STRESS AN ITS WARNING SIGNALS AND MANAGEMENT

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 RULES

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.

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.
	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.
	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.

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.
	The natural tendency is for people to let their stresses pile up rather than exchanging them.
	Overstress gradually occurs with the development of overstress, the person starts taking off on the wild roller coaster of ill health.
	In order to stay healthy, learn to exchange your stresses.

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.

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.

H L Card (2002) Effective stress management, An Occupational Psychology

 Division Product.

Joe Landsberger(2006) stress guides and strategies, University of Minnesota.

Kozier and Erb’s (2008) Fundamental of Nursing, concept, process and practice 8^th ed. by Pearson Hall, New Jersey.

www.Helpguard.com/stress_management_relief_coping with stress.

www.holistic online.com/stress management