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7/25/2015 49th Annual Meeting Disclosure Technician Track: Stress Management Khusbu Patel, Pharm.D. Assistant Director of Pharmacy Cleveland Clinic Florida I do not have a vested interest in or affiliation with any corporate organization offering financial support or grant monies for this continuing education activity, or any affiliation with an organization whose philosophy could potentially bias my presentation OWNING CHANGE: Taking Charge of Your Profession Objectives Define stress and stressors Understand the Stress Response Identify symptoms of stress Identify disease that can be caused by stress Learn management strategies for stress What is Stress? Coined by Hans Selye in 19361: “Non-Specific response of the body to demand for change” Conducted experiments with lab rats exposing them to physical and emotional stimuli Blaring Rats lights, deafening noise, perpetual frustration exhibited pathological changes Stomach ulcerations, enlarged adrenal glands, development of disease similar to humans Other Definitions of Stress Most common1: “Physical, What are Stressors? mental, or emotional strain or tensions” Another popular definition1: “a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilize” Defined as “anything that causes a release of stress hormones”1 2 Types: Physiological: illness, temperature changes, pain, social interactions, major life events, etc. Psychological: lack of sleep, overloaded schedule, pessimistic outlook, unrealistic expectations, etc. How do you define stress??? 1 7/25/2015 Types of Stress1 Acute Stress Abrupt Car events that last a short period of time accident, cramming for an exam, flight delay, etc. Chronic Stress Daily living Bills, Where do you want to be? Job, Family, etc. Eustress Stress in daily life with positive connotations Getting married, having a baby, promotion, etc. http://www.stress.org/daily-life/ General Stress Syndrome1 Stage 1: Alarm Stage Body prepares to defend itself Hormones and chemicals excreted Increase in blood pressure, respiratory rate, heart rate https://psychlopedia.wikispaces.com/Fight-or-Flight+Response General Stress Syndrome1 General Stress Syndrome1 Stage 2: Resistance Body begins to adapt to the stress Depends on body’s stored energy and the intensity of the stressor Heart rate, respiratory rate, hormones, etc. still remain at high levels and then begin to drop once body adapts http://www.videtteonline.com/index.php/2014/02/04/non-traditionally-yours-rubberband/ General Stress Syndrome1 Stage 3: Exhaustion Body becomes exhausted if stressors continue exhaustion Adrenal Progressive http://faithandfitness.net/node/2836 mental and physical stress http://www.integrativepro.com/Resources/Integrative-Blog/2014/General-Adaptation-Syndrome-Stages 2 7/25/2015 Symptoms of Stress: Body2 Headaches Muscle tension Chest pain Fatigue Sleep disturbances Upset stomach Sweating N/V http://www.bodystressreleasesa.co.za/CaseStudies.aspx Symptoms of Stress: Behaviour2 Symptoms of Stress: Mood2 Anxiety Restlessness Lack of motivation Depression Anger Irritability http://orlandograce.org/2011/04/the-power-of-moods-to-shape-the-mood/ Physiology of the Stress Response Overeating Under eating Angry Outburst Drug/Alcohol abuse Social withdrawal Obsessive/Compulsive Apathy http://www.stress.org/daily-life/ Diseases caused by stress4 Muscle Leads tension Diseases caused by stress4 to chronic and painful musculoskeletal disorders Respiratory Release of stress hormones glands produce cortisol and epinephrine Liver produces more glucose Adrenal system Potentially lead to hyperventilation Trigger asthma attacks Cardiovascular Increase in heart rate and contraction of the heart muscle Causes elevation in blood pressure Hypertension, heart attacks, strokes, etc. Endocrine Potentially leading to uncontrolled diabetes Gastrointestinal Esophagus: eating more leads to heartburn or reflux vomiting or ulcers Bowel: diarrhea or constipation Stomach: 3 7/25/2015 Diseases caused by stress4 Nervous system Diseases caused by stress4 Chronic stress leads to wear and tear on the body Physical reactions Drain energy Absent or irregular menstrual cycles PMS symptoms Physical symptoms of menopause can be heightened due to increased levels of stress Sexual dysfunction Worsening Male reproductive system Affects: Testosterone production production Sexual dysfunction Female reproductive system Stress impacts the whole body in a negative way Sperm Statistics: 20141 Research conducted by American Psychological Association and the American Institute of Stress Top causes of stress in the U.S. 1. 2. 3. 4. 5. 6. 7. Job pressure Money Health Relationships Poor nutrition Media overload Sleep deprivation Managing Stress4 Learn to identify stressors Develop healthy responses Establish boundaries Take time to recharge Learn how to relax Get some support Statistics: 20141 77% of people regularly experience physical symptoms caused by stress 73% of people regularly experience psychological symptoms caused by stress 33% of people feel they have extreme stress 48% of people think their stress has increased over the years 76% of people cited money and work as leading cause of stress Managing Stress Identifying stressors4 Keep a journal and track which situations create the most stress Record how you felt, people who were involved, etc. awareness3 the situation and allows for you to develop a plan to minimize the stressors3 Potentially interrupt behavior patterns3 Promotes Analyze http://www.thinkgeek.com/product/e81f/ 4 7/25/2015 Managing Stress Develop healthy responses4 Managing Stress Turn to positive choices when feeling stressed overeating and alcohol consumption Instead turn to physical activity Establish boundaries4 Pressure of being available 24/7 due to cell phones and emails Take time to disconnect Turn off phone and avoid emails past a certain time of day Take time out of the day for yourself Avoid Exercise Yoga Hobbies Sewing Coloring Painting http://www.pitt.edu/~nyj1/hobbies.html Managing Stress Take time to re-charge4 http://www.christianassemblywc.com/#!Dont-Wreck-Disconnect-Pastor-Marvin-Tennant/c1gpm/65051502-EC8F-4BB8-98E81FAA05E6A8B2 Managing Stress Vacation Techniques Focus Learn that can help melt sway stress deep breathing exercises Meditation Mindfulness in things you do on things you enjoy to do Quality sleep Regular massages http://www.whenworkworks.org/blog/unlimited-vacation-days-despite-issues-a-bold-move Managing Stress Learn how to relax4 Get some support4 Accept help from trusted friends or family Can improve ability to mange stress Talk to a psychologist to help change unhealthy behavior related to stress http://littlepearlpublishing.com/deep-breathing-exercises-the-answer-to-anxiety-stress-and-depression/ References 1. 2. 3. 4. AIS. (2015). What is stress? Retrieved June 30, 2015 from <http://www.stress.org/what-is-stress/> Mayo Clinic. (2015). Stress Symptoms. Retrieved July 1, 2015 from <http://www.mayoclinic.org/healthy-lifestyle/stress-management/indepth/stress-symptoms/art-20050987> Michie, S. (2002). Causes and management of stress at work. Occup Environ Med: 59; 67-72. American Psychological Association (APA). (2015). Coping with stress at work. Retrieved June 30, 2015 from <http://www.apa.org/helpcenter/work-stress.aspx> http://www.innerfireouterlight.com/2013/02/22/5-ways-to-recharge-your-creativity/ 5 7/25/2015 Questions?? “Every stress leaves an indelible scar, and the organism pays for its survival after a stressful situation by becoming a little older.” - Hans Selye, MD, PhD http://www.vishwaamara.com/special-days/special-days-for-meditation-february-2012/ 6
