This presentation discussed coping with stress and depression. It began by defining stress and identifying common signs of stress like digestive issues and forgetfulness. Chronic stress can increase risks for infections, anxiety, depression and other health issues. The presentation then discussed healthy and unhealthy ways to cope with stress, such as exercise, spending time with others, limiting alcohol, and mindfulness-based stress reduction. It defined anxiety and depression as medical conditions and listed common signs. Treatment options were provided, including talking to a doctor, therapist or using screening tools online. Resources for help and information were also presented.

1. Coping with Stress and Depression
Presented by
Zaza Sakhat, LICSW
& Susan Weinstein

2. Agenda
• How to identify signs of stress
• What are ways to reduce stress
• What is mindfulness-based stress reduction
• How to identify when it s more than stress
• What are anxiety and depression
• How and where to get help

3.  Consider: What causes you the most stress?
 Stress is a fact of life, but it can be managed
Viewer Activity

4. Stress is your body's
way of responding to
any kind of demand. It
comes from the strains
of day-to-day life or
acute events.
Definition of stress

5. Acute Stress—How does it feel ?
You are driving
You see a dog in the road
You slam on the brakes
What happens to your body?

6. Signs of Stress
 Digestive problems
 Tense muscles and aches
 Racing heartbeat and
restlessness, sweating
 Skin problems
 Getting sick more frequently
 Irritability, quick temper
 Worried, anxious thoughts
 Forgetfulness, problems
concentrating
 Less interest in sex
 Menstrual or fertility problems
 Drinking more alcohol,
smoking more often

7. How stress impacts the body
You have a fight or flight response
 Adrenaline and other body chemicals are
released
 Good for short spurts, not long term
 Chronic stress without healthy release has
long-term consequences to physical and
emotional health

8. Chronic stress can take a toll
Increased vulnerability to
 Infections, viruses
 Sleep problems
 Anxiety
 Depression
 GI problems
 Heart conditions
 Weight gain or loss
 Infertility
 Compromised glucose
control (diabetes)
Take the Holmes and Rahe stress test at
www.stresstips.com/lifeevents.htm

9.  Healthy ways and unhealthy ways
How do you cope with stress?

10. Strategies for coping with stress
 Relax deliberately and breathe
deeply
 Eat well, with a healthy, balanced
variety of foods
 Stop smoking
 Limit coffee and alcohol
 Exercise and move your body
 Sleep long enough to feel rested
 Set limits
 Spend time with others
 Laugh and sing
 Practice spirituality
 Focus on your goals

11. Rationale for reframing
Reframing negative thoughts can help us:
• Turn them into positive possibilities
• Reduce stress and improve mood

12. Reframing
What nourishes you?

13. Inventory your personal attributes
Reframing

14. Practice gratefulness
 I recognize
 I acknowledge
 I appreciate

15. Mindfulness-Based Stress
Reduction (MBSR)
Mindfulness means paying
attention in a particular
way—deliberately, in the
present moment, and
without judgment

16.  Decreases the negative effects of stress
 Some success easing other health
problems
 MBSR is a lifestyle change, more
effective in the long run
Benefits of MBSR
The MBSR program was founded in 1979
by Dr. Jon Kabat-Zinn, U-Mass Medical
Center; now offered at centers and
clinics nationwide
Citations: Carmody & Baer, Relationships between mindfulness
practice and levels of mindfulness, etc., J Behav Med, Feb 2008;
Marchand, Mindfulness-based stress reduction … for depression,
anxiety, pain, and psychological distress, J Psychiatr Pract, Jul 2012

17. Ways to practice MBSR
 Meditation
 Yoga
 Tai chi
 Other body-centered meditative
approaches
By increasing awareness in
a conscious way, you can
work through your stress

18. Commit to reducing stress
For your eyes only, jot down one or two things you
can do starting tomorrow (maybe even tonight?) to
help manage your stress—at home and at work.
I commit to:
 [doing what?]
 [by when?].

19. Remember to breathe!

20. Beyond
Stress

21. Anxiety or clinical
depression
Do you know someone
who is anxious or
depressed?

22. These are medical conditions
Clinical depression and anxiety:
 Affect people of any age, gender, race, income level
 Are treatable medical conditions
 80% of people improve with treatment
 Are often biologically based
 Like diabetes or heart disease

23. What is anxiety?
Excessive dread, fear, or worry
that is intense and ongoing

24. Who has anxiety?
Anxiety is very common:
• 40 million adults in the U.S.
suffer from anxiety disorders* *Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and
comorbidity of twelve-month DSM-IV disorders in the National
Comorbidity Survey Replication (NCS-R). Archives of General
Psychiatry, 2005 Jun;62(6):617-27

25. Signs of anxiety disorders
• Irrational feelings of fear,
uneasiness, dread
• Excessive worry
• Impaired concentration or
selective attention
• Feeling restless or on edge
• Heart palpitations or racing
heartbeat
• Avoiding activities or people
• Easily startled or jumpy
• Bothered by normal
surrounding noise or
conversation
• Irritability
• Sweating
• Fatigue
• Headaches and stomach
problems
• Insomnia
• Repetitive/compulsive
behaviors (checking, counting,
washing)
• Nervousness

26. What is clinical depression?
 A treatable medical
condition
 Affects people
regardless of gender,
race, income level, age
 More than sadness or
“the blues”

27. Who has clinical depression?
Common
• 14.8 million American adults in a given year1
• About 7% of American adults are depressed1
• 20% of teens will experience depression by adulthood2
If untreated, can lead to suicide
• 30% attempt suicide, and half of those take their lives3
1: Archives of General Psychiatry, 2005 Jun; 62(6): 617-27
2: American Academy of Child and Adolescent Psychiatry,
Facts for Families, The Depressed Child, 2008
3: National Center for Health Statistics, 2007.

28. Depression—what others notice
• Talking very negatively
• Acting without concern
for others
• Abusing alcohol or drugs
• Picking fights, being
irritable, critical, or mean
• Withdrawing from people
• Having trouble at work
• Talking suddenly about
separation or divorce
• Complaining of medically
unexplained aches and
pains
• Eating or sleeping too
much or too little
• Behaving unusually or
uncharacteristically

29. Abusing alcohol and drugs
Common sign
9% of full-time workers—about 12.7 million people
—have problems with alcohol consumption.*
*2011 National Survey on Drug Use and Health,
Substance Abuse and Mental Health Services Administration

30. Markers of depression
For at least 2 weeks:
• Feeling miserable,
depressed, sad, empty, or
irritable
• Losing interest or pleasure
in most activities
Thinking of death or suicide
- Seek help immediately

31. Help and Resources

32. Where to go for help
• Employee Assistance Program at your company
• Your doctor (get a referral)
• Mental health clinician (e.g., psychiatrist, psychologist,
social worker, psychiatric nurse, family therapist)
• Complete an online screening, give to your clinician to
get a full evaluation
 Depression and Bipolar Test: www.familyaware.org, click Tools
 Massachusetts residents: www.stopmysadness.com
 Outside Massachusetts: www.helpyourselfhelpothers.org

33. Nonprofit organization helping families recognize
and cope with depression and bipolar disorder to
get people well and prevent suicides
Visit Families for Depression Awareness at
www.familyaware.org
Learn More, Get Support

35. Audio Podcast Series
Depression in the Family
• Signs of Depressive Disorders
• Diagnosis and Treatment
• Helping a Family Member
• Caregiver Burnout
• Family Communication
• How to Find and Pay for
Treatment
• Family History

36. Depression Test
• Anonymous, confidential
• Available at
www.familyaware.org
• Print out results, take to
clinician

37. Mental Health Family Tree

38. Depression Wellness Analyzer
Computer-based tool to
monitor treatment.
Download at
www.familyaware.org

39. Care for Your Mind
Bringing people with mood disorders
and their families into a
conversation about mental health
care system and how to fix it
• Collaboration with Depression and
Bipolar Support Alliance
• www.CareForYourMind.org

40. Coping with Stress Training
 Stress is top health concern among
employees
 Depression training helps employers reduce
the cost of untreated or poorly treated
depression
We can present a company-specific webinar or
in-person workshop to employees
We also have a Coping with Stress Workshop,
including Facilitator’s Guide, so you can
present the workshop to your company,
community group, or other organization

41. Massachusetts Department
of Public Health
The Massachusetts Workplace
Mental Health Initiative

42. Stay Engaged With Us
• Sign up for our email newsletter (go to homepage at
www.familyaware.org)
• Volunteer or share your story (go to
www.familyaware.org and click Volunteer tab)
• Participate on www.CareForYourMind.org

43. Special Thanks
Zaza Sakhat, LICSW, today’s
presenter
Educational grant support from:
• Massachusetts Department of
Public Health
• Takeda and Lundbeck
• AstraZeneca
• Forest Laboratories
and contributions from individuals
like you!

44. Next Steps
• Please complete the online evaluation to
receive your free Coping with Stress
brochure and reframing handout:
https://www.surveymonkey.com/s/HV3DY9Z
• Implement your commitments to reducing
stress
• Visit www.familyaware.org to learn more,
volunteer, and/or donate to Families for
Depression Awareness

45. Thank you!