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Transcript
Stress Management NJ AIHA Local Section Meeting October 19, 2006 Definitions Stress Human Definition Engineering Definition Human Definition What the Dictionary Says Stress: A mentally or emotionally disruptive or disquieting influence Engineering Definition What the Dictionary Says Stress: An applied force or system of forces that tends to strain or deform a body The History of Stress To be, or not to be: that is the question. Whether ‘tis nobler in the mind to suffer The slings and arrows of outrageous fortune, Or to take arms against a sea of troubles, And by opposing end them? Dr. Hans Selye Endocrynologist: Johns Hopkins University Recognized that stress is a normal part of life. (ca. 1926) He developed a theory of the influence of stress on people’s ability to cope with the physical pressures of injury and disease More of Hans Selye’s Views Stress is the response of the body to any demand placed upon it whether that demand produces pleasure or pain. Richard Lazarus, Ph.D. Professor of Psychology: UC Berkeley Stress is a state of anxiety produced when events and responsibilities exceed one’s ability to cope with their forces. Stress in Modern Times Dr. Selye’s research indicates that up to 70 - 80 percent of diseases and illnesses are either caused or exacerbated by stress. And only recently has the word become common to describe the emotional impact of life forces. Factors Drawing Attention to Stress Rapid change has become the norm of modern society The number of (perceived) stressors is increasing; Leisure time is (perceived) to be decreasing Furthering the Definition Stress is also –a culturally defined concept. The Result: –different interpretations exist. Some Examples Eastern philosophies - stress is an absence of inner peace. Western culture - stress is a loss of control. Holistic Medicine View Stress is the inability to cope with a real (or imagined) threat to one’s – – – – physical mental emotional, and spiritual well-being This results in a series of physiological changes known as the stress response. The Stress Response: A Basic Decision: Fight or Flight? Concept conceived by Walter Cannon (WWI era) A survival instinct. Meant for physical stressors. I’ll be Back! Never mind, “I’ll be Back!” I’m here now, I’m in your face, and what are you going to do about it!!!??? The Stress Response Also occurs for emotional or spiritual stressors. Occurs if the threat is real or imaginary. Occurs in proportion to the perceived level of danger. Danger – Warning Response Stages Stimuli are received (continuously) by the brain through all of its sensory channels simultaneously. The brain (also continuously) monitors the information. —Like any continuum, there is a range of values, against which the sensory information is measured. —When values become seriously elevated, a threatening condition is perceived and physical responses are initiated. —These physical responses are chemically-based and continue until well after the sensory levels have returned to normal values. —Body chemistry and physical conditions then slowly return to pre-threat levels. i.e., the chemical half-life effect. Vision Sensory Channels – Photopic – Scotopic Hearing Smell Taste Kinesthesis (proprioception) – – – – Muscle Tension Tendon Tension Joint Position Joint Acceleration Vestibular (Balance) Feeling – – – – – – Pressure Contact Deep Pressure Prick Pain Quick Pain Deep Pain Temperature – Heat – Cold Stress Response Effects Stress Types Eustress Neustress Distress Eustress: Positive Stress Motivates Excites Energizes Distress: Negative Stress Oppresses Severely Elevates Emotions Can Degrade Performance Neustress Toxicology Basic Concept The dose determines whether a chemical is toxic or not. A similar concept can be applied to stress. The level determines if there will be positive, negative, or neutral effects on health and the human ability to cope with life forces. Neustress is defined as the optimal stress level for normal human functioning. The Eustress - Distress Curve Maximum Performance Poor Eustress Distress poor performance low bored illness Low performance Good poor performance moderate optimal high overwhelmed High Basic Types of Stressors Physical Psychological Social General Adaptation Syndrome Stage 1 Alarm & React Stage 2 Resist & Endure Stage 3 Exhaustion & Burnout General Adaptation Syndrome Stage 1 (Alarm) – Escalating Emotions » Confusion » Anxiety »Worry »Fear »Shock General Adaptation Syndrome Stage 2 (Resist and Endure) – Focus on To-Do List – Git-R Done Attitude – Psychological Profiles » Aggression » Fixation General Adaptation Syndrome Stage 3 (Exhaustion) – Physiological » Headaches » Tremors » Illnesses – Psychological Profiles » Depression » Repression » Withdrawal – Interpersonal » Damaged Relationships Burnout – Unable to continue The Physiology of Stress Recall: Dr. Hans Selye recognized that there is a direct relationship between chronic stress and excessive wear and tear throughout the body. Brain Architecture The Triune Brain R-Complex Limbic System Neomammalian (neocortex) The Reptilian Complex Lowest level comprised of the: – brain stem – reticular formation The Reticular Formation Reticular Activating System (RAS) A link connecting the brain to the spinal cord. Stress physiologists believe it is a communication link joining the mind and body Function: – The RAS controls the sleep wake cycle and the level of attention when awake. It sends its signals to the cortex to arouse it from sleep. Brain Stem Comprised of Several Discreet Parts – mesencephalon (midbain) – pons – medulla oblongata Responsible for involuntary functions – heart beat – respiration – vasomotor activity Limbic System Emotion Control Center – – – thalamus hypothalamus pituitary gland » a k a. the master endocrine gland – These three glands work together to maintain a level of homeostasis Neomammalian Level Gray Matter Highest level of the brain Processes sensory information – along the continuum from levels representing normal conditions to threatening – where cognition takes place. Can override a lower level Can influence emotional responses ? Cerebellum (motor function) Physiological Systems Involved in the Stress Response: Nervous system Endocrine system Immune system {Electrical} {Chemical} {Chemical} Sympathetic Nervous System Responsible for responses associated with fight-or-flight response This physical arousal is stimulated through release of hormones – Epinephrine (adrenaline) – Norepinephrine (noradrenaline) – Corticol Epinephrine Epinephrine is a catecholamine. It acts on receptor sites of the sympathetic nervous system. Its most prominent actions are on the heart, vascular, and other smooth muscle groups. When introduced, it produces a rapid rise in blood pressure by: Direct stimulation of cardiac muscle and strengthening its contraction, Increasing the heart rate, and Constricting the arterioles in the skin, mucosa and visceral areas of the circulation. Endocrine system Glands involved with the stress response: – Pituitary: releases trophic hormones that stimulate other endocrine glands. Receives releasing hormones from the hypothalamus – Thyroid: releases thyroxine and triiodothionine that regulate metabolic rate – Adrenals: release corticol and adrenaline Effects Associated with Stress Response Three Stages Immediate effects Intermediate effects Prolonged effects Immediate Effects 2 - 3 seconds Sympathetic nervous response Epinephrine & nor-epinephrine released Adrenal Cortex and Blood Flow Inferior Vena Cava Intermediate Effects 20 - 30 seconds Adrenal response Epinephrine & norepinephrine continue to be released Prolonged Effects minutes, hours, days, weeks Continued elevated levels of stress hormones and continued vasodilation: thought processes emotional processes motor functions and physical performance sleep-wake cycle hunger, thirst, and digestive system immune system Stress Management (to be continued) NJ AIHA Local Section Meeting November 16, 2006