3. STRESS IS A PERSON’S PHYSICAL AND EMOTIONAL RESPONSE TO CHANGE.

4. CLASSIFICATION OF STRESS POSITIVE STRESS NEGATIVE STRESS ACUTE STRESS CHRONIC STRESS

5. WHAT CAUSES STRESS ? LIFE EVENTS SUCH AS DIVORCE OR SEPARATION, DEATH OF A LOVED ONE, THE BIRTH OF A CHILD, MOVING, A MAJOR FINANCIAL SETBACK, EMPLOYMENT CHANGES OR BECOMING THE VICTIM OF A CRIME OR NATURAL DISASTER DAILY EVENTS SUCH AS TRAFFIC CONGESTION, LONG COMMUTES, WORKING OVERTIME, DEADLINES, PERSONAL CONFLICTS, CAR TROUBLE, JOB STRESS, AND JUGGLING HOUSEHOLD CHORES AND CHILDCARE ENVIRONMENTAL STRESSORS SUCH AS POLLUTION, WEATHER EXTREMES OR EXCESSIVE NOISE PHYSICAL STRESSORS SUCH AS PHYSICAL INJURY, CHRONIC PAIN, TIRING PHYSICAL ACTIVITY (SUCH AS TRAVELING), AND UNSATISFIED PHYSICAL NEEDS SUCH AS HUNGER, THIRST OR LACK OF SLEEP Continued….

6. 1. DEATH OF A SPOUSE 2. DIVORCE 3. MARITAL SEPARATION 4. IMPRISONMENT 5. DEATH OF A CLOSE RELATIVE 6. PERSONAL INJURY OR ILLNESS 7. MARRIAGE 8. FIRED FROM A JOB 9. MARITAL RECONCILIATION 10. RETIREMENT 11. ILLNESS OF A RELATIVE 12. PREGNANCY 13. SEXUAL PROBLEMS 14. BIRTH OR ADOPTION 15. BUSINESS READJUSTMENT Continued…

7. 16. Change in financial status 17. Death of a close friend 18. Change to different work 19. Increased arguments with spouse 20. Mortgage or loan for major purchase 21. Foreclosure on mortgage or loan 22. Change in job responsibilities 23. Child leaving home 24. Problems with in-laws 25. Outstanding personal achievement 26. Spouse begins or stops work 27. Begin or end school 28. Change in living conditions 29. Changing personal habits 30. Problems with your boss Continued…

8. 31. CHANGE IN WORK 32. HOURS/CONDITIONS 33. CHANGE IN RESIDENCE OR SCHOOL RECREATION 34. CHURCH OR SOCIAL ACTIVITIES 35. MORTGAGE OR LOAN 36. CHANGE IN SLEEPING HABITS 37. CHANGE IN FAMILY GATHERINGS 38. CHANGE IN EATING HABITS 39. VACATION 40. ANY FESTIVALS 41. MINOR LAW VIOLATION

9. PREDISPOSING FACTORS FOR STRESS GENETIC FACTORS INABILITY TO ADAPT INADEQUATE RELAXATION RESPONSE RESPONSE ACTIVITY VARIATIONS AGE PERSONALITY ISOLATION Environment

10. SYMPTOMS OF STRESS Behavioral symptoms Physical symptoms

11. BEHAVIORAL SYMPTOMS TOO MUCH SLEEP (HYPERSOMNIA) OR TOO LITTLE SLEEP (INSOMNIA) NIGHTMARES NERVOUS HABITS LIKE NAIL- BITING OR FOOT-TAPPING DECREASED SEX DRIVE TEETH GRINDING IRRITABILITY OR IMPATIENCE CRYING OVER MINOR INCIDENTS DREADING GOING TO WORK OR OTHER ACTIVITIES

12. PHYSICAL SYMPTOMS MIGRAINE OR TENSION HEADACHES DIGESTIVE PROBLEMS LIKE HEARTBURN OR DIARRHEA SHALLOW BREATHING OR SIGHING COLD OR SWEATY PALMS JAW PAIN, NECK PAIN,SHOULDER PAIN

13. EARLY WARNING SIGNS OF STRESS 1. Excessive fatigue 2. Gastric disturbance 3. Withdraw from social life 4. Menstrual problems 5. Speech difficulties 6. More impatient 7. Headaches 8. Infertility 9. Ulcers 10. Nail biting 11. Grinding teeth 12. Low blood sugar 13. High blood sugar

14. EARLY WARNING SIGNS OF STRESS-2 14. Need more sleep 15. Tired but can't sleep 16. Sudden weight loss 17. Sudden weight gain 18. Low blood pressure 19. High blood pressure 20.Lack of coordination 21. Repeated influenza 22. Repeated colds 23. Muscle aches 24. Hair loss 25. Chest pain

15. EARLY WARNING SIGNS OF STRESS-3 1. Forgetfulness 2. Nervous talking 3. Lower back pain 4. Loss of appetite 5. Increased appetite 6. High cholesterol 7. High triglycerides

16. Physical signs and symptoms of stress Increased heart rate Pounding heart Elevated blood pressure Sweaty palms Tightness of the chest, neck, jaw, and back muscles Headache Diarrhea Constipation Urinary hesitancy Trembling Being easily startled Chronic pain and Dysponea Twitching Stuttering and other speech difficulties Nausea Vomiting Sleep disturbances Fatigue Shallow breathing Dryness of the mouth or throat Susceptibility to minor illness Cold hands Itching

17. Emotional signs and symptoms of stress Irritability Angry outbursts Hostility Depression Jealously Restlessness Withdrawal Decreased perception of positive Experience opportunities Narrowed focus Obsessive rumination Reduced self-esteem emotional response reflexes Weakened positive emotional response reflexes Anxiousness Diminished initiative Feelings of unreality or over-alertness Reduction of personal involvement with others Lack of interest Tendency to cry Being critical of others Self-deprecation Nightmares Impatience Reduced self-esteem Insomnia Changes in eating habits

18. Cognitive/Perceptual Signs and Symptoms of Stress Forgetfulness Preoccupation Blocking Blurred vision Errors in judging distance Diminished or exaggerated fantasy life Reduced creativity Lack of concentration Diminished productivity Lack of attention to detail Orientation to the past Decreased psychomotor reactivity and coordination Attention deficit Disorganization of thought Negative self-esteem Diminished sense of meaning in life Lack of control/need for too much control Negative self- statements and negative evaluation of experience

19. Behavioral Signs and Symptoms of Stress Increased smoking Aggressive behaviors (such as driving - road rage, etc.) Increased alcohol or drug use Carelessness Under-eating Over-eating Nervous laughter Compulsive behavior Impatience Withdrawal Listlessness Hostility Accident-proneness

20. Signs of Stress in The Workplace Stress Arousal Stage Persistent irritability and anxiety Bruxism and/or Insomnia Occasional forgetfulness and/or inability to concentrate Stress Resistance Stage Absenteeism or tardiness for work Tired and fatigued for no reason Procrastination and indecision Social withdrawal with cynicism Resentful, indifferent, defiant Increased use of coffee, alcohol, tobacco, etc.

21. Severe Exhaustion Stage Chronic sadness or depression Chronic mental and physical fatigue Chronic stress related illnesses (headache, stomach ache, bowel problems, etc.) Isolation, withdrawal, self-destructive thoughts

22. OUR BODY’S REACTION TO STRESS (GENERAL ADAPTATION SYNDROME (GAS)) ALARM REACTION RESISTANCE OR ADAPTATION EXHAUSTION

23. ALARM REACTION MUSCLES TENSE HEART BEATS FASTER THE BREATHING AND PERSPIRATION INCREASES THE EYES DILATE THE STOMACH MAY CLENCH

24. RESISTANCE OR ADAPTATION FATIGUE CONCENTRATION LAPSES IRRITABILITY AND LETHARGY

25. EXHAUSTION DECREASED STRESS TOLERANCE PROGRESSIVE MENTAL AND PHYSICAL EXHAUSTION ILLNESS AND COLLAPSE

26. STRESS MANAGEMENT BREATHING EXERCISE RELAXATION EXERCISE MEDITATION EXERCISE AND PSHYCOLOGICAL COUNSELLING

27. HEALTHY STRATEGIES FOR RELAXATION STRETCHING TAKING A BATH TAKING A WALK PETTING AN ANIMAL TAKING A BREAK/VACATION GETTING A MASSAGE JOINING A SUPPORT GROUP PRAYING Continued….

28. HEALTHY STRATEGIES FOR RELAXATION PAINTING, DRAWING, OR PLAYING A MUSICAL INSTRUMENT ENGAGING IN A HOBBY USING POSITIVE SELF-TALK (E.G., “I CAN DO THIS”) READING INSPIRATIONAL OR SPIRITUAL WORDS WRITING IN A JOURNAL OR DIARY CONFIDING IN, OR “VENTING” TO, A FRIEND LISTENING TO RELAXING MUSIC OR AN INSPIRATIONAL TAPE LISTENING TO RELAXATION TAPES (AVAILABLE FROM A COUNSELOR OR BOOKSTORE) ON WHICH A RECORDED VOICE GUIDES THE LISTENER IN RELAXING FROM HEAD TO TOE WATCHING TELEVISION

29. EXAMPLES OF MANAGING STRESS CHANGING UNREALISTIC GOALS (E.G., NOT TRYING TO BE PERFECT ALL THE TIME) CHANGING UNREALISTIC EXPECTATIONS (E.G., NOT EXPECTING OTHERS TO BE PERFECT ALL THE TIME) RE-PRIORITIZING (E.G., MAKING TIME TO TAKE CARE OF YOURSELF) DELEGATING A TASK/CHORE TO SOMEONE ELSE (E.G., NOT TRYING TO DO EVERYTHING ALONE) Continued….

30. EXAMPLES OF MANAGING STRESS FORGIVING SOMEONE (E.G., LETTING GO OF AN OLD GRUDGE) PLANNING AHEAD (E.G., BEING PREPARED FOR THE LITTLE SURPRISES THAT OFTEN ARISE) VIEWING A STRESSOR AS CHALLENGING INSTEAD OF TERRIBLE, AWFUL, OR CATASTROPHIC BECOMING MORE ASSERTIVE (E.G., SPEAKING UP AND LEARNING TO SAY NO) RESOLVING CONFLICTS THROUGH SHARING AND LISTENING, RATHER THAN ALLOWING CONFLICTS TO FESTER Continued….

31. EXAMPLES OF MANAGING STRESS GETTING MORE SUPPORT (E.G., ASKING FOR HELP INSTEAD OF TRYING TO “TOUGH IT OUT” ALONE) AVOIDING QUARRELSOME PEOPLE AS MUCH AS POSSIBLE (E.G., NOT SEEKING OUT TROUBLE) BRINGING MORE HUMOR INTO YOUR DAILY ROUTINE TAKING A VACATION, BECAUSE STUDIES SUGGEST THAT NOT DOING SO MAY INCREASE THE RISK OF HEART DISEASE AND EARLY DEATH

32. TWO TYPES OF OPTION FOR CONTROLING STRESS CHANGING THE SITUATION OR LEARNING TO ACCEPT IT WITHOUT FEELING STRESS

33. THE FAMOUS SERENITY PRAYER: “Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”

34. SUMMARY GETTING ENOUGH SLEEP EXERCISING REGULARLYEXERCISING TO EAT A BALANCED DIETDIET