Stress and coping, health

1. Stress and
Health
Dr. Irene Karayianni

2. What is stress?
Image sources
http://gainesvillescene.com/2013/12/04/de-stress-during-finals/

3. Any event that exceeds our ability to cope
We experience stress when we perceive that demands exceed
our resources. In less formal terms, we feel stressed when we
feel that "things are out of control".
Image sources
http://www.mindtools.com/pages/article/newTCS_82.htm

4. What causes stress?
Image sources
http://madamsecretary.co.nz/

5. What causes stress
• Life events can be positive or negative
– Violence, war, sexual assault
– Loss of family member – spouse, child
– Natural disasters
– Terrorism – anxiety, depression, sleep problems, flashbacks
– Daily hassles, inconveniences
– Positive life events – graduation, birth of child, promotion, moving
• Frustration – when we can’t satisfy a motive
• Pressure – stress from threat of negative events
• Environment conditions: temperature, pollution, noise, humidity,
crowding, etc
• Secondhand stress: people around you

6. Holmes and Rahe stress scale
list of stressful life events that can contribute to illness
Event Mean value
Death of a spouse 100
Divorce 73
Marital separation 65
Imprisonment 63
Death of a close family member 63
Personal injury or illness 53
Marriage 50
Dismissal from work 47
Marital reconciliation 45
Retirement 45
Change in health of family member 44
Pregnancy 40
Sexual difficulties 39
Gain a new family member 39
Business readjustment 39
Change in financial state 38
Death of a close friend 37
Change to different line of work 36
Change in frequency of arguments 35
Major mortgage 32
Foreclosure of mortgage or loan 30
Event Mean value
Change in responsibilities at work 29
Child leaving home 29
Trouble with in-laws 29
Outstanding personal achievement 28
Spouse starts or stops work 26
Beginning or end school 26
Change in living conditions 25
Revision of personal habits 24
Trouble with boss 23
Change in working hours or conditions 20
Change in residence 20
Change in schools 20
Change in recreation 19
Change in church activities 19
Change in social activities 18
Minor mortgage or loan 17
Change in sleeping habits 16
Change in number of family reunions 15
Change in eating habits 15
Vacation 13
Christmas 12
Minor violation of law 11
Score of 300+: At risk of illness.
Score of 150-299: Risk of illness is moderate (reduced by 30% from the above risk).
Score <150: Only have a slight risk of illness.

7. …for non adults
Event Mean value
Death of parent 100
Unplanned pregnancy/abortion 100
Getting married 95
Divorce of parents 90
Acquiring a visible deformity 80
Fathering a child 70
Jail sentence of parent for over one year 70
Marital separation of parents 69
Death of a brother or sister 68
Change in acceptance by peers 67
Unplanned pregnancy of sister 64
Discovery of being an adopted child 63
Marriage of parent to stepparent 63
Death of a close friend 63
Having a visible congenital deformity 62
Serious illness requiring hospitalization 58
Failure of a grade in school 56
Not making an extracurricular activity 55
Hospitalization of a parent 55
Score of 300+: At risk of illness.
Score of 150-299: Risk of illness is moderate. (reduced by 30% from the above risk)
Score <150: Slight risk of illness.
Event Mean value
Jail sentence of parent for over 30 days 53
Breaking up with boyfriend or girlfriend 53
Beginning to date 51
Suspension from school 50
Becoming involved with drugs or alcohol 50
Birth of a brother or sister 50
Increase in arguments between parents 47
Loss of job by parent 46
Outstanding personal achievement 46
Change in parent's financial status 45
Accepted at college of choice 43
Being a senior in high school 42
Hospitalization of a sibling 41
Increased absence of parent from home 38
Brother or sister leaving home 37
Addition of third adult to family 34
Becoming a full fledged member of a church 31
Decrease in arguments between parents 27
Decrease in arguments with parents 26
Mother or father beginning work 26

8. Conflict
• Conflict – two or more motives can’t be satisfied because they interfere
with one another
– Approach – approach: choose between two desirable alternatives
– Avoidance – avoidance: choose between two undesirable alternatives
– Approach – avoidance: a goal is both desirable and undesirable (positive
and negative consequences)
– Multiple approach – avoidance: choose between options that have both
attractive and negative aspects
Image sources
http://xiamenwriting.wikispaces.com/False+Dilemma

9. How do we react to stress?
Image sources
http://leadershipfreak.wordpress.com/2009/12/28/frustration-or-inspiration/

10. Stress reactions
• Both physiological and psychological reactions
• Our body’s reaction is the same, whether the stress is physical or
psychological
Physical stress
Psychological
stress
Physical
reaction
Psychological
reaction
Emotions
Cognitions
Motivations
Anxiety
Depression
Anger
Irritability
Difficulty concentrating
Can’t think clearly
Less energy
Change in appetite
Sympathetic
nervous system
Stress hormones

11. Health problems associated with stress
• Impaired immune system
• Coronary Heart Disease and stroke
• Increased blood pressure
• Increase blood sugar
• Gastrointestinal problems such as ulcers
• Insomnia, headache
• Backache
• Drug & alcohol use

12. Physical reactions
• Stress influences the way our body functions
• The body reacts in the same way as it reacts to infection or injury
• The body mobilizes its defenses  General Adaptation Syndrome (GAS)
• GAS best works in emergencies. Dangerous if prolonged.
1. Alarm
2. Resistance
3. Exhaustion

13. How stress affects health
• Direct effect
– Raises blood pressure
– Impairs immune system
– Stomachache
– etc
• Indirect effect
– Less positive behaviors (exercise, healthy diet, lack of sleep)
– More negative behaviors (drinking, smoking, unhealthy diet)

14. Student Academic Support Services
• Offers two major types of academic support: one-on-one sessions and
group sessions. These are open to all and the goal is to help students
become independent learners and succeed in their studies.
– One-on-one Sessions. Conducted on a one-on-one basis between a
facilitator and a student. They are provided on a first-come-first-served
basis and cover a wide range of college skills.
– Group Sessions. Designed to emphasize direct interaction between
participants:
• Academic-skills workshops focus on sharpening quantitative or qualitative skills
for courses or help participants sharpen conversational skills in a foreign
language.
• Study-skills workshops are designed to help participants improve a particular
study skill, such as studying, note-taking or exam preparation.

15. Stage 1: alarm
Sympathetic nervous system – prepare for physical struggle
• Body mobilizes its stored resources
• "fight or flight” prepares the body for physical struggle
• Stress hormones cortisol, adrenaline, noradrenaline are released
• Increase heart rate, blood pressure, blood sugar
• Increase sweating
• Blood away from digestion
• Immune cells are activated to fight infection
• When prolonged  feeling of sickness:
– Stomachache, headache, muscle tension, damage blood vessels of the heart
and brain, damage to cells and muscle tissues, cardiovascular conditions,
stroke, gastric ulcers, and high blood sugar levels
Image sources
http://thenetworkgarden.blogs.com/.a/6a00d8341c285b53ef01156f9ee0bc970c-popup

16. Stage 2: resistance
following long exposure to stressor
• Body’s resources are fully mobilized
• Resistance to stressor is high
• If new stress is encountered, the body is less able to deal with it
• If stress continues, resources become depleted
• Problems begin to manifest when we repeat this process too often
with little or no recovery. Ultimately this moves us into the final stage.
Image sources
http://www.conflictdynamics.org/blog/2011/11/anger-and-conflict

17. Stage 3: exhaustion
• Often referred to as overload, burnout, adrenal fatigue
• resources are exhausted, resistance is lowered
• The immune system, and the body's ability to resist disease, may be
almost totally eliminated. Patients who experience long-term stress
may succumb to heart attacks or severe infection due to their reduced
immunity.
Image sources
http://wholistichealthcare.ca/exhaustion/

18. The science of stress
• https://www.youtube.com/watch?v=eYG0ZuTv5rs

19. Image sources
http://www.cookinglight.com/cooking-101/techniques/pressure-cooker-recipes-00412000068028/
What influences how we react to stress?

20. Why does stress sometimes lay us low and sometimes cause
only temporary changes in our well being?
Situation Ourselves
Stressor
Social support
etc
Reactions
Personality
Health

21. Less stress…
• Past experience with the stressor
• We are older
• The stressor is predictable. However, when the stress continues over
long periods of time, predictable stress is more stressful.
• We have some control
• We have support from friends & family / spouse  healthier in marriage
– Get it off our chest
– Trained psychotherapist
• Higher intelligence people
• Don’t interpret events in stress provoking ways
• Men are less likely to experience long lasting reactions to traumatic
events
• Are low in neuroticism trait
• Not Type A personality
• Belong to the majority group in society instead of minority

22. Type A personality
• Aggressive
• Competitive
• Hostile
• Workaholic
• Multi-task
• Take on more than they can handle
• Ambitious
• Perfectionist
• Don’t stop to smell the roses
• Rigidly organized
• Impatient
• Proactive
• Sense of time urgency
• Obsessed with time management
• Heart disease
• High blood pressure
• Cholesterol
Image sources
http://www.voicefilm.com/features/

23. Image sources
http://www.funwallz.com/bamboo-stones-zen-meditation-fresh-new-27535.html
How can we cope with stress?

24. You may not be able to smooth out the surf,
but you can learn to ride
the waves
Image sources
http://gust.com/blog/2012/01/30/8-ways-to-surf-the-entrepreneur-information-wave/
Either remove the stressors or control our reactions

25. Ineffective coping
not what we do, but why and how we do it
• Withdrawal from stressor – avoiding more effective coping
• Aggression
• Self-medication – tobacco, alcohol and other drugs
• Defense mechanisms when overdone
– Displacement: direct threatening feelings from primary object to someone
else.
– Sublimation: channel unacceptable desires into acceptable behaviors
– Projection: attribute our threatening impulses to others
– Reaction formation: make something appear as the exact opposite
– Regression: retreat to earlier, childish safe stage
– Rationalization: give self justifying explanations for negative events
– Repression: push anxiety thoughts into unconscious
– Denial
– Intellectualization: think of stressor in detached, cold way

26. Effective coping
• Remove or reduce the stressor
• Change the way we think about or interpret the stressful event
(reappraisal)
• Focus our attention away from stressor
• Interpret events based on religious beliefs (condition is in God’s hands)
• Engage in relaxing activities (gym, hobbies, talk to friends, relaxation
training)
• Learn how to relax from a Health Psychologist – progressive relaxation
– Sense difference between tense and relaxed muscles
– Deeply relax large body muscles
• Improve eating habits - Lose weight – BMI
• Regular moderate aerobic exercise
• Not smoking
Image sources
http://www.deeppencil.com/hugh-jackman-fat-bastard/
http://www.youtube.com/watch?v=UyjezioxtGA