1. Stress Management Phyllis M. Connolly PhD, RN, CS

2. Stress A person-environment interaction Sources –Biophysical –Chemical –Psychosocial –Cultural

3. External stimuli Emotional feelings Peripheral physiological changes Central nervous system arousal Internal stimuli Genetic equip Past experience Stress Individual perception of stressor- conscious or unconscious Stress

4. Sources of Stress Heat-cold noise radiation exhaustion physical inactivity alcohol nicotine caffeine

5. More Stress Anger Frustration Hostility hopelessness Unrealistic expectations Work Pressures

6. Responses to Stress Demanding situation--stressor Internal state –Tension –Anxiety –Strains

7. Anxiety Normal--response to a threat to one’s safety, well-being, or self-concept Charateristics –Appropriate to the threat –Anxiety can be relieved –Can cope either alone or with some support –Problem solving slow but still usable

8. Abnormal Anxiety Occurs more frequently, longer and more intense Interferes with one’s life Function is more impaired Disproportionate to threat Blocks learning from the experience

9. Psychosis Brief Reactive Psychosis Panic Dread Loneliness Rituals Avoidance Psychosomatic Heartpound Palpitations Shakiness Butterflies All senses alert Calm Daydreaming Sleep Panic Acute and Chronic Normal RELATIVE SEVERITY OF ANXIETY (Haber p.437)

10. Crisis Intervention Deep breathing Self Talk Time out Leave the situation Visualization Music

11. Prevention Diet and nutrition Exercise and physical activity Self-help groups Assertiveness training Having fun Playing

12. Prevention Cont. Visualization Meditation Hypnosis Meet Spiritual Needs

13. Prevention Cont. Massage Acupressure Acupuncture Biofeedback Progressive Relaxation Therapeutic touch

14. Resources Audiotapes Books Courses –Tai Chai –Stress Management –Assertiveness Training –Water Exercise