Stress Management

STRESS MANAGEMENT

The word stress is derived from the Latin word "stringi", which means, "to be drawn tight". Stress can be defined as follows:

Definition of Stress:

In medical terms stress is described as, "a physical or psychological stimulus that can produce mental tension or physiological reactions that may lead to illness." When you are under stress, your adrenal gland releases corticosteroids, which are converted to cortisol in the blood stream. Cortisol have an immune suppressive effect in your body.

Another Definition of Stress:

According to Richard S Lazarus, stress is a feeling experienced when a person thinks that "the demands exceed the personal and social resources the individual is able to mobilize."

Your body tries to adjust to different circumstances or continually changing environment around you. In this process, the body is put to extra work resulting in "wear and tear". In other words, your body is stressed. Stress disturbs the body's normal way of functioning.

Most of us experience stress at one time or another. Without stress, there would be no life. However, excessive or prolonged stress can be harmful. Stress is unique and personal. A situation may be stressful for someone but the same situation may be challenging for others. For example, arranging a world level symposium may be challenging for one person but stressful to another. Some persons have habit of worrying unnecessarily.

Stress is not always necessarily harmful. Hans Selye said in 1956, "stress is not necessarily something bad – it all depends on how you take it. The stress of exhilarating, creative successful work is beneficial, while that of failure, humiliation or infection is detrimental." Stress can be therefore negative, positive or neutral. Passing in an examination can be just stressful as failing.

Sometime we know in advance that doing a certain thing will be stressful, but we are willing to doing that. For example, while planning a vacation to a hill station you know that it would be stressful at certain times. But you are willing to face those challenges.

People often work well under certain stress leading to increased productivity. Many times you do not know in advance and the stress periods may be sudden. The situation may not be under your control. Too much stress is harmful. You should know your level of stress that allows you to perform optimally in your life.

Types of Stress:

Eustress

Eustress is one of the helpful types of stress. It is the type of stress you experience right before you have the need to exert physical force. Eustress prepares the muscles, heart, and mind for the strength needed for whatever is about to occur.

Eustress can also apply to creative endeavors. When a person needs to have some extra energy or creativity, eustress kicks in to bring them the inspiration they need. An athlete will experience the strength that comes form eustress right before they play a big game or enter a big competition. Because of the eustress, they immediately receive the strength that they need to perform.

When the body enters the fight or flight response, it will experience eustress. The eustress prepares the body to fight with or flee from an imposing danger. This type of stress will cause the blood to pump to the major muscle groups, and will increase the heart rate and blood pressure to increase. If the event or danger passes, the body will eventually return to its normal state.

Neustress

 It is a sensory stimuli that have no consequential effect; it is consider neither good nor bad. For example news of an earthquake in remote corner of the world.

Distress

Distress is one of the negative types of stress. This is one of the types of stress that the mind and body undergoes when the normal routine is constantly adjusted and altered. The mind is not comfortable with this routine, and craves the familiarity of a common routine. There are actually two types of distress: acute stress and chronic stress.

Types of distress:

Acute Stress

 Acute stress is the type of stress that comes immediately with a change of routine. It is an intense type of stress, but it passes quickly. Acute stress is common in people who take too many responsibilities and are overloaded or overworked, disorganized, always in a hurry and never in time. These people are generally in positions of importance at their workplace and stressful lifestyle is inherent in them.

Symptoms of this type of stress are prolonged tension headaches, hypertension, migraines, chest pain and heart disease.

Chronic Stress

This type of stress is the most serious of all the  stress types. Chronic stress is a prolonged stress that exists for weeks, months, or even years. This stress is due to poverty, broken or stressed families and marriages, chronic illness and successive failures in life. People suffering from this type of stress get used to it and may even not realize that they are under chronic stress. It is very harmful to their health.

General causes of stress:

Threat

A perceived threat will lead a person to feel stressed. This can include physical threats, social threats, financial threat, and so on. In particular it will be worse when the person feels they have no response that can reduce the threat, as this affects the need for a sense of control.

Generally speaking, any threat to needs is likely to lead to stress being experienced.

Fear

Threat can lead to fear, which again leads to stress. Fear leads to imagined outcomes, which are the real source of stress.

Uncertainty

When we are not certain, we are unable to predict, and hence feel we are not in control, and hence may feel fear or feel threatened by that which is causing the uncertainty.

Cognitive dissonance

When there is a gap between what we do and what we think, then we experience cognitive dissonance, which is felt as stress. Thus, if I think I am a nice person then do something that hurts someone else, I will experience dissonance and stress.

Dissonance also occurs when we cannot meet our commitments. We believe we are honest and committed, but when circumstances prevent us from meeting our promises we are faced with the possibility of being perceived as dishonest or incapable (i.e. a social threat).

Life causes:

There are many causes of stress in life including:

Death: of spouse, family, and friend

Health: injury, illness, pregnancy

Crime: Sexual molestation, mugging, burglary, pick-pocketed

Self-abuse: drug abuse, alcoholism, self-harm

Family change: separation, divorce, new baby, marriage

Sexual problems: getting partner, with partner

Argument: with spouse, family, friends, co-workers, boss

Physical changes: lack of sleep, new work hours

New location: vacation, moving house

Money: lack of it, owing it, investing it

Environment change: in school, job, house, town, jail

Responsibility increase: new dependent, new job  

Stress signs and symptoms:

Cognitive Symptoms

• Memory problems
• Inability to concentrate
• Poor judgment
• Seeing only the negative
• Anxious or racing thoughts
• Constant worrying

Emotional Symptoms

• Moodiness

• Irritability or short temper
• Agitation, inability to relax
• Feeling overwhelmed
• Sense of loneliness and isolation
• Depression or general unhappiness

Physical Symptoms

• Aches and pains
• Diarrhea or constipation
• Nausea, dizziness
• Chest pain, rapid heartbeat
• Loss of sex drive
• Frequent colds

Behavioral Symptoms

• Eating more or less
• Sleeping too much or too little
• Isolating yourself from others
• Procrastinating or neglecting responsibilities
• Using alcohol, cigarettes, or drugs to relax
• Nervous habits (e.g. nail biting, pacing)

The stress Response

The fight-or-flight response, also called the fright, fight or flight response, hyper arousal or the acute stress response, was first described by Walter Cannon in 1915. His theory states that animals react to threats with a general discharge of the sympathetic nervous system, priming the animal for fighting or fleeing. This response was later recognized as the first stage of a general adaptation syndrome that regulates stress responses among vertebrates and other organisms.

The "fight or flight response" is our body's primitive, automatic, inborn response that prepares the body to "fight" or "flee" from perceived attack, harm or threat to our survival.

There are four stages of fight or flight response:

Stage 1. Stimuli from one or more of the five senses are sent to brain.

Stage 2. The brain deciphers the stimulus as either a threat or a non threat; this is the end of response. If response is decoded as a real threat, the brain then activates the nervous and endocrine systems to quickly prepare for defense and or escape.

Stage 3. The body stays activated, aroused, until the threat is over.

Stage 4. The body returns to homeostasis, a state of physiologically calmness, once the threat is gone.

Following table explains the bodily changes that take place during stress.

Target	Sympathetic Stress, Fight/Flight	Parasympathetic Normal function (opposite of stress response)
Heart Rate	Increased	Decreased
Coronary Arteries	Dilate	Constrict
Blood Pressure	Increase	Decrease
Bronchioles	Dilate	Constrict
Respiratory Secretions	Decrease	Increase
Pupil	Dilate	Constrict
Skin Blood Flow	Decrease	Increase
Digestive Blood Flow, Secretions and Muscular Activity	Decrease	Increase
Sweating	Increase	Decrease
Blood Glucose	Increase	Decrease

General Adaptation Syndrome:

Hans Selye researched the effects of stress on rats and other animals by exposing them to unpleasant or harmful stimuli. He found that all animals presented a very similar series of reactions, broken into three stages. In 1936, he described this universal response to the stressors as the general adaptation syndrome, or GAS.

Alarm is the first stage. As you begin to experience a stressful event or perceive something to be stressful psychological changes occur in your body.  This experience or perception disrupts your body’s normal balance and immediately your body begins to respond to the stressor as effectively as possible. It describes the cannon’s fight or flight response.

Resistance is the second stage. If the stressor persists, it becomes necessary to attempt some means of coping with the stress. Although the body begins to try to adapt to the strains or demands of the environment, the body cannot keep this up indefinitely, so its resources are gradually useless.

Exhaustion is the third and final stage in the GAS model. At this point, all of the body's resources are eventually useless and the body is unable to maintain normal function. At this point the initial autonomic nervous system symptoms may reappear (sweating, raised heart rate etc.). If stage three is extended, long term damage may result as the capacity of glands, especially the adrenal gland, and the immune system is exhausted and function is impaired resulting in decompensation. The result can manifest itself in obvious illnesses such as ulcers, depression, and diabetes, trouble with the digestive system or even cardiovascular problems, along with other mental illnesses.

COPING STRATEGIES FOR STRESS:

1) Healthy diet:

• Promotes connection of mind and body.
• Recognizes control over one’s own health.

2) Spiritual Practice

The relationship between stress and human spirituality is gaining more and more attention in the aalied health fields. Prayer is perhaps one of the most common coping techniques for those stressors that seem beyond the grasp of human resources.

3) Physical activity:

• Improves self-esteem.
•  Decreases risk of diseases and disability.

4) Sleep hygiene:

• Sleep deprivation exacerbates stress.
• Unrealistic expectations about sleep can cause stress.

5) Social support

• Social support greatly reduces stress.
•  When people bond together in times of trouble, they are better able to cope with the problems at hand.

6) Setting realistic goals:

• Take small steps.
• Work on what is most important first.

7) Rest:

Get a minimum of six hours of continuous rest

8) Anger management

• Learn to manage your anger
• Anger affects your health
• Anger causes you to over react to many situations

9) Forgiveness

• We get angry often because someone did not do what we thought they should
• Rethink the situation and learn to be more flexible

10) Cognitive restructuring:

The term cognitive restructuring was coined by Meichenbaum in1975 to describe a coping technique for patients diagnosed with stress related disorders. This coping style aimed to modify internal self-dialogue by tuning into the conversation within the mind. The practice of cognitive restructuring was an important step in what Meichanbaum referred to as stress inoculation, a process to build up positive thoughts when negatively perceived events encountered. Bandura in 1977 and Beck in 1976 also supported the concepts of cognitive change perceptions as a mean to effectively deal with stress.

The purpose of cognitive restructuring is to widen ones conscious perspective and thus allow room for a change in perception. Cognitive restructuring involves assuming responsibility, facing the reality of a situation, and taking the offensive to resolve the issues causing stress.

To restructure your perceptions to experience more good luck, something we can all do. Wiseman suggests adopting four attitudinal behaviors.

1.      Maximize your chances opportunities by taking a proactive stance rather than playing the role of a victim.

2.      Listen to your intuition. Go with your gut feelings and learn to listen to the voice of intuition rather than the voice of fear that tends to hold you back.

3.      Focus on the positive and take calculated risks. Meeting new people and trying new activities increase the chance of expanding your thoughts and possibly making and succeeding with new goals.

4.      Find the good in bad situation. Every situation has a good side and a bad side; at each moment you decide which is which.

Steps to initiate cognitive restructuring:

A simple four –stage process introduced by the field of behavioral medicine by Roger Allen (1983) is a model for implementing changes in lifestyles behaviors through cognition to promote health. The following model explains how cognitive restructuring can be implemented as a coping technique to reduce stress. The steps are as follows:

1.     Awareness: the awareness process has three steps. In first, stressors are identified and acknowledged. This may include writing down what is on your own mind, including all frustrations and worries. The second step of the awareness process is to identify why these situations and events are stressors and, more specifically, what emotional attitudes are associated with each. In the last step, a primary appraisal given to the main stressors and acknowledgment of the feelings associated with it. If the original perception appears to be defensive or negative, and inhibits you from resolving this issue, then the next stage is a reappraisal.

2.     Reappraisal of the situation. A secondary appraisal, or reappraisal, is a “second opinion” you generate in your mind to offer a different objective. A reappraisal is a new assembly or restructuring of the factors involved, and the openness to accept a new frame of mind.

3.     Adaptation and substitution. The most difficult part of any attitudinal change is its implementation. Once a new frame of mind is created, it must then be adopted and implemented. Humans to be creatures of habit, finding comfort in known entities even if the “known” is less than desirable. With cognitive restructuring, the new mind frame must often be substituted when the stress is encountered and repeated again and again.

4.        Evaluation. The test of any new venture is to measure its effectiveness. Did this attitude work? Initially, it may not. The first attempt to shoot a basket through the hoop may result in an embarrassing miss. Evaluate the new attitude and decide how beneficial it was. If it turns out that the new mind frame was a complete.

11) Journal writing:

Journal writing is perhaps the most effective coping skill available to provide profound internal vision and enhance the self-awareness process. Journal writing initiates the communication of self-reflection between the mind and soul, the necessary first step in the resolution and closure of perceived stress. Journaling, in its own way, is a vehicle for meditation. As a technique to clear the mind of thoughts a claming effect takes place as thoughts and feelings are transferred from the mind. Although few studies have investigated the effectiveness of expressive writing, there is consensus that when encouraged, this technique can prove meaningful on many fronts, from expressing guilt and worry, to planting and harvesting the seeds of creative problem solving. Current research suggests that journal writing is not only good for the soul, as a mode of catharsis to express the full range of emotions, but has proven to be good for the soul. The healing process of self –expression through poetry described Morris Morrison in his book, Poetry as Therapy, incorporates imagination, intuition, and the development of personal insight- three characteristics essential in the healing process. Poetry therapy is currently used as a therapeutic tool in the treatment of emotional disorders. Thus, this method of writing is encouraged as a complementary journal writing style.

Steps to initiate Journal Writing:

Only three essential elements re needed for effective journal writing: (1) a notebook dedicated solely to the journal, (2) a pen or pencil, and, perhaps most important, (3) a quiet, uninterrupted environment to collect your thoughts and then put them down on paper.    

Although there is no specific formula for successful journal writing, some criteria aid the writer to use this coping strategy to deal more effectively with perceived stress. These include the following:

1.      Try to identify those concerns and problems that cause the most frustration, grief and tensions.

2.      Ask yourself what emotions are elicited when these stressors are encountered.

3.      Allow the writing process to augment your creative process to further resolution.

 12)Humor&Laughter:

besides respite care, humor may reduce caregiver stress.  Humor therapy is defined as the use of humor for the relief of physical or emotional pain and stress.  Humor is a coping mechanism that a caregiver may use repeatedly or in the ‘heat of the moment’.  When a situation with the care receiver has gone awry, laughter may be the best medicine.

Humor:

• Is a complementary method to promote health and cope with illness?
• Is generally used to improve quality of life, provide some pain relief, encourage relaxation and reduce stress. 
• May allow people to feel in control of their situations and make the situation seem more manageable. 
• Allows people to release fears, anger and stress, all which harm the body over time.

Laughter:

• Appears to change brain chemistry and may boost the immune system. 
• Appears to increase breathing, increase heart rate and increase oxygen use within the body.
• Allows more oxygen to be used by your body which stimulates the circulatory system.
• Exercises the same muscles and organs used for breathing.
• May release endorphins (neurotransmitters in the brain) which help to control pain.

13) Communication skills:

Good communication skills can relieve a stressful situation. A communication skill lesson plan can help build effective communication. You can communicate your feelings by a putting a frown on your face. Or you could wave across the street to someone. This is known as body language or "non-verbal" communication. Or you could communicate by speaking. Sometimes our verbal communication does not match our non-verbal gestures.

"Interpersonal communication is the process where meaning is exchanged."

"A meaning is exchanged through the sending and receiving of messages."

Meanings are your ideas and feelings. When you communicate your ideas and feelings to someone else you are using both verbal and nonverbal elements. When you are listening you are processing both the words and nonverbal cues and add meaning to them. Effective communication skills: Effective communicators use skills such as paraphrasing and questioning skills what the other person was saying to clarify if they understood the message as the person intended.

Effective Communication Helps to Relieve Stress and Remove Tension: Effective communication is an important technique for stress management and build to a health work and personal life. People who cope with stress well use their communication skills to calmly reach a solution. They are able to talk about their feelings and listen to the other person until the problem is solved. Both parties consider each others position and viewpoint until a happy medium can be found, or until they agree on something.

14) Creative Problem Solving:

Going beyond the traditional process for creating and implementing solutions to problems, this course will: Equip participants with skills to evaluate underlying purposes for solving problems Teach the process of formulating solutions that compel participants to probe “solutions after next” to understand the dynamics of future solutions or system requirements Create powerful in-class exercises and problem-solving activities tailored to specific needs of individuals or groups.

Participants will discover:

• A process for identifying challenges and potential solutions
• How to look beyond problems to the potential challenges ahead
• How to utilize problem solving to reach organizational goals and vision
• A visual model for problem solving (return to top)

15) Time Management: Optimizing Performance:

In an effort to be more productive and efficient, organizations must realize the value of using time wisely. Misspent time is lost opportunity and profit. This interactive course will teach: Critical skills for monitoring and scheduling time Tools for monitoring the quality of how time is spent Processes for determining and setting priorities Innovative in-class exercises and examples to emphasize concepts.

• Participants will discover:
• How to prioritize
• Time management tools and techniques in the work environment
• How to be proactive rather than reactive (“putting out fires”) at work.