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STRESS MANAGEMNT 1. What is Stress?

Stress is a state that occurs when people undergo a pattern of physiological and psychological responses; when faced with events or set of consequences they perceive as endangering their physical or psychological well being; and they are unsure of their ability to handle them. 2. Is all Stress bad? No, mild stress can be beneficial. There is a saying, Some stress is essential for life, too much can be damaging and too little boring. 3. Relationship between Stress and Performance

4. What are Stressors? The circumstances that cause stress are called stressors. 5. Types of Stressors a. Catastrophes-A catastrophe is a sudden, often life-threatening calamity or disaster that pushes people to the outer limits of their coping capability. b. Major Life Changes (Life Events) c. Daily Hassles like power failures, traffic jams etc. d. Life Styles example sedentary and Jobs example Medicine, Law etc. e. Conflicts(Approach-Approach, Avoidance-Avoidance, ApproachAvoidance) f. Organizational i. ii. iii. iv. v. vi. vii. viii. ix. x. xi. xii. Rigid Rules/ Rigid Routines Urgency and Deadlines Overworked Lack of Recreation Lack of Training War/ Border Area Duties Postings/ Temp Duties Lack of Communication Lack of Accommodation Promotion/ Demotion/ Punishment ACR Zero Error Syndrome

g. Mobile and Media 6. Factors Determining the Severity of Stressful Events

Cognitive Evaluation. What the Event Means to You?

Cognitive Errors

Personality Traits Type A Behavior

How Much Stress You Feel?

Feeling Of Competency

Predictability Of Stressful Events

Availability Of Social Support Control Over Duration

7. General Adaptation Syndrome (GAS)-The Stress Response a. Alarm Reaction: This is an acute reaction by body mediated by Autonomic Nervous System through release of Adrenaline. . The muscles tense, the heart beats faster, the breathing and perspiration increases, the eyes dilate, and the stomach may clench. b. Resistance: If the cause for the stress is not removed; GAS goes to its second stage called resistance or adaptation which is mediated by Hypothalamic-Pituitary-Adrenal Axis. This is the bodys response to long term protection. It secretes further hormones that increase blood sugar levels to sustain energy and raise blood pressure. If this adaptation phase continues for a prolonged period of time sufferers become prone to fatigue, concentration lapses, irritability and lethargy as the effort to sustain arousal slides into negative stress.

c. Exhaustion: In this stage, the body has run out of its reserve of body energy and immunity. Mental, physical and emotional resources suffer heavily. The body experiences "adrenal exhaustion". The blood sugar levels decrease as the adrenals become depleted, leading to decreased stress tolerance, progressive mental and physical exhaustion, illness and collapse. 8. Effects of Stress a. Autonomic b. Psychomotor c. Psychological Effects d. Diseases related with stress e. Decreased immune response f. Mental illnesses 9. Autonomic Effects a. Pale looking b. Cold sweating c. Dry mouth d. Palpitations e. Increased blood pressure f. Increased blood sugar level g. Diarrhea h. Increased Frequency Of urine i. Abdominal discomfort 10.Psychomotor a. Tremors

b. Agitation c. Aggressive Acts d. Muscle Tension 11.Psychological a. Disturbed or excessive sleep b. Decreased or increased appetite c. Loss or gain of weight d. Panic attacks, apprehensiveness e. Fear of having disease f. Constant low mood and low self esteem g. Weeping episodes h. Irritability i. Regression j. Fear of failure k. Worrying about the future l. Preoccupation with thoughts/tasks m. Inability to concentrate n. Forgetfulness o. Increased smoking, started taking drugs and alcohol p. Being accident prone 12.Decreased Immune Response a. Increased chances of infections 13.Psychiatric Disorders

a. Anxiety Disorders b. Dissociative Disorders c. Somatoform Disorders d. Acute Stress Reaction e. Adjustment Disorders f. Post Traumatic Stress Disorder 14.How to recognize Stress? a. Danger signals at home b. Danger signals at work c. Social Readjustment Scale 15.Danger Signals at Home a. No contribution to important domestic decisions b. Feeling that life is no fun c. Regularly coming late to home d. Spending too little time with the family e. Reluctance to discuss the problems f. Not inclined to take physical exercise regularly 16.Danger Signals at Work a. Complaints about the quality of work b. Frustrations and failures to get the desired results c. Inability to determine the priorities d. Ill prepared commitments and meetings e. Clashes with colleagues

f. Too busy to have holidays or even a day off g. Taking work at homes at nights and weekends h. Unwilling to discuss the problem with colleagues i. Memory impairment or lack of concentration 17."Social Readjustment Rating Scale" by Thomas Holmes and Richard Rahe S No. Event 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. Death of Spouse Divorce Menopause Separation from Living Partner Jail Term or Probation Death of Close Family Member (Other than Spouse) Serious Personal Injury or Illnesses Marriage or Establishing Life Partnership Fired at Work Marital or Relationship Reconciliation Retirement Change in Health of Immediate Family Member Work More than 40 Hours Per Week Pregnancy Sex Difficulties Gain of New Family Member Unit Value 100 60 60 60 60 60 45 45 45 40 40 40 35 35 35 35

17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40.

Business or Work Role change Change in Financial State Death of a Close Friend (Not a Family Member) Change in Number of Arguments (With Spouse or Life Partner) Mortgage or loan for a major purpose Foreclosure of mortgage or loan Sleep less than eight hours per night Change in responsibilities at work Trouble with in-laws, or with children Outstanding personal achievement Spouse begins or stops work Begin or end school Change in living conditions (visitors, change in roommates) Change in personal habits (diet, exercise, smoking etc) Chronic allergies Trouble with boss Change in work hours or conditions Moving to new residence Presently in pre-menstrual period Change in schools Change in religious activities Change in social activities (more or less than before) Minor financial loan Change in frequency of family get-togethers

35 35 30 30 25 25 25 25 25 25 20 20 20 20 20 20 15 15 15 15 15 15 10 10

41. 42. 43.

Vacation Presently in winter holiday season Minor violation of the law TOTAL SCORE ________________

10 10 5

Mild 151-200 (33% chance of illness, Moderate 201-299 (50% chance of illness, Major 300 or greater (80% chance of illness) 18.Stress Management a. Defense Mechanism b. Coping Strategies c. Maintain Healthy Life Style d. Develop Positive Personal Habits e. Develop good communication skills f. Develop support g. Time Management h. Work Management i. Anger Management j. Financial Management k. Relaxation Techniques 19.Defense Mechanism a. Repression b. Denial c. Rationalization d. Regression

e. Substitution 20.Coping Strategies a. Adaptive b. Maladaptive 21.Adaptive Coping Strategies a. Problem solving b. Emotion reducing 22.Problem Solving a. Identify specific stressor b. Identify maladaptive pattern if any c. Conscious effort to change the coping strategy d. Collection of data & information about different aspects of problems e. Consider and weigh different options f. Implement the situation g. Examine the outcome h. Revise the decision if needed 23.Emotion Reducing a. Ventilation b. Positive appraisal 24.Maladaptive Coping Strategies a. Excessive use of defense mechanism b. Drug abuse c. Deliberate self harm

d. Histrionic behavior e. Aggressive behavior f. Withdrawing from friends, family and activities g. Avoidance behavior (Procrastinating, Sleeping too much) 25.Maintain Healthy Life Style a. Take balanced diet b. Exercise regularly c. Sleep well d. Do not abuse drugs e. Plan leisure time/ Take holidays 26.Positive Personal Habits a. Be kind to yourself b. Do not be perfectionist c. Talk out problems d. Add humor e. Be in control of yourself f. Know whats important g. Be assertive h. Do things you enjoy i. Develop hobbies/ Seek new interest j. Faith in religion 27.Good Communication Skills a. Giving compliments

b. Receiving compliments c. Giving criticism d. Receiving criticism e. Giving feedback f. Starting a conversation

28.Time management

Do not procrastinate Do not over do Pace yourself Make a list Take a break Be aware of stress Urgent Not Urgent II

Import- I ant Not III Important


29.Anger Management a. Do not feel embarrassed b. Identify signs of anger c. Once anger overwhelms you than take deep breaths d. Disengage from that situation by leaving that place if possible

e. Distract yourself by taking glass of water f. Talk to yourself g. Sublimate your energy in some positive way like sports 30.Relaxation Techniques a. Stretch stress b. Breathing exercises c. Biofeedback d. Self hypnosis e. Yoga f. Meditation g. Aerobic exercises h. Visual Imagery i. Aroma therapy j. Color therapy k. Massage l. Stress releasing gadgets 31.Stress Stretch a. When you are under stress, tension accumulates in your neck and jaw. b. Take a minute to gently and slowly move your head from front to back, side to side, and in a full circle. For your jaw, stretch your mouth open and slowly move your lower jaw from side to side and front to back. 32.Breathing exercises a. Deep breathing


b. Abdominal breathing c. Progressive muscular relaxation 33.Deep Breathing a. Relax your muscles b. Take a deep breath through nose c. Hold the breath d. Exhale slowly 34.Abdominal Breathing a. Breathe in through your nose on a slow count of three. b. Push your stomach out as you breathe in. c. Breathe out through your mouth on a slow count of six. d. Repeat two more times. 35.Progressive Muscular Relaxation a. Contract your both lower limbs and at the same time inhale through nose b. Keep it till count of 6 c. Than relax the muscles and exhale slowly through mouth d. Now contract your abdominal muscles and do the same e. Than contract your upper limbs f. Lastly contract your whole body g. Do about thrice a day 36.Biofeedback a. It is some control of biological functions


b. You measure the blood pressure. If it is high than you apply relaxation techniques and lower it c. In this way you gradually reduce the blood pressure 37.Self Hypnosis a. It is through self suggestion 38.Yoga a. Breathing b. Postures c. Meditation 39.Visual Imagery a. Close your eyes b. Breathe deeply c. Think of the most relaxing place d. Use all your senses to get engross into that scene e. For 10-15 minutes 2-3 times a day 40.Aroma Therapy


God grant me the serenity to accept the things I cannot change, courage to change the things I can and wisdom to know the difference