1
Stress Management

• Are the Pressures of Life Taking A Toll On You?

2
What Is Stress?

• Stress is a psychological and physiological
  response to events that upset our personal
  balance in some way. When faced with a threat,
  whether to our physical safety or emotional
  equilibrium, the body's defenses kick into high
  gear in a rapid, automatic process known as the
  fight-or-flight response.
• We all know what this stress response feels like
  heart pounding in the chest, muscles tensing up,
  breath coming faster, every sense on red alert.
• The biological stress response is meant to
  protect and support us. Its what helped our
  stone age ancestors survive the life-or-death
  situations they commonly faced. But in the modern
  world, most of the stress we feel is in response
  to psychological rather than physical threats.
• Caring for a chronically-ill child or getting
  audited by the IRS qualify as stressful
  situations, but neither calls for either fight or
  flight. Unfortunately, our bodies don't make this
  distinction.
• Whether were stressed over a looming deadline,
  an argument with a friend, or a mountain of
  bills, the warning bells ring. And just like a
  caveman confronting a sabertooth tiger, we go
  into automatic overdrive.

3
What Is Stress?

• If you have a lot of responsibilities and
  worries, you may be running on stress a good
  portion of the timelaunching into emergency mode
  with every traffic jam, phone call from the
  in-laws, or segment of the evening news.
• But the problem with the stress response is that
  the more its activated, the harder it is to shut
  off. Instead of leveling off once the crisis has
  passed, your stress hormones, heart rate, and
  blood pressure remain elevated.

• Furthermore, extended or repeated activation of
  the stress response takes a heavy toll on the
  body. Prolonged exposure to stress increases your
  risk of everything from heart disease, obesity,
  and infection to anxiety, depression, and memory
  problems.
• Because of the widespread damage it can cause,
  its essential to learn how to deal with stress
  in a more positive way and reduce its impact on
  your daily life.

4
The Bodys Stress Response

• The fight-or-flight stress response involves a
  cascade of biological changes that prepare us for
  emergency action. When danger is sensed, a small
  part of the brain called the hypothalamus sets
  off a chemical alarm.
• The sympathetic nervous system responds by
  releasing a flood of stress hormones, including
  adrenaline, norepinephrine, and cortisol. These
  stress hormones race through the bloodstream,
  readying us to either flee the scene or battle it
  out.
• Heart rate and blood flow to the large muscles
  increase so we can run faster and fight harder.
  Blood vessels under the skin constrict to prevent
  blood loss in case of injury, pupils dilate so we
  can see better, and our blood sugar ramps up,
  giving us an energy boost and speeding up
  reaction time.
• At the same time, body processes not essential to
  immediate survival are suppressed. The digestive
  and reproductive systems slow down, growth
  hormones are switched off, and the immune
  response is inhibited.

5
Signs and Symptoms of Stress

• To get a handle on stress, you first need to
  learn how to recognize it in yourself. Stress
  affects the mind, body, and behavior in many
  ways all directly tied to the physiological
  changes of the fight-or-flight response. The
  specific signs and symptoms of stress vary widely
  from person to person.
• Some people primarily experience physical
  symptoms, such as low back pain, stomach
  problems, and skin outbreaks. In others, the
  stress pattern centers around emotional symptoms,
  such as crying or hypersensitivity. For still
  others, changes in the way they think or behave
  predominates.

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Stress Warning Signs and Symptoms

• Cognitive Symptoms
• Memory problems
• Indecisiveness
• Inability to concentrate
• Trouble thinking clearly
• Poor judgment
• Seeing only the negative
• Anxious or racing thoughts
• Constant worrying
• Loss of objectivity
• Fearful anticipation
• Emotional Symptoms
• Moodiness
• Agitation
• Restlessness
• Short temper
• Irritability, impatience
• Inability to relax

• Physical Symptoms
• Headaches or backaches
• Muscle tension and stiffness
• Diarrhea or constipation
• Nausea, dizziness
• Insomnia
• Chest pain, rapid heartbeat
• Weight gain or loss
• Skin breakouts (hives, eczema)
• Loss of sex drive
• Frequent colds
• Behavioral Symptoms
• Eating more or less
• Sleeping too much or too little
• Isolating yourself from others
• Procrastination, neglecting responsibilities
• Using alcohol, cigarettes, or drugs to relax
• Nervous habits (e.g. nail biting, pacing)

7
Causes of Stress

• The potential causes of stress are numerous and
  highly individual. What you consider stressful
  depends on many factors, including your
  personality, general outlook on life,
  problem-solving abilities, and social support
  system. Something that's stressful to you may not
  faze someone else, or they may even enjoy it
• For example, your morning commute may make you
  anxious and tense because you worry that traffic
  will make you late. Others, however, may find the
  trip relaxing because they allow more than enough
  time and enjoy listening to music while they
  drive.
• The pressures and demands that cause stress are
  known as stressors. We usually think of stressors
  as being negative, such as an exhausting work
  schedule or a rocky relationship. However,
  anything that forces us to adjust can be a
  stressor.
• This includes positive events such as getting
  married or receiving a promotion. Regardless of
  whether an event is good or bad, if the
  adjustment it requires strains our coping skills
  and adaptive resources, the end result is stress.

8
Causes Of Stress

• Major life changes
• Major life events are stressors. Whether it be a
  divorce, a child leaving home, a planned
  pregnancy, a move to a new town, a career change,
  graduating from college, or a diagnosis of
  cancer, the faster or more dramatic the change,
  the greater the strain. Furthermore, the more
  major life changes youre dealing with at any one
  time, the more stress youll feel.

• Top Ten Stressful Life Events
• Spouses/childs death
• Divorce
• Marriage separation
• Jail term
• Death of a close relative
• Injury or illness
• Marriage
• Fired from job
• Marriage reconciliation
• Retirement
• Source Holmes-Rahe Life Stress Inventory

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Causes Of Stress

• Daily hassles and demands
• While major life changes are stressful, they are
  also relative rarities. After all, its not every
  day that you file for divorce or have a baby.
  However, you may battle traffic, argue with your
  family members, or worry about your finances on a
  daily basis. Because these small upsets occur so
  regularly, they end up affecting us the most.
• Daily causes of stress include
• Environmental stressors Your physical
  surroundings can set off the stress response.
  Examples of environmental stressors include an
  unsafe neighborhood, pollution, noise (sirens
  keeping you up at night, a barking dog next
  door), and uncomfortable living conditions. For
  people living in crime-ridden areas or war-torn
  regions, the stress may be unrelenting.
• Family and relationship stressors Problems with
  friends, romantic partners, and family members
  are common daily stressors. Marital
  disagreements, dysfunctional relationships,
  rebellious teens, or caring for a chronically-ill
  family member or a child with special needs can
  all send stress levels skyrocketing.

• Work stressors In our career-driven society,
  work can be an ever-present source of stress.
  Work stress is caused by things such as job
  dissatisfaction, an exhausting workload,
  insufficient pay, office politics, and conflicts
  with your boss or co-workers.
• Social stressors Your social situation can
  cause stress. For example, poverty, financial
  pressures, racial and sexual discrimination or
  harassment, unemployment, isolation, and a lack
  of social support all take a toll on daily
  quality of life.
• Internal Causes of Stress
• Not all stress is caused by external pressures
  and demands. Your stress can also be
  self-generated. Internal causes of stress
  include
• Uncertainty or worries
• Pessimistic attitude
• Self-criticism
• Unrealistic expectations or beliefs
• Perfectionism
• Low self-esteem
• Excessive or unexpressed anger
• Lack of assertiveness

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Stress ManagementHow to Reduce, Prevent, and
Cope with Stress

• If youre living with high levels of stress,
  youre putting your entire well-being at risk.
  Stress wreaks havoc on your emotional
  equilibrium, as well as your physical health. It
  narrows your ability to think clearly, function
  effectively, and enjoy life.
• The goal of stress management is to bring your
  mind and body back into balance. By adopting a
  positive attitude, learning healthier ways to
  cope, and changing the way you deal with stress,
  you can reduce its hold on your life.  

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Taking Charge of Stress

• In our frenetic, fast-paced world, many people
  deal with frequent or even constant stress. The
  overextended working mother, the hard-charging
  Type A personality, the self-critical
  perfectionist, the chronic worrier theyre
  always wound up, always stretched to the breaking
  point, always rushing around in a frenzy or
  juggling too many demands.
• Operating on daily red alert comes at the high
  price of your health, vitality, and peace of
  mind. But while it may seem that theres nothing
  you can do about your stress levelthe bills
  arent going to stop coming, there will never be
  more hours in the day for all your errands, your
  career will always be demandingyou have a lot
  more control than you might think. In fact, the
  simple realization that youre in control of your
  life is the foundation of stress management.

• Managing stress is all about taking charge
  taking charge of your thoughts, your emotions,
  your schedule, your environment, and the way you
  deal with problems. The ultimate goal is a
  balanced life, with time for work, relationships,
  relaxation, and funand the resilience to hold up
  under pressure and meet challenges head on.
• Dealing with Stressful Situations
• Change the situation
• Avoid the stressor.
• Alter the stressor.
• Change your reaction
• Accept the stressor.
• Adapt to the stressor.

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Stress Management Strategies

• Avoid unnecessary stress
• Learn how to say no Know your limits and
  stick to them. Whether in your personal or
  professional life, refuse to accept added
  responsibilities when youre close to reaching
  them. Taking on more than you can handle is a
  surefire recipe for stress.
• Avoid people who stress you out If someone
  consistently causes stress in your life and you
  cant turn the relationship around, limit the
  amount of time you spend with that person or end
  the relationship entirely. 
• Take control of your environment If the evening
  news makes you anxious, turn the TV off. If
  traffics got you tense, take a longer but
  less-traveled route. If going to the market is an
  unpleasant chore, do your grocery shopping
  online.
• Your to-do list Analyze your schedule,
  responsibilities, and daily tasks. If youve got
  too much on your plate, distinguish between the
  shoulds and the musts. Drop tasks that arent
  truly necessary to the bottom of the list or
  eliminate them entirely.

• Alter the situation
• Express your feelings instead of bottling them
  up. If something or someone is bothering you,
  communicate your concerns in an open and
  respectful way. If you dont voice your feelings,
  resentment will build and the situation will
  likely remain the same.
• Be willing to compromise. When you ask someone to
  change their behavior, be willing to do the same.
  If you both are willing to bend at least a
  little, youll have a good chance of finding a
  happy middle ground.
• Be more assertive. Dont take a backseat in your
  own life. Deal with problems head on, doing your
  best to anticipate and prevent them. If youve
  got an exam to study for and your chatty roommate
  just got home, say up front that you only have
  five minutes to talk.
• Manage your time better. Poor time management can
  cause a lot of stress. When youre stretched too
  thin and running behind, its hard to stay calm
  and focused. But if you plan ahead, you can avoid
  these stress-inducing pitfalls.

13
Stress Management Strategies

• Accept the things you cant change
• Dont try to control the uncontrollable. Many
  things in life are beyond our control
  particularly the behavior of other people. Rather
  than stressing out over them, focus on the things
  you can control such as the way you choose to
  react to problems.
• Look for the upside. As the saying goes, What
  doesnt kill us makes us stronger. When facing
  major challenges, try to look at them as
  opportunities for personal growth. If your own
  poor choices contributed to a stressful
  situation, reflect on them and learn from your
  mistakes.
• Share your feelings. Talk to a trusted friend or
  make an appointment with a therapist. Expressing
  what youre going through can be very cathartic,
  even if theres nothing you can do to alter the
  stressful situation.
• Learn to forgive. Accept the fact that we live in
  an imperfect world and that people make mistakes.
  Let go of anger and resentments. Free yourself
  from negative energy by forgiving and moving on.

• Adapt to the stressor
• Reframe problems. Try to view stressful
  situations from a more positive perspective.
  Rather than fuming about a traffic jam, look at
  it as an opportunity to pause and regroup, listen
  to your favorite radio station, or enjoy some
  alone time.
• Look at the big picture. Take perspective of the
  stressful situation. Ask yourself how important
  it will be in the long run. Will it matter in a
  month? A year? Is it really worth getting upset
  over? If the answer is no, focus your time and
  energy elsewhere.
• Adjust your standards. Perfectionism is a major
  source of avoidable stress. Stop setting yourself
  up for failure by demanding perfection. Set
  reasonable standards for yourself and others, and
  learn to be okay with good enough.
• Focus on the positive. When stress is getting you
  down, take a moment to reflect on all the things
  you appreciate in your life, including your own
  positive qualities and gifts. This simple
  strategy can help you keep things in perspective.
  

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Stress Reduction Tips

• Beyond a take-charge approach and a positive
  attitude, you can reduce stress in your life by
  making healthy lifestyle choices and taking care
  of yourself. If you regularly make time for rest
  and relaxation, youll be in a better place to
  handle lifes stressors when they inevitably
  come.
• Healthy stress reducers
• Go for a walk.
• Spend time in nature.
• Talk to a supportive friend.
• Sweat out tension with a good workout.
• Do something for someone else.
• Write in your journal.
• Take a long bath.
• Play with a pet.
• Work in your garden.
• Get a massage.
• Curl up with a good book.
• Take a yoga class.
• Listen to music.
• Watch a comedy.

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Stress Reduction Tips

• Nurture yourself
• Dont get so caught up in the hustle and bustle
  of life that you forget to take care of your own
  needs. Nurturing yourself is a necessity, not a
  luxury.
• Set aside relaxation time. Include rest and
  relaxation in your daily schedule. Dont allow
  other obligations to encroach. This is your time
  to take a break from all responsibilities and
  recharge your batteries.
• Connect with others. Spend time with positive
  people who enhance your life. A strong support
  system will buffer you from the negative effects
  of stress.
• Do something you enjoy every day. Make time for
  leisure activities that bring you joy, whether it
  be stargazing, playing the piano, or working on
  your bike.
• Keep your sense of humor. This includes the
  ability to laugh at yourself. The act of laughing
  helps your body fight stress in a number of ways.
  
• Adopt a healthy lifestyle
• Exercise regularly. Physical activity plays a key
  role in reducing and preventing the effects of
  stress. Make time for at least 30 minutes of
  exercise, three times per week. Nothing beats
  aerobic exercise for releasing pent-up stress and
  tension.
• Eat a healthy diet. Well-nourished bodies are
  better prepared to cope with stress, so be
  mindful of what you eat. Start your day right
  with breakfast, and keep your energy up and your
  mind clear with balanced, nutritious meals
  throughout the day.
• Reduce caffeine and sugar. The temporary "highs"
  caffeine and sugar provide often end in with a
  crash in mood and energy. By reducing the amount
  of coffee, soft drinks, chocolate, and sugar
  snacks in your diet, youll feel more relaxed and
  youll sleep better.
• Avoid alcohol, cigarettes, and drugs.
  Self-medicating with alcohol or drugs may provide
  an easy escape from stress, but the relief is
  only temporary. Dont avoid or mask the issue at
  hand deal with problems head on and with a clear
  mind.
• Get enough sleep. Adequate sleep fuels your mind,
  as well as your body. Feeling tired will increase
  your stress because it may cause you to think
  irrationally.

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Relaxation Techniques for Stress Relief

• Chest Breathing vs. Abdominal Breathing
• When you breathe from your chest, you inhale
  about a teacup of oxygen. Instead, you should
  breathe from your abdomen. When you breathe from
  your abdomen, you inhale about a quart of oxygen.
  The more oxygen you inhale, the better.
• How you breathe also affects your nervous system.
  Chest breathing makes your brain create shorter,
  more restless brain waves. Abdominal breathing
  makes your brain create longer, slower brain
  waves. These longer and slower brain waves are
  similar to the ones your brain makes when you are
  relaxed and calm. So, breathing from the abdomen
  helps you relax quickly.
• With its focus on full, cleansing breaths powered
  by the diaphragm, deep breathing can help you get
  your stress levels in check.

• Deep breathing for stress relief
• If youd like to explore relaxation techniques,
  deep breathing is a good place to start, since it
  is used in many relaxation practices including
  yoga, meditation, and visualization. Deep
  breathing involves not only the lungs but also
  the abdomen, or diaphragm.
• Most of us dont breathe from the diaphragm.
  Instead, we take shallow breaths from our upper
  chests. When were stressed, our breath becomes
  even shallower.
• The problem is that shallow breathing limits the
  amount of oxygen we take inwhich makes us feel
  even more tense, short of breath, and anxious.
  Deep breathing, on the other hand, encourages
  full oxygen exchange throughout the chest and
  lungs.

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Deep Breathing Stress Relief

• The next time you feel uptight, try taking a
  minute to slow down and breathe deeply
• Sit comfortably with your back straight. Put your
  hands on your stomach.
• Breathe in through your nose. Your hands on your
  stomach should rise.
• Exhale through your mouth, pushing out as much
  air as you can while contracting your abdominal
  muscles. Your hands on your stomach should move
  in as you exhale.
• Continue to breathe in through your nose and out
  through your mouth. Try to inhale enough so that
  your lower abdomen rises and falls. Count slowly
  as you exhale.
• If you have a hard time breathing from your
  abdomen sitting up, lie on the floor, put a small
  book on your stomach, and try to breathe so that
  the book rises as you inhale and falls as you
  exhale.
• Breathing techniques can be practiced almost
  anywhere and can be combined with other
  relaxation exercises, such as aromatherapy and
  music. All you really need is a few minutes and a
  place to stretch out.

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Progressive Muscle Relaxation for Stress Relief

• Progressive muscle relaxation is another
  effective and widely used strategy for relieving
  stress. It involves a two-step process in which
  you systematically tense and relax different
  muscle groups in the body.
• With regular practice, progressive muscle
  relaxation gives you an intimate familiarity with
  what tensionas well as complete relaxationfeels
  like in different parts of the body. This
  awareness helps you spot and counteract the first
  signs of the muscular tension that accompanies
  stress. And as your body relaxes, so will your
  mind. You can combine deep breathing with
  progressive muscle relaxation for an additional
  level of relief from stress.

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Progressive Muscle Relaxation for Stress Relief

• Loosen your clothing, take off your shoes, and
  get comfortable.
• Take a few minutes to relax, breathing in and out
  in slow, deep breaths.
• When youre relaxed and ready to start, shift
  your attention to your right foot. Take a moment
  to focus on the way it feels.
• Slowly tense the muscles in your right foot,
  squeezing as tightly as you can. Hold for a count
  of 10.
• Relax your right foot. Focus on the tension
  flowing away and the way your foot feels as it
  becomes limp and loose.
• Stay in this relaxed state for a moment,
  breathing deeply and slowly.
• When youre ready, shift your attention to your
  left foot. Follow the same sequence of muscle
  tension and release.
• Move slowly up through your body legs, abdomen,
  back, neck, face contracting and relaxing the
  muscle groups as you go.

• Progressive Muscle Relaxation Sequence
• Right foot
• Left foot
• Right calf
• Left calf
• Right thigh
• Left thigh
• Hips and buttocks
• Stomach
• Chest
• Back
• Right arm and hand
• Left arm and hand
• Neck and shoulders
• Face

20
Guided Imagery

• A variation of traditional meditation involves
  guided imagery or visualization. When used as a
  relaxation technique, guided imagery involves
  imagining a scene in which you feel at peace,
  free to let go of all tension and anxiety.
• Choose whatever setting is most calming to you,
  whether a tropical beach, a favorite childhood
  spot, watching a spectacular sunset or a quiet
  wooded glen.
• Close your eyes and let your worries drift away.
  Imagine your restful place. Picture all the
  details as vividly as you caneverything you can
  see, hear, smell, and feel.
• If your chosen spot is a dock on a quiet lake,
  visualize what it looks like as the sun sets over
  the water, the smell of the pine trees, the sound
  of the geese flying overhead, the taste of the
  clear country air, and the feel of the cool water
  on your bare feet.

21
Making a Stress Management Plan

• Stress management starts with identifying the
  sources of stress in your life. This isnt as
  easy as it sounds. Your true sources of stress
  arent always obvious, and its all too easy to
  overlook your own stress-inducing thoughts,
  feelings, and behaviors. Sure, you may know that
  youre constantly worried about deadlines. But
  maybe its your procrastination, rather than the
  actual job demands, that leads to deadline
  stress.
• Look closely at your habits, attitude, and
  excuses. Do you explain away stress as temporary
  (I just have a million things going on right
  now) even though you cant remember the last
  time you took a breather? Do you define stress as
  an integral part of your work or home life
  (Things are always crazy around here) or as a
  part of your personality (I have a lot of
  nervous energy, thats all). Do you blame your
  stress on other people or outside events, or view
  it as entirely normal and unexceptional? Until
  you accept responsibility for the role you play
  in creating or maintaining it, your stress level
  will remain outside your control.
• There are many healthy ways to reduce stress or
  cope with its effects, but they all require
  change. You can either change the situation or
  change your reaction. When deciding which option
  to choose, its helpful to think of the four As
  avoid, alter, accept, or adapt.
• Since everyone has a unique response to stress,
  there is no one size fits all solution to
  managing it. No single method works for everyone
  or every situation, so experiment with different
  techniques and strategies. Focus on what makes
  you feel calm and in control.

22
Measure Your Stress

• Take a brief stress assessment!
• Go to
• http//stresstest.net/
• If score high on the assessment, please see
  Michelle or Vanessa for stress management
  assistance.

23
Quiz Questions(Please answer the quiz questions
and give a copy of the answers to a SSS staff
member)

1. Define stress.
2. What is the bodys response to stress?
3. List five (5) symptoms of stress.
4. List five (5) causes of stress.
5. What are the top ten most stressful life events?
6. What is the goal of stress management?
7. List five (5) stress management strategies.
8. List five (5) stress reduction tips.
9. Which three relaxation techniques are mention for
   stress relief?
10. What is your stress management plan?