I dare someone to do it in 6 hours

GEHP 3000

Well-Being and Quality of life

Javier A Osorio

Adapted from a presentation created by Dr. Gulrukh Hashmi

Managing Stress:

Coping with Life’s

Challenges

Definition

 Types of stressors

Types of stress

Body response to stress

Stress and illness

Occupational stress

Post traumatic stress disorders

 Scales to measure stress

 Stress management

Summary

Stress is the process by

which we perceive and

respond to certain

events that we see as

threatening or

challenging.

Any event or circumstance that causes stress is called

stressor.

Stressor as such does not cause stress but our

perception of that event, the meaning we attach to it and

the way we react to it leads to symptoms or diseases of

stress.

STRESSOR

Types of stressors

Biological stressors

 Any illness or disease

Disabilities

Injuries

Environmental stressors

 Poverty

Overcrowding

Natural disasters

 Inability to solve a problem

Coming up with creative projects

Cognitive stressors

Life change stressors

 Death of loved ones

 Divorce

Trouble among family and friends

Types of stress

 Acute Stress

Acute stress is the reaction to an immediate threat,

commonly known as the fight or flight response. The threat

can be any situation that is experienced, even

subconsciously or falsely, as a danger.

Common acute stressors include:

• noise

• crowding

• hunger

 Chronic stress

Frequently, however, modern life poses on-going stressful

situations that are not short-lived and the urge to act (to fight

or to flee) must be suppressed. Stress, then, becomes chronic.

Common chronic stressors include:

• on-going highly pressured work,

• long-term relationship problems,

• loneliness, and

• persistent financial worries.

Eustress

 It is the “good” kind of stress

Something pleasing will result at the

end of the stressful situation

Examples:

• Planning a wedding

• Planning a party

• Completing your last semester before

graduation

Distress

 It is a displeasing kind of stress

It is the “bad” kind of stress

It causes the most harm to the body

Examples:

Death of a loved one

 Natural disasters like earthquakes, floods

Financial problems

 Stress resides neither in the person alone nor in the

situation alone, but rather in a transaction between

the two.

Subjective (cognitive) interpretation of stressful

events or life changes

Transaction model

Fight /flight mechanism

Walter Cannon (1932)

 When an organism

perceives threat systems of the body get activated.

Responses to stress

Seyle’s general adaptation syndrome

There are 3 stages:

1. Alarm stage :- occurs when person recognizes threat

and mobilizes resources.

2. Resistance :- occurs when the stress is prolonged

3. Exhaustion :- occurs when body’s resources are

depleted.

Stress and illnesses  PSYCHOSOMATIC DISEASES are defined as

physical ailments with a genuine organic basis that are

caused in part by psychological factors, especially

emotional distress… hypertension, ulcers, asthma, eczema,

and migraine headaches

 EMOTIONAL PROBLEMS like anger, panic, fatigue,

sleep disorders, depression, suicide/attempted suicides.

Two fold effects of stress

 Stress weakens the immune system by diverting the

energy required for its functioning to deal with the

stress.

 Cortisol, a hormone released during stressful situations,

affects the immune system greatly by preventing the

production of cytokines.

 During chronic stress, cortisol is over produced, causing

fewer receptors to be produced on immune cells so

that inflammation cannot be ended.

Stress and immunity

Clogging of the vessels that nourish the heart

muscles.

 Chronic stress causes

- increase in the levels of lipids

- blood to become stickier (possibly in preparation

of potential injury), increasing the likelihood of an

artery-clogging blood clot.

Stress and chronic heart diseases

TYPE B

 Easygoing

 Relaxed

TYPE A

 Competitive

 Hard driving

 Impatient

 Verbally aggressive

 Anger prone

Types of personalities

 Essential Hypertension is a condition in which there

is chronic high blood pressure, usually with no

known biological cause.

 . An individual that shows an exaggerated cardiac

response to a variety of stimuli is more likely to

develop hypertension.

Stress and hypertension

Stress and diabetes mellitus  Cortisol causes

increase in blood

sugar level to help

boost energy.

 This may be

compounded by

unhealthy eating

habits.

The hormones released during stress response

can alter the numbers and types of immune

cells, such as T-cells and natural killer (NK)

cells produced by the body and also increase

inflammation.

 Since immunity and inflammation affect

cancer, stress is extrapolated to affect

cancer on this basis.

Stress and cancer

 There is intense constriction of blood

vessels supplying to brain.

 This is followed by distension to allow blood to

flow back to the brain.

 These distended blood vessel pushes on the nerve

causing headaches

Stress and headaches

• Asthma: Chronic inflammatory disease of the airways

in the lungs, in which the airways become constricted,

making it difficult to empty the lungs and therefore

reducing the amount of air that can be inhaled.

• Psychological factors

Stressful situations

Negative family environment

Emotional arousal

Stress and asthma

 It has been suggested that there occurs disturbance

in gut-brain axis.

 The large intestine becomes irritated, and its

muscular contractions are spastic rather than

smooth and wave like. The abdomen is bloated and

the patient experiences cramping and alternating

periods of constipation and diarrhea.

Stress and irritable bowel syndrome

 Ulcers

 Chronic Fatigue Syndrome

 Menstrual cycle disorders

 Memory loss

 Insomnia

 Kidney disorders

Other stress related disorders

Social problems like

1. Drug and alcohol use

2. Gambling

3. Broken/ problem families

4. Accidental injuries

5. Suicides

 Childhood experiences

 Personality traits

 Genetic traits

 Immunological diseases like rheumatoid arthritis

 Older adults

 Caregivers

 Divorced or widowed individuals

Risk factors for stress

Occupational stress

Work-related stress is the response people may have

when presented with work demands and pressures

that are not matched to their knowledge and abilities

and which challenge their ability to cope

Competition and rivalries

Excessive work , long hours of work or night

shift work

Drab and monotonous jobs, job insecurity.

Lack of opportunities for advancement

Unpleasant physical conditions at work.

Causes:

Apart from health related problems there can

be

Increased absenteeism

Industrial accidents

Irresponsibility and violence

Effects of occupational stress

It is a disorder that follows exposure to a life

threatening or other extreme event that caused

feelings of horror or helplessness.

 Common after

 Sexual assault, rape,

 robbery, aggravated assault

 Combat veterans

 Survivors of disasters

Post traumatic stress disorder

Symptoms include

•Flashbacks

•Nightmares

• Impaired concentration

• Emotional numbing

• Depression.

• Symptoms can last for years

Measuring stress

1. Daily hassles scale: for minor but frequent stress

2. Social readjustment rating scales: it measures the

impact of various life events

3. Face to face interviews.

4. Life experience surveys

Social readjustment rating scale

Life Events Score

 Death of spouse 100

 Divorce 73

 Marital separation from mate 65

 Detention in jail, other institution 63

 Death of a close family member 63

 Major personal injury or illness 53

 Marriage 50

 Fired from work 47

 Marital reconciliation 45

 Retirement 45

 Major change in the health or behavior of a family member 44

 Pregnancy 40

 Sexual difficulties 39

 Gaining a new family member 39 (e.g., through birth, adoption, oldster moving, etc.)

 Major business re-adjustment 39 (e.g., merger, reorganization, bankruptcy)

 Major change in financial status 38

 Death of close friend 37

 Change to different line of work 36

 Major change in the number of arguments with spouse 35

 Taking out a mortgage or loan for a major purchase 31

 Foreclosure on a mortgage or loan30

 Major change in responsibilities at work 29

Less than 150 life change units = 30% chance of

developing a stress-related illness

150 - 299 life change units = 50% chance of illness

Over 300 life change units = 80% chance of illness

Richard Lazarus and his colleagues have suggested

that the petty annoyances, frustrations, and

unpleasant surprises we experience every day

reduce psychological well being.

 These may add up to more grief

worsening already present illnesses.

Daily hassles scale

It is important to recognize early signs of stress.

 If these signs are present all the efforts should be

directed towards strengthening the coping

strategies.

Early signs of stress

 Frustration

 Nervousness

 Boredom

 Mood swings

 Low self esteem

 Loneliness

Emotional effects Physical effects Headaches

Diarrhea

Insomnia

Indigestion

Back pain

Ringing in ears

Nervous twitches

 Not eating/ over eating

 Verbal / physical

outburst

 Smoking

 Gambling

 Driving too fast

 Constant worry

 Obsessive thoughts

 Trouble thinking

 Unable to take

decisions

 Forgetfulness

Mental effects Behavioral effects

Individual level

Family level

Community level

Stress management

Learn decision making techniques

Developing time management skills

Undertaking regular

physical exercise

Progressive muscular relaxation

Yoga and meditation

Individual level

Family acts as the first support system for an

individual.

Children model their parent’s behaviors, including

those related to managing stress.

Having regular conversations can help

a family work together to better

understanding and address any stress.

Family level

 Focus has been more on work related stress.

 Sakhi/saheli program under Rajiv Gandhi scheme

for empowerment of adolescent girls.

 Stress management program in colleges.

Community level