stress management: how to recognize and alleviate … · how to recognize and alleviate common...
TRANSCRIPT
Stress
Stress can be anything such as:
Mental and Emotional
Work, family or social
Physical
Gravity, trauma or exercise
Physiological (functions and activities of
living organisms and their parts )
Diet or diseases
Stress in the Work Environment
Price tag for U.S. industry estimated at over $300 billion
annually as a result of:
Accidents
Absenteeism
Employee turnover
Diminished productivity
Direct medical, legal, and insurance costs
Workers' compensation awards as well as tort and FELA
judgments
Stress in the Work Environment
Assessment of Work Stress. Do you experience any of these challenges?
Cannot finish work in time available
Too many interruptions
Infrequent work breaks
Work schedule is inflexible
Too much overtime
Shifts are too long
Too many days without time off from work
Too much paperwork
Colleagues or co-workers not available
Too many job duties to manage
Work is incongruent with training and experience
Source: Adapted from Muldary TW. Burnout and Health Professionals: Manifestations and Management. California: Capistrano Press, 1983.
Psychosomatic Syndromes
Psychosomatic syndromes have often been dismissed
as "all in your head."
At the physiological level, stress is viewed in terms of
disruptions of bodily functions.
Fight or Flight• Brain perceives a stress stimulus
• Pituitary gland responds by increasing the release of a hormone called adrenocorticotropic hormone (ACTH)
• ACTH is like an alarm system going off deep inside your brain
• Adrenal glands (situated atop your kidneys) releases a flood of stress hormones into your bloodstream
• Including cortisol and adrenaline
• A whole series of physiological changes in your body occur
• Increasing your heart rate and blood pressure
• Shutting down your digestive system
• Altering your immune system
• Increased blood sugar
• Cortisol sustains energy, but it also curbs the surge of adrenaline
(Image credit: Kathryn Born)
How can stress cause so many
diseases?
1. Sympathetic Nervous System activity
• Dilates pupils, heart rate increases and the hearts force of contraction intensifies, bronchioles of the lungs dilates
2. Endocrine System activity
• Chronic/Long term release of Adrenaline Hyper-excitable, irritability, and more
• Chronic/Long term release of Cortisol Impaired concentration, weight gain, fatigue and more
Affects of Prolonged/Chronic Stress
Respiratory System Triggering hyperventilation syndrome, chronic bronchitis, or asthma
Cardiovascular System High blood pressure, migraine headaches, or irregular heartbeats
Gastrointestinal System Aggravation of peptic ulceration, irritable bowel syndrome
Genitourinary System Menstrual disorders or frequent infections
Musculoskeletal system Backache, neck pain or tension headache
Source: Jamison J. Health Promotion for Chiropractic Practice. Maryland: Aspen Pub, 1991;167-172.
Affects of Prolonged/Chronic Stress
Weakened immune system
Exacerbates present health conditions
Psychological disorders
Suspected shortened life span
Biological vs. Chronological Age
Telomeres
Possible Signs of Stress
Anxiety
Back pain
Constipation / Diarrhea
Depression
Fatigue
Headaches
High blood pressure
Irritable
Loss of sex drive
Poor attitude
Relationship problems
Shortness of breath
Sleep disturbances
Stiff neck or jaw
Upset stomach
Weight gain or loss
Dr. Hans Selye
―Father of Stress Research"
Negative stress - ―distress‖ When we are Mentally, Emotionally, Physically and/or
Physiologically traumatized • Short-term: such as a trauma
• Long-term: chronic or repetitively insulted
Positive stress - ―eustress‖ Rollercoaster ride, scary movie, being a new parent
Stress such as deadlines, competition, confrontation -even our frustration and sorrow - adds depth, enrichment, character and quality to our lives
Preparedness for stress leads to better outcomes
Virginia Satir
―Life is not what it's supposed to be. Its what it is.
The way you cope with it is what makes the
difference.‖
Virginia Satir (1916-1988)
―The Pioneer of Family Therapy‖
Her books Peoplemaking and Conjoint Family are
two of the central texts of humanistic psychology
On the Job Stress Management
Plan ahead
Prepare for stressful events
Prioritize Daily tasks
Weekly tasks
Break all the larger tasks up into bits you can handle
Be realistic about how long each task will take
As you complete each task, check it off your list
Delegate
Work as a team when possible
Take time to set the project down for 15 or 20 minutes and regroup your thoughts
Listen to your gut
On the Job Stress Management
For the Employer and/or Management
Ways to decrease stress by work management Define roles and responsibilities
Allow workers to utilize their skills
Involve workers to make decisions that affect their jobs
Reduce uncertainty about future job prospects
Short term and long term evaluations Subjective reports from employees
Objective reports such as attendance and health conditions
On the Job Stress Management
Keeping a positive attitude
Try to look at change as a positive
challenge, not as a threat
Don't worry about things you can't control
Have a back–up plan
Limit water cooler and coffee break gossip
of doomful predictions that may never
come to fruition
Complementary and Alternative
Medicine
What is CAM?
Used with, and in place of, conventional medicine Combines medical and Complementary and Alternative
Medicine therapies for which there is some high quality evidence of safety and effectiveness
Hippocratic Oath Start with least invasive
Example: Start with sleep habits, diet, exercise, then dietary supplements then other CAM therapies then medications and surgeries.
Classification of CAM
1. Mind – Body InterventionsPrayer, Meditation, Relaxation Therapy, Hypnotherapy, Biofeedback, T’ai Chi
Biologically-Based Treatments Diet Based Therapies, Megavitamin Therapy, Natural Products (Herbs)
Manipulative and Body-Based MethodsChiropractic, Massage, Osteopathic Medicine
1. Alternative Medical SystemsAcupuncture / Traditional Asian Medicine, Homeopathy, Naturopathic Medicine
Dietary Choices
Malnutrition leads to the bodies inability to
combat stress
Eat for energy
―Eat clean‖
―Live foods‖
Foods high in ―good fats‖
Fruits and Vegetables
―Live foods‖
2 cups a day of fruits
daily
Snack on dried fruits
Add berries to cereal or
oatmeal
Add frozen fruit to plain
yogurt Don’t get fooled by juices—check the
label to make sure they’re 100% fruit.
2.5 cups a day of
vegetables daily
Try fresh or frozen
Choose different
colors for different
nutrients.
Considered Good Fat Anti-Infammatory Diet: Omega-3 / Fish Oil
The polyunsaturated fats are from:
Omega-3 (EPA, DHA, Linolenic)• Mostly seafood
• Better fat to fight inflammation.
Omega-6 (Arachidonic Acid, Linoleic)
• Vegetable oils
• Found in chips, crackers, french fries, fast food
Omega-3 consumption should be balanced with omega-6 fatty acids
Omega-6 to Omega-3 ratio (between 1:1 and 4:1)
No more than four grams omega-6 for every one gram of omega-3
EAT MORE FISH AND/OR TAKE FISH OIL SUPPLEMENTS
Monosaturated and polysaturated are healthier than Transfats and Saturated Fats
Avoid Simple Carbohydrates
Simple carbohydrates Low in fiber and are rapidly
broken down by the body, so they can be consumed in large amounts WITHOUT feeling full.
Can trigger overeating, as well as blood-glucose slumps, which can lead to…
Fatigue Headaches
Craving sweets
Depression
Irritability
And a host of other symptoms
Examples of BAD choices
Sugar
Candy
Pizza
Chips
Cookies
White bread
Caffeine and Soft Drinks
Soft Drinks - AVOID
Adds senseless calories to your daily intake.
Blood maintains equal levels of both calcium and phosphorus.
High in phosphorus and causes the body to leech calcium from the bones. (Anti-Aging and Osteoporosis, Dynamic Chiropractic, Nancy Molina, DC)
Caffeine - AVOID
Increases loss of calcium and magnesium
Is a diuretic, causing you to loose important electrolytes.
Dietary Supplements Magnesium
Energy metabolism (carbohydrates, fats, proteins)
30% is in muscle, when under stress Magnesium is released to fight stress
Whole grains, nuts, seeds (esp. pumpkin), vegetables, potatoes
Vitamin D D3 Cholecalciferol (Most beneficial/Bioavailable)
Replenishes adrenal glands of the body, immune system, bone development
Best from the sun, yet supplementation is beneficial
5-HTP with B6 Responsible for producing serotonin (the bodies feel-good neurotransmitter)
Dark leafy green vegetables and beans
B-Complex Release of serotonin and dopamine in the brain
Relieves anxiety
Whole grains, nuts, dried fruits and eggs
St. John’s WartHypericum perforatum
There is scientific evidence that St. John's Wort may be useful for short-term treatment of:
Mild to Moderate Depression
Used to prepare teas, tablets, and capsules containing concentrated extracts. Liquid extracts and topical preparations are also used.
St. John's Wort interacts with many medications in ways that can interferewith their intended effects. Examples of medications include: Antidepressants
Birth control pills
Cyclosporine, which prevents the body from rejecting transplanted organs
Digoxin, a heart medication
Indinavir and possibly other drugs used to control HIV infection
Irinotecan and possibly other drugs used to treat cancer
Seizure-control drugs, such as dilantin and phenobarbital
Warfarin and related anticoagulants.
Tips for Dealing with Stress
Sleep Cooler temperatures help
many people doze easier.
Try lowering yours to 68
degrees and adjust from
there
The process of digestion
can actually make it
harder to get to bed
No fewer than four hours
before sleeping)
Exercise Releases endorphins and enkephalins
Occurring naturally in the brain
Binds to pain receptors and blocks pain sensation
Creates longer telomeres Slows down the aging process
Numerous studies have shown that people who begin exercise programs demonstrate a marked improvement in their ability to: Concentrate
Sleep better
Suffer from fewer illnesses
Suffer from less pain
Report a much higher quality of life than those who do not exercise
Exercise
2 ½ hours each week
Moderate aerobic activity, Example: walking fast or
biking
Minimum of 10 minutes at a time
Do strengthening activities Example: sit–ups or lifting
weights
At least 2 days a week
Consider exercising outside. Boot camps
Active Rest
Relaxing in a way the rejuvenates you Sports and exercise
Socializing with friends
Hobbies of your choice• Reading
• Painting
• Listening to music
• Playing a musical instrument or singing
Sitting, reading, or even watching television for 20 minutes a day, caring nothing of the world or your responsibilities does not make you lazy or irresponsible
Limit round the clock news coverage of the negative state of the economy Limit negativity
Relaxation Techniques
Types and Goals Achieve a hypometabolic state of
reduced sympathetic nervous system arousal
• Example: Breathing techniques
Reduction of muscular tension
• Example: Progressive muscle relaxation in which muscles are alternatively tensed and relaxed
Steps to Elicit the
Relaxation Response
1. Sit quietly in a comfortable position.
2. Close your eyes.
3. Deeply relax all your muscles, beginning at your feet and progressing up to your face. Keep them relaxed.
4. Breathe through your nose. Become aware of your breathing. As you breathe out, say the word, "one―, silently to yourself. For example, breathe in ... out, "one",- in .. out, "one", etc. Breathe easily and naturally.
5. Continue for 10 to 20 minutes. You may open your eyes to check the time, but do not use an alarm. When you finish, sit quietly for several minutes, at first with your eyes closed and later with your eyes opened. Do not stand up for a few minutes.
Do not worry about whether you are successful in achieving a deep level of relaxation. Maintain a passive attitude and permit relaxation to occur at its own pace. When distracting thoughts occur, try to ignore them by not dwelling upon them and return to repeating "one."
With practice, the response should come with little effort. Practice the technique once or twice daily, but not within two hours after any meal, since the digestive processes seem to interfere with the elicitation of the Relaxation Response.
Progressive Muscle Relaxation
NCCAM
The goal of progressive muscle relaxation is to reduce the tension in your muscles.
Quiet place where you’ll be free from interruption.
Tense each muscle group for at least five seconds and then relax for at least 30 seconds.
Repeat before moving to the next muscle group.
Relaxed breathing
Also called diaphragmatic breathing
Place a hand on your stomach, just above your navel.
1. Inhale: With your mouth closed and your shoulders relaxed, inhale as slowly and deeply as you can to the count of six.
• As you do that, push your stomach out. Allow the air to fill your diaphragm.
2. Hold: Keep the air in your lungs as you slowly count to four.
3. Exhale: Release the air through your mouth as you slowly count to six.
4. Repeat: Complete the inhale-hold-exhale cycle three to five times.
Transcendental Meditation NCCAM
As many as six million people have been trained in the TM technique, including The Beatles and other well-known public figures.
A mantra sound is utilized as a thought in the meditation process, and as a vehicle that allows the individual's attention to travel naturally to a less active, quieter style of mental functioning. The technique is practiced morning and evening for 15–20 minutes each time.
The total number of mantras used is 16, and that they are assigned using a simple formula based on gender and age
Transcendental Meditation
Helps Young Adults Cope With Stress
Researchers from Maharishi University of Management and American University studied approximately 200 students from American University and other schools in the Washington, D.C., area.
Significant improvement in: Total psychological distress
Anxiety
Depression
Anger/hostility
Coping ability
Blood pressure (Changes in psychological distress and coping paralleled changes in.)
Yoga
Meditative
Postural
Breathing Techniques
No serious adverse effects
Risk vs. Benefit Balance: Positive
The Status of Yoga Research
Research suggests that yoga may: Improve mood and sense of well-being
Counteract stress
Reduce heart rate and blood pressure
Increase lung capacity
Improve muscle relaxation and body composition
Help with conditions such as anxiety, depression, and insomnia
Improve overall physical fitness, strength, and flexibility
Positively affect levels of certain brain or blood chemicals
More well-designed studies are needed before definitive conclusions can be drawn about yoga's use for specific health conditions.
Massage
Scientific evidence on massage therapy is limited.
According to one analysis, however, research supports the general conclusion that massage therapy is effective.
A single session of massage therapy can reduce "state anxiety" (a reaction to a particular situation) Blood pressure
Heart rate
Multiple sessions can reduce "trait anxiety" (general anxiety-proneness) Depression
Pain
In addition massage may benefit certain conditions Chronic low-back pain.
Chronic neck pain
Advanced cancer patients may have some relieve of pain and improvement in their moods
Somatic Numbing
Disconnect between the mind and the
body
Example: Massage therapist palpates their
patients and finds muscles that are tight
and painful, which the patient did not know
was present until then
Chiropractic Care―Move well and feeling well‖
Alleviating pain
Correcting alignment
problems
Functional Joints
Joints that move as they should
Increased range of motion
Increased exercise
Increased daily activities
Increased bone and muscle
building
Nervous system functioning at
a greater capacity Chiropractic promotes homeostasis,
which is the bodies inherent was of doing
things the right way.
Chiropractic
A 2010 review of scientific evidence on manual therapies concluded that spinal manipulation / mobilization may be benefit:
Migraine headaches
Cervicogenic (neck-related) headaches
Neck pain
Upper- and lower-extremity joint conditions
Back pain
Whiplash-associated disorders
Weak Posture
Causes pain and effects overall health
―Posture affects & moderates every physiologic function from breathing to hormone production.‖
―Spinal pain, headache, mood, blood pressure, pulse, and lung capacity are among the functions most easily influenced by posture.‖
There is a ―striking influence of postural mechanics on function and symptomatology‖.
Postural & Respiratory Modulation of Autonomic Function Pain & Health. Lennon J., Shealy C., et.al., American Journal of Pain
Management, 1994; 4:36-39 Strong Posture
Diagram
Upper Cross Syndrome
Anterior head carriage
Headaches
Neck, upper back and
shoulder pain
Thoracic Outlet
Syndrome
Attitude of Optimism
Zig Ziglar
If you learn from defeat, you haven't really lost.
Expect the best. Prepare for the worst. Capitalize on what comes.
Failure is a detour, not a dead-end street.
Virginia Satir
―We need 4 hugs a day for survival.
We need 8 hugs a day for maintenance.
We need 12 hugs a day for growth.‖
Mayo Clinic Proceedings
Discovered that there were 41% of websites that had incorrect, misleading, and harmful claims?
How can you determine if CAM claims are true?
FDA, FTC and NCCAM
www.pubmed.gov
Internet Reliable Sources
U.S. Food and Drug Administration (FDA)
The FDA oversees the safety of many products, such as foods (including dietary supplements), medicines, medical devices, and cosmetics. Web site: www.fda.gov
National Center for Complimentary and Alternative Medicine website:
The National Center for Complimentary and Alternative Medicine is a very resourceful organization that has a very helpful website to find evidence based medicine. A lot of healthcare is based upon a persons beliefs, individual experiences and sales tactics. The National Center for Complimentary and Alternative Medicine does research to determine the validity of many claims made in areas of healthcare. I like this website a lot. http://nccam.nih.gov/
Office of Dietary Supplements (ODS), NIH
ODS seeks to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, supporting research, sharing research results, and educating the public. Its resources include publications and the International Bibliographic Information on Dietary Supplements (IBIDS) database. Web site: ods.od.nih.gov
American Pain Society http://www.ampainsoc.org/
Center for Food Safety and Applied Nutrition (CFSAN)
CFSAN oversees the safety and labeling of supplements, foods, and cosmetics. Publications include "Tips for the Savvy Supplement User: Making Informed Decisions and Evaluating Information." Web site: cfsan.fda.gov
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www.provancechiropractic.com
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Metairie, Louisiana 70001
504-456-9296