Stress is the reaction people have to excessive pressures or other types of demands placed upon them. It arises when they worry that they can’t cope.

1. • Chairperson Designate ICOG –Indian College of OB/GY
• National Corresponding Editor-Journal of OB/GY of India JOGI
• National Corresponding Secretary Association of Medical Women, India
• Founder Patron & President –ISOPARB Vidarbha Chapter
• Chairperson-IMS Education Committee 2021-23
• President-Association of Medical Women, Nagpur AMWN
• Nagpur Ratan Award @ hands of Union Minister Shri Nitinji Gadkari
• Received Bharat excellence Award for women’s health
• Received Mehroo Dara Hansotia Best Committee Award for her work as
Chairperson HIV/AIDS Committee, FOGSI 2007-2009
• Received appreciation letter from Maharashtra Government for her work in the
field of SAVE THE GIRL CHILD
• Senior Vice President FOGSI 2012
• President Menopause Society, Nagpur 2016-18
• President Nagpur OB/GY Society 2005-06
• Delivered 11 orations and 450 guest lectures
• Publications-Thirty National & Eleven International
• Sensitized 2 lakh boys and girls on adolescent health issues
Dr. Laxmi Shrikhande
MBBS; MD(OB/GY);
FICOG; FICMU; FICMCH
Medical Director-
Shrikhande Fertility Clinic
Nagpur, Maharashtra

2. Stress Management
Dr Laxmi Shrikhande
Nagpur

3. Stress Management
“Everyone knows what stress is,
but no one really knows.”
Hans Selye
Stress is an unavoidable consequence of life.

4. WHAT IS STRESS ?
Stress is the reaction people have to excessive pressures or other
types of demand placed upon them.
It arises when they worry that they can’t cope.

5. S = P > R
Stress occurs when the pressure is greater than the resource

6. TYPES OF STRESSORS
External
Internal

7. EXTERNAL STRESSORS
• Physical Environment
• Social Interaction
• Organisational
• Major Life Events
• Daily Hassles

8. INTERNAL STRESSORS
• Lifestyle choices
• Negative self - talk
• Mind traps
• Personality traits

9. EXTERNAL STRESSORS
• Physical Environment
• Social Interaction
• Organisational
• Major Life Events
• Daily Hassles

10. PHYSICAL ENVIRONMENT
• Noise
• Bright Lights
• Heat
• Confined Spaces

11. SOCIAL INTERACTION
• Rudeness
• Bossiness
• Aggressiveness by others
• Bullying

12. ORGANISATIONAL
• Rules
• Regulations
• “Red - Tape”
• Deadlines

13. MAJOR LIFE EVENTS
• Birth
• Death
• Lost job
• Promotion
• Marital status change

14. DAILY HASSLES
• Commuting
• Misplaced keys
• Mechanical breakdowns

15. INTERNAL STRESSORS
• Lifestyle choices
• Negative self - talk
• Mind traps
• Personality traits

16. LIFESTYLE CHOICES
• Caffeine
• Lack of sleep
• Overloaded schedule

17. NEGATIVE SELF - TALK
• Pessimistic thinking
• Self criticism
• Over analysing

18. MIND TRAPS
• Unrealistic expectations
• Taking things personally
• All or nothing thinking
• Exaggeration
• Rigid thinking

19. PERSONALITY TRAITS
• Perfectionists
• Workaholics

20. TYPES OF STRESS
 Negative stress
 Positive stress

21. Negative Effects of Stress
1. Physical
- Weight gain/loss
- Unexpected hair loss
- Heart palpitations
- High blood pressure
2. Emotional
- Mood swings
- Anxiety
- Can lead to depression
3. Can also lead to unhealthy coping
strategies (i.e. alcohol, drugs, etc)

22. POSITIVE STRESS
Stress can also have a positive effect, spurring motivation and
awareness, providing the stimulation to cope with challenging
situations.
Stress also provides the sense of urgency and alertness needed for
survival when confronting threatening situations.

23. SYMPTOMS OF STRESS
 Physical symptoms
 Mental symptoms
 Behavioural symptoms
 Emotional symptoms

24. PHYSICAL SYMPTOMS
• Sleep pattern changes
• Fatigue
• Digestion changes
• Loss of sexual drive
• Headaches
• Aches and pains
• Infections
• Indigestion
• Dizziness
• Fainting
• Sweating & trembling
• Tingling hands & feet
• Breathlessness
• Palpitations
• Missed heartbeats

25. MENTAL SYMPTOMS
• Lack of concentration
• Memory lapses
• Difficulty in making decisions
• Confusion
• Disorientation
• Panic attacks

26. BEHAVIOURAL SYMPTOMS
• Appetite changes - too much or too little
• Eating disorders - anorexia, bulimia
• Increased intake of alcohol & other drugs
• Increased smoking
• Restlessness
• Fidgeting
• Nail biting
• Hypochondria

27. EMOTIONAL SYMPTOMS
• Bouts of depression
• Impatience
• Fits of rage
• Tearfulness
• Deterioration of personal hygiene and appearance

28. COSTS OF STRESS
80% of all modern diseases have their origins in stress.

29. ABC STRATEGY
A = AWARENESS
What causes you stress?
How do you react?

30. ABC STRATEGY
B = BALANCE
There is a fine line between positive / negative stress
How much can you cope with before it becomes negative ?

31. ABC STRATEGY
C = CONTROL
What can you do to help yourself combat the negative effects of stress
?

32. Stress Management Techniques
• Change your thinking
• Change your behaviour
• Change your lifestyle

33. Change your Thinking
• Re-framing
• Positive thinking

34. Re-framing
 Re-framing is a technique to change the way you look at things in
order to feel better about them.
 There are many ways to interpret the same situation so pick the one
you like.
 Re-framing does not change the external reality, but helps you view
things in a different light and less stressfully.

35. Positive Thinking
Forget powerlessness, dejection, despair, failure
Stress leaves us vulnerable to negative suggestion so focus on
positives;
• Focus on your strengths
• Learn from the stress you are under
• Look for opportunities
• Seek out the positive - make a change.

36. Change your Behaviour
• Be assertive
• Get organised
• Ventilation
• Humour
• Diversion and distraction

37. Be Assertive
 Assertiveness helps to manage stressful situations, and will , in time,
help to reduce their frequency.
 Lack of assertiveness often shows low self - esteem and low self -
confidence.
 The key to assertiveness is verbal and non - verbal communication.
 Extending our range of communication skills will improve our
assertiveness.

38. Get Organised
 Poor organisation is one of the most common causes of stress.
 Structured approaches offer security against ‘out of the blue’
problems.
 Prioritising objectives, duties and activities makes them manageable
and achievable.
 Don’t overload your mind.
 Organisation will help avoid personal and professional chaos.

39. Time Management
• Make a list
What MUST be done
What SHOULD be done
What would you LIKE to do
• Cut out time wasting
• Learn to drop unimportant activities
• Say no or delegate

40. Time Management
• Plan your day
• Set achievable goals
• Don’t waste time making excuses for not doing
something

41. Ventilation
‘A problem shared is a problem halved’
Develop a support network through friends or colleagues to talk with.
It’s not always events that are stressful but how we perceive them.
Writing a diary or notes may help release feelings but do not re-read
what has been written.

42. Humour
• Good stress - reducer
• Applies at home and work
• Relieves muscular tension
• Improves breathing
• Pumps endorphins into the bloodstream - the body’s natural
painkillers

43. Diversion and Distraction
• Take time out
• Get away from things that bother you
• Doesn’t solve the problem
• Reduce stress level
• Calm down
• Think logically

44. Change Your Lifestyle
• Diet
• Smoking & Alcohol
• Exercise
• Sleep
• Leisure
• Relaxation

45. Diet
• Healthy eating habits
• Caffeine (Stimulant)
• Salt

46. Smoking and Alcohol
• Moderate your consumption

47. Benefits of Exercise
• Uses up excess energy released by the ‘Fight or Flight’ reaction.
• Improves blood circulation
• Lowers blood pressure
• Clears the mind of worrying thoughts
• Improves self image
• Makes you feel better about yourself
• Increases social contact

48. Sleep
• Good stress reducer
• Difficult to cope when tired
• Wake refreshed after night’s sleep
• Plenty of daytime energy

49. Leisure
• Interest
• Gives you a ‘break’ from stresses
• Provides outlet for relief
• Provides social contact

50. Benefits of Relaxation
• Decreases mental worries
• Increases concentration
• Increases productivity
• Increases clear thinking
• Lowers blood pressure
• Combats fatigue
• Promotes sleep
• Reduces pain
• Eases muscle tension

51. Alternatives
• Conventional Medicine
• Counselling & psychotherapy
• Relaxation
• Meditation
• Massage
• Yoga
• Acupuncture
• Aromatherapy
• Floatation
• Herbalism
• Biofeedback
• Homeopathy
• Hypnotherapy
• Osteopathy
• Pet Therapy
• Reflexology

52. Summary
• Causes of stress
• Identification and admission
• Ways to control stress
• Alternative methods

53. Review
• Stress is part of everyday life
• It can promote growth and competency
• If unrelenting or overwhelming it can cause adverse effects
• Adaptive coping enhances resilience
• Maladaptive coping causes additional problems

54. Review: Practical Tips
• Set realistic expectations
• Exercise regularly
• Eat healthy
• Get adequate sleep
• Maintain a work-leisure balance
• Positive Reframing & optimism
• Enhance social support

55. Covid times-

57. +
Action Plan
1) What is the biggest source of stress in your life right now?
2) Is this a positive or negative stress? Why?
3) What (if anything) can you do to eliminate this stress in a positive manner from
your life?
4) What healthy activity will you do to deal with this stress?
5) What are some campus resources you are willing to use to deal with this stress?
On a note card or piece of paper answer the following…

58. Serenity Prayer
“Grant me the courage to change the things I can change,
the serenity to accept the things I can’t change,
and
the wisdom to know the difference.”
--Reinhold Niebuhr, Serenity Prayer

59. Proprietary and confidential — do not distribute
My World of sharing happiness!
Shrikhande Fertility Clinic
Ph- 91 8805577600
shrikhandedrlaxmi@gmail.com

61. Proprietary and confidential — do not distribute
The Art of Living
Anything that
helps you to
become
unconditionally
happy and loving
is what is called
spirituality.
H. H. Sri Sri Ravishakar