Stress And Coping Stress is defined as “non- specific physiological response of the body to any demand upon it”. Stress has both physiological and psychological components Stressor: an environmental event or condition that results in stress. 1

Physiologic & psychologic responses of stress * Physiological component: - Palms sweat. -Increase heart rate. - Neck and shoulder muscles tense. -Headache. 2

* Psychological component: -Irritability -Increase concentration. -Hyper arousal. -↓ memory and performance. -Worry. -Gets angry about little things. -unpleasant thoughts and perceptions. 3

Stages of stress: 1- Alarm reaction: The initial emergency state. stimulation of sympathetic nervous system, that release of adrenaline and nor-adrenaline, heart rate, muscle tension and dilation of the pupils. 4

2- Resistance stage: - Defensive reactions reach their limits of adaptation. - If exposure to stress continues, body resources become depleted and resistance can’t be maintained. 3-Exhaustion stage:- -Defenses failed, stress become overwhelming. - If stress continues, Sever mental illness or death is possible. 5

Types of stressors: 1- Major changes affecting large number of people and universally stressful: - outside control such as, earthquakes, volcanoes, tornadoes, wars, torture, ethnic inequality. 2- Major disastrous events affecting only one or few persons, such as death of a loved one, major illness, & divorce. 3- Daily hassles: irritate and distress people as having too many responsibilities, feeling lonely or work overload 6

Trauma, Grief, Mourning * Psychological trauma: seen as the reaction following the exposure to stressful overwhelming experience that is out of control and coping strategies are insufficient. * Grief: subjective emotions and affect that are a normal response to the loss. * Mourning: the outward expression of grief 7

* Stages of grieve and mourning: 1. Denial: 2. Anger: 3. Bargaining 4. Depression: 5. Acceptance: 8

stressful person-environment relationships: and their immediate and long-term outcomes: 1- Cognitive appraisal: a- Primary appraisal: the person evaluates if there is potential harm or benefit on self- esteem. b- Secondary appraisal: the person evaluates what can be done to prevent or overcome harm. 9

c- Reappraisal: incorporating new information that may increase or decrease level of stress. 2- Coping with stress: - " Constantly changing cognitive and behavioral efforts to manage the internal and external demands that are appraised as exceeding the resources of the person". 10

Forms of Coping Strategies: A) Problem focused coping: - It is consisted of direct efforts to alter the demands on the person, - It includes the following coping strategies: 1. Confrontational coping:- fighting for what want. Ex: If you are fired from work, you need to know why you were fired and try do convince your boss change his mind. 11

Confronting is the best way to deal with stress (gathering information and taking action to solve the problem). People who deal with a problem directly are more likely to solve the problem & also are better prepared to handle future stress. 12

2- Seeking for Instrumental support: - Find out the needed information, and available resources to solve the problem. 3- Planned problem solving: Defining the problem, set & weighing alternative solutions, then selecting the most appropriate one. 13

B) Emotional focused coping: Efforts to regulate the emotional consequences of a stressful situation. Positive or negative emotional strategies. * Positive emotional focused strategies: 1- Accept responsibility:- Acknowledge that you brought this on yourself. 2- Positive reappraisal:- -Ex. reappraise getting fired as being the push you need to look for more interesting job. 14

3- Venting of emotions: -Expressing feelings verbally, or through crying, drawing or playing is very effective. 4- Seeking for social and emotional support: Turning to others for comfort and advice on how to hand the situation. feel with acceptance and empathy from family members, friends, therapist & other significant people. 15

Negative emotional focused strategies: 1- Self control:- -Keeping your chin up and not letting your feelings show. 2- Distancing:- - Make your self busy in other activities to take your mind off the problem. 16

3- Escape / avoidance: - Escaping through drugs, drinking or overeating. chronic avoidance may lead to related health problems (ulcers, hypertension). C) Religious coping: - Religion interlock in an individual's life and help him to deal with stresses in life. 17

Factors mediating the response to stress 1.personality characteristics, cognitive abilities, believes, attitudes,..etc. 2.Previous ways of coping. 3.Characteristics of the stressful situations.(nature,severity, frequency and duration). - Poor coping may result from sever life threatening stressors. 18

4. parenting : predict child resilience and use of more adaptive coping strategies. 5. Locus of control. 6. Social support: emotional responsiveness, empathy, and communication 19

Stress and physical illness strong correlation 1.Cardiovascular: as "MI", and "CVA". 2.Endocrine: as DM, and thyrotoxicosis. 3.Central nervous system: headache, and migraine. 4.Gastrointestinal tract: as ulcerative colitis and peptic ulcer. 5.Immune system: ↓immunoglobulin, lymphocytes. 6.Cancer. 20

Stress Management 1.Modify the stressful environment 2. Change the individual cognition. 3. Reduce stress by treating the individuals. 21

Techniques in stress management A. Biofeedback: monitoring body physiological functions as heart rate, respiratory rate, blood pressure...etc. and learning to control them. *“Effective in the management of some conditions as migraine &essential hypertension”. B. Relaxation techniques: decrease muscle tension. (relaxation techniques can be practiced at home using a tape recorded instructions). 22

C. Meditation: the most effective ways of dealing with stress symptoms. “It is a psychological form of relaxed concentration necessary for peak performance”. *The ability to focus on a specific word or object. 23

D. Exercise: swimming, walking, running etc. release tension and improve mood and general sense of well being and help decrease anxiety. E. Group therapy: working with groups of similar back grounds. “Clients gives each other support and exchange experiences can be helpful for some groups”. 24

F. Cognitive-behavioral therapy: is used successfully to treat stress related disorders. *Positive reframing: means turning negative messages into positive messages. H. Assertiveness training: helps the person take more control over life situations. “THE END” 25