Psychology unit iv -stress

stress (Psychology)

1. Prepared By: Mrs. AKila . A, M.Sc (N), M.Sc (PSY), Associate Professor STRESS

2. INTRODUCTION Stress is a universal phenomenon. All people experience it. Stress affects the whole person in all the human dimensions, the perception of stress and the responses to it are highly individualised, not only from person to person, but also from one time to another in the same person .

3. DEFINITION Stress is the nonspecific response of the body to any demand for change – Selye . Stress as that which occurs when “ an individual perceives that the demands of an external situation are beyond his or her perceived ability to cope with them” - Lazarus and Folkman

4. TYPES OF STRESS According to “ selye ” there are two types 1.Distress or damaging stress. Example: Death of a loved one, Chronic illness 2.Eustress or stress that protects health. Eustress is motivating energy, such as happiness, hopefulness and purposeful movement. Example: Learning a new hobby

5. According to Lazarus, (1999) there are several types of stress – Work stress, Family stress, Chronic stress, Acute stress, Daily hassles, Trauma Crisis.

6. 1.Work and family stress interact, family being the background for work stress, and work the background for family stress. 2.Chronic stress occurs in stable conditions and from stressful roles. Chronic stress is living with a ling – term illness. 3.Acute stress is provoked by time – limited events that are threatening for a relatively brief period

7. STRESSORS Stressors are situations, circumstances or any stimulus that is perceived to be a threat. CLASSIFICATION OF STRESSORS: Life events or daily hassels : Death of a loved one Divorce, injury, being fired at work Trouble with in laws

8. 2.External or Internal : External Stressors are adverse physical conditions. Example : Hot or Cold temperatures Stressful Psychological environments Poor housing, Traffic Jams. Internal Stressors can be Physical conditions Example : Illness, U nrealistic Expectations Tendency to worry

9. 3.Physical, Psychological or Social Stressors: Physical: - Sleep deprivation, Lack of relaxation - alcohol abuse, Poor diet, Hyperglycemia Psychological: - unhappy childhood, Unemployment - excessive anger, low self esteem Social: - Poverty, Racial Prejudice, Victim of crime - H arassement and bureaucracy

10. Other classifications 1.ENVIRONMENTAL STRESSORS: Nature and manmade Catastrophies : -Earth quakes, floods, Fire breaking incidence and accidents. - Death of the near and dear - Robbery and cheating - Terrorist attacks - Communal Violence

11. 2 . INTERNAL OR PSYCHOPHYSIOLOGICAL STRESSORS: Some persons are characterized to posses a particular type of behaviour more prone to stress than others. Depending on the stress bearing or tolerance capacity Poor health, defective sensory organ, illness and fatal diseases. S leeping disorders, Drug addiction Unhappiness and frustration

12. STRESSORS ACROSS LIFESPAN DEVELOPMENT CHILDHOOD: -Conflicts between Parents, abuse, neglect - Unreasonable family expectations, - Changes in family’s financial situation - Low academic Performance - Chronic illness - Sudden hospitalisation

13. ADOLESCENCE: - Coping with academic pressures - Lack of acceptance by peers - Increased arguments with friends - Accepting their own physical changes - Relationship with opposite sex - Leaving home for higher studies

14. ADULTHOOD: - Starting a career, Marriage - Running a household independently - Adjusting with in- laws, Parents - Relocating, meeting deadlines in jobs, Loan payments.

15. MIDDLE AGE: Coping with health problems Dealing with teenage children Marriage and career of children Taking care of aged parents Job burnout Mid-career changes

16. OLD AGE: Failing health and stamina Relocating with children Living alone Living with reduced income Adjusting to retirement Loneliness

17. STRESS CYCLE

18. STRESS CYCLE

19. 1. Stressors which can be a problem at home, the work place, with friends or anything that causes stress. 2. Stress Reactions : If an individual perceives that he will not be able to cope with the stressor, it results in negative reactions like anxiety, worry, low energy and lack of interest. 3.Wear and Tear of the body : The nervous system responds by releasing stress hormones which prepares an individual to meet emergency situation. It weakens the immune system. Pain, aches, fatigue a well a memory and concentration problems are commonly seen at this stage.

20. 4.Reduced optimal health: C ontinuing Stress will leads to Reduced optimal health - Common Symptoms (physical): High BP, Digestive Problems Skin problems, Asthma, depression C ancer

21. 5. Increased Sensitivity: The stressed individual feels exhausted physically and emotionally and this will increase his sensitivity to stress, when minor matters can become overwhelming. Thus the vicious cycle of stress begins operating.

22. EFFECTS OF STRESS EFFECT OF STRESS ON HEALTH : 70% of today’s illnesses are stress related. It can affect by direct or indirectly Persistent stressors Release of stress hormones Circulatory Immune suppression Digestive system system illness

23. IMMEDIATE EFFECTS OF STRESS Behavioural changes: - Nervousness, Panic reactions, Exhaustion, Paralysed thinking - Alcohol consumption - Restlessness, Sleep disorders (ii) Physiological changes : - Increased in muscular tension - Abnormal changes in heart beat and BP - Problem related to digestion

24. (iii) Emotional Changes: - Victim of the outburst of anger, fear, jealousy and hatredness. - High state of anxiety, restlessness and depression. - Problems related to lack of interest in love making and social intimacy. (iv) Cognitive Changes: - Increased distractibility - Decreased concentration

25. LONG TERM EFFECTS OF STRESS Behavioural Changes : - Serious behavioural disorders - Forgetfulness , obesity - Excessive alcohol consumption and Drug addiction. (ii) Physiological Changes: - A known victim of high BP, heart diseases, skin diseases, Ulcer, even cancer

26. (iii) Emotional changes: - Serious emotional disorders like chronic anxiety, depression, fear and phobia - Changes in Personality and mental illness. (iv) Cognitive changes: - Serious cognitive disorder Example: - Memory Problems, obsessive thoughts and sleep disorder

27. ADAPTATION-Hans Selye’s theory In the 1930s, 1940s,and 1950s Hans Selye enlarged on cannon’s fight – or – flight hypothesis to describe the general adaptation syndrome ( GAS), A three – stage reaction to stress. The GAS describes how the body responds to stressors through the – - Alarm reaction - Resistance stage - Exhaustion stage .

28. Alarm reaction : - During the alarm reaction rising hormone levels result in increased blood glucose levels, epinephrine and nor epinephrine amounts, heart rate, blood flow to muscles, oxygen intake, and mental alertness. -In addition, the pupils of the eyes dilate to produce a greater visual field. This change in body systems prepares an individual for fight or flight and may last from 1 minute to many hours. If the stressor poses an extreme threat to life or remains for a long time, the person progress to the second stage, resistance.

29. Resistance stage : -During the resistance stage the body stabilizes and responds in an opposite manner to the alarm reaction. -Hormone levels, heart rate, blood pressure and cardiac output return to normal and the body repairs any damage that may have occurred. - If the stressor remains, and there is no adaptation the person enters the third stage, exhaustion

30. Exhaustion stage: -This occurs when the body no longer the effects of the stressor and when the energy necessary to maintain adaptation is depleted. -The physiological response is intensified, but the person’s energy level is compromised, and adaptation to the stressor diminishes. -The body is unable to defend itself against the impact of the event, physiological regulation diminishes, and if the stress continues, death may result .

31. COPING Stress requires not only bodily adaptation, but also adaptation at the mental level . -Coping is expending conscious effort to master, reduce or tolerate stress. -Coping defined as “ ongoing cognitive and behavioural efforts to manage specific internal or external demands that are appraised as taxing or exceeding the resources of the person.

32. TYPES OF COPING ACCORDING TO GENERAL STRATEGIES: 1.Direct Action response Example: Manipulating, escaping from stressor 2.Information Seeking(trying to understand better) 3. Inhibition of action (doing nothing) 4. Intra psychic or Palliative Coping (individual reappraises the situation- by d efense mechanism or changes in environment) 5.Turning to help from others and emotional support

33. 2.SPECIFIC STRATEGIES: Appraisal focused Strategies : It occurs when the person modifies the way he / she thinks. Example : Using positive appraisal or reframing a situation to see it in a positive light. 2. Problem focused Coping: It is aimed at changing or eliminating the source of stress. Example: seeking information or social support, Learning new skills to manage the problem.

34. 3.Emotion focused strategies: These are directed at managing or reducing emotional distress. Example: - Releasing pent up emotions - Watching TV - Exercises

35. OTHER METHODS OF COPING Task oriented coping or directed coping: It focuses on the immediate problem and aims to change an uncomfortable situation. ( i ) Attack (confrontation)- removing obstacles (ii) Withdrawl – Escaping from stress (iii) Compromise – Accepting the substitute goal.

36. TECHNIQUES OF COPING 1. Information providing techniques 2. Relaxation training 3. Cognitive restructuring techniques 4. Systematic desensitization 5. Biofeed back mechanism 6.Modelling techniques 7. Humour 8.Exercise 9. Diet

37. 10. Time management 11. Practising positive thinking 12. Giving up unrealistic expectations

38. IMPLICATIONS FOR NURSES Nurse should understand and identify the stressors of the patient. Nurses should manage work related stress - Dealing with death and dying - Heavy work load, Night shift - Low supportive relationships in workship. - Uncertainty about patients treatment.

39. Nurses are able to recognise the signs and symptoms of stress and identify the coping mechanisms. Nurse can encourage the patient to use the adaptive coping strategies and adaptive healthy lifestyle choices.

40. THANK YOU