Coping with Stress and Anxiety: Behavioral Jeffrey Miller, DNP, APNP Department of Psychiatry and Behavioral Medicine Medical College of Wisconsin Disclosure Nothing to disclose Objectives To provide an overview of stress and anxiety To explore the effects of stress on the body To explore the effects of stress on relationships and enjoyment To identify methods of coping with stress To provide an overview of relaxation techniques
Stress and Anxiety Stress: Natural part of life Anxiety: Uncontrollable worry and stress Similarities: Involve body, thoughts, and behaviors Can have negative health consequences in excess Components of Stress and Anxiety Body Body at attention Fatigue Thoughts Worry thoughts Worst case scenario thoughts Behaviors Avoidance Negative health behaviors How Stress Components Interact How am I going to get all of this done? Thoughts I will do that later. Where is the ice cream? Body Head ache, pounding heart, shallow breathing, upset stomach, etc. Behavior
How Stress Affects Health Long term stress (chronic) Stress hormone: Cortisol Chronic exposure to stress Heart problems Sleep problems Digestive problems Psychological problems Weight problems Memory problems Problems fighting infection How Stress Affects Health Short term stress (acute) Stress hormones: Epinephrine and norepinephrine Body ready for fight or flight Increased heart rate Increased breathing rate Creation of glucose from fat Blood directed away from digestion Too often, wears on system How Stress Affects Relationships May ignore or suppress origin of stress Needs not being met Contributes to feelings not fulfilled and resentment Funnel stress into interpersonal conflict Emotional vulnerability
How to Deal with Stress: Overview Lifestyle changes Prioritizing Saying no Health related changes Eating well Sleeping regularly Exercise Changing thoughts Regular practice Situational Lifestyle Changes Prioritizing Determining elements of life needed Separating required from needed elements Ranking required elements in order of importance Setting boundaries Lifestyle Changes Assertiveness Expressing your needs and wants in a respectful manner Balancing between aggressive and submissive Aggressive: Problems with relationships Submissive: Problems with selfesteem Assertive Asking for needs to be met it direct way Respecting self and others
Health related changes Eating well Avoiding stimulants Balanced diet Increase whole fresh food Sleeping regularly Sleep hygiene Exercise Regular routine Changing Thoughts Events are interpreted Through interpretation we have self talk Negative interpretation Negative self talk Not always accurate! Change interpretation (more realistic) Change self talk and stress level : Overview Gaining control of body reactions and tension Hard to be stressed in a relaxed body Fight or flight response Blood flows away from extremities Increased heart rate Increased breathing Tunnel vision Sweating Shaking
: Overview Body cannot be continuously aroused Body will naturally return to baseline This can be evoked Gaining control of body reactions and tension response Blood flows toward extremities Decreased heart rate Slowed breathing Full vision Normal secretion Calm body : Summary Use to evoke natural relaxation response to: Return body to baseline functioning Decrease muscle tension Provides a sense of control over body Controlled breathing Used to calm immediate body stress How it works: Slow breathing and heart rate Prompt parasympathetic (CALM) response Easier with practice
Example: Calming breathing exercise Deep breathing Hand on abdomen Rise and fall of stomach Breathe in through nose Breathe out through mouth Timed controlled breathing Breathe in to count of 3 Hold to count of 2 Breathe out to count of 5 Progressive Muscle Type of relaxation used to achieve deep relaxation How it works: Tensing and releasing tension in muscles Relieves tension and stress held in muscles Helps decrease physical tension in the body Not indicated for chronic pain Example: Progressive Muscle Frame of mind Start with controlled breathing Overall: Tense muscle group for 7 10 seconds Notice build up of tension and warmth/limpness with release
Example: Progressive Muscle Systematically go through muscle groups Fists Jaw Lower Biceps Back Buttocks Triceps Shoulders Thighs Forehead Chest Calves Eyes Stomach Feet Scan body for residual tension Wave of relaxation Summary Stress is a normal part of life Too much stress: Physical, emotional, and interpersonal implications Difficult to control stress and anxiety Work together with a mental health professional : Control bodily response to stress PRACTICE!!!! Questions or Comments? Thank you!