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INTERVENTION ACTION PLAN ON STRESS AND STRESS MANAGEMENT SUBMITTED BY RAMINDER MANN 4231400 1 TABLE OF CONTENTS S.NO TITLE PAGE NUMBER 1 INTRODUCTION 3 2 TERMINOLOGY 3-4 3 STRESS RESPONSE SYSTEM 4-6 4 SRESSFUL LIFE EVENTS 6-7 5 STRESS AND ITS IMPACT ON HEALTH 8-9 6 COPING STRESS 9-10 7 STRESS MANAGEMENT 10-11 8 CONCLUSION 11 9 REFERENCES 12 2 Stress and Stress Management INTRODUCTION: Stress (psychology), an unpleasant state of emotional and physiological arousal that people experience in situations that they perceive as dangerous or threatening to their well-being. The word stress means different things to different people. Some people define stress as events or situations that cause them to feel tension, pressure, or negative emotions such as anxiety and anger. Others view stress as the response to these situations. This response includes physiological changes-such as increased heart rate and muscle tension-as well as emotional and behavioral changes. However, most psychologists regard stress as a process involving a person's interpretation and response to a threatening event. TERMINOLOGY: 1. Health Psychology: Health and illness are influenced by a wide variety of factors. While contagious and hereditary illness are common, there are many behavioral and psychological factors that can impact overall physical well-being and various medical conditions. Health psychology is a specialty area that focuses on how biology, psychology, behavior and social factors influence health and illness. 2. Stress: In the field psychology, stress is often defined as a feeling of pressure, anxiety, overwhelm, irritability, insecurity, social withdrawal, among others. This emotional and psychological condition can be caused by factors such as trauma, personal issues, and mental challenge. Although stress is a part of our everyday life, the degree of stress that we experience differ from one another and that makes some people unable to handle their problem. But nevertheless, experiencing minimum degree of stress is natural and healthy. Some may call such as a positive stress as it improves one’s performance and ability to manage stress better and more efficient. Moreover, positive stress also helps a person to motivate, react, and adapt to the environment. 3. Stressors: A stressor is a chemical or biological agent, environmental condition, external stimulus or an event that causes stress to an organism. An event that triggers the stress response may include: Environmental stressors (elevated sound levels, over-illumination, overcrowding) daily stress events (e.g. traffic, lost keys, quality and quantity of physical activity) life changes (e.g. divorce, bereavement) workplace stressors (e.g. high job demand v. low job control, repeated or sustained exertions, forceful exertions, extreme postures) chemical stressors (e.g. tobacco, alcohol, drugs) social stressor (e.g., societal and family demands) Stressors have physical, chemical and mental responses inside of the body. Physical stressor produce mechanical stresses on skin, bones, ligaments, tendons, muscles and nerves that cause tissue deformation and in extreme cases tissue failure. Chemical 3 stresses also produce biomechanical responses associated with metabolism and tissue repair. Physical stressors may produce pain and impair work performance. Chronic pain and impairment requiring medical attention may result from extreme physical stressor or if there is not sufficient recovery time between successive exposures. 4. Acute Stress: Acute Stress is short-lived. It can be beneficial and create motivation. For example, when a deadline is approaching, stress may help you to focus and complete your task before the deadline. College students use this type of stress often to complete projects and "cram" for exams. Acute stress is the type of stress many people feel when they have a car accident, have trouble at work or their children have problems in school. Once the situation is resolved, the stress diminishes. 5. Chronic Stress: Chronic, or long-term stress, comes about as the result of a situation that has not been resolved or continued for many years prior to being resolved. This might be a traumatic event that happened during childhood. Although resolved, the feelings surrounding the situation may not have been dealt with and chronic stress remains. There may also be an ongoing situation, such as family abuse, dysfunctional home or an ongoing illness in the family. This stress has the ability to create additional health problems, for example heart disease or stomach ulcers. 6. Eustress: Eustress is the good stress that motivates you to continue working. Stress can be a motivator and provide incentive to get the job done. This "good stress" is what eustress can be identified as and some people enjoy it. Everyone needs a little bit of stress in their life in order to continue to be happy, motivated, challenged and productive. It is when this stress is no longer tolerable and/or manageable that distress comes in. 7. Distress: Bad stress, or distress, is when the good stress becomes too much to bear or cope with. Tension builds, there is no longer any fun in the challenge, there seems to be no relief, no end in sight. This is the kind of stress most of us are familiar with and this is the kind of stress that leads to poor decision making. Physiological symptoms of distress include an increase in blood pressure, rapid breathing and generalized tension. Behavioral symptoms include overeating, loss of appetite, drinking, smoking and negative coping mechanisms. STRESS RESPONSE SYSTEM: Although the presence of stressors does not mean that stress responses will necessarily follow, when they do, stress responses are the way in which people react to stressors. They are the experience of being stressed. Stress responses can be divided into three categories: psychological responses, physiological responses, and behavioral responses. A. Psychological Responses when people react to stressors, a wide variety of cognitive and emotional responses can occur. Examples of cognitive responses are as follows: 4 Concentration problems Indecision Forgetfulness Sensitivity to criticism Self-critical thoughts Rigid attitudes B. Physiological Responses Physiological responses follow what is called the general adaptation syndrome. The GAS has three stages: alarm, resistance, and exhaustion. The first stage, alarm, is basically the fight-or-flight response, the various physiological changes that prepare the body to attack r to flee a threatening situation. The sympathetic branch of the autonomic nervous system is activated and prompts the release of two catecholamine, epinephrine and norepinephrine, from the adrenal medulla .Additionally, glucocorticoids like cortisol are released from the adrenal cortex. The following examples of physiological changes characterizes the alarm stage: Increased heart rate Increased blood pressure Rapid or irregular breathing Muscle tension Dilated pupils Sweating Dry mouth Increased blood sugar levels In the second stage, resistance, the body tries to calm itself and restrain the fight-orflight response from the alarm stage. These changes allow people to deal with stressors more effectively over a longer period of time. When the body eventually runs out of energy from trying to resist stressors, the exhaustion stage takes over. In this stage, the body admits defeat and suffers the negative consequences of the stressors, such as a decreased capacity to function correctly, less sleep, or even death. C. Behavioral Responses People act differently when they are reacting to stressors. Sometimes, the behaviors are somewhat subtle, such as the following responses: 5 Strained facial expressions A shaky voice Tremors or spasms Jumpiness Accident proneness Difficulty sleeping Overeating or loss of appetite Behavioral responses are more obvious when people take advantage of the preparatory physiological responses of the fight-or-flight response. One side of the fight-or-flight response is that it prepares people to "fight", and people sometimes take advantage of that feature and behave aggressively toward other people. Unfortunately, this aggression is often direct toward family members. After Hurricane Andrew devastated south Florida in 1992, for example, reports of domestic violence doubled. The other side of the fight-or-flight response is that it prepares people for "flight" The following behavioral responses are examples of how people try to escape threatening situations: Quitting jobs Dropping out of school Abusing alcohol or other drugs Attempting suicide Committing crimes STRESSFUL LIFE EVENTS: Major life events that occur in an individual's lifetime such as death of a loved One, pregnancy, divorce or redundancy all cause stress. Stress, if left unresolved, could lead to serious health problems. No two people will respond to a crisis in the same way. Equally, different crises will not evoke the same reaction. A Major life event can subsequently impact each individuals' life in a unique way. However, there are some life events that can cause more stress than others. Life events are defined as discrete experiences that disrupt an individual's usual activities, causing a substantial change and readjustment. Examples of life events include marriage, divorce, illness or injury, and changing or losing a job. In the literature on stress, life events have been traditionally considered as one type of stressor, along with chronic strains (ongoing stressful circumstances such as living with disability or poverty). Stress can basically be put into two categories. The first is everyday stress. This is the stress created by the demands of daily life, including our jobs, our families and our social life. The most often cited everyday stressor is work. In today’s world of doing more with less, employees find themselves with 6 more work, fewer resources, and less time. We have tight deadlines and a competitive work environment in which only the best performers are guaranteed continued employment. All of these factors add up to a very stressful work environment. We work longer hours, take work home and worry about missing deadlines or performing inadequately. Other everyday stressors can include family demands. Whether they are taking care of aging parents or trying to raise children and maintain a home, our schedules are full of family activities and school events. Normal daily hassles such as too many things to do, juggling different responsibilities, time pressure, traffic noise, job dissatisfaction, poor health, negative attitudes, relationship demands, or financial problems can also cause significant stress. The stress that they create is because we must face these hassles repeatedly on a daily basis. Bills are due every month, and children place demands on us on a regular basis. These kinds of demands can wear us down over time, if we don’t make significant effort to take a break now and then, and practice stress management techniques to help recover from the stress. The second major category of stress is significant life events, which are often life changes that are out of our control. Major life events include items we choose, like getting married, having a child, moving and changing jobs, but also include devastating crises such as the death of a loved one or a natural disaster. Significant life events can blindside us with a tremendous amount of stress all at once. An unexpected illness, death or the loss of a job can leave us feeling helpless and overwhelmed. These events can take a toll on our mind and body in a very short amount of time if we don’t take measures to deal with them effectively. All of us will face both everyday stressors and significant life changes during the course of our lives. Knowing this makes it crucial that we develop some skills for coping with stress, so that it doesn’t take a major toll on our mental and physical health. Some biological and environmental factors can also induce stress. Some possible biological factors include: Low fitness level Poor diet Pregnancy, puberty, menopause or aging Poor health Possible environmental factors include: Relationship difficulties Moving Lack of social support Job pressures or unemployment Holidays Inner conflicts or unresolved issues 7 Stress and Its impacts on health: There have been many reports recently about stress and how it can affect your body and mind, causing very real physical and mental problems. Heart disease, high blood pressure, Anxiety Disorders, and depression have all been linked to chronic stress. Here are some physical conditions caused by stress: Heart disease – Research has confirmed that being under continual stress may place you at greater risk for having heart disease. This is especially true if your heart rate or blood pressure rise dramatically in response to everyday stress. Suppression of the Immune System – Stress has been linked to a suppression of the immune system, making you susceptible to illness or sicker if you already have an illness. You are much more susceptible to colds, flu and viruses. Cancer – Stress has been implicated as playing a role in cancer, particularly in the recovery of cancer patients. Research has implicated stress in the development of cancers related to the immune system, such as virus-related tumors. Gastrointestinal problems - Stress is recognized as a major contributor to gastrointestinal diseases, particularly irritable bowel syndrome. Skin problems – Stress can trigger or aggravate skin conditions such as hives, acne, eczema, psoriasis, rosacea, warts, cold sores, and blisters. Neurological disorders – Among other effects, stress compromises the blood-brain barrier, causing drugs taken for other purposes to enter the brain, causing headaches, nausea, and dizziness. Elevated blood pressure – Too much stress with little or no coping skills keeps the body in the “fight or flight” mode, which raises blood pressure. Following is a short list of mental disorders that are triggered or aggravated by stress: Depression – Stress can trigger short-term depression by elevating feelings of helplessness, hopelessness, sadness and so on. Untreated, these can develop into clinical depression. Bipolar disorder – The depressive/manic cycles of bipolar disorder can be triggered by stress, especially if a person has been enjoying a period of relief from symptoms. Panic attacks – Panic attacks are often triggered by stressful situations, or the anticipation of stressful situations. Panic Disorder – When stress is persistent, panic attacks come so frequently they can be diagnosed as Panic Disorder. The avoidance behavior typical of Panic Disorder is aggravated by stress. Social Phobia – By definition, one of Social Phobia’s primary triggers is stress caused by the reality of or the anticipation of a social situation. Stress can trigger Social Phobia’s several symptoms, and causes the diagnosed disorder itself to deepen. Generalized Anxiety Disorder – Worrying is the key symptom of Generalized Anxiety Disorder, and stress just causes more worrying, especially in relationships 8 and work situations. Stress has been shown to be a direct precursor to Generalized Anxiety Disorder. Obsessive-Compulsive Disorder – The behaviors associated with ObsessiveCompulsive Disorder are aggravated by stress, and chronic stress leads to the course of the mental disorder getting rapidly worse. Post-Traumatic Stress Disorder – Stress triggers many of the symptoms of PostTraumatic Stress Disorder, such as traumatic flashbacks. Other symptoms of PTSD, like relationship problems, tend to create more stress, which causes the condition to worse COPING WITH STRESS: In psychology, coping is expending conscious effort to solve personal and interpersonal problems, and seeking to master, minimize or tolerate stress. Three broad types of coping strategies appraisal-focused (adaptive cognitive) problem-focused: Any coping behavior that is directed at reducing or eliminating a stressor, adaptive behavioral emotion-focused: Directed towards changing one's own emotional reaction to a stressor Appraisal-focused strategies occur when the person modifies the way they think, for example: employing denial, or distancing oneself from the problem. People may alter the way they think about a problem by altering their goals and values, such as by seeing the humor in a situation: "some have suggested that humor may play a greater role as a stress moderator among women than men" People using problem-focused strategies try to deal with the cause of their problem. They do this by finding out information on the problem and learning new skills to manage the problem. Problem-focused coping is aimed at changing or eliminating the source of the stress. Emotion-focused strategies involve releasing pent-up emotions, distracting oneself, managing hostile feelings, meditating or using systematic relaxation procedures. Emotion-focused coping "is oriented toward managing the emotions that accompany the perception of stress" Typically, people use a mixture of all three types of coping strategies, and coping skills will usually change over time. All these methods can prove useful, but some claim that those using problem-focused coping strategies will adjust better to life Problem-focused coping mechanisms may allow an individual greater perceived control over their problem, 9 whereas emotion-focused coping may sometimes lead to a reduction in perceived control (maladaptive coping). STRESS MANAGEMENT: Social support: A strong social support network can be critical to help you through the stress of tough times, whether you've had a bad day at work or a year filled with loss or chronic illness. Since your supportive family, friends, and co-workers are such an important part of your life, it's never too soon to cultivate these important relationships. Numerous studies have demonstrated that having a network of supportive relationships contributes to psychological well-being. When you have a social support network, you benefit in the following ways: Sense of belonging. Spending time with people helps ward off loneliness. Whether it's other new parents, dog lovers, fishing buddies or siblings, just knowing you're not alone can go a long way toward coping with stress. Increased sense of self-worth. Having people who call you a friend reinforces the idea that you're a good person to be around. Feeling of security. Your social network gives you access to information, advice, guidance and other types of assistance should you need them. It's comforting to know that you have people you can turn to in a time of need. Exercise: Exercise increases your overall health and your sense of well-being, which puts more pep in your step every day. But exercise also has some direct stress-busting benefits. It pumps up your endorphins. Physical activity helps to bump up the production of your brain's feel-good neurotransmitters, called endorphins. Although this function is often referred to as a runner's high, a rousing game of tennis or a nature hike also can contribute to this same feeling. It's meditation in motion. After a fast-paced game of racquetball or several laps in the pool, you'll often find that you've forgotten the day's irritations and concentrated only on your body's movements. As you begin to regularly shed your daily tensions through movement and physical activity, you may find that this focus on a single task, and the resulting energy and optimism, can help you remain calm and clear in everything that you do. It improves your mood. Regular exercise can increase self-confidence and lower the symptoms associated with mild depression and anxiety. Exercise also can improve your sleep, which is often disrupted by stress, depression and anxiety. All this can ease your stress levels and give you a sense of command over your body and your life. 10 Imagery: Imagery, sometimes referred to as guided imagery, is the use of pleasant or relaxing images to calm the mind and body. By controlling breathing and visualizing a soothing image, a state of deep relaxation can occur. Know Your Limitations: Knowing yourself and your limits may be the most important way to manage stress effectively. 1. Dare to say no: One more little thing may be the “straw that breaks the camel’s back”. It’s okay to say “No”, “I can’t”, or “Later”. 2. Acquit yourself: Sometimes events really are out of control and you really are “Not Guilty”. Quit blaming yourself. 3. When you need help, get help: Even Atlas couldn’t bear the weight of the world on his shoulders forever. Whether you need help from kids or spouse in hauling groceries into the house, help from a colleague to solve a work-related problem, or professional help to find the causes of and effectively manage your stress, getting the help you need is in itself a major stress management tip! Other Tips Get a good night's rest. Eat healthily. Listen to your favorite music. Exercise, participate in a sport or engage in fun activity. Plan out your time and prioritize. Talk to a friend about your problems, don't hold it in. Get a massage. Take a nap. Take a warm bath. Read a book or watch TV. CONCLUSION: At the end it can be concluded that since causes and effects of stress are several so it is very important to use effective techniques to cope with stress. Stress can impact us physically as well as mentally, so if we don’t take necessary steps to cope with stress it may be too late and its consequences can be too bad. Although Stress is not a direct cause of death but many diseases are caused by stress which can cause death. Hence stress is root cause of many diseases. No doubt, social support is very important in coping with stress but side by side Proper food, sleep, exercise and meditation also play very important role in coping with stress. 11 RESOURCES USED: http://stress.researchpaperon.net/stress-essay/ http://psychology.about.com/od/branchesofpsycholog1/p/health-psychology.htm http://en.wikipedia.org/wiki/Stressor http://www.healthcentral.com/anxiety/c/22705/31980/stress-chronic http://www.brocku.ca/health-services/health-education/stress/eustress-distress http://www.holisticonline.com/stress/stress_gas.htm http://www.dreamessays.com/customessays/Psychology/10931.htm http://anxietypanichealth.com/2008/09/10/stress-and-its-impact-on-your-life http://en.wikipedia.org/wiki/Coping_(psychology) http://www.mayoclinic.com/health/social-support/SR00033 http://www.mayoclinic.com/health/exercise-and-stress/SR00036 http://stressmanagementtips.com/tips.htm 12 13