Stress Management for Medical Students

1
Stress Management for Medical Students

• Rowena White, MD
• Department of Psychiatry
• LSUHSC-S
• Phone [phone]
• Email rwhit2_at_lsuhsc.edu
• Pager 0761

2
Med School is not easy it is rewarding, yet
stressful.

• Stress can be
• Useful and adaptive, or
• Detrimental and maladaptive

3
DEFINITION

• Stress is the bodily responses to pressures,
  challenges, problems
• A stressor is anything that speeds up, keys up,
  or tenses your body anything that pushes you or
  worries you.
• Stress is unavoidable one can learn to minimize
  its negative effects

4
Stress

• Stress occurs with ANY new event in your life
• The death of a loved one,
• The birth of a child,
• A job promotion,
• A new relationship,
• Starting Med school...
• Taking exams.
• Stress will help you or hinder you, depending on
  how perceive the stress, and how you react.

5
INTERPERSONAL RELATIONSHIPS

• Can add to the stress of medical school
• This is especially true when we function in one
  of the 3 roles of the STRESS TRIANGLE
• These roles are Persecutor, Caregiver and Victim
• Often these patterns are deeply ingrained and
  outside ones awareness

6
Stress Producing Roles

• Persecutors dictatorial, controlling, critical,
  blaming (undermining others self esteem)
• Caregivers overprotective, too helpful, and seek
  to please others to detriment of self take care
  of others feelings, ignoring their own
• Victims act helpless, pity themselves and are
  nonassertive

7
Stress Triangle
Persecutor
Caregiver
Victim
8
Stress

• POSITIVE EFFECTS
• Compel you to action (Hmmm, maybe I should start
  NOW to study for that test in two weeks).
• NEGATIVE EFFECTS
• It can result in feelings of distrust, rejection,
  and anger.
• It can lead to health problems such as anxiety,
  depression, headaches, upset stomach, rashes,
  insomnia, ulcers, high blood pressure, heart
  disease, and stroke.
• Can result in a vicious cycle of feeling
  overwhelmed then procrastinatingetc.

9
Stress-Busters

• Believe in yourself.
• You are here today because you CAN do this.
• If you prepare properly you should do fine.
• Don't try to be perfect.
• If you think that "less than A failure" then
  you will be way overstressed. Med school is not
  that easy.
• Aim to do your best, but realize that you will
  not get a perfect grade all the time.

10
Be aware of your reaction to stress

• Notice your distress, don't ignore it.
• Determine what distresses you and how you react,
  e.g., the role you take with self/others
• Determine how your body responds to the stress,
  e.g., where you hold your tension
• Do you become nervous or physically upset? If so,
  in what specific ways?
• Pay attention to these Distress Signals!

11
Recognize what you can change

• Can you avoid the stressor?
• Dont study in noisy places if it disturbs you.
• Can you decrease the stress?
• Give yourself plenty of time to study for tests.
• Can you shorten your exposure to stress?
• Give yourself time to relax, as well. Practice
  positive self-talk. Visualize yourself as
  confident/successful
• Can you change your behavior?
• Set goals, manage time effectively, reward
  yourself for jobs well done. Practice positive
  self-talk. Plan.
• Take care of yourself!

12
Stress-Busters

• Take steps to overcome problems.
• If you have problems, get help, not stressed out.
  
• Course tutors, classmates, teachers, SMH
• Don't keep things bottled up.
• Talking to someone you trust who will be
  supportive is a great way to decrease stress.
• Keep things in perspective.
• Tests are only a small part of your whole life in
  the big picture.
• Remember that you have a life!

13
Diminish emotional reactions to stress

• The stress reaction is triggered by your
  perception of danger.
• Do you overestimate stressors? Do you overreact
  and view things as absolutely critical?
• Stop and think before you react.
• Try a less extreme view.
• Temper your emotional responses.
• Put the situation in perspective.
• Dont dwell on negative aspects.

14
Maintain emotional reserves

• Develop supportive friendships and relationships.
  
• Pursue your goals, not goals others have for you.
• Expect some frustrations, failures, and sorrows.
• Try yoga, tai-chi or other relaxation techniques.
  
• Maintain a spiritual role in your life.
• Plan. Plan alternatives. Plan ahead. Prepare.

15
Diminish physical reactions to stress

• Slow, deep breathing will decrease heart rate and
  respiration.
• RELAXATION TECHNIQUES
• can reduce muscle tension, increase energy and
  productivity, and reduce insomnia and fatigue
• can improve memory and concentration
• can prevent or reduce psychosomatic symptoms
• can prevent stress from becoming cumulative
• can increase self-confidence and decrease
  self-blame

16
Aids to relaxation

• Abdominal breathing
• Progressive muscle relaxation
• Visualizing a peaceful scene success
• Remembering past successes
• Positive self-talk
• Using audio and visual aids
• Meditation even for 2-5 minutes per day

17
Maintain physical reserves

• Exercise 3 to 4 times a week.
• Eat well-balanced, nutritious meals.
• Maintain your ideal weight.
• Avoid nicotine, caffeine, stimulants, and
  alcohol.
• Mix leisure with work. Take breaks.
• Get enough sleep.

18
More Stress-Busters

• Leave plenty of time for study, so you don't have
  to cram.
• Create a timetable so you can track your
  progress.
• Make sure you allow time for fun and relaxation
  so you dont burn out.
• As soon as you notice your mind is losing
  concentration, take a short break. You will then
  come back to your study refreshed.

19
Tips for the exam itself

• Dont panic!
• It's natural to feel some anxiety before you
  start the exam, but too much is detrimental.
• Avoid negative, anxious pre-exam interactions
• The best way to calm down
• Close your eyes
• Take several long, slow deep breaths.
• Visualize yourself feeling confident and
  successful
• Silently repeat "I am calm and relaxed" or "I
  know I will do fine, while you are
  deep-breathing.

20
Tips for the exam itself

• If your mind goes blank
• Don't panic!
• Focus on slow, deep breathing for one minute.
• If you still can't remember, move on, and return
  if you have time.
• After the exam
• Don't criticize yourself for stuff you think you
  got wrong.
• Often, your own self assessment is far too harsh.
  
• Congratulate yourself for the things you did
  right, learn from the stuff you did wrong, and
  move on.

21
Student Mental Health(SMH)

• If you begin to feel overwhelmed, you do have
  resources
• It is NOT a sign of strength to go it alone!
• It takes courage to ask for help!
• SMH sees 1/3 of the students in each class, as
  well as a number of house-staff and faculty

22
Student Mental Health

• If you begin to feel overwhelmed, you do have
  resources, and you are not alone.

23
Contact info

• Rowena R. White, MD
• Director of Student Mental Health
• Department of Psychiatry
• LSUHSC-S
• Phone [phone]
• Email rwhit2_at_lsuhsc.edu
• Pager 0761