1. Stress Management CDR Mark Mittauer

2. Enabling Objectives F Identify causes of stress F Discuss the harmful effects of stress F Discuss how to eliminate avoidable sources of stress F Discuss how to adjust to unavoidable sources of stress

3. Enabling Objectives (cont.) F Discuss techniques for improving assertiveness F Discuss techniques for better anger management F Describe and practice three stress management exercises

4. Causes of Stress F What are sources of stress in your life? F Stress may result from daily hassles F Stress may result from major life events F Stress may result from welcome life events (e.g., promotion, marriage) F CHANGE is a major source of stress

5. Harmful Effects of Stress F Illness - infections, cancer progression, high blood pressure, obesity from overeating, heart disease, ulcers F Fatigue - that may lead to mistakes and injury or death

6. Useful Stress F Stress can be helpful when it motivates us to accomplish a task now!

7. Symptoms of Stress F Physical F Emotional F Cognitive F Behavioral

8. Physical Symptoms of Stress F muscle tension F headache F fatigue F sleep problems F gastrointestinal problems F high blood pressure

9. Emotional Symptoms of Stress F irritability F arguing F anxiety F depression F lack of enjoyment F mood swings F suicidal thoughts F homicidal thoughts

10. Cognitive Symptoms of Stress F inattention F distractibility F forgetfulness F confusion F poor concentration

11. Behavioral Symptoms of Stress F social isolation F work problems F conflicts with coworkers, friends, and loved ones F unhealthy habits - overeating, alcohol misuse, nicotine use, caffeine misuse, workaholism F aviator: conflicts with peers, disregarding rules and checklists

12. Better Stress Coping F Eliminate avoidable causes of stress F Handle unavoidable causes of stress more effectively

13. Avoidable Causes of Stress F Nicotine F Alcohol F Overeating F Caffeine F Sleep problems

14. Nicotine F Chewing tobacco (“dip”) can cause mouth or lip cancer F Exhaled “secondhand” smoke can cause lung cancer, heart disease, and respiratory infections in nonsmoking bystanders F Smokers miss twice as much work as nonsmokers due to illness

15. Nicotine (cont.) F The medical effects of nicotine use should be well known F Children exposed to smoke develop colds, ear infections, asthma, bronchitis, and pneumonia F To stop smoking - talk to a medical department representative about smoking cessation classes and nicotine replacement products

16. Alcohol F Medical problems from alcoholism - depression, liver disease, ulcers, high blood pressure F Almost one half of sailors who suicide are drunk F A blood alcohol level of.15 increases your chance of a car wreck 24 times F NATOPS 3710.7Q: no alcohol within 12 hours of flight planning; no hangover!

17. Alcohol (cont.) F Drinking only two drinks at bedtime causes less restful sleep - leading to fatigue the next day F If you drink too much - talk to your command DAPA or medical department representative, or visit Alcoholics Anonymous (AA)

18. Overeating F Medical problems from overeating - obesity, high blood pressure, diabetes, heart disease, stroke, high lipid levels F Strict dieting or fasting does not result in sustained weight loss - your metabolism slows and you regain weight when you resume “normal” eating F Overeaters’ Anonymous may help

19. Overeating (cont.) F Commercial weight reduction programs and diets are costly and no more effective F Eat three meals a day - to avoid evening binges F Select a high fiber, low fat diet F Cut calories by using sugar substitutes, sugar-free sodas, fat-free salad dressing, and skim milk; avoid gravy, deserts F Healthy snacks - carrots, celery, pickles, lettuce, fruit

20. Caffeine F Caffeine increases your alertness for several hours - but then causes increased fatigue F Health problems from caffeine use - high blood pressure, anxiety, irritability, withdrawal headaches, sleep problems F Insomnia may result from any caffeine use after noon F Mountain Dew, chocolate, and tea have caffeine

21. Caffeine (cont.) F Decrease your caffeine intake to two or less cups of coffee (or the equivalent) per day F Decrease your caffeine use by eliminating one cup of coffee from your daily intake every few days

22. Sleep Problems F 80% of Americans do not get enough sleep F Poor sleep causes fatigue, irritability, depression, work inefficiency, and accidents F Optimal sleep - 8 to 8.5 hours per night (need minimum of 5 hours to avoid performance difficulties - especially for sedentary persons making complex decisions or needing to be attentive)

23. More Sleep Facts: F Causes of fatigue: 1) sleep debt 2) circadian rhythm disruption 3) prolonged effort (mental, physical) F Myths about sleep: 1) cannot “bank” sleep 2) wakeful rest does not replace sleep

24. Even More Sleep Facts: F Symptoms of sleep deprivation: 1) hallucinations (REM intrudes into day) 2) excessive yawning 3) impaired concentration and memory 4) head bobbing (due to “microsleep”) F Remedy for sleep deprivation: 1) caffeine 2) naps for 60 minutes max (if longer, allow 20 minutes to reach alert state)

25. How to Improve Sleep F avoid heavy exercise and alcohol before bed F avoid caffeine use after noon F go to bed and awaken at the same time F if unable to fall in 30 minutes, arise and read until you feel sleepy F avoid naps longer than 30 - 60 minutes F relax for 30 to 60 minutes before bedtime F relaxation techniques may induce sleep F do not check your alarm clock during night

26. How to Approach Unavoidable Stress F Try specific stress management techniques discussed later F Change your outlook on how you view stress

27. Specific Stress Management Techniques F Talk to someone (friend, chaplain, mentor, Family Service Center counselor, flight surgeon) F Create a support network of friends F Schedule fun activities - noncompetitive hobby, reading, music, sightseeing F Schedule down time when you have no other activities planned F Introduce spirituality into your life

28. Specific Techniques (cont.) F Volunteer to help someone - your life will feel meaningful F Aerobic Exercise (biking, running, walking, swimming, aerobics) at least 30 minutes three times a week - improves mood and mental alertness and relieves tension F Unclutter your brain - keep an appointment book; write down tasks and prioritize them F Allow extra time (arise 10 minutes earlier)

29. Improve Time Management F review your calendar and list of tasks daily F prioritize your tasks F tackle difficult or irksome tasks first F have an agenda for meetings - develop time limits for each agenda item F avoid taking office work home F work efficiently - you do not have to complete all tasks perfectly F make a “plan of attack” and set milestones

30. Reduce Job Stress F Remember that your job is important (hull technician example) F Be cheerful - the world will not end if you are grim and serious all the time! F Praise your coworkers often - with formal and informal awards F Take “fun breaks” at work - talk to someone or review pictures of momentos of fun times

31. Reduce Job Stress (cont.) F Divide the work day into “time chunks” F Plan a fun activity after work F Delegate work to others F If you fall behind, request help and inform your supervisor F Set limits on what you are asked to do F Establish realistic goals F If you feel overwhelmed, do something!

32. Change Your Outlook on Stress F When you feel stressed - take a break, breathe slowly, walk around F View life as a challenge or opportunity to excel - and not as a crisis F When something goes wrong - think of three ways the situation could be worse F Live life “one day at a time” - do not dwell on past mistakes, worry about the future, or wait (miserably) for future happiness

33. Change Your Outlook (cont.) F Learn to enjoy the simple pleasures of life F Do not wait for others to make you happy (maintain an internal locus of control) F You cannot control how you feel - but you can control what you do with those feelings and how long you keep them (example: when you are angry, do something fun after 30 minutes) F Find the positive part of every situation

34. Change Your Outlook (cont.) F Stop wasting time worrying - develop a plan to approach the problem and do something F Be prepared to wait - carry book to read, a portable cassette player, or hobby materials F Be wary of “the grass is always greener” syndrome before you leave your current situation F Always have a back-up plan F Decide now what is really important

35. Faulty Thinking Causes Stress F Catastrophizing - anticipating a terrible outcome; overexagerating the importance of a situation F “I can’t stand it” - deciding that you cannot handle a situation, without trying - alternative: “I can handle this!” F “Should” statements e.g. “I should always be happy” - alternative: “I’m human. I am allowed to make a mistake or have a bad day.”

36. Faulty Thinking (cont.) F “Beating yourself up” about past mistakes that you cannot change F Worrying about situations over which you have no control, or cannot change e.g., “If only I had 20/20 vision” F Overgeneralizing - viewing one negative event as predicting a never-ending pattern of defeat e.g., “My girlfriend dumped me. I will never date again!”

37. Faulty Thinking (cont.) F Emotional reasoning - thinking, “I feel it, so it must be true.” e.g., “I am anxious today, so something terrible will happen!” F Personalizing - blaming yourself for something that is not your fault F Fairness fallacy - becoming angry when something disappoints you because you think, “life is supposed to be fair!”

38. How to Correct Faulty Thinking F Recognize your faulty thought patterns F Replace irrational ideas with more accurate and realistic ideas

39. Anger Management F You can choose to control how you express your anger (others won’t respect you if you curse, yell, or use violence - and you are too important to let situations control you) F Speak calmly when disagreeing F If you are about to lose control - count to “10” slowly, breathe deeply, and walk away if necessary

40. Anger Management (cont.) F Set limits on how long you choose to be angry - then do something nice for yourself F When you disagree with someone, stick to the present issue (and avoid dredging up past hurts) F Criticize someone’s behavior, not their character

41. Assertiveness/Better Communication F Ask for what you desire F Refuse a “tasker” if you do not really want to do it, or if you lack the time to do it well F When you make a request, give a reason F Be specific with your request (tell the receiver exactly what you want done) F Be a good listener - give your full attention, show interest, and summarize what you heard

42. Relaxation Techniques F Slow deep breathing F Progressive muscle relaxation F Guided imagery

43. Slow Deep Breathing F Inhale slowly through your mouth or nose for 5 seconds, while allowing your stomach to push out F Without pausing, exhale slowly for 5 seconds, and tell yourself to relax F Perform this techniques for at least 5 minutes whenever you feel stressed, angry, anxious, overwhelmed, or unable to sleep

44. Progressive Muscle Relaxation F Sit in a comfortable chair or lie down F Practice slow deep breathing for several minutes F Then, tighten and relax each major muscle group in turn (you may choose to relax each muscle group twice)

45. Guided Imagery F Practice slow deep breathing for several minutes F Then, practice progressive muscle relaxation F Finally, imagine yourself in a pleasant, relaxing setting (example, the beach) F Use all of your senses to observe your surroundings

46. Any Questions?

47. Finis