STRESS TRAUMA GRIEF & LOSS Christine Buckingham, LCPC World Vision Employee Health Fair Washington, DC November 5, 2009 STRESS TRAUMA GRIEF & LOSS World Vision Employee Health Fair Washington, DC November 4, 2009 Christine Buckingham, LCPC Executive Director Life Christian Counseling Network, LLC © 2010 Christine E. Buckingham. All rights reserved

Hierarchy of stress Stress Adjustment disorders Acute stress disorder Post traumatic stress disorder (PTSD)

Trauma, grief, loss

Beyond Stress Counseling/Therapy Medication management More complicated stress levels such as Adjustment disorder, Acute Stress Disorder, and PTSD, require additional help and resources including Counseling/Therapy Medication management

Adjustment Disorder Marked distress in excess of what would be expected in response to a stressful event, or a significant impairment in social or occupational functioning. The symptoms usually occur within 3 months of the recognizable stressful event and should not last longer than 6 months after resolution of the stressful event or its consequences unless symptoms are in response to a chronic stressor. Individuals generally return to normal functioning within a few months

Acute Stress Disorder An Anxiety Disorder resulting from exposure to a traumatic event where a person develops anxiety symptoms, re-experiencing of the event, and avoidance of stimuli related to the event lasting less than four weeks. If symptoms persist, a diagnosis of PTSD may be given.

Post Traumatic Stress Disorder (PTSD) An anxiety disorder triggered by a traumatic event. A person can develop post-traumatic stress disorder when they experience or witness an event that causes intense fear, helplessness or horror. Onset can be delayed by as much as 6 months. Symptoms can last less than three months or can become chronic. Persistent re-experiencing (recollections, dreams, flashbacks, distress at reminder cues, psychological reactivity to perceived cues) Avoidance of stimuli Increased arousal Duration of sx more than 1 month Clinically significant impairment in social, occupational or other area of functioning

Stress Sources of Stress: GOOD AND BAD SOURCES: environment (weather, noise, traffic); social stressors (relationships, moves, promotions, family, work pressures, deadlines, financial problems) ; physiological (illness, aging, injury, exercise and lack of exercise, nutrition, inadequate sleep); thoughts (flight/flight responses)

OR Activating Event -- The STRESSOR STRESS RESPONSE: RELAXATION RESPONSE: Engages the Parasympathetic Nervous System -- Three minutes the F or F burns out & Systems return to Normal STRESS RESPONSE: Fight, Flight, Freeze Physiological Arousal of the Sympathetic Nervous System: INCREASED: heart rate, breathing rate, muscle tension, metabolism, blood pressure Blood diverted away from digestive system – butterflies in the stomach; extremities get cold. Pupils dilate OR CHRONIC STRESS: Adrenals produce corticoids Increased Vulnerability to illness Stressor Fight or flight or freeze EVEN IMAGINED DANGER ACTIVATES THIS – fear Hypothalamus in midbrain activates the Nervous System Corticoids – adrenaline or epinephrine and norepinephrine: inhibit digestion, reproduction, growth, tissue repair, and inhibit the activity of your immune and inflammatory systems. Your body begins to shut down and are vulnerable to stress related illnesses Chronic stress can occur whten stressors of life are unrelenting. YOU activate the Relaxation response – the all clear to the brain. 8. The good news? Your body can learn the relaxation response.

Stress Management The good news: Performance & efficiency actually improve with increased stress The bad news: Performance peaks as the stress level becomes too great. And it’s all downhill from there. Balance = types + amounts of stress for your individual personality, priorities, and life situation.

Symptoms of Stress On your body On your behavior Headache Back pain Chest pain Heart disease Heart palpitations High blood pressure Decreased immunity Stomach upset On your thoughts and feelings Sleep problems Anxiety Restlessness Worrying Irritability Depression Sadness Anger Feeling insecure Lack of focus Burnout Relationship conflicts On your behavior Forgetfulness Overeating Under-eating Over-eating Angry outbursts Drug or alcohol abuse Increased smoking Social withdrawal Crying spells Relationship conflicts Retrieved 11-4-09 from MayoClinic.com

Stress Management Physical Spiritual Soul/mind Self care Nutrition Exercise Rest/relaxation Soul/mind Boundaries Fun Thinking patterns coulda/woulda/shoulda Spiritual Relationships Worship Inspirational reading Music Study Service Reflection

Let’s Evaluate Holmes-Rahe Stress Scale Add up the stress factors in your life you have experienced in the last 24 months to see how these factors may be affecting your physical health.

The envelope, please… What were your top 5 stressors? And your score Less than 150......30 chance of developing a stress related illness 150-299......50% chance of developing a stress related illness Over 300.......80% chance of developing a stress related illness What were your top 5 stressors? What are your top 5-8 stressors?

how stressed do you feel Right now? On a scale of 1 to 10, how stressed do you feel right now?

RRREEE-LAAAXXXX Here we go… Dim lights.

Progressive Muscle Relaxation REEE-LAAAXXXX Progressive Muscle Relaxation Head to toe

Mindfulness REEE-LAAAXXXX Five things you hear Five things you see Five things you sense

Breathe REEE-LAAAXXXX Measured breathing: In through your nose, toungue to roof of mouth, out through a straw. Here we go -- Cleansing breath in and out……………..In ……..1…2…3..4 Hold…….1...2… Out……..1..2..3..4..5..6

Become aware of God’s presence REEE-LAAAXXXX Become aware of God’s presence As you continue breathing, become aware of your breath as it enters your body – As you breathe in, aware of God’s Holy Spirit filling you As you exhale, give him your worries,, cares, upplication

Evaluate present stress On a scale of 1 to 10, how stressed do you feel right now? Did your level change?