Stress and Stress

Management
 Objectives
1. Learn about the concept of stress.
2. Determine the different sources of
stress.
3. Differentiate the concepts of stress
as a stimulus, as a response and as
transactions.
4. Describe the 3 stages of Selye’s
General Adaptation Syndrome.
 Objectives
5. Describe the stages of Local
Adaptation Syndrome.
6. Identify the physiologic, psychologic
and cognitive indicators of stress
7. Discuss the indicators of stress.
8. Identify the types of stress.
 Objectives
9. Describe the things that happens to
the body when the person is
stressed.
10. Discuss the health implications of
daily stress.
11. Learn about his/her own stressors.
12. Realize the inappropriate ways of
dealing with stress.
.

What is
stress for
you?
 STRESS

Stress is a feeling of
uneasiness, apprehension,
fear, panicky sensations
throughout the body.
 STRESS
 isa condition in which an individual
experiences changes in the normal
balanced state.
 a state produced by a change in the
environment that is perceived as
challenging, threatening,
 STRESS
 isa condition in which an individual
experiences changes in the normal
balanced state.
 a state produced by a change in the
environment that is perceived as
challenging, threatening,
 Types of Stress:

1. Eustress – positive stress

2. Distress – negative stress
 Eustressalso gets the heart pumping,
increases your breathing rate, makes
you perspire more and causes
chemical reactions through your
system.

 The big difference is the type of

chemicals you produce when you are
excited and happy.
 Bad stress or Distress

 If a stimulus we react to is negative we

are actually feeling distress.
 Things that your body does when
you are stress:
 Chemicals such as adrenalin start pumping
 Heart rate goes up
 Blood vessels dilate
 Breathing increases
 Sweat production increases
 Metabolism slows down
 Muscle becomes tense
 Pupils enlarge
 Sex hormone production goes down
A study comparing the stress levels of various
professional students found that nursing
students experience higher levels of stress than
medical, social work and pharmacy students
(Beck et al 2007).

one third of nursing students experience stress

severe enough to induce mental health
problems such as anxiety and depression
(Pryjmachuk, 2004).
 
As a student, what
are your concerns?
 STRESSOR
 isany event or stimulus that causes
an individual to experience stress

 the change or stimulus that evokes

this state
 STRESSOR
 may be defined as an internal or
external event or situation that
creates the potential for physiologic,
emotional, cognitive, or behavioral
changes in an individual.
 Adaptation is the desired goal
 Adjustment to the change so that the
person is again in equilibrium and has
the energy and ability to meet new
demands.
Types of Stressors:
1. Physical
2. Physhiologic
3. Psychosocial
The Seven Stressors
1. Clutter and disorder
2. Electropollution
3. Chemical pollution
4. Environmental stress
5. Geopathic stress
6. Lifestyle stress
7. Unhealthy diet
Note: We need to focus on each of the
inlet pipes and work each of them.
Ways of turning on the tap to reduce the
stresses effectively:
1. Sleep
2. Good diet
3. Exercise
4. Getting in touch with nature
5. Relaxation
6. Sunlight
7. Creating harmony in our homes
Sources of Stress

1. Internal stressors
► originates within the person
(infection or feelings of depression)

2. External stressors
► originates outside the individual
( a move to another city, a death from
the family, peer pressure)
3. Developmental stressors

► occurs at predictable times

throughout an individuals life.
 Developmental Stressor
Child
 Beginning school
 Establishing peer relationships
 Peer competition
Adolescent
 Relationship involving sexual attraction
 Changing physique
 Exploring independence
 Choosing a career
YOUNG ADULT
 Marriage
 Leaving home
 Managing a home
 Getting started on an occupation
 Continuing one’s education
 Children
Older Adult
 Decreasing physical abilities and health
 Changes in residence
 Retirement and reduced income
 Death of spouses and friends
4. Situational Stressors
► unpredictable and may occur at any
time during life.
► can be positive or negative
 Concepts of stress as a stimulus,
Response and Transaction

Stimulus Based Stress Models

▪A stimulus or set of circumstances
that arouses a physiological or
psychological reactions that may
increase the individuals vulnerability
to illness
Response Based Models
▪ Stress may also be considered as a
response.
▪ Developed and described by Hans
Selye in 1956, 1976

Stress is a nonspecific response of the

body to any kind of demand made
upon it.
 Stress response is characterized by a
chain or pattern of physiologic
events called the GAS
(General Adapatation Syndrome)

· The body can also react locally that is

one organ or part of the body reacts
alone
(Local Adaptation Syndrome)
 GAS and LAS has 3 stages:
1. Alarm Reaction
2. Stage of Resistance
3. Stage of Exhaustion
1. Alarm Reaction
a. Shock phase
b. Counter shock phase
 a. Shock phase

 theadrenal medulla secretes

epinephrine and norepinephrine in
response to sympathetic stimulation
 Epinephrine
a. Increased myocardial contractility which
increases cardiac output and blood flow to
active muscles
b. bronchial dilation which allows increased
oxygen uptake
c. Increased blood clotting
d. Increased cellular metabolism
e. Increased fat mobilization to provide energy
and to synthesize other compounds needed
by the body
 Norepinephrine
a. decreased blood to the kidneys
b. increased secretion of renin.
All of these adrenal hormonal effects
permit the person to perform far
more strenuous physical activity than
would otherwise be possible.

The person is ready for fight or flight

b. Counter Shock phase

during this time, the changes

produced in the body during the
shock phase are reversed.
2. Stage of Resistance
► is when the body’s adaptation takes
place.

► The body attempts to cope with the

stressor and to limit the stressor to the
smaller area of the body that can deal
with it.
3. Stage of Exhaustion
The ways to cope with the stressors
have been exhausted.
 If adaptation has not overcome the
stressor, the stress effects may
spread the entire body.
 At the end of this stage, the body
may either rest and return to normal
or death may be the ultimate
consequence
Transaction based theories of stress are
based on the work of Lazarus (1966)

 The person and environment are

inseparable each affects and is affected by
the other.
 The individual responds to perceived
environmental changes with adaptive or
coping responses.
 INDICATORS OF STRESS

1. Physiological Indicators
- pupils dilate to increase visual perception
when serious threats to the body arise

- sweat production increases to control

elevated body heat due to increased
metabolism

- HR and cardiac output increase to transport

nutrients and by products of metabolism more
efficiently.
skin is pallid because of constriction of
peripheral blood vessels an effect of
norepinephrine.

sodium and water retention increase due to

release of mineralocorticoid which increases
blood volume.

- rate and depth of respirations increase because

of dilation of the bronchioles promoting
hyperventilation.
- urinary output decrease
- mouth may be dry
- peristalsis of the intestines decreases resulting
in possible constipation and flatus.
-for serious threats, mental alertness
improves
- muscle tension increases to prepare for rapid
motor activity or defense.
- blood sugar increases because of
release of glucocorticoids and
gluconeogensis
 Psychological Indicators
 anxiety,
fear, anger, depression
and unconscious ego defense
mechanism.
Anxiety

► a state of mental uneasiness,

apprehension, dread or a feeling of
helplessness related to an impending or
anticipated unidentified threat to self or
significant relationships
Anxiety can be manifested on 4 levels:

1. Mild – produces slight arousal that

enhances perception, learning and
productive abilities.
- a feeling of mild restlessness that
prompts a person to seek information
and ask questions
2. Moderate – increases the arousal to a
point where the person expresses feelings
of tension, nervousness or concern.

 Attention is focused more on a particular

aspect of a situation than on peripheral
activities
3. Severe
► consumes most of the persons
energies and requires intervention.
►The person is unable to focus on what
is really happening, focuses on only 1
detail of the situation generating the
anxiety.
 Category: Verbalization changes

Mild: Increased questioning

Moderate: Voice tremors and pitched
changes
Severe: Communication difficult to
understand
Panic: Communication may not
be understandable
 Category: Motor activity changes

Mild: Mild restlessness

Moderate: Tremors, facial twitches and
shakiness
Severe: Increased motor activity, inability
to relax
Panic: Increased motor activity, agitation
 Perception and attention changes
Mild: Feelings of increased arousal and
alertness
Moderate: Narrowed focus of attention,
able to focus but selectively inattentive
Severe: Inability to focus or concentrate,
easily distracted
Panic: Perception distorted or exaggerated
 Category: Respiratory and Circulatory
changes
Mild: None
Moderate: Slightly increased RR and HR
Severe: Tachycardia, hyperventilation
Panic: Dyspnea, palpitations, choking, chest
pain or pressure
 Category: Other changes
Mild: None
Moderate: Mild gastric symptoms
(butterflies in the stomach)
Severe: Headache, dizziness, nausea
Panic: Feeling of impending doom,
paresthesia (numbness or
tingling in the skin), sweating
Fear

- is an emotion or feeling of
apprehension aroused by impending
or seeming danger, pain or another
perceived threat
 Anxiety and fear differ in 4 ways:

 Source of anxiety may not be identifiable, the

source of fear is identifiable
 Anxiety is related to the future that is to an
anticipated event. Fear is related to the past,
present and future
 Anxiety is vague whereas fear is definite
 Anxiety results from psychological or emotional
conflict . Fear results from a specific or
psychological entity.
Anger

► an emotional state consisting of a

subjective feeling of animosity or strong
displeasure

A verbal expression of anger is a signal to

others of one’s internal psychological
discomfort and a call for assistance to
deal with perceived stress.
Depression

 Extremefeeling of sadness, lack of worth

or emptiness

 Emotional symptoms: feelings of

tiredness, sadness, emptiness
 Behavioral signs of depression:
▪ irritability,
▪ inability to concentrate,
▪difficulty making decisions, loss of sexual
desire, crying sleep disturbance, social
withdrawal.
 Physical signs:
▪ loss of appetite, ▪ dizziness
▪ weight loss,
▪ constipation,
▪ headache,
Ego Defense Mechanisms

- Unconscious psychological adaptive

mechanisms or mental mechanisms that
develop as the personality attempts to defend
itself, establish compromises among conflicting
impulses and calm inner tensions.
Ego Defense Mechanisms

1. Denial
2. Displacement
3. Dissociation
4. Fantasy
5. Identification
6. Intellectualization
7. Introjection
8. Projection
9. Rationalization
10. Reaction formation
11. Regression
12. Repression
13. Suppression
14. Undoing
Health Implications of daily stress
Its an accumulative process.
Eventually you can have a medical problems
like high BP or tension headaches etc.

* THINK YOUR BODY AS A LARGE TREE

TRUNK