1. Stress © By Abilio Munoz, MD September 19, 2007

2. Objectives What is Stress? What is Too Much Stress? Associated Problems Caused by Stress Symptoms of Stress Tips to treat your stress

3. Is Stress Good or Bad? Hans Hugo Bruno Selye “stress is not necessarily something bad – it all depends on how you take it. The stress of exhilarating, creative successful work is beneficial, while that of failure, humiliation or infection is detrimental.” The biochemical effects of stress would be experienced irrespective of whether the situation was positive or negative. Hans Hugo Bruno Selye “stress is not necessarily something bad – it all depends on how you take it. The stress of exhilarating, creative successful work is beneficial, while that of failure, humiliation or infection is detrimental.” The biochemical effects of stress would be experienced irrespective of whether the situation was positive or negative.

4. Distress vs. Eustress Distress is the most commonly-referred to type of stress, having negative implications, whereas eustress is a positive, desirable form of stress. Distress is the most commonly-referred to type of stress, having negative implications, whereas eustress is a positive, desirable form of stress. Both can be equally taxing on the body, and are cumulative in nature Both can be equally taxing on the body, and are cumulative in nature

5. Too Much Stress common signs that you’ve had too much excitement and need to slow down include: common signs that you’ve had too much excitement and need to slow down include: –Impatience or Edginess –Lack of Enjoyment –Sleep Problems –Exhaustion

6. Definition Now, the most commonly accepted definition of stress is that stress is a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilize. Now, the most commonly accepted definition of stress is that stress is a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilize.

7. Associated Conditions Anxiety/panic disorder Anxiety/panic disorder Depression Depression Insomnia Insomnia Anger Anger Headaches Headaches Lack of concentration Lack of concentration Lower libido Lower libido

8. Complications High blood pressure High blood pressure Heart disease Heart disease Stroke Stroke Shingles Shingles Eczema Eczema Abdominal pain - IBS Abdominal pain - IBS

9. Symptoms Physical – Physical – –HA, HTN, CP, indigestion, magnification of symptoms Psychological – Psychological – –depression, anxiety, irritability, helplessness, sad and sensative Behavioral – Behavioral – –Impatience, overeating, procrastination, isolation, poor personal hygiene, burnout

10. Mechanisms Fight or Flight Fight or Flight General Adaptation Syndrome General Adaptation Syndrome The Way We think The Way We think

11. “Fight-or-Flight” When an animal experiences a threat or shock, hormones are released which quickly will help escape the problem or deal with shock. When an animal experiences a threat or shock, hormones are released which quickly will help escape the problem or deal with shock.

12. “Fight or Flight”:Only with life threatening situations? Not really: Not really: – recent research shows that we experience the fight-or-flight response when simply encountering something unexpected.

13. General Adaptation Syndrome is response to longer-term exposure to causes of stress. is response to longer-term exposure to causes of stress. Three phases Three phases

14. Animals React in Three Stages First, in the Alarm Phase, they reacted to the stressor. First, in the Alarm Phase, they reacted to the stressor. Next, in the Resistance Phase, the resistance to the stressor increased as the animal adapted to, and coped with, it. This phase lasted for as long as the animal could support this heightened resistance. Next, in the Resistance Phase, the resistance to the stressor increased as the animal adapted to, and coped with, it. This phase lasted for as long as the animal could support this heightened resistance. Finally, once resistance was exhausted, the animal entered the Exhaustion Phase, and resistance declined substantially Finally, once resistance was exhausted, the animal entered the Exhaustion Phase, and resistance declined substantially

15. Normal Life Stress stress is subtle and occurs without obvious threat to survival. Most comes from things like work overload, conflicting priorities, inconsistent values, over-challenging deadlines, conflict with co-workers, unpleasant environments and so on. stress is subtle and occurs without obvious threat to survival. Most comes from things like work overload, conflicting priorities, inconsistent values, over-challenging deadlines, conflict with co-workers, unpleasant environments and so on.

16. The Way We Think

17. The way we think How stressed someone feels depends on how much damage they think the situation can do them, and how closely their resources meet the demands of the situation. This sense of threat is rarely physical. It may, for example, involve perceived threats to our social standing, other people’s opinions of us, our career prospects or to our own deeply held values. How stressed someone feels depends on how much damage they think the situation can do them, and how closely their resources meet the demands of the situation. This sense of threat is rarely physical. It may, for example, involve perceived threats to our social standing, other people’s opinions of us, our career prospects or to our own deeply held values.

18. So you have Stress Who cares? Who cares?

19. You Do. And you will need to take the appropriate steps to improve it. And you will need to take the appropriate steps to improve it.

20. Examine the Cause of Stress Is your job to stressful? Is your job to stressful? Are there relationships in your life that are causing stress Are there relationships in your life that are causing stress Family problems Family problems Financial problems Financial problems The way you think The way you think Do you worry too much about what others think Do you worry too much about what others think

21. Treatment Avoid stressors Avoid stressors Change the reaction to stressors Change the reaction to stressors Relieving stress after the reaction Relieving stress after the reaction

22. Avoid stressors Learn the power of “NO” Learn the power of “NO” Set realistic goals and modify your schedule Set realistic goals and modify your schedule Allow plenty of time – make time for time off Allow plenty of time – make time for time off Family time should be relaxing Family time should be relaxing Avoid Caffeine, enegry drinks, drugs Avoid Caffeine, enegry drinks, drugs Avoid: ephedra, guarana, synephrine, yohimbine Avoid: ephedra, guarana, synephrine, yohimbine

23. Changing the Reaction to the stressors Exercise: take a pleasure walk. Do a repetetive activity Exercise: take a pleasure walk. Do a repetetive activity Talk to a friend or a love one about day’s event. Talk to a friend or a love one about day’s event. Confront interpersonal conflict at work Confront interpersonal conflict at work Change your job Change your job Eat healthy/Sleep 8 hrs Eat healthy/Sleep 8 hrs

24. Relieve Stress Every once in a while, do something totally different and unexpected without prior planning. Every once in a while, do something totally different and unexpected without prior planning. Exercise Exercise Listen to music Listen to music Massage Massage Aromatherapy Aromatherapy Eat healthy/sleep 8 hrs Eat healthy/sleep 8 hrs If severe, talk to your doctor. If severe, talk to your doctor.

25. “Don’t” of Stress Don’t treat by eating, smoking, consuming caffeine, alcohol. Don’t treat by eating, smoking, consuming caffeine, alcohol. Don’t cram stress relieving activities Don’t cram stress relieving activities Don’t do activities that increase excitement or stress: ie: competitive activities Don’t do activities that increase excitement or stress: ie: competitive activities Don’t procrastinate Don’t procrastinate Don’t de-stress by arguing with others. Don’t de-stress by arguing with others.

26. Tips Try a repetitive activity – ie vacuuming, shredding paper, mowing the lawn. Try a repetitive activity – ie vacuuming, shredding paper, mowing the lawn. If in your car, turns on some tunes. Clench exercise in your car. If in your car, turns on some tunes. Clench exercise in your car. Exercise, swimming is great Exercise, swimming is great Recall a past success. Reflect on how you pulled through other stressful situations. Recall a past success. Reflect on how you pulled through other stressful situations. Back off stressful confrontations. Back off stressful confrontations.

27. What About Supplements? Multivitamin Multivitamin Vitamin C recommended 75 to 90 mg Vitamin C recommended 75 to 90 mg Calcium: 1500 mg daily Calcium: 1500 mg daily Magnesium: 400 mg daily Magnesium: 400 mg daily Vitamin B complex Vitamin B complex