1. LEARNING SKILL COURSE DepT. of Medical Education COLLEGE OF MEDICINE

2. Stress Management Objectives of the session : 1. Define stress 2. Identify the types of stress 3. Identify the relation between stress and our health 4. Recognize the mechanisms of stress 5. Recall the stress management strategy

3. Stress Definition stress is a feeling happened when a person facing external demands which exceed the adaptive capacities of his mind and body.

4. Useful or positive stress which enhancing performance & efficiency Harmful or negative stress which consuming the adaptive capacity and leads to increase susceptibility to mental and physical illness. Types of stress

5. Stress and our health

7. Stress and immune system : Stress associated with decreases in cellular immunity and increases susceptibility to infectious diseases and allergy. For example, Life stress is associated with 2-fold increase in susceptibility to the common cold virus.

8. Stress and physiological changes: Gastrointestinal, (peptic ulcer, diarrhea) Glandular ( DM, adrenalin, cortisone secretion) Cardiovascular (angina & hypertension) Stress and mental health Stress associated with higher levels of depression and anxiety.

9. Health professionals face many stressors in their work environment: Sleep deprivation Caring for critically ill or dying patients Attending examinations But keep in mind there is Differences in response to stress within and between individuals.

10. HUMAN FUNCTION CURVE Exhaustion Fatigue Breakdown Healthy Tension PERFORMANCEPERFORMANCE stress P = The point at which minimum arousal may bring on a breakdown P

11. Mechanisms of Stress Fight-or-Flight (adrenaline response ) General Adaptation Syndrome and Burnout

12. Fight-or-Flight (adrenaline response ) Cannon in (1932) early work on stress His work showed that when an animal experiences a shock or a threat, it quickly releases hormones. These hormones help him to run faster and fight harder Same hormones released in humans under stress (adrenaline)

13. Negative consequences of (adrenaline response ) 1. The person become excitable, anxious, and irritable 2. Unable to perform precise, controlled skills 3. Become more accident-prone and less able to make good decisions adrenaline response = Power, but little control

14. General Adaptation Syndrome and Burnout It is state of fatigue and frustration occurs in response to long term exposure to stress in a job or relationship.

15.  As a result, the person will lost his interest and motivation to this job or relationship and this is what we call burnout.(breakdown) Burnout mainly strikes committed, hard workers and successful people

16. Symptoms of Burnout Physical: fatigability and sleep disturbance. Emotional: frustration and feelings of depression and isolation Behavioural: Detachment from co-workers. Increased harshness in dealing with others.

17. Avoiding Burnout : In case of: Too much work to do, too little time See if you can cut away low-yield work use time management skills check that you are using all of the resources available to you.

18. Regarding Political and people problems : Not that major cause of burnout can happen when too many people lean heavily upon you. To avoid this you need to : Correctly managing your support network

19. Finally, avoid exhaustion to avoid burnout: Going on a good, long vacation Leave your laptop and mobile phone behind. make sure you get enough sleep and rest and healthy diet.

20. Intervention to consider for stress management Time Management Personal Management

21. Time Management 1- Write down commitments in “to do lists Daily to-do list Work on " urgent then important and finally less important items“ Master list filled with longer bigger tasks. managed through a week or a month. 2- Schedule all your time. 3- Put a reliable schedule.

22. Personal Management 1. 4-Steps to Interrupting Stress 2. Relaxation Response

23. 4-Steps to Interrupting Stress Stop  Each time you encounter a stress…stop…before (automatic) thoughts push you into worst possible scenarios. Breathe  Breathe deeply to release physical tension. Reflect  Focus energy on the problem & think on the cause of stress Choose  how to deal with stress

24. Relaxation Response 1. Pick a focus word, phrase, image. 2. Sit quietly in comfortable position. 3. Close eyes & relax. 4. Breathe slowly and repeat the focus word.

25. Stress management strategy strategy #1 : Avoid unnecessary stress : A. Learn how to say “no” B. Avoid people who stress you out

26. Stress management strategy strategy #2: Alter the situation : A. Express your feelings B. Be flexible C. Be assertive

27. Stress management strategy strategy #3: Adapt to the stressor : A. Reframe problems (time, ability or performance) B. Adjust your standards (working and sleeping hours) C. Focus on the positive and Recall motivations (the income or gain)

28. Stress management strategy strategy #4: Accept what you can’t change : (Don’t try to control the uncontrollable)

29. Stress management strategy strategy #5: Make time for fun and relaxation : (Do something you enjoy every day)

30. Stress management strategy strategy #6: a healthy lifestyle: Regular Exercise. Reduce caffeine and sugar in your dite. Avoid alcohol, cigarettes, and drugs. Get enough sleep.

31. CONCLUSION Stress can help you to improve performance, but too much stress without appropriate strategy to control it can be harmful for your mind and body.

32. Become the master of stress not its victim