Stress Management in Students

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Stress Management in Students

• Dr.T.V.Rao MD

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The Challenges in College

• The best years of your life? Expectations..
• Even positive change is stressful
• Greater academic demands
• Unstructured time
• Decreased adult availability
• Being on your own in a new environment
• Changing relations with family

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Challenges of College Choices

• Alcohol and other drugs
• Sex-identity, values, practices
• Food
• Sleep
• Balancing Academic and Extracurricular
• Roommates

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LIFE MANAGEMENT SKILLS

• GENERAL Life management skills, for the purposes
  of this section, include stress management, time
  management, information management, financial
  management, personal health management, and
  crisis management. Personal planning and
  adeptness at managing each of these issues will
  increase the serenity and reduce the stressors
  within a busy, productive life.

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Personal planning

• Personal planning and adeptness at managing each
  of issues will increase the serenity and reduce
  the stressors within a busy, productive life.

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Every body is under stress

• Every human on the earth will experience stress,
  even medical students and physicians--it is a
  common denominator in life. Some stress is good
  stress (eustress) that is helpful and assists the
  drive toward achievement and success. Negative
  stress (distress) affects life in an adverse
  manner and is a common cause of ill health in our
  society. Individuals who ignore stress signals or
  who cope in a negative fashion will experience
  escalating symptoms of stress. The symptoms may
  appear as burnout, exhaustion, emotional
  illnesses such as depression and anxiety, and
  physical illnesses such as ulcers, heart attacks,
  hypertension, and abuse of alcohol and other
  drugs with all the social and professional
  consequences.

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WHAT IS STRESS?

• Stress is your mind and bodys response or
  reaction to a real or imagined threat, event or
  change.
• The threat, event or change are commonly called
  stressors. Stressors can be internal (thoughts,
  beliefs, attitudes or external (loss, tragedy,
  change).

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Adolescents and stress ?

• Teens are under more stress
• Since adolescence is a period of significant
  changes
• physical,
• emotional,
• social, and
• academic changes
• many than at any other time of life.

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Stress is good and Bad too.

• It's important to remember that stress is a
  natural part of life. Experiencing stress can be
  good, but it can also have negative effects on
  one's well being. What makes stress a positive or
  negative factor lies with how effectively the
  person experiencing the stress is able to manage
  it.

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Impact of medical education and stress

• Medical education has deleterious consequences.
  Trainees (students, interns, and residents)
  suffer high levels of stress, which lead to
  alcohol and drug abuse, interpersonal
  relationship difficulties depression and anxiety,
  and even suicide. Medical students have mean
  anxiety scores one standard deviation above those
  of non-patients, and their depression levels
  increase significantly

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Signs and Symptoms of Stress

• Physical
• Poor appetite or overeating
• Feeing tired and fatigued
• Various aches and pains ---headache body ache
  muscle pain
• Nausea abdominal Pain
• Sleep problems
• Falling sick very often e.g. fever cough cold
  diarrhea
• ( because of lowering of immunity due to
  stress)

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Mental stress

• Feeling low
• Nervousness and Anxiety
• Excessive Anger or Depression
• Being easily upset
• Poor self confidence
• Low self esteem
• Lack of Concentration
• Poor performance in studies

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Exercise reduces stress

• As a way of draining off stress energy, nothing
  beats aerobic exercise. To understand why, we
  need to review what stress is. People often think
  of stress as pressure at work, a demanding boss,
  a sick child or rush-hour traffic. All these may
  be triggers but stress is actually the body's
  reaction to factors such as these. Stress is the
  fight-or-flight response in the body, mediated by
  adrenaline and other stress hormones, and
  comprised of such physiologic changes as
  increased heart rate and blood pressure, faster
  breathing, muscle tension, dilated pupils, dry
  mouth and increased blood sugar. In other words,
  stress is the state of increased arousal
  necessary for an organism to defend itself at a
  time of danger.

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EUSTRESS

• Eustress or positive stress occurs when your
  level of stress is high enough to motivate you to
  move into action to get things accomplished.

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DISTRESS

• Distress or negative stress occurs when
  your level of stress is either too high or too
  low and your body and/or mind begin to respond
  negatively to the stressors.

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ALARM STAGE

• As you begin to experience a stressful event
  or perceive something to be stressful
  psychological changes occur in your body. This
  experience or perception disrupts your bodys
  normal balance and immediately your body begins
  to respond to the stressor(s) as effectively as
  possible.

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The Paradox of MedicineBalancing between the
fact that people are mostly the same yet
uniquely different.
The Bell Curve
Individuals are all Genetic Snowflakes
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Obstacles

• Most people who need care dont seek it or
  receive it
• Stigma, cultural pressure, mistrust, lack of
  information keep people out of care
• So do lack of resources treatment and medication
  are expensive
• Care is disjointed
• Some schools dont see emotional well-being and
  growth as in their mission

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Common problems

• Relationship problems
• Depression
• Anxiety
• Eating Disorders
• Substance Abuse
• Sleep Problems

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Anxiety

• Situational
• Developmental
• Generalized anxiety disorder
• Performance
• Panic disorder, OCD, phobias

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Sleep Problems

• 35 of adult population experience insomnia
• 11 of college students get a good nights
  sleep
• Loss of cognitive functioning, driving
• Increased risk of depression
• lt 7 hours yields sleep deprivation

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LEARN Stress ManagementEmotion Focused Strategies

• L
• E
• A
• R
• N
• S

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LEARN Stress Management

• Laugh
• E
• A
• R
• N
• S

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Stress Management Tips

• Making little changes in your life can really add
  up to a big feeling of relief.
• Learn to recognize when you are feeling stressed
  and simple ways you can relax.
• Take a break. Have a cold drink, get some fresh
  air, or close your eyes for a minute to refocus.
• Stay positive to help friends and family cope
  with stress.
• Let others know you're feeling overwhelmed and
  tell them how they can help.
• Allow yourself to simply say "no" to friends and
  family when you know you cannot meet their
  demands without becoming overwhelmed.  

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Recognize what you can change

• Can you change your stressors by avoiding or
  eliminating them?
• Can you reduce their intensity (manage them over
  time instead of immediately)
• Can you shorten your exposure to stress (take a
  break, leave)
• Can you devote the
• time necessary to make
• a change

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Cultures, Humor Medicine

• Greeks home of the comediane
• Native Americans Clown Doctors
• Voltaire
• The Art of Medicine consists of amusing the
  patient while nature cures the disease.
• Medicine today?

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What is humor?

• An attitude toward life.
• Taking your work seriously but yourself lightly.
• Humor is healthy.
• Humor connects us to others!
• It makes us MORE effective!

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Humor a great tonic to stress enjoy it

• Humor is a wonderful stress reducer, an antidote
  to upsets. Laughter relieves tension. In fact, we
  often laugh hardest when we have been feeling
  most tense.
• Humor is an individual thing - what is funny to
  one individual may be hurtful to another. It is
  wonderful when patients can poke fun at
  themselves. We can also do this with patients,
  but we have to be careful and respectful in what
  we say. If you think of something funny that may
  help the patient, say it if you feel it will ease
  their tension and not be offensive. I will often
  throw in a quip or joke when I think it is
  appropriate. When it is done sensitively,
  laughter is a great gift to people you care
  about.

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What should colleges do?

• Gather Data
• Provide Rapid Access to Care
• Offer Education and Outreach
• Involve Students
• Coordinate Care
• Be aware of community resources
• Understand your limits

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Gather Data

• Documentation
• How busy is counseling? Identify patterns and
  peak times of use.
• Where else do students get care?
• How many students take time off for medical
  reasons? Who comes back?
• How many students are hospitalized?

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Education and Outreach

• Be known. Get out in the community.
• Train residence staff to recognize warning signs
  of common problems.
• Serve as liaisons/consultants to residence staff,
  deans, coaches.
• Supervise student groups peer counselors,
  wellness reps, advocacy groups
• Offer for-credit course to freshmen on stress
  and time management

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Wellness Activities

• Start a Wellness Center on campus
• Focus on prevention Eat, Sleep, Exercise
• Engage Students in community- study breaks,
  hikes, massage
• Teach yoga, sleep hygiene, relaxation response as
  part of leading balanced life.
• Have annual wellness or caring events or
  maximize academic potential, minimize stress
• Student Wellness Reps.

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Stress Management Plan

• Practice time management
• Learn relaxation exercises.
• Rehearse and practice situations.
• Learn practical coping skills.
• Decrease negative self talk. 
• Learn to feel good with a workable result Dont
  be a perfectionist.
• Build a network of friends.

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Involve Your Students

• Ultimately, the only people who can get through
  to students with any consistency are the students
  themselves Peer Counseling/ Education Programs
• Student Health Advisory Group
• Wellness representatives in the dorms
• Mental Health Advocacy Group
• Involve in screenings and education

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Understand Your Limits

• Legal issues
• Confidentiality
• What about parents?
• How much care for whom? How are sickest students
  cared for?
• When should students take a medical leave of
  absence? Re-entry?

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What about Parents?

• Orient them and make them partners
• Dont say I cant talk to you.
• Process of communication is key dont shut them
  out
• Invite them to get permission
• Discuss general concerns, suggestions without
  breaching confidentiality

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How Much Care for Whom?

• Balancing needs of individual and community
• Balancing care and education
• How are sickest students cared for?
• When should students take a medical leave of
  absence?
• Re-entry

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Return on Investment

• Emotional and physical well-being are crucial for
  academic success
• The entire student body benefits from a strong
  counseling program
• The institution benefits by increased retention
  and graduation, which enhance reputation

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exercise and Relaxation are Foundation for
Efficiency

• Get plenty of exercise and sleep. Improved focus
  and concentration help increase efficiency, so
  you can complete tasks in less time.

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Extracurricular activities reduces the stress

• Even during their medical colleges careers, many
  students take on extracurricular activities and
  projects that are not covered at medical
  colleges.
• Extracurricular activates reduces the stress level

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Maintain your emotional reserves

• Develop mutually supportive friendships/relationsh
  ips.
• Pursue realistic goals which are meaningful to
  you, rather than goals other have for you that
  you do not share.
• Expect some frustrations, failures and sorrows.
• Always be kind and gentle with yourself be a
  friend to yourself.

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Stress Management Tips

• Be prepared for unexpected problems such as
  traffic, a lost pet or a family emergency.
• Prioritize. Take control of your "to do" list by
  deciding what's really most important on your
  list.
• Write down feelings of sadness, frustration or
  anger to get a clearer perspective of your
  emotions.
• Enjoy life's simple pleasures like colorful
  flowers, dancing, music, and social outings, etc.
• Share your talents to better the lives of others
  as well as your sense of well-being.

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Best to way to overcome stress

• STRESS is very common
• Use stress in a positive way
• Limit NOT eliminate stress.
• Use it to improve your performance.
• Learn Coping Skills

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The Takeaway

• Academic performance is enhanced by physical and
  emotional health
• We can learn to recognize problems much earlier
• Depression, Anxiety and Stress are treatable
• Education, Psychotherapy and Medication are all
  effective
• Self Care--eat, sleep, exercise--is a cornerstone
  of health (for all of us!)

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Be realistic and not be overambitious

• Being in control of your life and having
  realistic expectations about your day-to-day
  challenges are the keys to stress management,
  which is perhaps the most important ingredient to
  living a happy, healthy and rewarding life.
• Marilu Henner

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• The programme created by Dr.T.V.Rao MD for
  Students in the Developing World
• Email
• doctortvrao_at_gmail.com