STRESS WARNING SIGNALS AND STRESS MANAGEMENT RULES
UGWUBUJO CALEB (RN, DAEN,)
Department of Accident and Emergency unit
Stress
is a universal phenomenon that essentially manifests itself in humans as a
result
of pressures emanating from several experiences or challenging situations. It
is a part of everyday life and it behooves on everyone to cope with it as best
as he can. Stress at work is an ever-increasing problem in contemporary
societies resulting in enormous costs both for the corporate organization
involved and for the individual employees.
You're
feeling anxious, simple things irritate you, you've got yet another headache
coming on and you're tired but there's no time to stop and rest. You're
suffering from mood swings, feel tense, are worrying endlessly and can't
concentrate on simple tasks. If this sounds like a familiar scenario, you could
well be suffering from stress. It is not just negative things that cause
stress; positive things can cause stress too.
Consider
the following situations:
• Getting
married
• The
birth of a child
• Christmas
time
• A
holiday abroad
These are
generally regarded as positive events or experiences.
Now
consider the following situations:
• First
day in a new job
• Stuck in
a traffic jam on way to the office
• Being
given several tight task deadlines
• Having a
disagreement with your boss
These
are generally regarded as potentially negative situations or experiences.
The
point is that some people perceive the situations set out above as challenging
and full of opportunity and potential for enjoyment or relaxation: other people
will see them all as very stressful and have feelings of being unable to cope.
It is this seemingly intangible nature of stress that can sometimes make it so
difficult to recognize and deal with. So it is important for you to find out
more about your own stress symptoms and causes and then take positive action to
establish an optimal personal stress level for better health and well being.
Stress can strike at any time during our lives and can be a
debilitating condition. Many factors can cause it, but common triggers tend to
be pressures of work, relationships, money, family problems or merely the fact
that life suddenly seems to be a constant tough battle. Once stress starts it
can impact on all areas of our health — physical, mental and emotional.
Continued stress that isn't dealt with can lead to increased
feelings of insecurity and can cause other conditions such as depression, high
blood pressure, peptic ulcers or a lowered immune system.
If there's a possibility you might be stressed
out but are yet to actually admit to it, use the checklist below to spot the
warning signs and symptoms.
Psychological Symptoms
* Anxiety
* Depression * Guilt * Paranoid Thinking * Tense * Mood Swings * Suicidal Feelings * Worrying * Cynical * Lack of Concentration |
* Anger
* Fear * Jealousy * Nightmares * Feeling of Helplessness * Exhaustion * Lack of Self-Esteem * Withdrawal * Ashamed * Feeling Hurt |
Physiological Symptoms
* Painful,
Tight Chest
* Breathlessness * Muscle Twitching * Back Ache * Fainting * Allergies * Sudden Allergies * Migraines * Sweating |
* Nausea
* Tiredness * Aches and Pains * Neck Ache * Frequent Colds or Flu * Rashes and Skin Irritations * Indigestion * Sudden Weight Loss or Gain * Change in Menstrual Cycle |
If you're feeling really low with depression
that won't seem to lift, are feeling increasingly anxious or are having
suicidal thoughts, don't hesitate to seek medical help. Also, some of the
symptoms of stress, such as a feeling of tightness on the chest or a low immune
system, can be caused by other things, so do ensure that you check with your
doctor first and rule out any other causes.
Admitting to suffering from stress is
definitely the first step to recovery. Now that you know why you're acting and
feeling this way you can gradually make changes in your life and really start
to beat it!
YOUR CURRENT APPROACH
Use the checklist below to get
some idea of your behaviors and approach to work and life.
Please circle the number that you
feel most closely describes your own behavior.
Never late
5 4 3 2 1 0 1 2 3 4 5 Casual
about appointments
Very competitive 5
4 3 2 1 0 1 2 3 4 5 Not competitive
Anticipates what others are going
to say,
Interrupts/finishes 5 4 3 2 1 0 1 2 3 4 5 Good listener
Always rushed 5
4 3 2 1 0 1 2 3 4 5 Never rushed
Impatient while waiting 5 4 3 2 1 0 1 2 3 4 5 Can wait patiently
Goes all out 5 4 3 2 1 0 1 2 3 4 5 Casual
Tries
to do too many things at once 5 4 3 2 1 0 1 2 3 4 5 Takes one thing at a time
Emphatic in speech (may pound) desk 5 4 3 2 1 0 1 2 3 4 5 Slow deliberate talker
Wants good job recognized by
others 5 4 3 2 1 0 1 2 3 4 5 happy with his job
Fast (walking, eating etc.) 5 4 3 2 1 0 1 2 3 4 5 Slow in doing things
Hard driving 5 4 3 2 1 0 1 2 3 4 5 Easy going
Hides feelings 5 4 3 2 1 0 1 2 3 4 5 Expresses feelings
Few interests outside work 5 4 3 2 1 0 1 2 3 4 5 Has outside
interests
SCORING
THE CHECKLIST
Each
line can score a maximum of 11 points, the points being allocated as shown
below. You score the points listed against the number you circled on the
questionnaire. There are 13 lines, so the maximum score is 143 and the minimum
is 13.
Number
circled 5
4 3 2
1 0 1
2 3 4 5
Points 11
10 9 8
7 6 5
4 3 2 1
Once you
have added up your total score you can find your behaviour tendency by
comparing it with the table below:
12-64
Extreme Type B, 65-90 Type B, 91-103 Type A, 104-143 Extreme Type A
Type
‘A’ – Ambitious
Active
and energetic. Impatient to wait in a queue. Conscientious. High standards.
Time is a problem, never have enough. Often intolerant of others slower actions.
Feel guilty when relaxing. Focused on own interests to the exclusion of other
people and the surroundings.
Type
‘B’-Placid
Quiet,
very little worries them. Often uncompetitive. Put their energies into things
they can alter, and leave others to worry about the rest.
Research
has shown that there is a link between what has come to be known as a Type ‘A’
personality and coronary heart disease. The danger occurs when Type ‘A’s are
subjected to high levels of demand and stress. Research into stress, like other
areas of research, is always moving on and refining existing theories. The Type
A/B distinction is no exception. There is now the suggestion that the really
dangerous
(i.e. related to ill-health) aspects of the Type A personality are to do with
aggression and anger. Being energetic, involved in and committed to your job
and other activities is not necessarily directly linked to stress-related
problems. As with all self-assessment questionnaires, it is well to take
results with a pinch of salt – that is to see them as indicating a tendency in
your behaviour rather than an unchangeable fact. This questionnaire should
never be used as the sole basis for determining likely reactions to stress.
Bearing this in mind you may find it helpful for someone who knows you well at
work to complete the checklist on your behalf. Compare not only the total
result but also the individual answers. You may find it very revealing.
Stress Management
is the ability to maintain control when situations, people, and events make
excessive demands. What you can do to manage your stress?
What are some strategies? It may seem that there’s nothing you can do about your stress level. The bills aren’t going to stop coming, there will never be more hours in the day for all your errands, and your career or family responsibilities will always be demanding. But you have a lot more control than you might think. In fact, the simple realization that you’re in control of your life is the foundation of stress management.
What are some strategies? It may seem that there’s nothing you can do about your stress level. The bills aren’t going to stop coming, there will never be more hours in the day for all your errands, and your career or family responsibilities will always be demanding. But you have a lot more control than you might think. In fact, the simple realization that you’re 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 Four A’s in stress management according to
Smith (2001) are:
·
Avoid the stressor
● Alter the
stressor
● Adapt to
the stressor.
● Accept the
stressor. (Smith, 2001).
The ultimate goal is a balanced life, with time for work,
relationships, relaxation, and fun –
plus the resilience to hold up under pressure and meet challenges head on.
Ø See if there really is something you can
change or control in the situation.
Ø Set realistic goals for yourself: Reduce
the number of events going on in your life and you may reduce the circuit
overload.
Ø Remove yourself from the stressful situation: Give
yourself a break if only for a few moments daily.
Ø Learn how to best relax yourself: Meditation
and breathing exercises have been proven to be very effective in controlling
stress. Practice clearing your mind of disturbing thoughts.
Ø Change the way you see your situation; seek alternative viewpoints: Stress is a reaction to events and problems,
and you can lock yourself in to one way of viewing your situation. Seek
an outside perspective of the situation, compare it with yours. And perhaps
lessen your reaction to these conditions.
Ø Get enough sleep:
Lack of rest just aggravates stress.
Ø Avoid self-medication or escape: Alcohol and drugs can mask stress.
They don't help deal with the problems.
Ø Work off stress:
with physical activity, whether it's
jogging, tennis, gardening.
Ø Try to "use" stress: If you can't remedy, nor escape from what
is bothering you, flow with it and try to use it in a productive way.
Ø Try to be positive:
Give yourself messages as to how well you can cope rather than how horrible
everything is going to be. "Stress can actually help memory,
provided it is short-term and not too severe. Stress causes more glucose
to be delivered to the brain, which makes more energy available to
neurons. This, in turn, enhances memory formation and retrieval. On
the other hand, if stress is prolonged, it can impede the glucose delivery and
disrupt memory.
Ø Most importantly, if stress is putting you in an unmanageable state or interfering
with your schoolwork, social and/or work life, seek professional help at your
school counseling center.
Ø Exercise,
recreational reading, arts, crafts, music,
reduce
work or school obligations, dance and meditation are all essential if you are
be combat stress effectively.
Three Rules to
Permanently Conquer Overstress
Rule One: Learn To Read Your Body Signs
Learn to check your body frequently for
signs of overstress. Watch for the altered disturbances in your sleep
pattern, as this is usually the earliest sign of overstress.
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You must learn to read your body signs in
much the same way as a diabetic learn the early warning signs of abnormal
blood sugar. In order to cope successfully with diabetes, a diabetic has to
learn to read his body's signals.
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Likewise, if you are a person who is prone
to overstress, you must learn to look for its earliest warning signs. As soon
as your sleep patterns change or you experience fatigue, lack of enjoyment of
life, anxiety, multiple aches and pains -- that is the time to go through the
overstress checklist.
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Rule
Two: Exchange Your Stresses
Keep your stress level below your individual
overstress point by "exchanging stresses". If a new stress comes
into your life, then make room for it by eliminating or postponing another
stress. This way, your total stress level remains low.
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The
natural tendency is for people to let their stresses pile up rather than
exchanging them.
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Overstress gradually occurs with the
development of overstress, the person starts taking off on the wild roller
coaster of ill health.
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In order to stay healthy, learn to exchange
your stresses.
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Rule
Three: Use Relaxation Techniques/Therapies
If you are feeling ill from overstress,
remember that the troubled sleep, fatigue, aches, lack of enjoyment of life,
and panic attacks are caused by chemical changes in your brain. Deep Muscle
Relaxation, Sensible Exercise and Healthy Diet are all essential in managing
stress.
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SELYE’S RESPONSE MODEL
Stress may also
be considered as a response. This definition was developed and described by
Selye (1956, 1976) as ''the nonspecific response of the body to any kind of
demand made upon it" (1976)
Selye's stress response is
characterized by a chain or pattern of physiologic events called the general
adaptation syndrome (GAS) or stress syndrome. To differentiate the
cause of stress from the response to stress, Selye (1976) used the term stressor
to denote any factor that produces stress and disturbs the body's
equilibrium. Because stress is a state of the body, it can be observed only by
the changes it produces in the body. This response of the body, the stress
syndrome or GAS, occurs with the release of certain adaptive hormones and
subsequent changes in the structure and chemical composition of the body.
Parts of the body particularly affected by stress are the
gastrointestinal tract, the adrenal glands, and the lymphatic structures. With
prolonged stress, the adrenal adrenal glands enlarge considerably; the lymphatic structures, such as the
spleen, and lymph nodes, atrophy (shrink); and deep ulcers in the lining of the
stomach.
In
addition to adapting globally, the body can also react locally that is, one organ or a part of
the body reacts alone. This is referred to as the local adaptation syndrome (LAS). One
example of the LAS is inflammation. Selye (19").76J proposed that both the
GAS and the LAS have three stages: alarm reaction, resistance and.
exhaustion
Three stages of adaptation to stress
Alarm Reaction
The initial
reaction of the body is the alarm
reaction, which alerts the
body's defenses. Selye (1976) divided these stage into two parts:
The shock phase and the countershock
phase.
During the shock phase; the stressor may be
perceived consciously or unconsciously by the person. Stressors stimulate the
sympathetic nervous system, which in turn stimulates the hypothalamus. The
hypothalamus releases corticotropin-releasing hormone (CRH), which stimulates
the anterior pituitary gland to release adrcnocorticotropic hormone (ACTH).
During times of stress, the adrenal medulla secretes epinephrine and
norepinephrine in response to sympathetic stimulation. Significant body
responses to epinephrine include the following:
1. Increased
myocardial contractility, which increases cardiac output and blood flow to active muscles
2. Bronchial
dilation, which allows increased oxygen intake
3. Increased
blood clotting
4. Increased
cellular metabolism
5. Increased fat mobilization to make energy available and to synthesize other compounds needed by the body
The principal effect of norepinephrine is
decreased blood to the kidneys
and increased secretion of renin. Renin is an enzyme that hydrolyzes one of
the blood proteins to produce an-siotensin. Angiotensin tends to increase the
blood pressure by constricting arterioles. The sum of all of these adrenal
hormonal effects permits the person to perform far more strenuous physical
activity than would otherwise be possible. The person is then ready for
"fight or flight." This primary response is short-lived, listing from
1 minute to 24 hours.
The second part of the alarm reaction is called
the counter shock phase. During this time, the changes produced in the body
during the shock phase are reversed. Thus, a person is best mobilized to react
during the shock phase of the alarm reaction.
Stage of Resistance
The second stage in the GAS and LAS syndromes,
the stage of resistance, is when the body's adaptation takes place. In other
words, the body attempts to cope with the stressor and to limit the stressor to
the smallest area of the body that can deal with it.
Stage of Exhaustion
During the third stage, the stage of exhaustion,
the adaptation that the body made during the second stage cannot be maintained.
This means that the ways used to cope with the stressor r.ave been exhausted.
If adaptation has not overcome the stressor. the stress effects may spread to
the entire body. At the end of this stage, the body may either rest and return
to normal, or death may be the ultimate consequence. The end of this stage
depends largely on the adaptive energy resources of the individual, the
severity of the stressor, and the external adaptive resources that are
provided, such as oxygen.
Reference
Di Martino, V., (2003). Relationship between work stress and
workplace violence in the health sector.
Division Product.
Joe Landsberger(2006) stress guides and strategies, University of Minnesota.
Kozier and Erb’s (2008)
Fundamental of Nursing, concept, process and practice 8th ed. by
Pearson Hall, New Jersey.
www.Helpguard.com/stress_management_relief_coping with
stress.
www.holistic online.com/stress management