STRESS MANAGEMENT IN

STUDENTS
Dr.T.V.Rao MD

DR.T.V.RAO MD

THE CHALLENGES IN COLLEGE

The best years of your life? Expectations.. Even positive change is stressful Greater academic demands

Unstructured time
Decreased adult availability Being on your own in a new environment Changing relations with family
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CHALLENGES OF COLLEGE: CHOICES

Alcohol and other drugs Sex-identity, values, practices Food Sleep Balancing Academic and Extracurricular Roommates
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LIFE MANAGEMENT SKILLS:

GENERAL: Life management skills, for the purposes of this section, include stress management, time management, information management, financial management, personal health management, and crisis management. Personal planning and adeptness at managing each of these issues will increase the serenity and reduce the stressors within a busy, productive life.
DR.T.V.RAO MD

DR.T.V.RAO MD

PERSONAL PLANNING
Personal planning and adeptness at managing each of issues will increase the serenity and reduce the
stressors within a busy, productive life.
DR.T.V.RAO MD

EVERY BODY IS UNDER STRESS

Every human on the earth will experience stress, even medical students and physicians --it is a common denominator in life. Some stress is good stress (eustress) that is helpful and assists the drive toward achievement and success. Negative stress (distress) affects life in an adverse manner and is a common cause of ill health in our society. Individuals who ignore stress signals or who cope in a negative fashion will experience escalating symptoms of stress. The symptoms may appear as burnout, exhaustion, emotional illnesses such as depression and anxiety, and physical illnesses such as ulcers, heart attacks, hypertension, and abuse of alcohol and other drugs with all the social and professional consequences.
DR.T.V.RAO MD

WHAT IS STRESS?
Stress is your mind and bodys response or reaction to a real or imagined threat, event or change. The threat, event or change are commonly called stressors. Stressors can be internal (thoughts, beliefs, attitudes or external (loss, tragedy, change).
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ADOLESCENTS AND STRESS ?

Teens are under more stress Since adolescence is a period of significant changes physical, emotional, social, and academic changes

many than at any other time of life.

STRESS IS GOOD AND BAD TOO.

It's important to remember that stress is a natural part of life. Experiencing stress can be good, but it can also have negative effects on one's well being. What makes stress a positive or negative factor lies with how effectively the person experiencing the stress is able to manage it.

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IMPACT OF MEDICAL EDUCATION AND STRESS

Medical education has deleterious consequences. Trainees (students, interns, and residents) suffer high levels of stress, which lead to alcohol and drug abuse, interpersonal relationship difficulties depression and anxiety, and even suicide. Medical students have mean anxiety scores one standard deviation above those of non-patients, and their depression levels increase significantly
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SIGNS AND SYMPTOMS OF STRESS

Physical
Poor appetite or overeating Feeing tired and fatigued Various aches and pains ---headache body ache muscle pain Nausea & abdominal Pain Sleep problems Falling sick very often e.g. fever cough cold diarrhea ( because of lowering of immunity due to stress)

MENTAL STRESS
Feeling low Nervousness and Anxiety Excessive Anger or Depression Being easily upset Poor self confidence Low self esteem Lack of Concentration Poor performance in studies

EXERCISE REDUCES STRESS

As a way of draining off stress energy, nothing beats aerobic exercise. To understand why, we need to review what stress is. People often think of stress as pressure at work, a demanding boss, a sick child or rush-hour traffic. All these may be triggers but stress is actually the body's reaction to factors such as these. Stress is the fight-or-flight response in the body, mediated by adrenaline and other stress hormones, and comprised of such physiologic changes as increased heart rate and blood pressure, faster breathing, muscle tension, dilated pupils, dry mouth and increased blood sugar. In other words, stress is the state of increased arousal necessary for an organism to defend itself at a time of danger .

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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 respond negatively to the stressors.

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ALARM STAGE
As you begin to experience a stressful event or perceive something to be stressful psychological changes occur in your body. This experience or perception disrupts your bodys normal balance and immediately your body begins to respond to the stressor(s) as effectively as possible.

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THE PARADOX OF MEDICINE:

BALANCING BETWEEN THE FACT THAT PEOPLE ARE MOSTLY THE SAME & YET UNIQUELY DIFFERENT.

The Bell Curve

Individuals are all Genetic Snowflakes

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OBSTACLES
Most people who need care dont seek it or receive it Stigma, cultural pressure, mistrust, lack of information keep people out of care So do lack of resources; treatment and medication are expensive Care is disjointed Some schools dont see emotional well-being and growth as in their mission

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COMMON PROBLEMS

Relationship problems
Depression Anxiety Eating Disorders Substance Abuse

Sleep Problems

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ANXIETY
Situational Developmental Generalized anxiety disorder Performance Panic disorder, OCD, phobias

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SLEEP PROBLEMS
35% of adult population experience insomnia 11% of college students get a good nights sleep Loss of cognitive functioning, driving Increased risk of depression < 7 hours yields sleep deprivation

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LEARN STRESS MANAGEMENT

EMOTION FOCUSED STRATEGIES

L E A R N S
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LEARN STRESS MANAGEMENT

Laugh E A R N S
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STRESS MANAGEMENT TIPS

Making little changes in your life can really add up to a big feeling of relief. Learn to recognize when you are feeling stressed and simple ways you can relax. Take a break. Have a cold drink, get some fresh air, or close your eyes for a minute to refocus. Stay positive to help friends and family cope with stress. Let others know you're feeling overwhelmed and tell them how they can help. Allow yourself to simply say "no" to friends and family when you know you cannot meet their demands without becoming overwhelmed.

RECOGNIZE WHAT YOU CAN CHANGE

Can you change your stressors by avoiding or eliminating them? Can you reduce their intensity (manage them over time instead of immediately)

Can you shorten your exposure to stress (take a break, leave)

Can you devote the

time necessary to make

a change

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CULTURES, HUMOR & MEDICINE

Greeks home of the comediane Native Americans Clown Doctors Voltaire:
The Art of Medicine consists of amusing the patient while nature cures the disease.

Medicine today?
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WHAT IS HUMOR?
An attitude toward life. Taking your work seriously but yourself lightly. Humor is healthy. Humor connects us to others! It makes us MORE effective!

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HUMOR A GREAT TONIC TO STRESS ENJOY IT

Humor is a wonderful stress reducer, an antidote to upsets. Laughter relieves tension. In fact, we often laugh hardest when we have been feeling most tense. Humor is an individual thing - what is funny to one individual may be hurtful to another. It is wonderful when patients can poke fun at themselves. We can also do this with patients, but we have to be careful and respectful in what we say. If you think of something funny that may help the patient, say it if you feel it will ease their tension and not be offensive. I will often throw in a quip or joke when I think it is appropriate. When it is done sensitively, laughter is a great gift to people you care about.
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WHAT SHOULD COLLEGES DO?

Gather Data

Provide Rapid Access to Care

Offer Education and Outreach Involve Students Coordinate Care Be aware of community resources Understand your limits
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GATHER DATA
Documentation

How busy is counseling? Identify patterns and peak times of use.

Where else do students get care?

How many students take time off for medical reasons? Who comes back?
How many students are hospitalized?

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EDUCATION AND OUTREACH

Be known. Get out in the community.

Train residence staff to recognize warning signs of common problems.

Serve as liaisons/consultants to residence staff, deans, coaches. Supervise student groups: peer counselors, wellness reps, advocacy groups

Offer for-credit course to freshmen on stress and time management

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WELLNESS ACTIVITIES
Start a Wellness Center on campus

Focus on prevention: Eat, Sleep, Exercise

Engage Students in community- study breaks, hikes, massage

Teach yoga, sleep hygiene, relaxation response as part of leading balanced life.
Have annual wellness or caring events or maximize academic potential, minimize stress Student Wellness Reps.
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Stress Management Plan

Practice time management Learn relaxation exercises. Rehearse and practice situations. Learn practical coping skills. Decrease negative self talk. Learn to feel good with a workable result Dont be a perfectionist.

Build a network of friends.

INVOLVE YOUR STUDENTS

Ultimately, the only people who can get through to students with any consistency are the students themselves Peer Counseling/ Education Programs Student Health Advisory Group Wellness representatives in the dorms Mental Health Advocacy Group Involve in screenings and education

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UNDERSTAND YOUR LIMITS

Legal issues

Confidentiality
What about parents? How much care for whom? How are sickest students cared for? When should students take a medical leave of absence? Re-entry?

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WHAT ABOUT PARENTS?

Orient them and make them partners Dont say I cant talk to you. Process of communication is key: dont shut them out Invite them to get permission Discuss general concerns, suggestions without breaching confidentiality

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HOW MUCH CARE FOR WHOM?

Balancing needs of individual and community Balancing care and education

How are sickest students cared for?

When should students take a medical leave of absence? Re-entry
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RETURN ON INVESTMENT
Emotional and physical well-being are crucial for academic success The entire student body benefits from a strong counseling program The institution benefits by increased retention and graduation, which enhance reputation

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EXERCISE AND RELAXATION ARE FOUNDATION FOR EFFICIENCY

Get plenty of exercise and sleep. Improved focus and concentration help increase efficiency, so you can complete tasks in less time.
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EXTRACURRICULAR ACTIVITIES REDUCES THE STRESS

Even during their medical colleges careers, many students take on extracurricular activities and projects that are not covered at medical colleges. Extracurricular activates reduces the stress level
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MAINTAIN YOUR EMOTIONAL RESERVES

Develop mutually supportive friendships/relationships. Pursue realistic goals which are meaningful to you, rather than goals other have for you that you do not share. Expect some frustrations, failures and sorrows. Always be kind and gentle with yourself be a friend to yourself.
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STRESS MANAGEMENT TIPS

Be prepared for unexpected problems such as traffic, a lost pet or a family emergency. Prioritize. Take control of your "to do" list by deciding what's really most important on your list. Write down feelings of sadness, frustration or anger to get a clearer perspective of your emotions. Enjoy life's simple pleasures like colorful flowers, dancing, music, and social outings, etc. Share your talents to better the lives of others as well as your sense of well-being.

BEST TO WAY TO OVERCOME STRESS

STRESS is very
common Use stress in a positive way

Limit NOT eliminate stress. Use it to improve your performance.

Learn Coping Skills

THE TAKEAWAY
Academic performance is enhanced by physical and emotional health We can learn to recognize problems much earlier Depression, Anxiety and Stress are treatable Education, Psychotherapy and Medication are all effective

Self Care--eat, sleep, exercise--is a cornerstone of health (for all of us!)

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BE REALISTIC AND NOT BE OVERAMBITIOUS

Being in control of your life and having realistic expectations about your day-to-day challenges are the keys to stress management, which is perhaps the most important ingredient to living a happy, healthy and rewarding life.
DR.T.V.RAO MD

Marilu Henner

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 The programme created by Dr.T.V.Rao MD for Students in the Developing World

Email

doctortvrao@gmail.com

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