1. Stress and Your Heart Cardiac Rehabilitation Program

2. Today’s Topics What is stress? How do you know that your stressed? How is stress connected to heart disease? How do you manage stress?

3. What is stress? The way we react to change Stress is constant Stress can be positive or negative The reaction to stress is more important than the stress itself

4. The Stresses of Life

5. What are the signs of stress? Physical Emotional Mental Relational

6. Fight or Flight Life-threatening situation Body prepares to fight the threat or to run from it

7. Fight or Flight and Your Heart Blood pressure, heart rate, breathing increases Glucose, triglycerides, fatty acids pumped into blood for fuel Liver becomes less efficient at clearing cholesterol from blood Kidneys shut down which prevents loss of water and thickens the blood

8. Chronic Stress Usually the Fight or Flight response turns off when the danger has passed But some stresses are ongoing and arise in situations we can neither “fight nor flee” The fight or flight response wears the body down

9. Chronic Stress Long term exposure to stress can lead to serious health problems Chronic stress can suppress your immune system and increase your risk for heart disease, depression and other physical illnesses

10. Holmes Schedule of Recent Experiences EventLife Change Units Death of a spouse100 Divorce 75 Marriage 50 Retirement 45 Change in financial status 40 Outstanding personal achievement 35 Change in residence 30 Change in social activities 20 Vacation 15 Christmas season 10

11. Holmes Schedule of Recent Experiences Scoring 150 - 199 Slight Risk 200 - 299 Moderate Risk › 300High Risk The higher your score, the higher the likelihood of incurring some form of illness within the next year. High scores are moderated by your ability to manage your stress.

12. Danger Signs Depressed Angry - Hostile Lonely or isolated

13. Depression and Heart Disease People who experience symptoms of depression are 40 % more likely to develop cardiac disease People who are depressed and have a heart attack are 4x more likely to die As many as 65% of heart attack patients report symptoms of depression

14. Type A Personality In the 1970’s researchers introduced the concept of the Type A Personality and its link to heart disease Type A’s were described as always in a hurry, hostile, competitive, impatient - and more likely to develop heart disease Current research is focusing on specific traits of the Type A - hostility and time pressure - as risk factors for heart disease

15. Social Supports Research has shown that people who have close friendships experience fewer stress symptoms than those without close friends Social support is related to good coronary artery disease outcome Having friends won’t cure heart disease but not having friends can increase your risk of dying after a cardiac event

16. How do you manage stress? Stress management works best when it is a lifestyle and not a response to a particular event There are hundreds of techniques, strategies and self- help books out there but if you only turn to them when you are completely overwhelmed they will have limited effect Preventing stress from becoming overwhelming is the key!

17. Stress Management Strategies To manage stress, everyone should have: A type of exercise – to discharge energy Workout at the gym Walk outsideDancePlay a sport

18. Stress Management Strategies To manage stress, everyone should have: Some form of relaxation – to calm yourself Structured Relaxation Listen to musicWatch the sunset

19. Stress Management Strategies To manage stress, everyone should have: A way to release emotions Talk with family or friends Keep a journal Be creativePray

20. Stress Management Strategies To manage stress, everyone should have: Some connection with others Spend time with family & friends Volunteer Walk a dog in the park Learn a new hobby

21. Stress Management Techniques 101 Change the situation Avoid, Be Assertive, Delegate Manage your time Change your body’s response Relaxation Techniques, Avoid chemicals Get enough sleep Change your mind Distract, Look at the big picture Talk yourself out of being upset Accept there are things you can’t change

22. Find the Support That You Need Talk to your family and friends Talk to your doctor or other health care provider Other Resources – books, websites, counselling services

25. Kerry Charuk, Psychological Associate Cardiac Rehabilitation Program Sudbury Regional Hospital 705 671-6600 ext. 2974 kcharuk@hrsrh.on.ca