Coach on Call. Letting Go of Stress. A healthier life is on the line for you! How Does Stress Affect Me?

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Coach on Call How Does Stress Affect Me? Over time, stress can affect the way you feel, think, and act. You need some time when you are free of stress. You need ways to get relief from stress. Without these things, the effects of stress build up and appear as symptoms. Symptoms are signs that something may be wrong with your health. Below, you will find a checklist of symptoms that long-term stress can cause. Do you think, feel, or act different than usual during or after stressful times? Those changes could be caused by stress. Think about the last 30 days, and then place check marks next to the symptoms you have had. Behavioral Symptoms r Smoking r Bossiness r Short temper r Being critical r Eating too little or too much r Sleeping too much r Having trouble sleeping r Putting off doing things r Driving too fast r Road rage r Grinding teeth r Abusing alcohol or drugs r Being unable to finish tasks r Nail biting r Fidgeting r Feeling alone or wanting to be all alone Emotional Symptoms r Easily bothered r Very sensitive r Annoyed r Defensive r Nervous or anxious r Edgy r Cranky r Feeling like you have no power to make things better r Sad r Crying easily r Having outbursts of feelings r Being short-tempered r Feeling under pressure r Angry r Lonely r Depressed r Moody r Feeling helpless r Feeling burned out CMN11-1117-5 UPMC _11_594 Copyright 2009 UPMC Health Plan, Inc. All rights reserved C ON C STRS LETGO C20091201-51 (MCG) 12/20/11 PDF

Page 2 of 8 Physical Symptoms r Dizzy r Shallow breathing r Very anxious r Tense muscles r Back pain r Tight neck or shoulders r Migraines/headaches r Ringing in the ears r Cold hands or feet r Sweaty palms r Restless r Fatigued r Disturbed sleep r Mouth or gum disease r Digestive troubles r Constipation or diarrhea r Upset stomach r Stomach aches r Ulcers r Not hungry r Stroke r High blood pressure r Heart attack r Very fast heartbeat Mental Symptoms r Forgetting things r Not able to focus r Having trouble thinking clearly r Not creative r Expecting too much of others r Can t make decisions r Worrying a lot r No sense of humor r Critical of self r Feeling things will go wrong, not right Finished marking symptoms you ve had in the last 30 days? Go back and circle the ones that you think may be related to stress.

Page 3 of 8 Important Message Are you having changes in the way you think, feel, or act? Have your symptoms become worse? Do they happen more often? You may be at risk of a stress-related illness. Note: Some symptoms are caused by health problems other than stress. Talk with your doctor about any symptoms you are having. Do you have very few symptoms of stress? Good for you! If you circled more than a few symptoms, don t be dismayed. Deep breathing, which can help you reduce the effects of stress, is easy to learn. Deep Breathing Breathing from the belly is the right way to breathe. Most people do not know the correct approach to breathing. Many breathe from their upper chest, which causes less oxygen to get into the bloodstream. The result is that your brain does not get enough oxygen, and you find it hard to stay alert and focused. When you breathe from your belly, it is called belly breathing. You take in more oxygen when you belly breathe, which helps you relax and think clearly. During belly breathing, you should feel your belly rise. This happens as your lungs fill with air. Belly breathing triggers your body to relax, causing you to feel less stressed. Let s Get Started! Deep breathing is a focused form of belly breathing. Before you practice deep breathing, try this warm-up. Try to have someone read you these steps as you do them. If that is not possible, read through all the steps yourself before trying deep breathing on your own. Look at the steps only when you need to. 1. Lie on your back and relax. You may sit if you are not able to lie down. 2. Put one hand on your belly. It should be right on top of your navel. Put your other hand on the center of your chest. 3. Breathe normally through your nose if you can do so with comfort. If not, breathe through your mouth. 4. Continue breathing normally. Notice how your hands are moving. Notice which hand is moving more. 5. Inhale. When you exhale, blow out all the air you can. Do this twice in a row. 6. Breathe normally for a few breaths. Notice the movement of your hands again. Do you notice any changes? 7. Now breathe in slower and deeper than usual. Focus on making your belly move more and your chest move less. 8. Take another breath this way.

Page 4 of 8 Was the hand on your belly moving more than the other hand? Good you ve got the hang of it! Did you find that the pause between breaths got a little longer by Step 6? If so, you are doing very well! If you didn t notice much change, try the above warm-up one more time. Deep Breathing Steps Read through the steps below. Picture yourself doing each step. 1. Uncross your arms and legs. 2. Let your face and jaw relax. (Your teeth should part a little. Your lips should stay together.) 3. Relax your neck. Drop your shoulders. Let your back melt into the floor or chair. 4. Inhale through your nose. Picture your belly as a balloon filling slowly with air. 5. Pause for a second. 6. Exhale slowly, all the way, through your nose. Keep your belly relaxed. Is your chest rising more than your belly? Then you are not deep breathing. Tip: Is it hard to breathe through your nose when deep breathing? If so, breathe through your mouth instead. Demo You can see a two-minute demonstration of deep breathing by going to http://healthylifestyle.upmc.com/stressrelaxation.htm

Page 5 of 8 As soon as you finish your practice, fill in your Less Stress Relaxation Record. Write down how you felt before and after you practiced. See the sample record below. Tip: Make some extra copies of the Relaxation Record before you write on it. UPMC MyHealth Less Stress Relaxation Record Date & Time Tension Score* Describe your mood and how your body Pre Post Score feels before deep Difference breathing. 5-23-08 evening 5 3 2 Lying on floor with pillows behind neck and knees. Had tension in upper back. Felt tired. Describe your mood and how your body feels after deep breathing. My back relaxed a little but the rest of my body relaxed a lot. I felt more energy when I finished. *Tension Scores: 1 Completely relaxed 2 Very relaxed 3 Somewhat relaxed 4 Neutral 5 Somewhat tense 6 Very tense 7 Extremely tense

Page 6 of 8 Tips on Practicing Deep Breathing Learning how to deep breathe will take practice. To start, practice deep breathing at times when you do not feel very tense. This will help you feel how deep breathing can relax you. Practicing this approach to breathing will help you use deep breathing to relax when you do feel very tense. How will deep breathing help you? It will: Reduce your stress Help you relax Focus your mind Improve how your body deals with stress Remember to practice, practice, practice. Practice deep breathing as often as you can. More Ways to Bust Stress You now know that stress both good and bad is part of daily life. Deep breathing won t change the things that cause stress in your life. But it will change the way your brain and body respond to stress. Make deep breathing a regular daily practice like brushing your teeth. Do deep breathing several times a day. Then you will feel less stressed, even though things in your life may not have changed. Have many things to do? Write them down. Keeping a list is the best way not to forget. Don t put tasks off till later. Do what needs to be done. Take a deep breath and focus on your tasks. Decide what you want to do first. Work on that task until it is done. Then cross it off your list. Put things in order. Reduce clutter. Keep things neat. Living in a neat house will help you relax. So will working in a neat office. Know that it s okay to say NO. You can t do everything. Smile and laugh and jump and sing every day! Practice being light. Get regular exercise. You ll look and feel better. See the glass as half full rather than half empty. Optimism rules. Remember you are a good person. Making mistakes is human. Forgive yourself and others. Don t compete. Do others say they have more stress in their lives than you? Let them. Be calm. There is no need to impress others with how much you have to do. It s okay to spend some quiet time. Sit and let your thoughts go to a lovely place. It s okay to have fun! Plan time in your schedule for things you enjoy. It s okay to share your feelings with others. Trusting others is the first step to having others trust you.

Page 7 of 8 It s okay to find comfort in thought, meditation, or prayer. Take a time out when you need to. Be a healthy lifestyle role model for others. Helping others is a great way to feel better about yourself. Eat a healthy, balanced diet and maintain a healthy weight. Learn to manage anger and hostility. Step back and think before you speak. Then respond in a helpful way. Be more mindful. Think about what you are doing as you do it. Let go of the past. Think about what you have to do later, later when you are doing it! Explore new ways to manage stress. UPMC Health Plan has a variety of programs, services, and resources. Call a UPMC Health Plan health coach to learn what is available to you. A Bonus Tip Here is something else good for you to do: Go for a walk. Walk every day. Walk whenever you can. Will walking help you feel happy and calm? Decide for yourself. Take Action: Some people post sticky notes to remind them to practice. Others write notes on their calendars. Some ask a family member or co-worker to help. These helpers watch for the person to look tense. Then they say a cue word like breathe. Do you have a reminder system that works for you? If not, choose one to try:

Page 8 of 8 UPMC MyHealth Less Stress Relaxation Record Date & Time Tension Score* Describe your mood and how your body Pre Post Score feels before deep Difference breathing. Describe your mood and how your body feels after deep breathing. *Tension Scores: 1 Completely relaxed 2- Very relaxed 3 Somewhat relaxed 4 Neutral 5 Somewhat tense 6 Very tense 7 Extremely tense