1. Stress Dr Jim White www.glasgowsteps.com Ronnie Menzies Welcome

2. What we will cover Scope. What is stress? How does stress affect us? Reducing the effect of Stress. Panic attacks.

3. Scope - Kyriacou (2001) Sources of stress Teaching pupils who lack motivation. Maintaining discipline. Time pressures and workload. Coping with change. Being evaluated by others. Dealing with colleagues. Self esteem and status. Admin. and management. Role conflict / ambiguity/emotional labour* Poor working conditions.

4. Scope - strategies for coping with stress Direct action – reduce source of stress  Identify problem then act to reduce e.g. adjust time frames for a deadline. Learn new skills.  Assertiveness skills. Palliative techniques – manage stress Not only a work related issue

5. What is Stress?

6. Like blood pressure we all have stress

7. The Stress Line Low stress Extreme stress

8. Extreme end of stress line The most common form of stress is a mix of anxiety and depression  Anxiety (tension, stress)  Depression (Low mood, feeling flat, sad) It is unusual to have a single problem, e.g. panic attacks. Most people have a mix As you would expect, a mix of problems is usually more severe than a single problem

9. When is stress a problem? Stress should cause concern if:  You can’t get rid of it even when you try  It affects your day-to-day life  There doesn’t seem a good reason for it to be there  Work context absenteeism / presenteeism

10. Who is affected by stress? It can affect anyone and everyone Right now, in Edinburgh, 1 in 5 of us has a problem with stress In our lifetime, almost 1 in 2 of us will have a problem with stress WHO estimates on depression 2030

11. Stress and teaching NAHT survey 2000 40% respondents stress related problems. 25% serious stress related problem. 20% considered drank too much. 1997 Times Educational Supplement 37% vacancies Secondary 19% Primary Schools due to ill health. cf nurses 9% bankers 5%. 2003 Schools Advisory Service 1 in 3 teachers off with sick leave previous year. Suicide rate 30 – 40 % higher than average

12. How common is stress? Top 10 conditions seen by GPs

13. 14 Most Common Signs Worry Anger Poor Sleep Tiredness Feeling Irritable Feeling Worthless Feeling Hopeless Feeling on edge Unable to switch off Panic Attacks Poor Concentration Tearful Drinking too much Waiting for the worst to happen Reported by people in the UK

14. How stress can affect us Stress

15. How stress affects our body

16. How anxiety can affect our body Stress Bladder/ Bowel Feel Faint Shaking Breathing NauseaChoking Jelly legs NumbSleep Stress Heart rate Headache Chest pain Muscle pain SweatingTired Pins & needles Unreal Dry mouth

17. Why ? Fight / Flight Response Stress: Ancient survival mechanism deal with threats to our physical wellbeing Triggered by sense of threat Physiological component to stress

18. Bear running towards you! Adrenaline Pupils Dilate Bladder/Bowels Sweating Heart Rate Muscle Tension Breathing, oxygen Heightened Awareness

19. Old mechanism - modern world Triggered by a sense of threat Not useful to deal with our anxiety Don’t burn off adrenalin or extra oxygen Vicious circle

20. Depression and the body Eat a lot less Eat a lot more Can’t get to sleep Wake up in the night Wake up very early Sleep a lot more Never feel 100% Headaches Body posture Weight gain Weight loss Lack of energy/sluggish Easily tired Feel exhausted Body feels numb Aches and pains ConstipationAgitation

21. STRESS CAN AFFECT THOUGHTS

22. How Stress can affect our: Thoughts Worry What if…. If only I am…… Thoughts and images Thoughts EmotionsBody Actions

23. Can include fear of: Looking foolishWorry MadnessPoor concentration Illness/diseaseIrritability ChallengesSelf criticism Losing controlBiased processing: Being aloneThreat perception Being criticisedThe blinkers RejectionGrasshopper thinking Meeting people

24. STRESS CAN AFFECT ACTIONS

25. How Stress can affect our: Actions You may: Avoid day to day events Avoid socialising Avoid making decisions Act differently Thoughts EmotionsBody Actions

26. How Stress affects our: Behaviour Slow response Withdrawal Lack of enthusiasm Complaining aches and pains Eating habits Poor concentration Self harming Self care Speaking too fast Unable to sit at peace Poor performance / Procrastination Always rushing Smoking/drinking more Accident prone Stammering Irritable Nail biting

27. Managing Stress

28. Clearing the decks Alcohol Caffeine The “miracle cure” Reassurance Self-criticism Avoidance

29. CONTROLLING YOUR BODY

30. Breathing and relaxation Slow regular breathing In through nose out through mouth Diaphragmatic breathing Progressive muscle relaxation

31. CONTROLLING YOUR THOUGHTS

32. Stage 2: The Big Five Challenges “What are the chances…..?” “What is the worst thing….?” “Am I right to think that ?” “The five year rule.” “Is it worth it ?”

33. Am I right to think that ? Situation: Having to repeat self numerous times to get pupils’ attention. Thought: “It is impossible to teach this class” What does the evidence say? Impossible ? The whole class? Always?

34. Plan to Tackle Stress Trying to ignore it does not work !!!! Plan Act Review

35. More thinking about thoughts Teaching specific research Flexible vs rigid thinking (musts and shoulds). Depersonalise situations review to change not to criticise. Internal vs external attributions.  Internal attributions for success and external for problems less stress!!!!

36. CONTROLLING YOUR ACTIONS

37. Helpful actions Exercise Face the fear Deal with issues causing stress Problem solving Developing a supportive environment Coping strategies

38. Panic attacks

39. Body, thoughts and actions Unpredicted panic, predictable and nocturnal Not dangerous

40. Hyperventilation and panic attacks Unpleasant Symptoms 1 2 3 5

41. Controlling panic Stay in the situation. Slow down breathing and relax body. Challenge thoughts as soon as they appear. Identify then stop safety behaviours. Plan ahead and start with easier situations.

42. Resources GP gate keeping role to other services. Stepped Care Model. Stress Control (self referral) Book prescription scheme Guided self help Psychology Living Life Teacher Support Network / Union websites

43. Useful references Kyriacou, C. (2001). Teacher stress: Directions for future research. Educational Review, 53, 28- 35. Howard, S. & Johnson, B. (2004). Resilient teachers: Resisting stress and burnout. Social Psychology of Education, 7, 399-420. Websites with helpful workbooks http://www.cci.health.wa.gov.au/resources/consumers.cfm

44. Questions?