Heart Disease
Stress Stress and the Immune System Stress Affects Hormones Affects Cytokines Infection
Stress <ul><li>Depression </li></ul><ul><li>20% of US population experiences an episode of depression in their lifetime </li></ul><ul><li>Anxiety </li></ul><ul><li>19 million American adults </li></ul>Stress, Mental Health & Emotional-Wellbeing
Stress <ul><li>Feeling overwhelmed </li></ul><ul><li>Anxious </li></ul><ul><li>Mood swings </li></ul><ul><li>Short temper </li></ul><ul><li>Rundown and tired </li></ul><ul><li>Headaches and body aches </li></ul><ul><li>Tightness in muscles </li></ul><ul><li>Back and neck pain </li></ul>Symptoms of Stress
Stress <ul><li>Anger </li></ul><ul><li>Depression </li></ul><ul><li>Heart palpitations </li></ul><ul><li>Irregular menstruation cycles </li></ul><ul><li>Loss of sexual function </li></ul><ul><li>Loss of sexual desire </li></ul>Additional Reactions to Stress
Stress What Contributes to Stress? <ul><li>Ordinary Life Events That Can Be Stressful </li></ul><ul><li>Starting a new job </li></ul><ul><li>Getting married </li></ul><ul><li>Graduation </li></ul><ul><li>Buying a home </li></ul><ul><li>Having a baby </li></ul><ul><li>Holiday season </li></ul>
Stress What Contributes to Stress? <ul><li>Life Situations or Events That Can Be Stressful </li></ul><ul><li>Money </li></ul><ul><li>Job loss </li></ul><ul><li>Workplace issues </li></ul><ul><li>Relationship problems </li></ul><ul><li>Family problems </li></ul><ul><li>Illness </li></ul><ul><li>Death of a loved one </li></ul><ul><li>Caring for a sick relative </li></ul>
Stress <ul><li>Overeating and/or unhealthy eating </li></ul><ul><li>Not eating </li></ul><ul><li>Excessive amounts of caffeinated beverages </li></ul><ul><li>Smoking </li></ul><ul><li>Use of alcohol or other substances </li></ul><ul><li>Inactivity </li></ul><ul><li>Not enough sleep or rest </li></ul><ul><li>Over committing yourself </li></ul>Unhealthy Behaviors
Stress <ul><li>79% of women and 69% of men report stress eating </li></ul><ul><li>Sweets and salty foods most common </li></ul><ul><li>( I’d Kill for a Cookie: A simple Six-Week Plan to Conquer Stress Eating , Susan Mitchell, Ph.D., R.D., L.D. and Catherine Christie, Ph.D., R.D., L.D., Penguin Group, 1997) </li></ul>Stress Eating
Stress <ul><li>Heavy drinking is consuming alcohol in excess of 1 drink per day on average for women and greater than 2 drinks per day on average for men </li></ul><ul><li>(National Institute on Alcohol Abuse and Alcoholism, 2004). </li></ul>Stress and Alcohol and Substance Abuse
Stress <ul><li>Despite the proven benefits of physical activity, more than 50% of U.S. adults do not get enough physical activity to provide health benefits </li></ul><ul><li>26% are not active at all in their leisure time. </li></ul><ul><li>(Centers for Disease Control) </li></ul>Stress and Inactivity
Stress <ul><li>Define stress </li></ul><ul><li>Identify stressors in your life </li></ul><ul><li>Identify unhealthy behaviors </li></ul><ul><li>Take decisive actions </li></ul><ul><li>Take care of yourself </li></ul><ul><li>Get support </li></ul>Behavior & Lifestyle Reduce and Manage Stress
Stress <ul><li>Exercise </li></ul><ul><li>Meditation </li></ul><ul><li>Yoga </li></ul><ul><li>Spiritual Activity </li></ul><ul><li>Rest </li></ul><ul><li>Reevaluate and re-do schedules </li></ul><ul><li>Get a stress-buster buddy </li></ul>Healthy Behavior & Lifestyle
Stress <ul><li>Create a worry-free zone </li></ul><ul><li>Turn off the cell phone </li></ul><ul><li>15 minutes of quiet time </li></ul><ul><li>Take 5 and focus on deep breathing </li></ul><ul><li>Plan fun time </li></ul><ul><li>Journaling </li></ul>Healthy Behavior & Lifestyle
Stress <ul><li>It’s okay to say “no.” </li></ul>Healthy Behavior & Lifestyle
Stress <ul><li>Take care of yourself </li></ul><ul><li>Identify sources of stress </li></ul><ul><li>Learn how to reduce & manage life stressors </li></ul><ul><li>Keep things in perspective </li></ul><ul><li>Get support </li></ul>Behavior & Lifestyle Overview of Tips
Stress Free materials and information on referrals are available online: www.APAHelpCenter.org , or by calling 1-800-964-2000 The American Psychological Association Practice Directorate gratefully acknowledges the assistance of Lynn Bufka, Ph.D., in developing this presentation.