1. Stress Reduction and Management Stephanie Taddeo, LISW-S Senior Manager of Development and Mental Health Visiting Nurse Association of Ohio

2. Defining Stress  Essentially, stress is the emotional and physical response you experience when you perceive an imbalance between demands placed on you and your resources at a time when coping is important.

3. Why do we care?  The psychological and mental harm caused by stress can adversely affect quality of life  It can cause a great deal of distress to you and the people in your life  It can affect your ability to work and engage in your personal life

4. Everybody has stress, but our reactions can be very different  Some stress is good. Stress is helpful when it increases our ability to be alert energized, switched on and resourceful in facing challenges we enjoy or have to deal with.  Stress becomes unhelpful when it leaves us feeling fatigued, tense, anxious, burnt out or overwhelmed.

5. Everyone’s Unique!  The tipping point between helpful and unhelpful stress is different for each of us and can also depend on what has happened and what is happening in our lives.

6. Stress can be caused by:  Family or relationship problems  Work/Caregiving  Care receiving/illness  Family member who is under stress  The news  Recent major changes

7. Physical Symptoms  Pounding heart  Elevated blood pressure  Sweaty palms  Tightness of chest  Aching neck, jaw and back muscles  Headache  Chest pains  Abdominal cramps  Nausea  Trembling  Sleep disturbance  Tiredness  Susceptibility to minor illness  Itching  Easily startled  Forgetfulness

8. Thoughts You may experience:  Your mind racing or going blank  Not being able to ‘switch off ’  A lack of attention to detail  Your self esteem and confidence plummeting  Disorganized thoughts  A diminished sense of meaning in life  A lack of control or the need for too much control  Negative self statements and negative evaluation  Difficulty in making decisions  A loss of perspective.

9. Thoughts (cont.) You may be:  Making ‘mountains out of molehills’  Driving yourself too hard with ‘I must do this, ought to do that, should do the other’ or demanding too much of others as well as yourself.

10. Behaviors You may:  Become withdrawn and not want to socialize  Increase your alcohol, nicotine or drugs intake  Under eat or over eat  Become accident prone and careless  Become impatient, aggressive or compulsive – pacing, fidgeting, swearing, blaming, throwing and hitting  Work longer hours – not take breaks, take work home, procrastinate with important projects, take the ‘headless chicken’ approach when under pressure, and manage time poorly  No longer have time for leisure activities.

11. Feelings You may feel:  Irritable  Angry  Depressed  Jealous  Restless  Anxious  Unreal or hyper alert  Unnecessarily guilty  Panicked

12. Consequences of Stress  Chronic stress=Chronic fight or flight

13. Consequences of Stress (cont.) Physical Illnesses such as heart disease, migraines, hypertension, IBS, Muscle, back and joint pain, ulcers

14. Consequences of Stress (cont.)  Mental Health Problems such as anxiety, depression, insomnia, feelings of inadequacy

15. Ineffective Ways of Coping  Drinking  Eating  Shopping  Smoking  ???

16. Effective Coping Strategies  Exercise  Prayer/meditation  Socialization  Breathing  Yoga  Humor

17. Effective Coping Strategies (cont.)  Recognizing Control Make it a great day vs. Have a great day Make it a great day vs. Have a great day

18. Change Your Mind  Do you believe stress is harmful for your health?  Belief stress response is negative led to death

19. Effective Coping Strategies (cont.)  Use your senses: Listen to soothing music Listen to soothing music Take a long hot bath or shower Take a long hot bath or shower Look at a beautiful picture or visualize a calming scene in your mind Look at a beautiful picture or visualize a calming scene in your mind Soothing scents Soothing scents

20. Vegging out in front of the TV is not enough!  Use what you know AND learn new techniques  Have a plan

21. Hope and Help  Scale back. Cut back on your obligations when possible. While it may seem easier said than done, take a close look at your daily, weekly and monthly schedule and find meetings, activities, dinners or chores that you can cut back on or delegate to someone else.

22. Hope and Help (cont.)  Prepare. Stay ahead of stress by preparing for meetings or trips, scheduling your time better, and setting realistic goals for tasks both big and small. Stress mounts when you run out of time because something comes up that you didn't account for — build in time for traffic jams, for example.

23. Hope and Help (cont.)  Reach out. Make or renew connections with others. Surrounding yourself with supportive family, friends, co-workers, or clergy and spiritual leaders can have a positive effect on your mental well-being and your ability to cope with stress. Volunteer in your community.

24. Hope and Help (cont.)  Take up a hobby. It may seem cliche, but when you engage in something enjoyable, it can soothe and calm your restless mind. Try reading, gardening, crafts, tinkering with electronics, fishing, carpentry, music — things that you don't get competitive or more stressed out about.

25. Hope and Help (cont.)  Relax. Physical activity, meditation, yoga, massage and other relaxation techniques can help you manage stress. It doesn't matter which relaxation technique you choose. What matters is refocusing your attention to something calming and increasing awareness of your body.

26. Hope and Help (cont.)  Get enough sleep. Lack of sufficient sleep affects your immune system and your judgment and makes you more likely to snap over minor irritations. Most people need seven to eight hours of sleep a day.

27. Hope and Help (cont.)  Get professional help. If your stress management efforts aren't helpful enough, consult a professional. Chronic, uncontrolled stress can lead to a variety of potentially serious health problems, including depression and pain.

28. Sweet Relief  We must learn to employ stress-reduction techniques during stressful times.  People, in general, can employ these same techniques in their everyday lives.  Learn to identify feelings. Practice self- evaluation.

29. In the Moment  Controlled breathing  Guided imagery  Stretching  Muscle Relaxation  Music Therapy

30. Social Support  Help create a positive, supportive environment  Practice positive feedback  Foster a team approach

31. Perspective   “People are often unreasonable and self-centered. Forgive them anyway. If you are kind, people may accuse you of ulterior motives. Be kind anyway. If you are honest, people may cheat you. Be honest anyway. If you find happiness, people may be jealous. Be happy anyway. The good you do today may be forgotten tomorrow. Do good anyway. Give the world the best you have and it may never be enough. Give your best anyway. For you see, in the end, it is between you and God. It was never between you and them anyway.” ― Mother TeresaMother Teresa

32. Thank You!