5/3/2012

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STRESS AND HEALTH

Thomas P Carey Jr. RRT MPH

Professor of Allied Health

Berkshire Community College

Stressed-Out? Welcome to the Club!

A US News survey found 7 out of 10 people felt

stress at some point on a typical weekday.

Prevention Magazine, 54% of respondents felt

they had more stress in their lives than their

parents did.

About 75% of those asked said that stress was

preventing them from enjoying their lives more.

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The American Psychological

Association(APA) study,

Stress in America 2012

What’s causing stress in America?

Money, work and the economy.

As well as personal health and their

family’s health

People experience more stress whenever

they are subjected to a lot of change in a

short period of time.

These days it is a excess of change

More uncertainty

Often feeling threatened

Overwhelmed

Getting frazzled at work

For most people, their jobs and careers

are the biggest source of stress in their

lives.

Heavier workloads

A boss from hell

Toxic coworkers

Restructuring

Lay offs

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Frazzled @ Home

Meals have to be prepared

The house cleaned

Laundry to be done

Bills paid

Chores completed

Lawn and garden tended

Homework to be done

Kids chauffeured

Did I mention the dog?

Money Malaise-lack of

Mortgage

College tuition

Braces

Camp

Travel

Taxes

Savings for retirement

The little things add up!

Besides major stressors and moderate

stressors there are micro-stressors.

Obnoxious neighbors

Wal-Mart (Hotel California)

Long lines

Cable TV repair only between 12-5

Cell phones going off everywhere

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Identifying the Effects of

Stress (APA)

About 50% of those surveyed said that stress was affecting their health.

21% said that stress was negatively affecting their friendships.

19% said that stress was hurting their marriages.

15% said that stress was affecting their performance at work.

What is the biggest

cause of stress in our

lives.

Answer: Its other people

Interaction with

people is largely

responsible for the

amount of stress we

experience

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Stress in human

relationships comes from a

combination of failure to

meet expectations of

others and failure to get

yours met.

Defining Stress

“Defining stress is

like nailing Jell-o to a

tree”

Its like defining

happiness.

Stress is what you

experience when you

believe you cannot cope

effectively with a

threatening situation or…

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Stress is created when your mind overrides the

body’s basic desire to choke the living sh*t out

of some idiot who desperately deserves it.

How This Whole Stress

Thing Got Started

Stress way back when

was nature’s way of

keeping you alive.

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The Autonomic Nervous

System

The Sympathetic Nervous System

The fight, flight or Fright response

The Parasympathetic Nervous System

The rest and digest response

Physiologic Changes

in the Fight or Flight Response

Heart

HR Increases, force of contraction increases

BP

Increases

Lungs

RR increases, bronchodilation

Blood Clotting

Blood clots faster

Blood flow to skin

Redirected to the brain and skeletal

muscles

Eyes-Pupil size

Pupils dilate

Fat Tissue

Increased breakdown of stored fat

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Brain

Increased blood flow and increased metabolism of glucose

Liver

Converts glycogen to glucose

GI tract

Decreased protein synthesis and decreased salivation

Stress can convict you

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Stress is a well documented cause of

illness

Mind body disease-any condition to be

the result of excess emotional arousal,

maladaptive coping and chronic distress

Anxiety, anger, fear and frustration can

increase the body’s susceptibility to

disease

Stress plays a major role

in circulatory diseases

Stress:

Increases BP

Constricts blood vessels

Increases your cholesterol level

Increases HR and rate of blood clotting

Triggers arrhythmias

Such as

Coronary Artery Disease

CVA’s

Sudden Cardiac Death

Stress is implicated in

@ least 80% of illnesses

Stress lowers the body’s resistance

to disease

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Up to 75% of all Dr’s

visits are for

complaints/conditions

that are stress related

Experiencing severe stress

for more than 1 month but

less than 6 months

doubled a person’s risk of

coming down with a cold

Stress linked to Obesity

and Depression

68% of adults are overwt, 34% are

obese.

1 in 10 American adults suffer from

depression.

Obesity and depression are often

exacerbated by stress.

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Unhealthy behaviors due

to stress: (APA)

29% skipped a meal due to stress

39% reported overeating or eating

unhealthy foods

44% reported lying awake at nite.

41% Lack of motivation(esp when it

comes to exercise)

Caregiving and Stress (APA)

Millions of Americans providing care for

aging of chronically ill family members at

home

55% of caregivers say they feel

overwhelmed by the amount of care their

aging or chronically ill family member

requires.

Asthma and Stress

Lancet 2000

“Severe events, both on their own and in

conjunction with chronic stress,

significantly increased the risk of new

asthma attacks”

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Asthma and Stress

The stress of school

examinations on

otherwise healthy

young college

students with mild

asthma increased

the number of

eosinophils in the

blood and sputum. AJRCCM 2002; 165-171

Stressful life events increase the likelihood of a

new asthma attack in children, according to the

results of a prospective study published in the December issue of

Thorax 2005

Maternal stress during pregnancy is linked to a

higher risk for asthma in the offspring, according to

the results of a prospective study reported online March 18, 2010

in the American Journal of Respiratory and Critical Care Medicine

Stress and violent crime can contribute to

the severity of childhood asthma, according to

a longitudinal study presented here at the American Academy of

Allergy, Asthma and Immunology (AAAAI) 2010 Annual Meeting

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Stress and Cancer

ABC News March 6, 2006

“While the research is young, “inflammatory

pathways activated by stress have been

implicated in the development of tumors,

metastasis of tumors, and resistance to

chemotherapy”

Apr 12, 2010 Journal of Clinical Investigation

showed that stress hormones, such as

adrenaline, can directly support tumor growth

and metastasis

Can stress increase a person’s

risk of developing cancer?

Results of some studies have indicated a link

between various psychological factors and an

increased risk of developing cancer, a direct

cause-and-effect relationship has not been

proven.

Clinical Psychology Review 2004; 24(3):315–338

Dalton European Journal of Cancer 2002; 38(10):1313–1323.

Midlife Psychological Stress and

Risk of Dementia

Lena Johansson and colleges published in Brain.

2010;133(8):2217-2224

found an association between

psychological stress in middle-aged

women and development of dementia,

especially Alzheimer's disease

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Vent Pts

Difficulty in

communication was

a positive predictor of

patient’s

psychological

distress. AJRCCM 2011; 20(6)

“Stress Can Be Good!”

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Stress Can Be:

Motivating

Energizing

Exciting

Fun

Challenge us to greater endeavor

Stress is often in the eye

of the beholder

A situation might be

stressful to you

Might be a minor

irritation to some one

else

Or not stressful at all

to others

Wally-World

Physical Signs of Stress Arousal

Muscle tension

Tiredness, Fatigue

Shakiness, tremors

Heartburn, indigestion

Diarrhea/constipation

Drug/ETOH abuse

Overeating/loss of appetite

Gum Disease

Ulcers

Excessive sweating

Rashes/hives itching

Sleep disturbances

Nail biting

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Psychological Signs

Depression

Anxiety

Withdrawal

Hostile/aggressive behavior

Irritability

Moodiness

Intrusive racing thoughts

Memory Lapses

Difficulty concentrating

Lowered productivity

Feeling overwhelmed

Loss of sense of humor

The Emotional and Physical Toll of Stress

Americans reported s/s of stress:

Irritability or anger 42%

Fatigue 37%

Lack of interest/motivation 35%

Headaches 32%

Upset stomachs 24%

Change in appetite 17%

There are two kinds of

stressors

External

Physical Env: noise,

lights, heat

Social-interaction with

people

Organizational-rules,

regs, deadlines

Major Life Events

Daily Hassles

Internal

Lifestyle choices: too

much caffeine, not

enough sleep

Negative Self talk:

pessimistic thinking

Mind traps: unrealistic

expectations

Stressful personality

traits-workaholic

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Stress, which is now the 2nd

highest

work related disease in the US,

accounts for 20-25% of all

occupational claims. (Cooper 2000)

Downsizing

Restructuring

Mergers

Job insecurity

Culture of longer working hours

Information overload

The combination of high job

demands and low control over

the job put people in greater

risk for heart disease, a risk

similar to that of smokers or

those with elevated serum

cholesterol levels.

Individual Stressors at

Work

Occupational frustration

Lack of communication

Discrimination/reverse discrimination

Bureaucracy

Technological change

Promotion

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Retirement

Forced to retire from a very rewarding job

suffer from some of the following symptoms:

Depression

A sense of worthlessness and a loss of self

esteem

Decreased appetite

Lack of motivation

Increased in cardiovascular complaints

Biological Factors in the

Workplace

Shift work fatigue- trying to adjust to an unnatural pattern of sleeping

Shift workers have a higher risk for CV disease, neurotic disorders, dysfunctional alterations in appetite and s/s of depression.

Computers and Eyestrain

STRESS

MANAGEMENT

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Understanding Stress Is

As Simple As ABC

A is the activating event

B is your beliefs, thoughts or perceptions

about “A”

C is the emotional Consequence or

stress that results from holding these

beliefs

A potentially stressful situation►

Your perceptions►

Your stress (or lack of stress)

Having to wait in line-

My thoughts about waiting in line

Potential stress

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Or At Work...

Fairly busy workload and you get report

that the ER is a “zoo”

Your thoughts about the busy workload

Potential stress

Managing Stress: A

Three-Pronged Approach

Changing your “A” means modifying your

environment

Changing your “B” change the way you

perceive the stressor

You can change your “C” if you can’t

change “A” or “B” you can learn how to

relax your body and quiet your mind

Some Ways To Master

Stress

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Change Lifestyle Habits

Decrease your intake sympathomimetic agents

Maintain a Well Balanced Diet

Maintain a well balanced diet

Increased adrenaline production causes the body to step up the metabolism of proteins, fats and carbs.

Causing the body to excrete AAs, K+, and P; to deplete Mg stored in muscle tissue, and to store less Ca++

The body does not absorb ingested nutrients well under stress

Stress promotes the formation of free radicals and depletes B complex, C and D vitamins

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Eat slowly

Avoid junk food

Take a multivitamin

Eat your colors

Drink plenty of water

GET REGULAR EXCERISE!

MANAGE TIME EFFICIENTLY

Time Management is NOT

Watching a clock

Compiling schedules

Organizing

Its ABOUT:

Planning your course in life

Balancing multiple priorities

Enjoying life

Making decisions about the use of your time

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Time management

is your decision!

If a To Do list is to work you must

keep it short and PRIORITIZE it

Create a Stress Free

Home Environment

Creating a peaceful room/corner can be an

effective stress buffer, color therapy

Plan quiet time alone for you

Leave the TV off

Unplug the phone

Your personal life-choose people who in your

opinion have a low risk : benefit ratio

Stay away from co-dependent energy drainers

Leisure Time

Do something for

yourself everyday!

Get a hobby

Go for a quiet walk

alone

Do a mindless

activity

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Monitor Your Internal

Conversations

Use positive self talk

Some therapist recommend shouting

“GET OUT" (or any phrase you choose)

immediately when a intrusive or

unpleasant worries enter your thoughts

Try To Get Enough Sleep

Ventilation/ Support

System

“a problem shared is

a problem halved”

Develop a support

system of trusted

friends or relatives

“When my life is

going well, I live it.

When it’s not going

well I write it”

Write the nastiest

letter to the person

you are pissed at

then burn it

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Lack of willpower is a

problem.

The A.P.A’s annual report on

Stress in America 2011, found

that Americans cited lack of

willpower as the biggest

barrier to adopting healthier

behavior.

Altruism-giving to others

Pelletier(1994)

conducted a 5yr

study of 51

prominent altruistic

individuals who

showed an unusual

ability to cope with

stress and to grow in

spite of it. (international book giving day)

Have a good sense of humor

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Don’t worry about the

unimportant stuff!

A common source of stress is unrealistic

expectations.

“No expectations, no disappointments”

Will it really matter a year from now.

Don’t Sweat the Small Stuff!

Be more patient

Stay in the PRESENT

“The secret of health for both mind and body

is not to mourn for the past, worry about the

future, or anticipate troubles, but to live in the

present moment wisely and earnestly” BUDDHA

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Avoid losing your temper-anger

management

Stop and think before you react

Practice deep breathing

Try meditation

Progressive relaxation

Investigate aromatherapy

Sex and intimacy can reduce stress

If you feel you cannot

handle the stresses in

your life , consider

seeking outside help.

Psychotropic medications

for emotional stress

Some people may need medications for

stress related symptoms, treatment for

depression and anxiety

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Some helpful references

Stress Management for Dummies by Elkin

Controlling Stress and Tension 8th ed by

Girando

The Precious Present by Spencer Johnson

Don’t Sweat The Small Stuff.. By Richard

Carlson

Don’t Sweat The Small Stuff Workbook by

Richard Carlson

Exercise #1

List of 10 most stressful jobs

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Answers CareerCast.com

1. Enlisted Soldier

2. Firefighter

3. Airline Pilot

4. Military General

5. Police Officer

6. Event Coordinator

7. Public Relations Executive

8. Senior Corporate Executive

9. Photojournalist

10. Taxi Driver

Exercise #2

List the Top Ten Stressors

Answers Exercise #2

1. Loss of a loved one

2. Major illness or injury

3. Divorce or separation

4. Serious financial difficulties

5. Loss of a job.

6. Getting married

7. Moving to a new place

8. A serious falling out with a close friend

9. Birth of a child.

10. Retirement

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Just How Stressed

Are you?

The simplest way to measure your

stress is using a stress gauge.

Exercise #3

10

9 I feel extremely stressed

8

7

6 I feel a moderate amount of stress

5

4

3 I feel only a little stress

2

1

0 I don’t feel any stress

The Stress-

Symptom Scale

Exercise #4

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Knowing where your

stress is coming from

Exercise #5

How Patient Are You?

Exercise #6