Handling Stress on the High Seas Kim C. McCall MS RD LDN

What we are going to do today We are going to learn about stress and scientific evidence documented on the effects of Acute Stress & Chronic Stress. Discover Stress Signals and Coping Mechanisms Learn 6 tips/techniques to manage stress

What is Stress? Sudden change in the environment causes a stress response Example of a Flight or Fight Response – animal like Muscle Tension Higher Blood Pressure Faster Heart Rate Anger Fear Confusion Sweating Sources: Openhandweb.org http://ektherapies.blogspot.com/2011/11/what-is-fight-or-flight-response.html

What about stress in today’s world? Examples of challenges that cause these same symptoms

When stress subsides The body relaxes Heart Rate decreases Blood pressure returns to normal Muscles relax

Acute vs Chronic Stress Good vs. Bad Stress Short term stress can be good for us, but long term chronic stress may not be. Good Stress - Stimulates norepinephrine production Creates new memories, improves mood, problems feel like challenges, encourages creative thinking, and new connection in brain are formed. Bad Stress - Chronic over-secretion of stress hormones adversely affects brain function, especially memory. Too much cortisol can prevent the brain from laying down a new memory, or from accessing already existing memories.

Bad Stress - Females at Higher Risk from Noise Stress- Study (Texas A&M and Cornell University) Stress Compromises the Blood-Brain Barrier (Gulf War – Israeli soldiers)

Are you chronically stressed? Possible signs of stress Anxiety Back pain Constipation or diarrhea Depression Fatigue Headaches Stiff neck or jaw Upset stomach Weight gain or loss High blood pressure Trouble sleeping or insomnia Problems with relationships Shortness of breath

Ok – yeah I’m stressed out, like I thought…what can I really do about it?

Coping with Stress Before we talk about coping mechanisms, let’s try to understand ourselves first. Identify how stress affects you can help you pick an appropriate coping strategy

Stress Signals Stress affects each of us in different ways, and it is important to be aware of your unique stress "signals". Stress signals fall into four categories. When you are under stress, you may experience any number of the following: Feelings Thoughts Behaviors Physical

Stress Signals Feelings Thoughts Behaviors Physical Feelings – anxiety, fear, irritability, moodiness, embarrassment Thoughts - self-criticism, difficulty concentrating or making decisions, forgetfulness, preoccupation with the future, repetitive thoughts, fear of failure.

Stress Signals Feelings Thoughts Behaviors Physical Behaviors - crying, increased or decreased appetite, "snapping" at friends, acting impulsively, alcohol or other drug use (including smoking), nervous laughter, teeth grinding or jaw clenching, stuttering or other speech difficulties, being more accident-prone. Physical - sleep disturbances, tight muscles, headaches, fatigue, cold or sweaty hands, back or neck problems, stomach distress, more colds and infections, rapid breathing, pounding heart, trembling, dry mouth.

Worksheet Two Worksheets per person Write down a stressful situation that you would be comfortable sharing with your group on TWO WORKSHEETS Hand 1 Worksheet to the person on your left Fill out your worksheet completely (FRONT PAGE ONLY) Then, fill out your neighbor’s worksheet with their stressful situation (what would you do?)

Positive Coping Examples Negative Coping Examples Listening to music Playing with a pet Laughing or crying Going out with a friend (shopping, movie, dining) Taking a bath or shower Writing, painting, or other creative activity Praying or going to church Exercising or getting outdoors to enjoy nature Discussing situations with a spouse or close friend Gardening or making home repairs Criticizing yourself (negative self- talk) Driving fast in a car Chewing your fingernails Becoming aggressive or violent (hitting someone, throwing or kicking something) Eating too much or too little or drinking a lot of coffee Smoking or chewing tobacco Drinking alcohol Yelling at your spouse, children, or friends Taking a recreational drug to calm yourself Avoiding social contact

Coping Mechanisms If you are doing any Negative Coping – STOP If you are doing Positive Coping – continue, but know it may not always work, but will not be harmful

Set yourself up to handle stress with these Tips/Techniques CHALLENGE - Adopt at least 1 of these over the next year and see if it makes a difference

Tip #1 Sleep Well Sleep 7-8 hours a night or what your body needs If you are rested, you will be able to handle stressful situations when they arise

Tip #2 Eat Well Eat Every 4-6 hours Get all the nutrients you need

It’s snack time… Take a Break if you need one Then take about 10 minutes to check out the Apps on the IPAD and the laptop Breathe2Relax App Stress Check I Compliment Apps for Journaling Live Journal

Fun Apps to De-Stress http://t2health.org/apps/breathe2relax https://itunes.apple.com/us/app/stress- check/id330049595?mt=8 https://itunes.apple.com/us/app/icomplim ent-free/id327769277?mt=8 http://mac.appstorm.net/roundups/10-apps-to- store-your-thoughts/ www.livejournal.com/

Tip #3 Let Go Don’t worry about things you cannot control

Tip #4 Prepare Prepare ahead for events that you know will be stressful And apply what you learned from previous experiences

Tip #5 Diaphragmatic Breathing Many of us have heard about taking a deep breath when we are stressed to calm down Expansion of the abdomen, not the chest Hypothesized that voluntary slow deep breathing resets the autonomic nervous system through stretch-induced inhibitory signals and sends nerve signals to the heart, lungs, limbic system, and cortex Activates the parasympathetic nervous system. Slow stuff down.

Diaphragmatic Breathing https://www.youtube.com/watch?v=_7ySG gAFAAo

Tip #6 Progressive Muscle Relaxation (PMR) Developed by Edmund Jacobson (physician) in 1920s Since muscle tension accommodates anxiety, one can reduce anxiety by learning how to relax the muscle tension. Combining a mental and physical component of stress Physical component– tensing and relaxing the muscle groups over the entire body (legs, abdomen, chest, arms, face), with eyes closed. Tense the muscle group for 10 seconds and then release it for 20 seconds. Mental component – individual must focus on the feelings of the tension and the relaxation. Must stay present. Relaxation technique that can be done in 10 minutes

Tip #6 Progressive Muscle Relaxation (PMR) Research shows Reduction in salivary cortisol levels and generalized anxiety Decrease Blood Pressure Decreased Heart Rate Decreased Headaches Better management of cardiac rehabilitation Improvement in quality of life of patients after bypass surgery Improvement of quality of life of patients with multiple sclerosis

Progressive Muscle Relaxation (PMR) https://www.youtube.com/watch?v=bX5JYe YE8FI

Back to your worksheets Review the stressful situation that you previously wrote down Flip over the paper What would you do differently in the future? Consider the tips and techniques that we just went through Remember a similar situation could happen again – how would you handle it now?

Thank you Email me with questions, comments, or for a copy of the presentation. Kmccall@mgsd.k12.nc.us

References http://www.fi.edu/learn/brain/stress.html Stress Management Techniques: evidence-based procedures that reduce stress and promote health - Liza Varvogli1, Christina Darviri HEALTH SCIENCE JOURNAL ® VOLUME 5, ISSUE 2 (2011) http://www.nlm.nih.gov/medlineplus/tutorials/managingstress /htm/_no_50_no_0.htm http://www.cmhc.utexas.edu/stress.html http://www.nimh.nih.gov/health/publications/stress/fact- sheet-on-stress.shtml http://www.hsj.gr/volume5/issue2/521.pdf http://www.mayoclinic.com/health/relaxation- technique/sr00007 http://www.medicinenet.com/script/main/art.asp?articlekey =47281 Science of Slumber: How Sleep Affects Your Memory J Med Invest. 2004 Aug;51(3-4):139-45