STRESS
MANAGEMENT
Presented by:-
Mr. Suresh Kumar Sharma
RN, MSN(PSYCHIATRY)

What do you understand by
Stress?
• The way our body and
•mind react to life changes

HELP ME!
WHAT IS STRESS ?
Stress is the reaction people have to
excessive pressures or other types of
demand placed upon them. It arises when
they worry that they can’t cope.

I HATE YOU
WHAT IS STRESS ?
Stress is the “wear and tear” our minds and
bodies experience as we attempt to cope
with our continually changing environment

DEFINITIO
N
An adaptive response to an
internal & external situation that
results in physical, psychological
and behavioural deviations
Adaptation – a coping up mechanism
S=P>R
Stress occurs when the pressure is greater than the resource

ROLE OF H-P-A IN
STRESS

Adolescents and stress ?
 Teens are under more stress
 Since adolescence is a period of
significant changes
 physical,
 emotional,
 social,
and
 academic changes
many than at any other time of
life.

Where does stress come from ?
Stress can come from Inside -
– INTERNAL STRESSOR:-
– Body image
– Not happy with the way you look
– self-conscious feel everyone is staring at
you
Stress can come from Outside
EXTERNAL STRESSOR:-
i.e. surroundings, environment
– Family ……..
– School ….
– Friends /Peers …
– Society ….
– Others ……

Stresses physical
– Prolonged school
hours
– Over-packed class
rooms
– Transport
– Pollution air, noise
– Overcrowding road
– Poor ventilation
– Bad furniture

Stresses psychological
– Bullies,
– Changing schools,
– Conflicts with teacher,
– Forced
competitiveness,
– Falling grades,
– Have to present in
class
– Learning disorders,
– Special recognition

Stress psychosocial
 Relationships
 Peers –
– You want to spend time with peers
but without parental supervision
– Their opinions more important than
that of parents
 Conflicts with parents, friends
 Media internet
 Secret lives ……

How do we react to stress?
 Reaction
– FFF (Fight – Flight – Freeze)
ULTIMATELY how each person reacts will
decide how STRESS will affect YOU
This means that whether we get “stressed out
or not” depends mainly on US

HEALTHY RESPONSE TO STRESS
1. LAS 2. GAS
 LOCAL ADAPTION SYNDROME(LAS)-
Eg. Wound healing, blood clotting,
accommodation of eye to light
 Characteristic of stress response-
 Localised
 Adaptive - stimulation of stressor is necessary.
 Natural & protective- catecholamine
HR & BP

Characteristic of stress response
IN LAS-
 LIMITS IN ABILITY TO COMPENSATE
 MAGNITUDE & DURATION IS GREAT
THAT HOMEOSTATIC MECHANISM FOR
ADJUSTMENT FAIL, LEADING TO DEATH.
 INDIVIDUAL DIFFERENCES.
 RESPONSE IS SHORT TERM.
 RESTORATIVE

2.GENERAL ADAPTION SYNDROME
 SELYE, 1976

EFFECT OF
STRESS

Signs and Symptoms of Stress
Physical
 Poor appetite or overeating
 Feeing tired and fatigued
 Various aches and pains ---headache body ache
muscle pain
 Nausea & abdominal Pain
 Sleep problems
 Falling sick very often e.g. fever cough cold diarrhea
( because of lowering of immunity due to stress)

Mental
 Feeling low
 Nervousness and Anxiety
 Excessive Anger
 Depression
 Being easily upset
 Poor self confidence
 Low self esteem
 Lack of Concentration
 Poor performance in studies

Is STRESS good or bad for
us ?
 Some amount of stress is essential for us to
excel in life. This is good stress or “EUSTRESS”
 Butwhen stress is too much then it reduces
performance. This is bad stress or “DISTRESS “

Stress and Performance:
.

Stress and Performance:
.
Eustress

Stress and Performance:
.
Distress

Stress and Performance
Dealing more effectively with stress improves
performance and the quality of life
It is like salt and pepper to life

The Stress Model
..

The Stress Model

The Stress Model
 TheStress Model helps us understand differently the
behavior . The Stress Model states:
– All behavior arises from a state of stress.
– In between the stress and behavior is the presence of an
emotion.
– The emotion is either love or fear.
– It is through the expression, processing, and understanding
of the emotion that we can calm the stress and diminish the
behavior.

Stress
 We must first be aware of our own stress
before we can begin to address the stress in
others.
 Let’s dissect these situations.
 What stresses do you face each day?
– Work related? Home related? System related?

Stress
 Thinkabout the situations that prompted you
to come here today…
– What is it about this particular situation that is so
stressful?
– Where in your life has this situation occurred
before?

STIMULUS-BASED MODEL:-
(Holmes and Rahes model-1960)
 Stress:-
a stimulus , a life event, or a set of
circumstances that arouses physiologic &
psychological reactions that may increase
the individual’s vulnerability to illness.

SRRS(SOCIAL READJUSTMENTS
RATING SCALE)
 43 life changes or events.
 Both positive & negative in nature.
 Considered stressful.
 Identify the Effect of stressor in person’s life.
 If stressor is more in short period(1-2yr) then
more likely physical illnesses, mental
disorders or other stress response will follow.

SRRS MEASURING
 SRRS SCORE STRESS HIGH
 SRRS SCORE STRESS LOW
 But results are depends on mediating factor
– Eg. Coping strategies,
– Role of stressor, perception of individual etc.

RESPONSE-BASED MODEL
(SELYES STRESS RESPONSE)
 HANS SELYE, 1945
 PHYSIOLOGIC EVENTS AS GAS

TRANSACTION-BASED MODEL
(LOZARAS, 1966)
 Cognitive, affective & adaptive(coping)
response that arise from person-environment
tractions.
 Environment & person is not separable.
 Environment changes person responds with
coping response.
 Different individual show different reaction to
response. Eg. Illness respone one denial,
another anxiety, still another depression

Applying The Stress Model
 Absolutely, the first step when we are
triggered in our stress is to ACKNOWLEDGE
our stress!
BREATHE!
 Stress causes us to:
– React from the past
– Obsess about the future
– Take us out of the present

Applying the Stress Model
 Acceptance
– we must develop an accepting relationship with
individual. We must also teach the parents about
acceptance and model this for them.
 Understanding
– this is really seen in our perception of the child’s
behavior. If we see anger, we do not truly
understand this child. What is your child trying to
communicate through their behavior?

Applying the Stress Model
 Empathy
– Defined as the ability to experience and identify
with the emotional state of another person.
Empathy and reflecting feelings does not mean
we have to agree. It means that we get what is
going on.
 Patience
– We ourselves must be emotionally regulated in
order to exercise patience.

Applying the Stress Model
 Trust
– Our children trusting us may be more important
than our trust in our children.
 Love
– Takes effort, love is in the action of doing all the
things above.
– This is the opposite of fear. We must know love
in order to teach and model love. This is what we
want to replace fear.

Applying the Stress Model
 Training
– “form habits, thoughts, or behaviors by discipline
and instruction”
 Affection
– physical contact can be calming
 Structure
– chaotic vs. organized- home vs. school?
 Expectations
– be clear and communicate them, clarify that the
child understands

Applying the Stress Model
 Time-In
– “I see that you are in need of something, come and sit
beside me until you feel better.” When we think a child is acting out
to get attention, it is because a child needs attention.
 Mentoring
– connect this child to another adult outside the parent/child
relationship.
 Awareness
– Early identification of stress
 Containment
– keep the child in a space of more direct proximity to the
teacher than what may be needed for other students.

Applying the Stress Model
 Team
– the power and importance of a team working with this youth
is vital.
 Reduced Peer Interaction
– match the developmental needs of the youth.

Applying The Stress Model
 Reacting versus responding
– Flexibility versus Rigidity
– Windows of Tolerance
 Trauma
– Our relationship blueprints are affected by the
trauma we experience.

Summary
 Understanding our own stress before we engage
with a child is sure to help reduce the child’s stress.
 A child’s behavior is a way of communicating that
he/she is stressed and needs regulation.
 Adults are responsible for teaching and modeling
regulation.
 Understanding the stress underlying the behavior
assists us in helping a child change his/her behavior.

Is STRESS good or bad for
us ?
All stresses can be GOOD
So all efforts should be to convert all
stresses into EUSTRESS –This can be
achieved by stress management techniques

STRESS IN ADOLESCENTS
ADOLESCENT FRIENDLY SCHOOL INITIATIVE
AND ITS MANAGEMENT

STRESS TRIANGLE
Psychological
Physical behavioural

STRESS MANAGEMENT
MANAGE AT ALL THE THREE LEVEL
– PSYCHOLOGICAL LEVEL: MEDITATION,
REASSESSING OUR THOUGHTS & FEELINGS
– PHYSICAL LEVEL: EXERCISES, YOGA,
PHYSICAL ACTIVITIES
– BEHAVIOURAL LEVEL: RESPONDING WITH
EQUANIMITY AND CALMNESS
IF the distress crosses the threshold
level medical problems like
Depression, Anxiety disorders,
Hypertension etc. sets in. seek medical
help from a qualified medical
practitioner

SUGGESTED COPING
STRATEGIES
 Take life the way it comes
 Stop blaming others
 Develop your own inherent potential
 Live in the present & Work for the future
 Maintain harmonious relation with others
 Learn to be happy & cheerful

SUGGESTED COPING
STRATEGIES
 Respond to situations with equanimity, detachment,
courage, determination
 Avoid negative emotional reactions like anger,
grumbling, worrying and apprehensions.
 Create a supportive climate
 Redesign and enrich the job content*
 Reduce conflict & clarify roles
 Seek professional counseling

Meichenbaum’s approach to
stress management
1. Teaching individuals that negative self-
evaluation increase stress
2. Monitoring one’s own self-defeating
strategies – teaching new cognitive
strategies
3. Teaching new skills like relaxation
4. Providing real life homework assignment
that become increasingly difficult to carry
out

CONCLUSION
 Stress is manageable -It needs efforts
 Engage truthful thinking
 Modulate your behavioral pattern
 Lead a well balanced life of satisfaction.
 Assert control on self in terms of thinking &
action
ADAPTABILITY IS THE “MOTHER KEY” TO
CONVERT DISTRESS TO EUSTRESS

Stress Management Tips
 Making little changes in your life can really add up
to a big feeling of relief.
 Learn to recognize when you are feeling stressed
and simple ways you can relax.
 Take a break. Have a cold drink, get some fresh air,
or close your eyes for a minute to refocus.
 Stay positive to help friends and family cope with
stress.
 Let others know you're feeling overwhelmed and
tell them how they can help.
 Allow yourself to simply say "no" to friends and
family when you know you cannot meet their
demands without becoming overwhelmed.

Stress Management Tips
 Be prepared for unexpected problems such
as traffic, a lost pet or a family emergency.
 Prioritize. Take control of your "to do" list by
deciding what's really most important on your
list.
 Write down feelings of sadness, frustration
or anger to get a clearer perspective of your
emotions.
 Enjoy life's simple pleasures like colorful
flowers, dancing, music, and social outings,
etc.

Stress Management Plan
 Exercise regularly.
 Have healthy eating habits never skip breakfast
 Reduce sedentary activities like TV Video
games etc.
 Eat healthy nutritious food. Avoid Junk food .
 Avoid excess caffeine intake eg tea coffee
chocolates and cola drinks
 Do NOT TAKE QUICK FIX REMEDIES like
alcohol tobacco and drugs
‘as they have long term and very harmful
effects on your body and mind ‘’.

Stress Management Plan
 Practice time management
 Learn relaxation exercises.
 Rehearse and practice situations.
 Learn practical coping skills.
 Decrease negative self talk.
 Learn to feel good with a workable result –
Don’t be a perfectionist.
 Build a network of friends.

Stress Management Plan:
Relaxation Techniques
Breathing Awareness
– Abdominal Breathing
– Sigh Breathing
Progressive Muscle Relaxation
Visualization
 Meditation
 PETS
 MUSIC

METHODS OF ACHIEVING
RELAXATION:-
1. Deep-breathing exercises:-
 Oxygen inserted so tension released.(sobel &
ornstein,1996)
 Reducing anxiety, depression, irritability,
muscular tension and fatigue.
 It can be done at anywhere and at any time.
 3 0r 4 time a day or whenever feels tenseness.

2. Progressive relaxation
3. Modified (or passive)
progressive relaxation
4. Mental imagery
5. Biofeedback
6. Physical exercise

STRESS CONTROL
ABC
STRATEGY

ABC STRATEGY
A = AWARENESS
What causes you stress?
How do you react?

ABC STRATEGY
B = BALANCE
There is a fine line between positive /
negative stress
How much can you cope with before it
becomes negative ?

ABC STRATEGY
C = CONTROL
What can you do to help yourself combat
the negative effects of stress ?

Stress Management Techniques
 Change your thinking
 Change your behaviour
 Change your lifestyle

Change your Thinking
 Re-framing
 Positive thinking

RE-FRAMING
Re-framing is a technique to change the way
you look at things in order to feel better about
them. There are many ways to interpret the
same situation so pick the one you like. Re-
framing does not change the external reality,
but helps you view things in a different light
and less stressfully.

Positive Thinking
Forget powerlessness, dejection, failure
Stress leaves us vulnerable to negative
suggestion so focus on positives;
 Focus on your strengths
 Learn from the stress you are under
 Look for opportunities
 Seek out the positive - make a change.

Change your Behaviour
 Be assertive
 Get organised
 Ventilation
 Humour
 Diversion and distraction

Be Assertive
Assertiveness helps to manage stressful
situations, help to reduce their frequency.
Lack of assertiveness often shows low self -
esteem and low self - confidence. The key to
assertiveness is verbal and non - verbal
communication. Extending our range of
communication skills will improve our
assertiveness.

Equality and Basic Rights
1) The right to express my feelings
2) The right to express opinions / beliefs
3) The right to say ‘Yes/No’ for yourself
4) Right to change your mind
5) Right to say ‘I don’t understand’
6) Right to be yourself, not acting for the benefit
of others

7) The right to decline responsibility for other
people’s problems
8) The right to make reasonable requests of
others
9) The right to set my own priorities
10) The right to be listened to, and taken
seriously

Being Assertive
Being assertive involves standing up for your
personal rights and expressing your
thoughts, feelings and beliefs directly,
honestly and spontaneously in ways that
don’t infringe the rights of others.

Assertive People
 Respect themselves and others
 Take responsibility for actions and choices
 Ask openly for what they want
 Disappointed if ‘want’ denied
 Self - confidence remains intact
 Not reliant on the approval of others

Assertive Skills
 Establish good eye contact / don’t stare
 Stand or sit comfortably - don’t fidget
 Talk in a firm, steady voice
 Use body language
 ‘I think’ / ‘I feel’
 ‘What do you think?’ ‘How do you feel ?’
 Concise and to the point

Benefits
 Higher self-esteem
 Less self-conscious
 Less anxious
 Manage stress more successfully
 Appreciate yourself and others more easily
 Feeling of self-control

Get Organised
Poor organisation is one of the most common
causes of stress.
Prioritising objectives, duties and activities
makes them manageable and achievable.
Don’t overload your mind.
Organisation will help avoid personal and
professional chaos.

Time Management
 Make a list
What MUST be done
What SHOULD be done
What would you LIKE to do
 Cut out time wasting
 Learn to drop unimportant activities
 Say no or delegate

 Plan your day
 Set achievable goals
 Don’t waste time making excuses for not
doing something

Ventilation
‘A problem shared is a problem halved’
Develop a support network through friends or
colleagues to talk with. It’s not always events
that are stressful but how we perceive them.
Writing a diary or notes may help release
feelings but do not re-read what has been
written.

Humour
 Good stress - reducer
 Applies at home and work
 Relieves muscular tension
 Improves breathing
 Pumps endorphins into the bloodstream - the
body’s natural painkillers

Diversion and Distraction
 Take time out
 Get away from things that bother you
 Doesn’t solve the problem
 Reduce stress level
 Calm down
 Think logically

Change Your Lifestyle
 Diet
 Smoking & Alcohol
 Exercise
 Sleep
 Leisure
 Relaxation

Diet
 Healthyeating habits
 Caffeine (Stimulant)
 Salt

Smoking and Alcohol
 Moderate your consumption

Exercise
 Uses up excess energy released by the
‘Fight or Flight’ reaction.
 Improves blood circulation
 Lowers blood pressure
 Clears the mind of worrying thoughts
 Improves self image
 Makes you feel better about yourself
 Increases social contact

Sleep
 Good stress reducer
 Difficult to cope when tired
 Wake refreshed after night’s sleep
 Plenty of daytime energy

Leisure
 Interest
 Gives you a ‘break’ from stresses
 Provides outlet for relief
 Provides social contact

Relaxation
 Lowersblood pressure
 Combats fatigue
 Promotes sleep
 Reduces pain
 Eases muscle tension

 Decreases mental worries
 Increases concentration
 Increases productivity
 Increases clear thinking

Alternatives
 Conventional Medicine  Herbalism
 Counselling &  Biofeedback
psychotherapy  Homeopathy
 Relaxation  Hypnotherapy
 Meditation  Osteopathy
 Massage  Pet Therapy
 Yoga  Reflexology
 Acupuncture
 Aromatherapy

Stress Management Plan:
How to seek help to destress
Talk and confide to a person whom you trust : friend,
parent, teacher, relative, etc.
If you feel that you are not able to cope with your
distress do not hesitate to go to your - school
counselor /family doctor/ adolescent pediatrician

How do you recognize that you
need professional help ?
 Deteriorating school performance
 Inability to sleep or excessive sleep
 Losing or gaining weight
 Feeling low or tired all the time
 Mood swings : crying, getting angry
 Not wanting to talk to anybody

The only difference between a
diamond and a lump of coal is that the
diamond had a little more pressure put
on it. –
ANONYMOUS

KEY POINTS
STRESS is very common
Use stress in a positive way
– Limit NOT eliminate stress.
– Use it to improve your performance.
Learn Coping Skills

Research on stress:-
Problem statement:-
“ A STUDY ON STRESS MANAGEMENT OF
WORKING WOMEN IN COIMBATORE DISTRICT”
DR. M. DHANABHAKYAM*; V. ANITHA**
*Assistant Professor, Department of Commerce,
Bharathiar University, Coimbatore - 46.
**Ph.D Fulltime Scholar, Department of Commerce,
Bharathiar University, Coimbatore - 46.

Objective:-
(i) To study the kind and level of stress faced by
working women in the study area.
(ii) To identify the sources of stress of working
women.
(iii) To identify the impact of stress of working
women.
(iv) To identify the physical reactions faced by the
working women due to high level of stress.

•RESEARCH DESIGN
 descriptive research design.
 data collection from the primary sources.
sampling techniques :-
Non -probability convenient .
sample :-
300 working women
Population:-
 among the working women of Coimbatore District.

Tools for Data analysis:-
 (a) Percentage Analysis:-
 (b) Henry Garrett Ranking:-
 (c) Two way table ANOVA:-

CONCLUSION:-
 Finally this study concluded that the
information technology supported and fast
 growing work environment, stress is an
inevitable one. Working women population
has also in
 the growth stage. Working women face
stress in managing their personal life with
work life.

PROBLEM STATEMENT:-
 Stress management: a randomized study of
cognitive behavioural therapy and yoga.
Granath J, Ingvarsson S, von Thiele U, Lundberg U.
Source
Department of Psychology and Centre for Health Equity
Studies (CHESS), Stockholm University, Stockholm, Sweden.
 In this study, a stress management program based on cognitive
behavioural therapy principles was compared with a Kundalini yoga
program.

Sample & sampling tecnique:-
 26 women and 7 men from a large Swedish
company were divided randomly into 2
groups for each of the different forms of
intervention.
 a total of 4 groups.
 . The groups were instructed by trained
group leaders and 10 sessions were held
with each of groups, over a period of 4
months.

FINDINGS
 Psychological:- self-rated stress and stress
behaviour, anger, exhaustion, quality of life.
 Physiological:- blood pressure, heart rate,
urinary catecholamine, salivary cortisol.
 measurements obtained before and after
treatment showed significant improvements on
most of the variables in both groups as well as
medium-to-high effect sizes.

Conclusion:-
 However, no significant difference was found
between the 2 programs. The results indicate
that both cognitive behaviour therapy and
yoga are promising stress management
techniques.

Thank You