Stress Dr Jim White Ronnie Menzies Welcome

What we will cover Scope. What is stress? How does stress affect us? Reducing the effect of Stress. Panic attacks.

Scope - Kyriacou (2001) Sources of stress Teaching pupils who lack motivation. Maintaining discipline. Time pressures and workload. Coping with change. Being evaluated by others. Dealing with colleagues. Self esteem and status. Admin. and management. Role conflict / ambiguity/emotional labour* Poor working conditions.

Scope - strategies for coping with stress Direct action – reduce source of stress  Identify problem then act to reduce e.g. adjust time frames for a deadline. Learn new skills.  Assertiveness skills. Palliative techniques – manage stress Not only a work related issue

What is Stress?

Like blood pressure we all have stress

The Stress Line Low stress Extreme stress

Extreme end of stress line The most common form of stress is a mix of anxiety and depression  Anxiety (tension, stress)  Depression (Low mood, feeling flat, sad) It is unusual to have a single problem, e.g. panic attacks. Most people have a mix As you would expect, a mix of problems is usually more severe than a single problem

When is stress a problem? Stress should cause concern if:  You can’t get rid of it even when you try  It affects your day-to-day life  There doesn’t seem a good reason for it to be there  Work context absenteeism / presenteeism

Who is affected by stress? It can affect anyone and everyone Right now, in Edinburgh, 1 in 5 of us has a problem with stress In our lifetime, almost 1 in 2 of us will have a problem with stress WHO estimates on depression 2030

Stress and teaching NAHT survey % respondents stress related problems. 25% serious stress related problem. 20% considered drank too much Times Educational Supplement 37% vacancies Secondary 19% Primary Schools due to ill health. cf nurses 9% bankers 5% Schools Advisory Service 1 in 3 teachers off with sick leave previous year. Suicide rate 30 – 40 % higher than average

How common is stress? Top 10 conditions seen by GPs

14 Most Common Signs Worry Anger Poor Sleep Tiredness Feeling Irritable Feeling Worthless Feeling Hopeless Feeling on edge Unable to switch off Panic Attacks Poor Concentration Tearful Drinking too much Waiting for the worst to happen Reported by people in the UK

How stress can affect us Stress

How stress affects our body

How anxiety can affect our body Stress Bladder/ Bowel Feel Faint Shaking Breathing NauseaChoking Jelly legs NumbSleep Stress Heart rate Headache Chest pain Muscle pain SweatingTired Pins & needles Unreal Dry mouth

Why ? Fight / Flight Response Stress: Ancient survival mechanism deal with threats to our physical wellbeing Triggered by sense of threat Physiological component to stress

Bear running towards you! Adrenaline Pupils Dilate Bladder/Bowels Sweating Heart Rate Muscle Tension Breathing, oxygen Heightened Awareness

Old mechanism - modern world Triggered by a sense of threat Not useful to deal with our anxiety Don’t burn off adrenalin or extra oxygen Vicious circle

Depression and the body Eat a lot less Eat a lot more Can’t get to sleep Wake up in the night Wake up very early Sleep a lot more Never feel 100% Headaches Body posture Weight gain Weight loss Lack of energy/sluggish Easily tired Feel exhausted Body feels numb Aches and pains ConstipationAgitation

STRESS CAN AFFECT THOUGHTS

How Stress can affect our: Thoughts Worry What if…. If only I am…… Thoughts and images Thoughts EmotionsBody Actions

Can include fear of: Looking foolishWorry MadnessPoor concentration Illness/diseaseIrritability ChallengesSelf criticism Losing controlBiased processing: Being aloneThreat perception Being criticisedThe blinkers RejectionGrasshopper thinking Meeting people

STRESS CAN AFFECT ACTIONS

How Stress can affect our: Actions You may: Avoid day to day events Avoid socialising Avoid making decisions Act differently Thoughts EmotionsBody Actions

How Stress affects our: Behaviour Slow response Withdrawal Lack of enthusiasm Complaining aches and pains Eating habits Poor concentration Self harming Self care Speaking too fast Unable to sit at peace Poor performance / Procrastination Always rushing Smoking/drinking more Accident prone Stammering Irritable Nail biting

Managing Stress

Clearing the decks Alcohol Caffeine The “miracle cure” Reassurance Self-criticism Avoidance

CONTROLLING YOUR BODY

Breathing and relaxation Slow regular breathing In through nose out through mouth Diaphragmatic breathing Progressive muscle relaxation

CONTROLLING YOUR THOUGHTS

Stage 2: The Big Five Challenges “What are the chances…..?” “What is the worst thing….?” “Am I right to think that ?” “The five year rule.” “Is it worth it ?”

Am I right to think that ? Situation: Having to repeat self numerous times to get pupils’ attention. Thought: “It is impossible to teach this class” What does the evidence say? Impossible ? The whole class? Always?

Plan to Tackle Stress Trying to ignore it does not work !!!! Plan Act Review

More thinking about thoughts Teaching specific research Flexible vs rigid thinking (musts and shoulds). Depersonalise situations review to change not to criticise. Internal vs external attributions.  Internal attributions for success and external for problems less stress!!!!

CONTROLLING YOUR ACTIONS

Helpful actions Exercise Face the fear Deal with issues causing stress Problem solving Developing a supportive environment Coping strategies

Panic attacks

Body, thoughts and actions Unpredicted panic, predictable and nocturnal Not dangerous

Hyperventilation and panic attacks Unpleasant Symptoms

Controlling panic Stay in the situation. Slow down breathing and relax body. Challenge thoughts as soon as they appear. Identify then stop safety behaviours. Plan ahead and start with easier situations.

Resources GP gate keeping role to other services. Stepped Care Model. Stress Control (self referral) Book prescription scheme Guided self help Psychology Living Life Teacher Support Network / Union websites

Useful references Kyriacou, C. (2001). Teacher stress: Directions for future research. Educational Review, 53, Howard, S. & Johnson, B. (2004). Resilient teachers: Resisting stress and burnout. Social Psychology of Education, 7, Websites with helpful workbooks

Questions?