1. A Presentation for the SOMC Medical Imaging Department Kendall L. Stewart, MD, MBA, FAPA March 2, 2002 Dealing With Stress Some Practical Questions & Answers The Portable Mentor Presentation Series SOMCPress

2. What’s in this for me? Stress happens! Stress can and does diminish the quality of our lives. You can learn to cope more effectively with stress. Individualized approaches are the only ones that work. This presentation may produce some insights that you can use. Even the smallest sustained change takes real effort. “Parking the Impala”

3. What is stress? A physical, chemical or emotional factor that causes bodily or mental tension and may be a factor in disease causation Bodily or mental tension resulting from factors that tend to alter an existing equilibrium We are all like balls connected with strings. “Jonathan’s trials as a first year teacher.”

4. What are some of the common unpleasant stresses in our lives? Illness Unemployment Conflict Increasing demands Crime Death Information overload And we call it women’s liberation. “Claudia gesturing, on phone and pulling away with the door open.”

5. What are some of the common pleasant stresses in our lives? Retirement Vacation New baby Moving New job New phase of life Children leaving home Family visits A woman won the lottery. She asked the preacher to tell her husband.

6. How are stress and health related? More than 200 points on the Social Readjustment Assessment Scale in one year was associated with an increased incidence of –Myocardial infarction –Psychiatric illness –Peptic ulcer disease –Infection

7. What are the relative scores of some common life events? Your first day on a new job, look cool. “You look more like one of us.”

8. What disorders are negatively affected by stress? Psychiatric disorders Cardiovascular disorders GI disorders Neurological disorders Musculoskeletal disorders

9. What are some psychological responses to stress? Irritability Preoccupation Difficulty with concentration Anxiety Depression Sleep changes Avoidance Psychological defense mechanisms Denial is a powerful defense. “Your racehorse, Suzy, called today.”

10. What are some physiological responses to stress? Increased heart rate Increased respiration Increased perspiration Diarrhea Tremor Flushing Stress can be very uncomfortable. “Treating a MI patient in the Air Force”

11. What factors often distract us from the realization that we are stressed? Time pressure Demand for productivity Emphasis on quantity Materialism Competition Selfish interests No sense of purpose or meaning Longer task lists Resentment You can know too much. “We hope to get better speakers next year”

12. What are some unhealthy strategies? Working harder Taking it out on others Withdrawing Ignoring issues Congregating with other miserable people Doing nothing Eating Drinking Using chemicals Indulging in pathologic relationships Ruminating Being a couch potato Forget changing others. Change yourself. “Waiting on my wife”

13. What are some healthy mental strategies? Meditation Healthy distraction Thought stopping Ventilation Reframing Ignoring Assertiveness Prayer Even ugly pictures look better in an attractive frame. “Reframing on call duties as ministry”

14. What are some healthy physical strategies? Exercise Proper diet Recreation Avoidance of stressful situations Lifestyle change Physical labor Use of sensory override techniques Few of us enjoy vigorous exercise. “Combine it with something your do enjoy.

15. What are some suggested next steps? Decide whether stress is an issue you want to address in your life. Decide on your priorities. Make a commitment. Identify measures of your success. Organize your “project team.” Set incremental goals. Celebrate all progress. Be realistic. Celebrate small accomplishments. “Climbing Camelback mountain”

16. What insights can I take away? Stress happens. Not all stress is bad. There are many successful strategies for minimizing the negative impact of stress on our lives. The most effective strategies are individualized and dynamic. Dealing more effectively with stress will improve your productivity and the quality of your life.

17. Where can I learn more? Stewart, Kendall L, Stress Management: Dealing Effectively with Stress at Work and in Life. A SOMC White Paper, 2002. (Watch for it on http://www.somc.org)http://www.somc.org Davis, Martha, McKay Matthew and Eshelman, Elizabeth Robbins, The Relaxation & Stress Reduction Workbook. 5 th ed., New Harbinger Publications, 2000. Carnegie, Dale, How to Stop Worrying and Start Living. Pocket Books, 1985. Weeks, Claire, Hope and Help for your Nerves. Signet, 1991. Davidson J. The Complete Idiot’s Guide to Managing Stress, Alpha Books, 1996 How to Master Stress http://www.mindtools.com/smpage.htmlhttp://www.mindtools.com/smpage.html

18. How can we contact you? Kendall L. Stewart, M.D. Medical Director Southern Ohio Medical Center 1805 27th Street Portsmouth, Ohio 45662 740.356.8153 stewartk@somc.org www.somc.org

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