Stress Management Input

7/29/2019 Stress Management Input

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STRESS

MR. NELSON R. MENDOZA

Psychosocial Specialists

Program ManagerNational Mental Health Program

Department of Health


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Promoting Healthy

Lifestyles

Department of Health

2005


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How do you know if you are

suffering from stress? Are you constantly tired?

Do you experience flashes of anger over a

minor problem?

Have you noticed a change in sleeping or

eating patterns?

Do you suffer from chronic pain,

headaches or backaches


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How do you know if you are

suffering from stress? Do minor problems and disappointments

upset you excessively?

Do the small pleasures of life fail tosatisfy you?

Are you unable to stop thinking of your

worries?

Do you feel inadequate or suffer from self

doubt?


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Which of these is stress?

You receive a promotion at work.

Your car has a flat tire.

You go to a fun party that lasts till 2:00 a.m.

Your dog gets sick.

Your new bedroom set is being delivered. Your best friend and his wife come to stay at

your house for a week.

You get a bad case of hay fever.

All of the above.


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ALL OF THESE ARE STRESS

If you are used to thinking that stress is

something that makes you worry, you have the wrong

idea of stress.

Stress is many different kinds of things: happythings, sad things, allergic things, physical things.


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Presentation Outline

Stress

Definition

SourcesEffects

Identification

Management Modalities

Stress Management as Health promotionactivity


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MAN IS:

PHYSICAL MENTAL SOCIAL SPIRITUAL

Feels Thinks

Reacts

Environment Stimuli

Internal External


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Facts About Stress

75-90% of visits to physicians are stress-

related

Stress related disorders are a major causeof rapidly increasing health care cost

Job stress is a major health factor costing

an estimated $150B annually


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More Facts About Stress

70% of people with drinking problemsand 62% of drug users were in full timeemployment

Fatalities at work, related to drug andalcohol use account for 15-30% of allaccident cases

Problematic drug and alcohol users have2 to 4 times more accidents than otheremployees


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Still More Facts About Stress

Problematic drug and alcohol users have2 to 3 times more absences than otheremployees

Problematic drug and alcohol users have2 to 3 times more level of sickness benefitclaims

Some industries have 15-40% of theirdisciplinary cases involving employeeswith alcohol and drug use


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Most Stressful JobsNational Institute for Occupational Safety & Health,

USA, 1994

Licensed Practical Nurse

Public Relations Specialist

Quality Control Inspector

Computer Programmer

Bank Teller


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10 Leading Causes of Mortality

1968 and 1994

Diseases of the heart

Diseases of the vascular

system

Pneumonia

Malignant neoplasm Tuberculosis, all forms

Accidents

Obstructive pulmonary

diseases

Diarrheal diseases

Other respiratory diseases

Diabetes mellitus

Pneumonia

Tuberculosis , all forms

Gastroenteritis & colitis

Diseases of the vascular

system Bronchitis

Diseases of the heart

Malignant neoplasm's

Accidents

Beriberi

Nephritis and nephrosis

Source: Council for Health and Development


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10 Leading Causes of 10 Leading Causes of

Morbidity (2008) Mortality (2005)

1. Acute Respiratory Infection 1. Diseases of the Heart2. Acute lower RTI and Pneumonia 2.Diseases of the Vascular System

3. Bronchitis/ Bronchiolitis 3. Malignant neoplasm

4. Hypertension 4. Pneumonia

5. Acute Watery Diarrhea 5. Accidents

6. Influenza 6. Tuberculosis, all forms7. TB Respiratory 7. Chronic Lower Respiratory

Diseases

8. Acute Febrile Illness 8. Diabetes Mellitus

9. Diseases of the Heart 9. Certain conditions originatingin the Perinatal Period

10. Chickenpox 10. Nephritis, nephrotic syndrome

and Nephrosis

Source: National Epidemiology Center, Department of Health


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Changing times- Need social engineering


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Alcohol abuseDrug abuse

Depression

Violence

High blood Pressure

High Cholesterol

Imbalanced or Over-

Eating

Cigarette Smoking

Weakening of Immune

system

Accidents

Cirrhosis of liver

Suicide

Homicide

Stroke

Heart attack

Cancer

Diabetes

Pneumonia and influenza

Asthma, Emphysema,Bronchitis

MEDIATING PATHWAYS TO STRESS-

RELATED DEATHS


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Mission Impossible?


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STRESS - Definition

The rate of wear and tear within the body

Hans Selye

A state of body disequilibrium.


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Definition

Is an everyday fact of life

All stress is not bad

Is an individual reaction


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Definition

A state where ones coping is not enough

to maintain balance or equilibrium.

Automatic reaction to danger or demandwhich may be physical and psychological,

the resulting state may lead to illness or

death

Duane Hagen


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Definition

A major cause of low productivity, high

absenteeism, bad judgment, misallocation

of resources and poor moral.

Robert Axles


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THE DYNAMICS OF STRESS

SENSATIONS

FEELINGS

EMOTIONS

BALANCE

*Eustress

*Distress

STRESS

PERCEPTION

G.A.S.

BODY IN

ACUTE TENSION

(Temporary Imbalance)

CREATIVE

ACTION

INEFFECTIVE

ACTION

INACTION

PAIN

TRAUMA

DISEASES OF

ADAPTATION

Int. / Ext.

S

T

R

E

S

S

O

R

S (+)

(-)

(-)

MAIN REFERENCE: Selye, Hans. 1974. Stress Without Distress. Signet Books. New York.

+ / -


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(FIGHT OR FLIGHT RESPONSE)

THREAT BODY ALARMS GO OFF

When the body has a demand placed on it or

perceives a threat, it responds physically with the

fight or flight responses


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When a stressful event or situation occurs, the mind quickly assesses its significance and sends

messages throughout the body via the central nervous system. Energy is rapidly distributed

throughout the body by the bloodstream and the body's resources are mobilized to defend itself

against the perceived threat. The level of your stress in a situation depends on the intensity of

meaning you attach to the source of the stress.

Danger/threats

Mind quickly assesses

Central Nervous System

Increased energy

through bloodstream

Bodys resources

Mobilized to defend itself

Stress level increase

Stress

sends messages throughout

the body via the centralnervous system

energy increasedthroughout the body

Blood pressure increases

Sugar pumped to fuel muscles

Adrenalin floods nerve endings

Blood clotting time reduced


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General Adaptation Syndrome

(G.A.S.)

Increase in...

Blood Pressure

Breathing rate

Muscle blood

flow

Heart rate

Blood clotting

agents

White blood count

Body metabolism

Energy to handle

perceived threat

Flight or

Fight Response

SOURCE: Productive Stress Management and Winning Lifestyle. ADB Tape..


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E

F

F

I

C

I

E

NC

Y

0

100%

STRESS

CRITICAL

LINE

TOO

LITTLE

STRESS

JOY

OF

STRESS

TOO

MUCH

STRESS

To find where you are on this graph, simply ask one question: Will the added stress of a new responsibility at work or at ho me ( no matter

how small) increase my efficiency, or decrease it? To make the best use of your energy, make sure your tasks are essential to your health,

wealth, and happiness, and not a waste of time.


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Who is the most vulnerable to

distress? Research shows that all types of people sometimeexperience distress. No one is immune. Yet these alsoare evidence that members of certain categories andgroups are specially likely to encounter distress.

Rates of CHD, CA and suicide are higher forseparated-persons than unmarried people.

Unhappily married people suffer more stress-relatedillness than people who are happily re-married.

All married groups-men and women, over 30 andunder 30 with and without childrenreport highersatisfaction, general good feelings and less stress thanunmarried groupssingle, divorced, or widowed.


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Widows and widowers are more likely than others their ageto become ill and die (especially after the death of theirspouse)

More wives than husbands have felt they were about to havea nervous breakdown, have experience more intense anxiety,and report feelings of inadequacy, depression, and phobia

Compared with non-employed housewives, working wives

are happier, communicate better than their husbands,report feeling better physically and mentally, and are moresatisfied with their marriages and life in general.

Compared with husband of non-employed wives, husbandsof working wives are less happy, experiencing greater jobpressures, poorer health and more dissatisfaction with their

jobs and marriages.


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The ages of greatest stress-related ailments are 15-35and 55-65

The poor are more likely to experience all types ofdistress than middle-class or wealthy persons.

Teenagers with high-achievement pressures fromparents are specially likely to be hypertensive.

Urban dwellers have more stress related illnesses thanrural dwellers.

Parents with young children report more feelings orpressure and stress than any other age or marital-status group

Blue collar workers experiences more boredom, stressrelated illness and job dissatisfaction than white-collarworkers.


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Depression is up to twice as common amongwomen as men.

Migrants from rural areas to the city are morelikely to experience stress-related illness anddeath than are non-migrants

Families that move a greater deal are speciallylikely to experience suicide, ulcers, separationand emotional breakdown

The unemployed are more likely than the

employed to experience suicide ulcers, divorce,and emotional breakdown.


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Sources of Stress

1) Personal

2) Family

3) Occupational

4) Environmental


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Personal

1) Minor annoyances

2) Adverse life experiences

3) Major life changes4) Extreme life experiences


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Family

1) Spouse/Parents

2) Children/Siblings

3) In-Laws/Other relatives

4) No house help


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Occupational

1) Physical Environment

2) Interpersonal Relationship

3) Organizational


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Organizational

1) Role Demands

2) Task Demands

3) Benefits4) Promotion/Demotion/Stagnation


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Environmental

1) Peace and Order Situation

2) Socio-economic

3) Political


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Life is not a destiny

but a journey to be

enjoyed.Synergy Unlimited


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Challenge energizes us psychologically andphysically, and it motivates us to learn new skills

and master our jobs. When a challenge is met, we

feel relaxed and satisfied. Thus, challenge is animportant ingredient for healthy and productive

work.a little bit of stress is good for you.

the challenge has turned into job demands that cannot be met

relaxation has turned to exhaustion

sense of satisfaction has turned into feelings of stress

stress

stress

stress

But if


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One-fourth of employees view their jobs as the

number one stressor in their lives.- Northwestern National Life

Three-fourths of employees believe the worker has

more on-the-job stress than a generation ago.

- Princeton Survey Research Associates

Problems at work are more strongly associated

with health complaints than are any other life stressor-more so than even financial problems or family

problems.

- St. Paul Fire and Marine Innsuance Co.

Common Costly problem in the workplace:

St i T d ' W k l


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Stress in Today's Workplace

The longer he waited, the more David worried. For weeks he

had been plagued by aching muscles, loss of appetite, restless sleep,

and a complete sense of exhaustion. At first he tried to ignore theseproblems, but eventually he became so short-tempered and irritable

that his wife insisted he get a checkup.

Now, sitting in the doctor's office and wondering what the

verdict would be, he didn't even notice when Theresa took the seat

beside him.

"You got out just in time," he told her. "Since the reorganization,

nobody feels safe. It used to be that as long as you did your work, you had a

job. That's not for sure anymore. They expect the same production rates

even though two guys are now doing the work of three. We're so backed up

I'm working twelve-hour shifts six days a week. I swear I hear those machineshumming in my sleep. Guys are calling in sick just to get a break. Morale is

so bad they're talking about bringing in some consultants to figure out a

better way to get the job done."


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"Well, I really miss you guys," she said. "I'm afraid I jumped

from the frying pan into the fire. In my new job, the computer routes

the calls and they never stop. I even have to schedule my bathroom

breaks. All I hear the whole day are complaints from unhappycustomers. I try to be helpful and sympathetic, but I can't promise

anything without getting my boss's approval.

Most of the time I'm caught between what the customer

wants and company policy. I'm not sure who I'm supposed to keep

happy. The other reps are so uptight and tense they don't even talkto one another. We all go to our own little cubicles and stay there

until quitting time.

To make matters worse, my mother's health is deteriorating.

If only I could use some of my sick time to look after her. No wonder

I'm in here with migraine headaches and high blood pressure. A lotof the reps are seeing the employee assistance counselor and

taking stress management classes, which seems to help. But

sooner or later, someone will have to make some changes in the

way the place is run."


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Job Conditions That May Lead to Stress

Management Style.

Lack of participation by workers in decision- making, poorcommunication in the organization, lack of family-friendly policies.

Example:

Theresa needs to get the boss's approval for everything and the company is

insensitive to her family needs.

The Design of Tasks.

Heavy workloads, infrequent rest breaks, long work hours andshift work; hectic and routine tasks that have little inherent meaning, do

not utilize workers' skills, and provide little sense of control.

Example:

David works to the point of exhaustion. Theresa is tied to the computer,allowing little room for flexibility, self-initiative, or rest.


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Work Roles.

Conflicting or uncertain job expectations, too much responsibility,

too many "hats to wear.

Example:

Theresa is often caught in a difficult situation trying to satisfy both the customer's

needs and the company's expectations.

Interpersonal Relationships.

Poor social environment and lack of support or help from co-workers and supervisors.

Example:

Theresa's physical isolation reduces her opportunities to interact with other

workers or receive help from them.


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Environmental Conditions.

Unpleasant or dangerous physical conditions such as crowding, noise, airpollution, or ergonomic problems.

Example:

David is exposed to constant noise at work.

Career Concerns.

Job insecurity and lack of opportunity for growth, advancement, or

promotion; rapid changes for which workers are unprepared.

Example:

Since the reorganization at David's plant, everyone is worried about their future

with the company and what will happen next.


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Job Conditions That May Lead toStress The Design of Tasks

Management Style

Career Concerns Environmental Conditions

Career Concerns

Environmental Conditions


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Ten Major Occupational

Stressors Work overload, under load/stagnation

Ambiguity or rigidity of task

Role conflict

Extreme amount of responsibility Negative competition

Constant changes

Ongoing contact with stress carriers

Containment or emotional reactions

Poor interaction with management

Matters related to corporate work


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Five Basic Reactions to Stress

Share grievance without ignoring the situation

Work longer and harder to reduce overload

Switch to an engrossing recreation to berefreshed

Physical withdrawal, quitting or reducing the

time and energy spent at work

Analyzing the situation, revising strategies and

look for ways to change things


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The interplay of several variables which largely

determines what happens to a person or family whenstressors or problems are encountered.

These variables include:

1) the hardships associated with the condition or event,

2) how the situation is perceived or defined,

3) the inner resources and coping capacities the person orfamily has, and

4) the external resources and supports which the family orperson can mobilize--formal agencies or professionalsand informal networks of kin, friends, and neighbors.

Why be stressed:


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Perception

"Seeing is believing. I wouldn't have seen it if I hadn't believed it."

(Ashleigh Brilliant)

1. Communication

2. Problem-solving

3. Decision-making

4. Stress Management

When humans get data (information) from any of their senses, they

"perceive" it. That is, they make some sense or meaning of it; they interpret;

they define situations and events; they make inferences and draw

conclusions.

Perceptions Affects: individuals and families involved


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What is the most important factor

in PRODUCTIVITY?

The most important factor is clearly our

emotional state during the work situation.

When we are feeling motivated, relaxed,

determined, energized, calm and confident,

high productivity will naturally flow.


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Are all forms of Stress BAD?

Certain amount of stress maybe needed tobe motivated (e.g. working well under

pressure)

EUSTRESSenough stress to be motivated,challenged and productive

DISTRESSunder loaded (boredom) or

over loaded


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EUSTRESS

Eustress or positive stress occurs when your

level of stress is high enough to motivate you

to move into action to get things accomplished.


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DISTRESS

Distress or negative stress occurs when your

level of stress is either too high or too low and

your body and/or mind begin to respondnegatively to the stressors.


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What are the causes of Stress?

ANYTHINGdifferent people (social

status), different stress

Rich & Powerfulgetting richer, more powerful

Middle Classsustenance, future

Poorday to day subsistence

Nobody is spared from, stress


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Basic Causes of Stress:

CHANGEinevitable stressor

e.g. Rapid development., technological

advances, lifestyles, growth & development.

SNEAKING STRESSlittle things that

add up

E.g. being late, traffic, work load, etc.


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PERSONAL TRAITSstress coming from within

(ones personality) E.g worrier type (negative thinker, perfectionist,

unrealistic expectations, low self-esteem)

Remember WORRY is a mental abuse, a self-inflicted

abuse

PHYSICAL ENVIRONMENT Noise, uncomfortable chair, smoke-filled surrounding

undisciplined people, etc.


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COGNITION VS EMOTION

NORMAL STRESS NORMAL

Th M h i f th


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The Mechanism of the

Physical Stress Response

Stress stimulates the nervous system

The sympathetic and parasympathetic system areactivated

The Sympathetic Nervous System stimulates

catecholamine release of the adrenals .

Flight reactions cause adrenaline secretion



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Aggression or fight reactions cause Noradrenaline

secretion.

The adrenal cortex produces cortisol, to enhance theaction of the cathecolamines.

Increased cortisol may suppress the immune system

causing the body to be susceptible to infection/illness



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The effects of cathecolamines are:

Dilated pupils

Constricted blood vessels of the head

Skeletal blood vessels are dilated Peristalsis reduced

Renal muscles, relaxed, urine secretion decreased

Bladder is relaxed, sphincter closed

Sex organs and genitalia relaxed, blood vessels constricted Mental ability is reduced



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Utilization of energy by the body is increased

Vit. B Com. , C, E & other energy giving nutrients

and minerals are depleted in case of chronic stress

Inc of energy requirement may result togluconeogenesis

Energy burned creates by products--lactic acid,

uric acid, urea and CO2

Excretion of by products is aided by movement

of muscles, circulation of blood & lymph

Th M h i f th


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Accumulated by products cause stiffness & soreness

of the muscles, affecting the gliding action of muscles

Chronically stressed muscles become fatigued causing

loss of elasticity, tone & irritability

On the other hand, constantly relaxed muscles may

loose their tone, elasticity and irritability accumulating

by products that produce frozen joints & knotted

muscles.


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(Signs/Symptoms of Stress)

Physical

Intellectual

Interpersonal Emotional


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(Physical Symptoms of Stress)

Headaches

Sleep disorders (e.g. insomnia, oversleeping, early awake)

Lower back pains, Clenching the jaws or grinding teeth

Constipation, diarrhea, colitis, indigestion or ulcer

Skin rashes

Muscle aches (especially neck & shoulders)

Hypertension or heart attack

Excessive perspiration Appetite change


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(Interpersonal Symptoms)

Inappropriate distrust of others

Blaming others

Missing appointments or canceling them on

short noticeFaultfinding and verbal attacking

Overly defensive attitude

Giving others the silent treatment

I t ll t l S t


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Intellectual Symptoms

Trouble concentrating

Difficulty in making decisions

Forgetfulness

Confusion

Poor memory & recall

Excessive daydreaming

Preoccupation with a single thought or idea

Loss of sense of humor

Decreased productivity,lower quality of work

Increased number of errors

Poor judgment


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(Emotional Symptoms)

Anxiety or worry Depression or cries easily

Mood swings

Irritability

Nervousness

Lowered self-esteem or feelings of insecurity

Increased sensitivity or feeling easily hurt

Angry outburst Aggression or hostility

Feeling emotionally drained or burned out

Unhealthy ways of coping with stress


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Smoking

Drinking too much

Overeating or undereating

Zoning out for hours in front of the TV or computer

Withdrawing from friends, family, and activities Using pills or drugs to relax

Sleeping too much

Procrastinating

Filling up every minute of the day to avoid facingproblems

Taking out your stress on others (lashing out, angry

outbursts, physical violence)

These coping strategies may temporarily reduce stress, but they causemore damage in the long run:

Cognitive Theory of Stress


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g y

(Lazarus)

Primary Appraisal

Harm or loss

Threat

Challenge Secondary Appraisal

Evaluation of Coping Resources

Physical

Social Psychological

Material

Contingencies

FLAMEOUT


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A preventable and treatable condition

which occurs when the need for periodic

rest. Food, exercise and relaxation is

overlooked or ignored.

Also known as Rapid Onset Burnout

FLAMEOUT


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A state of mental, emotional and physical

exhaustion, characterized by changes

attitudes towards work colleagues andclients.

BURNOUT


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Dont waste your Health to

gain WEALTH otherwise atthe end you will loose all

your wealth to gain backyour HEALTH.


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Your problems are not yourproblems. How your problem

affect youyour attitudeis

your problem. Fix that and yourproblems are no problem.

Unhealthy ways of coping with stress


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Smoking

Drinking too much

Overeating or undereating

Zoning out for hours in front of the TV or computer

Withdrawing from friends, family, and activities Using pills or drugs to relax

Sleeping too much

Procrastinating

Filling up every minute of the day to avoid facingproblems

Taking out your stress on others (lashing out, angry

outbursts, physical violence)

These coping strategies may temporarily reduce stress, but they causemore damage in the long run:


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Shift Hours

L o n g H o u r s

Publ i c Scr ut i ny OrganizationalStress

The Police Officers Paradox


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To function effectively in our job, you must

annihilate, smother, and suppress normal

emotions like fear, anger,

revulsion, andeven compassion. To

do other wise is to

invite overwhelming

doubt or hesitancy when

decisive action is required.

The penalty for your achieved

competence is a mind set thatmight as well be a foreign

language to your social

contemporaries.

We are..victims of our own success. When

these same normal and appropriate

emotions..surface in personal

relationships, we automatically shut down

and wonder why, over time, that the people

we care about the most complain that we are

aloof, cold, and uncommunicative.

Lt. Al Benner, Ph.D.

San Francisco Police

ff


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Alcoholism: Myths and Realities

Myth: Once an alcoholic, always an alcoholic

Reality: Alcoholism is a disease for which recovery is guaranteed ifthe alcoholic begins and sticks

with a recovery program. If not, whats guaranteed is premature death.

Myth: Alcoholism is caused by a lack of willpower, immorality, weak character, or police stress.

Reality: No one really knows what drives a person to drink. Studies alternately have implicated physical,

genetic, psychological, environmental, and social factors.

Myth: All alcoholics are skid-row drunks.

Reality: Many alcoholics hold high-level jobs and function well at work for years before their performance

is noticeably affected by drinking.

Myth: If an alcoholic can stop drinking, he or she doesnt have a problem.

Reality: Abstinence is not a sign that someone is free of alcoholism. Alcoholics Anonymous (AA)

calls these abstainers dry drunks because they have no real understanding of their condition,

no new ways to cope, and are almost certain to fall off the wagon.

Myth: Alcoholics drink every day.

Reality: Alcohol abuse patterns vary. Some people get drunk daily, and others only on the weekends.

Some stay sober for months and then go on a long binge.

From E. Kirschman, I Love a Cop: What Police Families Need to Know, 1977.


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Depression

Significant lossactual or threatened

Substance abuse

Previous suicide attempts or threats

Marked change in personality

Giving things away Reckless behavior

Anniversary reactions

Reunion fantasies


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Domestic Abuse

Domestic abuse exists along a continuum from verbal abuse tophysical violence.

All controlling behaviors are reasons for concern and for the potentialvictim to seek help.

Domestic abuse is not about anger. All couples get angry and fight.

Domestic abuse may be related to PTSD, substance abuse, poor coping

or personality.

It is the abusers responsibility to control his/her behavior and gethelp for stress or substance related problems. It is the victimsresponsibility to look after his/her own safety and the safety ofhis/her children.

Toll free national hot line is 800-799-SAFE.


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Awareness of job-

related stress

factors and

the ability to

recognize

stress.

A family

structure

with

clearly

defined

roles and

responsibilities.

Conflict

resolution

and

problem

solving

skills.

Social Support system:

Family

Friendsinside/outside

police work.

Religiouscommunities

Social groups Each other

Organizational Support For

Family Friendly Policies.

Mental health benefits

(EAP) Peer Support Program CIS intervention resources Police Chaplains Flexibleassignments Rotation policies Child care


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Strengthening Your Couple Connection

Spend time alone, without children, regularly every week.

Keep this time sacred and free from interruption.

Decide how you want to spend this time. If you disagree, problem solve so thatyou both win.

Use this time to actively listen to each other.

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