Stress

Stress is the body's natural defense against predators and danger

1. Presented by Sakuntala Giri SUM Nursing College

2. STRESS Concept of stress Stress is a universal phenomenon. All people experience it. Stress can have both + ve & - ve effects. Stress is produce by a change in environment that is perceived as a challenge, threat or danger. Stress affect the whole person in all human dimensions( physical,emotional,intellectual,social & spritual ). The perception of stress & the response to it are highly individualized, not only from person-to - person but also from one time to another in the same person. Stress is a condition in which the human system responds to changes in its normal balanced state.

3. DEFINITION According to Hans selye-1956 “Stress as the nonspecific response of the body to any demand made upon it” According to Schafer -2000 Stress is the arousal of mind and body in response to demands made upon them.

4. Stressor – “a stressor is any event, experience or environmental stimulus that causes stress in an individual

5. TYPES OF STRESSOR INTERNAL STRESSORS- originates inside an individual(such as fever, pregnancy, feelings of depression) EXTERNAL STRESSORS- originates outside an individual(such as loudnoise , a marked change in environmental temperature, peer pressure, a change in the family or social role, a death in the family) DEVELOPMENTAL STRESSORS- occures at predictable time throughout an individual life SITUATIONAL STRESSORS- unpredictable and occurs at any time

6. STRESS CYCLE

7. STRESSOR: - Stressor can be any stimulus that causes an individual to experience stress.Stressor is either + ve / - ve . Ex:death,divorce,new job,marriage . Ways to reduce stress: Avoiding /managing stress. Choosing what is important in life. Time management. Simple living Learning to say NO

8. REACTION TO STRESS Once there is a stressor our body will react to it. Reaction to stress relate to perception of the stress. When a person feels stressed from the stressor, the body begins to release chemicals to confront the stressor. Reducing the reaction to stress: Asking GOD forhelp Spritual practices CBT Reframing the problem Visualization of results.

9. Wear & tear on the body & organ system When a person becomes stressed & does not correct the stressor,the same stress reaction which helped in the beginning to cope,begin to wear one self down. Remedies : Improving diet, regular exercise, yoga, meditation

10. Reduced optimum health After a sustained period of chronic stress the body wears down ,which can invite more serious disease like high BP,heart problem diabetes,asthma,depression,cancer . Remedies : Consulting alopathies / homeopathydoctor . Naturopathy to make a plan for regaining health.

11. Increased sensitivity to stress While once body is worn down & emotions worn and exhausted,sesitivity to stress increases, a smaller & smaller stressor initiates the same stress reaction initiates same stress reaction that a big event used to get. Remedies: Deep breathing ,meditation Taking walk Talking with an friend may help to reduce sensitivity to stress.

12. EFFECTS OF STRESS

13. ADAPTATION TO STRESS All of us face stress in our lives. Some psychologist believes that daily life actually involves a series of repeated consequences of perceiving a threat, considering ways to cope with it & ultimately adapting to threat with greater or lesser success. Although adaptation is often minor & occurs without our awareness, adaptation requires major efforts when stress is more severe or long lasting. So our attempts to overcome stress can produce biological & psychological responses that result in health problem.

14. General Adaptation Syndrome(GAS) Homeostatic mechanisms are aimed at counteracting the everyday stress of living. If they are successful, the internal environment maintains normal physiological limits of temperature, chemistry & pressure. If stress is extreme or long lasting, the normal mechanism may not be sufficient In this case the stress triggers a wide range of bodily changes called the general adaption syndrome(GAS). Hans selye, developed GAS model that suggests a persons response to stress consists of three stages. Alarm Resistance Exhaustion

15. Contd ….. When stress appears, it stimulates hypothalamus to initiate the GAS through two pathways: First pathways is stimulation of sympathetic divison of the ANS & adrenal medula.This produces an immediate set of responses. Second pathways, called resistance reaction involves the anterior pituitary gland &adrenal cortex; the resistance reaction is slower to start, but its effects last longer.

16. Alarm Reaction/Fight or Flight Response Alarm reaction is the body's initial reaction to a stressor. It is a set of reaction initiated when the hypothalamus stimulates the sympathetic division of the ANS & the adrenal medulla. The alarm reaction meant to counteract a danger by mobilizing the body's resources for immediate physical activity. The stress responses, which characterize the alarm reaction include the following: ↑HR & strength of cardiac muscle contraction, this circulates blood quickly to areas where it is needed to fight the stress.

17. 2.Constriction of blood vessels supplying to skin & viscera (except heart and lungs), at the same time dilation of blood vessels supplying to skeletal muscle & brain; these responses route more blood to organ active in the stress response, thus ↓blood supply to organ which do not have immediate active role. 3.↑RBC production leads to an ↑in the ability of the blood to clot, which helps to control bleeding. 4. Liver converts glycogen into glucose and release it into the blood stream, this provides energy needed to fight the stressor. 5.Rate of breathing increases & respiratory passages widen to accommodate more air, which enables the body to acquire more o 2 6. ↓production of saliva & digestive enzyme. This reaction takes place As digestive activity is not essential for counteracting stress.

18. Resistance reaction Resistance reaction is the 2 nd stage in the stress response. It is initiated by regulating hormones secreted by the hypothalamus & is a long-term reaction. These regulating hormones are corticotropin -releasing hormone(CRH),growth hormone releasing hormone(GHRH),& thyrotropine -releasing hormone(TRH) CRH stimulates the anterior pituitary to ↑its secretion of adenocorticotrophin hormone(ACTH). ACTH stimulates the adrenal cortex to secrete more of its hormone. The action of these hormone helps to control bleeding, maintain BP.

19. GHRH stimulates anterior pituitary to secrete HGH.TRH causes the anterior pituitary to secrete TSH.Both HGH &TSH helps to supply additional energy to the body. Resistance reaction allows the body to continue fighting a stressor, thus it helps us to meet emotional crisis, perform sternus tasks, fight infection. Resistance reaction helps us to cope with a stressful situation & our body return to normal.occasionally it fails to fight the stressor, in this case the GAS moves into the stage of exhaustation .

20. Exhaustion stage At this stage cells starts to die & organ weaken. A long term resistance reaction puts heavy demand on heart, blood vessels and adrenal cortex, which may fail suddenly under the strain. In this respect, ability to handle stressor is determined to a large extent by the general health.

21. COPING WITH STRESS

22. Coping refers to the thoughts & behaviors we use to handle stress or anticipated stress. Coping includes efforts to control,reduce or learn to tolerate the threats that occures due to stress. Effective coping depends on the nature of the stressor & the degree to which it is possible to control. There are 3 categories of coping strategies: Emotion- focused coping Problem focused coping Avoidance coping

23. Emotion focused coping In this coping people try to manage their emotions in the face of stress, seeking to change the way they feel about or perceive a problem. Example –accepting sympathy from others, seeking social support, denial of stress etc. This strategies are more frequently used when stressful situation is unchangeable.

24. Problem-focused coping It includes taking direct action to solve problems as well as changing or modifying the stressful problem. It helps to change in behaviour or to the development of a plan of action to deal with stress. Example- starting a group study to improve poor classroom performance. It is used when stressful situation is relatively modifiable.

25. Avoidance coping In this coping style people try to minimize or avoid threatening event. People who cope using avoidance may not make enough cognitive & emotional efforts to anticipate & manage long-term problems. Avoidance strategies are more effective in dealing with short-term threats

26. Coping style according to Roger & Nash(1995) According to Roger & Nash, coping styles are adaptive & maladaptive . Adaptive style involve an appropriate adjustment to the environment & gaining from the experience. These can be detached or rationale. Maladaptive style involve failing to adjust to environment and experiencing misery and unhappiness as a result. These can be emotional and avoidance coping style.

27. DETACHED RATIONALE Not seeing the problem or situation as a threat Taking action to change things Keeping a sense of humor Taking one step at a time & approaching the problem with logic. Resolving the issue by dividing things into parts. Using past experience for working out how to deal with the situation. Taking nothing personally & seeing the problem as separate from one self. Giving the situation full attention and treating it as a challenge to be met. Adaptive coping style

28. Emotional Avoidance Feeling helpless,miserable,depressed & angry. Pretending there is nothing, if people ask. Showing frustration on other people. Sitting simply and hoping it all goes away Preparing for the worst possible outcome and seeking sympathy from others. Thinking about something else and talking about the matter as little as possible. Trusting in fate and believing things will sort themselves out. Maladaptive coping style

29. Classification of coping strategies according to Cohen and Lazarus(1979) Direct action response: The individual tries to directly change or manipulate the stressful situation such as coping with it or removing it. Information seeking: The individual tries to understand the situation better & predict future event that are related to the stress. Inhibition of action: Doing nothing. Intrapsychic or palliative coping: The individual reappraises the situation(use of psychological defense mechanism) or change the internal environment(through drugs,alcohol,relaxation or meditation) Turning to others: Seeking others help or emotional support.