Stress What is it? Stress is an automatic reaction to danger or. Stress:

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1 Stress Management Presented by: AdvantageHealth Corporation 7900 International Dr. Suite 200 Bloomington, MN

2 Stress What is it? Stress is an automatic reaction to danger or demand Stress: is natural effects us physically, emotionally and mentally comes from positive and negative stressors threatens health if unmanaged can be managed and used for growth is the physiological i l opposite of relaxation

3 No, It s NOT All In Your Head Stress is Physical Too 60-90% of all medical visits are for stress-related disorders 1 Stressor Personal Stress Response Brain Hypothalmus Pituitary Adrenal Sympathetic Nervous System *PHYSICAL RESPONSE* increased HR, BP, breathing rate, muscle tension, and blood sugar levels 3

4 Stress Over the Long Haul General Adaptation Syndrome 2 The Alarm Stage (fight or flight response), is an appropriate reaction to a life-threatening situation Shortly after the danger has passed, the mind and body begin to relax, entering gthe Resistance Stage. If the stressor continues without resolution (no fighting or fleeing), the body enters the Exhaustion Stage like a car constantly revving its engine, chronic stress eventually causes damage to the bodily systems

5 Is All Stress Bad? Not all stress is distress (bad) a certain amount is needed to challenge and promote adaptation 4 Beneficial stress = eustress or positive stress

6 Degrees of Stress Low: Distress Leads to boredom, fatigue, frustration, ti dissatisfaction Optimum: Eustress Leads to creativity, it problem solving, progress, change, learning, satisfaction High: Distress Leads to irrational thoughts, irritability, frustration, decreased dperformance

7 Degrees of Stress Graph

8 Yerkes-Dodson Law As stress goes up, performance goes down. * Performance also decreases if not enough arousal (i.e., boredom).

9 Symptoms of Stress Physical 1 Fatigue, headache, insomnia, muscle aches/stiffness, palpitations, chest pains, cramping, nausea, cold extremities, frequent colds Mental Decreases concentration/memory, indecisiveness, confusion, loss of sense of fhumor Emotional Anxiety, nervousness, depression, anger, frustration, worry, fear, irritability, impatience, short-tempered Behavioral Pacing, fidgeting, g nervous habits, eating, smoking, drinking, crying, yelling, blaming, hitting

10 External Sources of Stress Physical Environment 1 Noise Bright light Heat Confined space Organizational Social Rules/regulations Deadlines red tape Rudeness Bossiness Aggressiveness Major Life Events Job changes (getting terminated, promoted or retiring) Getting married or divorced Injury, illness (you or others) New baby or death of loved one Daily Life Money Family Commuting Losing Keys, etc.

11 Internal Sources of Stress Lifestyle Choices 1 Caffeine Lack of Sleep Overloaded schedule Mind Traps Negative Self-Talk Pessimism i Self-criticism Over-analyzing Stressful Personality Traits Unrealistic expectations Type A All-or-nothing thinking Perfectionist Rigidity Workaholic Pleaser

12 The Stress Cycle Sources of stress interact with Individual personality characteristics And can result in ill health Which can lead to disease state Coronary artery disease obesity digestive disorders high blood pressure Coronary artery disease, obesity, digestive disorders, high blood pressure, mental illness, cancer, stroke

13 Characteristics of Stress Hardy People Have a sense of personal commitment to what they are doing Have significant control over their lives Let go of things they know they can t control Enjoy challenges Have a strong support system Have a belief in a higher power or a set of values which guides Have a belief in a higher power or a set of values which guides them

14 Controlling Stress To master stress, you must change your: Behavior Thinking Lifestyle Environment

15 How Do I Start? Determine stress-related symptoms Identify sources of stress Change what you can, accept what you can t Practice relaxation techniques STICK WITH IT!

16 The Four A s of Stress Management AVOID. 5 A lot of needless stress can simply be avoided. Try to avoid putting yourself in situations that cause you stress. Prioritize, and ditch those things that are least important. ALTER. Attempt to change your situation, so your stress decreases. Respectfully ask others to change their behavior and be willing to do the same ADAPT. The perception that you can't cope is one of the greatest stressors. Be Proactive. Be the change you want to see in the world. Adopt a mantra. Create a saying such as "I can handle this," and mentally repeat it in tough situations. Look at the big picture. Ask yourself, "Will this matter in five years?" ACCEPT. Sometimes we have no choice but to accept things the way they are. Forgive. It takes energy to be angry. Smile. Even if you have to fake it, smiles are contagious.

17 Benefits of Relaxation Exercises Improved self-confidence and self-awareness Increased ability to deal with stressful situations Improved focus Promotion of rest, recovery and recuperation Removal of stress-related reactions, e.g. increased muscular tension, etc. Establishes a physical and mental state that is conducive to optimal efficiency alayerkes-dodson ----(which will then create more time for more relaxation!)

18 Relaxation Techniques Deep Breathing Meditation Mental Imagery/Visualization Progressive e Muscle Relaxationatio

19 Relaxation Techniques: Getting Started Find appropriate time, when no disturbance is expected 4. Loosen your clothing and get in a comfortable position. If you are sitting, find a chair with good back support. Get in a quiet environment, with little or no outside noise.

20 Deep Breathing Inhale slowly into the lower lungs. Expand the sides, back, and front of the lower ribs. Once lower lungs are filled, inhale more air into the upper chest. Hold breath for one second before beginning exhale.

21 Deep Breathing Exhale air from upper chest very slowly. l Keep lower lungs full. Contract abdominal muscles to push all air out and exhale remaining air. Relax.

22 Meditation: 108 Exercise 1. Silently say "One". 2. Do it again and say "Two". 3. On and on up to 108. Seems easy enough, right? It is easier said than done! Try it and see how long it takes before you become distracted then try to get a little further each time.

23 Meditation: Exercise 1. Inhale deeply for 4 seconds and visualize good things coming in. 2. Hold your breath for 4 seconds and think of those good things filling your body 3. Exhale for the count of 8, blowing out all the stress and tension.

24 Progressive Muscle Relaxation (PMR) The PMR procedure teaches you to relax your muscles through a two-step process 4 : 1. First you tense up certain muscle groups so that they are as tightly contracted as possible. 2. Then release the contraction and focus on relaxing the muscles as much as possible. Feel the warmth as blood flow increases into the relaxed area. With practice, you ll learn how to differentiate between muscle tension and relaxation and induce physical relaxation at the first signs of the tension. *** With physical relaxation comes mental calmness.

25 Progression Options for PMR Begin at feet and work towards head or vice-versa Begin on right side of body and work to the left Work around circumference and then to the center Right, left, then both together

26 Mental Imagery 1. Close your eyes and think of the goal of the imagery, e.g., to change a mood, or practice a new behavior or skill. 2. Picture the positive outcome after your goal is achieved. 3. Put yourself in the picture and begin to experience the image. How do you look? How do you feel? 4. Picture how others react to you in this imagined activity, e.g., are they rewarding you, reinforcing you? 5. Picture how you react to the others' response. 6. Open your eyes slowly once you reach your desired mental state. Practice this mental image until it becomes a reality for you.

27 Visualization Visualization lets your mind focus on something positive. Like organized daydreaming, it offers a mental break. With your eyes closed, imagine yourself someplace you really enjoy. Picture a beach, ski slope, trout stream, or forest. Bring all your senses ses into play. Your imagination will transport you to a place where you are relaxed and calm. In a few minutes, you can clear your mind, if only briefly, of the stressful clutter of everyday living.

28 Nutrition A balanced diet, based on the Food Guide Pyramid, is essential to managing daily stress. In addition to a balanced diet, the following should be noted: Caffeine: Caffeine is a stimulant. One of the reasons you probably drink it is to raise your level of arousal (i.e. stress). If you are drinking many cups of coffee a day, then you may find that you can reduce a lot of stress by switching to decaffeinated coffee for a portion of your daily intake. Alcohol: In small amounts alcohol may help you relax. In larger amounts it may increase stress as it disrupts sleep (and causes hangovers!). In large amounts over a long term alcohol will damage your body. Sugar: Sugar-rich foods can raise energy in the short term. The problem with this is that your body copes with high levels of sugar by secreting insulin, which reduces the amount of sugar in your blood stream. Insulin can persist and continue acting after it has normalized levels of blood sugar. This can cause an energy dip.

29 Exercise Exercise can cause release of chemicals called endorphins into your blood stream. These give you a feeling of happiness and well- being. Exercise reduces blood pressure and helps to manage weight. Exercise improves blood flow to your brain, bringing additional oxygen and energy, which may be needed when you are thinking intensely For balance, include both cardiovascular exercise and strength training exercises. Try Yoga, Tai Chi or Pilates!

30 Some Final Tips to Reduce Stress Find humor or absurdity in stressful situations Get enough sleep Get a massage to relieve tension Read a good book or see an upbeat movie Do volunteer work or start a hobby Soak in a hot bath Talk lkto friends or family and sharing your thoughts ht and dfears Listen to music or relaxation tapes Take frequent breaks and schedule time for relaxation Think positively

31 Any Questions? Have a Relaxing Day! * THANK YOU *

32 Resources For additional and more detailed information, visit the following websites. 1. Helpguide.org 2. Holistic Online 3. Mayo Clinic 4. Mount Sinai i Institute t and Center for Cardiovascular Health 5. Ohio Health

33 Questions? AdvantageHealth Corporation 7900 International Dr. Suite 200 Bloomington, MN Thank you for attending!