Transcript - Being Jeengar

Stress Management
Dr. Arvind Barad
MBBS MD (Psychiatry), FIPS, MAPA (U.S.A)
Consultant neuropsychiatrist,
Dept of Psychiatry
SMS Medical College, Jaipur
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STRESS ?
“An internal state which can be caused by
 physical demands on the body (disease, exercise, extremes of
temperature etc.) or
 by environmental and social situations which are evaluated
as potentially harmful, uncontrollable, or exceeding our
resources for coping”
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Stressor
 Any physical, environmental and social cause of stress.
 Almost any change in the environment, pleasant (e.g. marriage)
or unpleasant (e.g. divorce) could be a stressor
 Results in two kind of responses Physical responses Increase heart rate etc.
 Psychological responses Anxiety
 Hopelessness etc.
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 Stress can come from any situation or thought that makes you
feel frustrated, angry, or anxious
 Anxiety Feeling of apprehension caused by anticipation of danger, which may
be internal or external
 Fear Unpleasurable emotional state consisting of psychophysiological
changes in response to a realistic threat or danger.
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4 Basic Sources of Stress
Environment
 weather,
 noise,
 crowding,
 pollution,
 unsafe and substandard
housing, and crime.
Social Stressors
 Financial problems,
 job interviews,
 disagreement
 loss of a loved one divorce,
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and co-parenting.
Physiological
 Rapid Growth of adolescence
 Menopause, Illness,
 Aging, Giving birth
 Poor nutrition, and
 Sleep disturbances.
Thoughts
 Brain interprets and
perceives situations as
stressful, difficult, painful,
or pleasant.
Is it always bad?
 Some amount of stress is essential for us to excel in life. This is
good stress or “EUSTRESS”
 But when stress is too much then it reduces performance. This is
bad stress or “DISTRESS “
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Eustress
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Distress
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Positive stress
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Negative stress
 Motivates, focuses energy
 Causes anxiety
 Is short-term
 Can be short or long-term
 Is perceived as within our
 Is perceived as outside of our
coping abilities
 Feels exciting
 Improves performance
coping abilities
 Feels unpleasant
 Decreases performance
 Can lead to mental and physical
problems
e.g.
 Receiving a promotion at work
 Starting a new job
 Marriage
 Buying a home
 Having a child
e.g.
 The death of a partner
 Filing for divorce
 Losing contact with loved ones
 The death of a family member
Signs and Symptoms of Stress Overload
Cognitive Symptoms:
 Memory problems
 Moodiness
 Inability or difficulty
 Irritability or short-
concentrating
 Poor judgment
 Seeing only the negative
Anxious, racing thoughts
 Constant worrying
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Emotional Symptoms:
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tempered
Agitation, inability to relax
Feeling overwhelmed
Sense of loneliness or
isolation
Depression or general
unhappiness
Physical Symptoms:
Behavioral Symptoms:
 Aches and pains, muscle
 Eating more or less
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tension
Diarrhea or constipation
Nausea, dizziness
Chest pain or rapid heartbeat
Loss of sex drive
Frequent colds
Shallow breathing and
sweating
 Sleeping too much or too
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little
Isolating yourself from others
Procrastinating or neglecting
responsibilities
Using alcohol, cigarettes, or
drugs to relax
Nervous habits (nail biting,
pacing)
How to cope with stress
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METHODS
 RELAXATION
 COGNITIVE TECHNIQES
 BIOFEEDBACK
 HYPNOSIS AND
RELAXATION
 SYSTEMIC
DESESNSITIZATION
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The Relaxation Response
(Herbert Benson)
 Just as stimulating an area of the hypothalamus can cause the
stress response, activating other areas of the brain results in
its reduction (relaxation response)
 Effects metabolism decreases
 heart beats slower and muscles relax
 breathing becomes slower
 blood pressure decreases
 return to a calmer state of being.
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Eliciting the Relaxation Response
 There are two essential steps:
 Repetition of a word, sound, phrase, prayer, or muscular
activity.
 Passive disregard of everyday thoughts that inevitably come to
mind and the return to your repetition
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Other techniques
 Mindfulness meditation
 Progressive Muscle Relaxation
 Deep Breathing
 Self-Massage
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Mindfulness meditation
 An effort to maintain concentration and
to bring it back to the present moment
when mind wanders or start to drift off.
 With regular practice, it strengthens the
areas of the brain associated with joy and
relaxation.
 It provides a potentially powerful
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antidote to the common causes of daily
stress such as time pressure, distraction,
agitation, and interpersonal conflicts.
Progressive Muscle Relaxation
It is a 2 step process  tense and relax different muscles in the body.
 With regular practice, progressive muscle relaxation helps
recognize what tension as well as complete relaxation feels like in
different parts of the body.
 This awareness helps spot and counteract the first signs of the
muscular tension that accompanies stress.
 As the body relaxes, so will mind.
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Deep breathing
 It’s a relaxation technique that can be self-
taught.
 Releases tension from the body and clears the
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mind, improving both physical and mental
wellness.
We tend to breathe shallowly or even hold our
breath when we are feeling anxious.
Shallow breathing limits the oxygen intake and
adds further stress to the body.
Breathing exercises can help to reduce this
stress.
The key is to breathe deeply from the abdomen,
getting as much air as possible into lungs.
Self Massage
 Getting a massage provides deep relaxation, and as the
muscles in your body relax, so does your overstressed mind.
 There are many simple self-massage techniques you can use
to relax and release stress
 Ex- feet & legs, arms and hands, shoulders, head and neck
etc.
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Thought Stopping Techniques
 It has been well documented that negative and frightening
thoughts invariably precede negative and frightening emotions.
 If the thoughts can be controlled, overall stress levels can be
significantly reduced.
 Thought stopping involves concentrating on the unwanted
thoughts and, after a short time, suddenly stopping and emptying
the mind.
 The command “Stop” or a loud noise is generally used to
interrupt the unpleasant thoughts.
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Ask yourself these questions about each
stressful thought you identified:
 Thought ??
 realistic or unrealistic?
 productive or counter-productive?
 easy or hard to control?
 Is it possible that this thought could come true? Just how
probable is it?
 Thought stopping requires consistent motivation
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Thought Substitution –
 In place of the stressful thought, make up some positive, assertive
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statements that are appropriate in the target situation.
For example, if you are afraid of flying, you might say to yourself,
“This is a fantastically beautiful view from way up here.”
Develop several alternative statements to say to yourself, since
the same response may lose its power through repetition.
Be aware that thought stopping takes time. The thought will
return and you will have to interrupt it again.
The main effort is to stifle each thought just as it begins, and to
concentrate on something else.
Biofeedback
 It is the process of becoming aware of
various physiological functions using
instruments that provide information
on the activity of those same systems,
with a goal of being able to manipulate
them at will.
 Processes that can be controlled
include muscle tone, skin
conductance, heart
rate and pain perception etc.
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It works on following principles Instrumental conditioning feedback information rewards learners for specific physiological
responses
 Relaxation biofeedback teaches skills in generalized relaxation
 Cognitive model people learn to control internal processes by using self-statements
or specific mental images
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Hypnosis and visualization
 Self hypnosis is a powerful stress
management tool that can be
learned quickly
 Self hypnosis is a method by
which we can visualize people,
place or even objects that enable
us to feel calm and relaxed.
 Ex- many people find the beach
and sounds of the sea relaxing
and self hypnosis allows us to
imagine a beach scene as if we
were really there.
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Systemic desensitization
 It is a type of behavioural therapy bases a the principle of
classical conditioning.
 The therapist begins by pairing relaxation with very week
fears, then increases the strength of the fears gradually.
 The skillful therapist first induces relaxation, then introduces
images of fear producing stimuli, starting at the least feared
end of the hierarchy.
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Stress Busters
 Start off your day with breakfast.
 Organize your work - set priorities.
 Don't try to be perfect. Don't feel like you must
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do everything.
Avoid trying to do two, three, or more things at a
time.
Develop a support network.
If possible, reduce the noise level in your
environment.
Always take a lunch break (preferably not at your
desk).
 Optimize your health with good
nutrition, sleep and rest.
 Get regular exercise.
 Turn more events into special
occasions.
 Develop a variety of resources
for gratification in your life,
whether it's family, friends,
hobbies, interests, special
weekends Or vacations.
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Meditation
“To meditate is to live simply and honestly in the world as it is.”
-Jonathan C.S
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Mindfulness meditation, is
“a psychological state of active passivity and
creative quiescence,” meditator purposefully and
nonjudgmentally
pays
attention
to
the
present
moment, attending to the multitude of sights, sounds,
sensations, feelings, and thoughts that simultaneously present
themselves to his or her awareness in each moment.
 His or her focus is on the process, or flow of psychic
content, rather than on the content itself.
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 Meditator becomes more aware of the nature of the process of
experience (reperceiving),
 what was previously “subject” (thoughts and feelings that make up
a sense of self) now becomes the “object” of awareness.
 Practitioners describe a subjective experience of “waking up”
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 In this state of subjectively enhanced awareness, there is a
disidentification of self from ego, as the meditator enters a
hypoegoic state.
 In this state, unity with the present moment brings an
acceptance, even as one acts to make changes, accompanied by
subjective experiences of understanding, joy, serenity, freedom
and self fulfilment.
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 Meditation promotes the diminishment of psychiatric
illness, character change, and the resolution of neurosis
when used adjunctively with psychodynamically oriented and
cognitive behavioural psychotherapy.
 Several studies have indicated a positive impact of meditation in
reducing stress and enhancing general wellbeing.
 Several studies have also suggested that meditation can be helpful
for the treatment of anxiety, addiction, aggression,
suicidality, and depression.
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 There is role of meditation in the treatment of chronic
medical illnesses, including
insomnia, and hypertension.
chronic
pain,
 Decreased stress and hypertension by
 decreasing autonomic arousal or reactivity,
 positive emotions,
 reduced
oxidative damage,
and enhanced
immune functioning,
 preserving cognition and reduce age-related
allostatic stress and neuronal loss,
 promotes brain longevity, plasticity, and learning.
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 Imaging studies have shown increased gray matter,
particularly in the prefrontal cortex, the right anterior insula,
and the putamen, areas associated with attention, and sensory
processing, with differences correlating with meditation
experience, suggesting neural plasticity with meditation.
 Imaging studies show increased regional blood flow to
the anterior cingulate cortex and dorsolateral
prefrontal cortex during meditation.
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