STRESS AND ITS MANAGEMENT

INTRODUCTION:
The word stress is derived from the Latin word, “string” which means “to be drawn tight”.
Stress is a feeling of emotional or physical tension. It can come from any event or thought that
makes you feel frustrated, angry, or nervous.
Stress is a common problem that affects all of us at some point in our lives .Learning to identify
when you are under stress, what is stressing you and different ways of coping with stress can
greatly improve both your mental & physical well being.

DEFINITION:
 In medical term stress is defined as a, “physical or psychological stimulus that can
produce mental tension or physiological reactions that may lead to illness”.
 Acc. To Richard S. Lazarus – “Stress is a feeling experienced when a person thinks that
the demand exceed personal & social resources, the individuals is able to mobilize”.

STRESSOR:
A stressor is a chemical or biological agent, environmental condition, external stimulus or an
event that causes stress to an organism. Psychologically speaking, a stressor can be events or
environments that an individual would consider demanding, challenging, and or threaten the
individual's safety.
An event that triggers the stress response may include:

 environmental stressors (hypo or hyper-thermic temperatures, elevated sound

levels, over-illumination, overcrowding)
 daily stress events (e.g., traffic, lost keys, money, quality and quantity of physical
activity)
 life changes (e.g., divorce, bereavement)
 workplace stressors (e.g., high job demand vs. low job control, repeated or sustained
exertions, forceful exertions, extreme postures, office clutter
 chemical stressors (e.g., tobacco, alcohol, drugs.
 social stressor (e.g., societal and family demands

CAUSES OF STRESS:
There are mainly two types of stressors:
1. External
2. Internal
1. EXTERNAL STRESSORS
External stressors include followings:
 Physical environment
 Social interaction
 Organizational
 Major life event
 Daily hassles

a. Physical Environment
 Change in climate or weather
 Pollution
 Noise
 Due to any chemical substance

b. Social Interaction
 Rudeness
 Bossiness
 Aggressiveness by others
 Bullying
 Change in economic condition

c. Organizational
 Rules
 Regulation
 Dead lines

d. Major Life Events

 Birth
 Death
 Lost job
 Promotion
 Marital status change

2. INTERNAL STRESSORS:
 Life – style choices (lack of sleep, over loaded schedule)
 Negative self talk
 Mind traps
 Personality traits
TYPES OF STRESS:
There are main four types of stress:
1. Eustress ( Positive stress )
2. Distress ( Negative stress )
3. Hyper stress
4. Hypo stress

1. Eustress (Positive stress):

This stress is of helpful type of stress. Eustress can be experienced before you use the
physical forces. Eustress provides the inspiration to the person when some extra energy or
creativity is needed by him. The strength that comes from eustress can be felt by the player
before playing a big game or entering a big competition.
Stress can also have a positive, effect spurring motivation & awareness providing the
stimulation to cope with challenging situation. Stress also provides the sense of urgency
&alertness needed for survival when confronting threatening situation.
This type of stress prepares the body of person to fight with the any kind of trouble.
2. Distress (Negative stress):
This stress is not a helpful one. When the daily routine is changed & adjusted the mind &
body feels the distress. The minds don’t feel comfortable with this type of stress. This stress
creates lots of mental problems in a person.
It is a contributory factor in major conditions such as headaches, digestives problems,
skin complaints, insomnia & ulcers.
Excessive, prolonged & unrelieved stress can have a harmful effect on mental, physical &
spiritual health. Distress can be divided into two type of stress:
1. Acute stress
2. Chronic stress

 Acute stress

Acute stress is usually for short time & may be due to work pressure, meeting deadline
pressure, minor accidents or increased physical activity.
Symptoms: Headache, backache, rapid heart rate, body pain & migraines.
 Chronic stress:

Chronic stress is most serious of all type of stress. Chronic stress is a prolonged stress
that exists for weeks, months or even years. This stress is due to poverty, broken or stressed
families, chronic illness & successive failure in life. It is very harmful to their health.
Symptoms: Body feels something not favorable then it tries to defend itself in a situation.
3. Hyperstress :
Hyper stress is created when a person is pushed away from the task which he or she can
handle. It can be a result of over load or over work; even little things can activate a strong
emotional response. A trader in street can experience hyper stress.
4. Hypostress :
Hypo stress is just opposite to hyper stress. This stress is created when a person feels
boring or unchanging the people who are impatient and dull experience. This stresses the person
working in a factory performing repetitive task to through hypo stress.

SYMPTOMS OF STRESS:
There are mainly four types of symptoms of stress:
1. Physiological symptoms
2. Mental symptoms
3. Behavioral symptoms
4. Emotional symptoms

1. Physiological symptoms:
 Sleep pattern changes
 Fatigue
 Digestion changes
 Headache
 Aches & pains
 Infection
 Dizziness
 Fainting, increase cardiac output
 Sweating & trembling
 Pupils dilated
 Tingling of hands & feet’s
 Breathlessness
 Palpitation
 Increase blood pressure

2. Mental symptoms :
 Lack of concentration
 Memory lapses
 Difficulty in making decision
  Confusion
 Disorientation
 Panic attack
3. Behavioral symptoms:
 Appetite change : too much or too little
 Eating disorder : anorexia or bulimia
 Increase intake of alcohol & drugs
 Increased smoking
 Restlessness
 Nail biting
4. Emotional symptoms
 Irritability
 Depression
 Anger
 Fear
 Feeling overwhelmed
 Mood swings.

STRESS MANAGEMENT TECHNIQUES

Mainly three types of stress management technique.

 Change your behavior

 Change your thinking
 Change your lifestyle

Change your behavior

1) Be Assertive:
Assertiveness helps to manage stressful situations, and will , in time, help to reduce their
frequency. Lack of assertiveness often shows low self - esteem and low self - confidence.

2) 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.
 3) Humor:
 Good stress - reducer
 Applies at home and work
 Relieves muscular tension
 Improves breathing

4) 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 Thinking

1. 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.
2. Positive Thinking
3. Forget powerlessness and failure
4. Stress leaves us vulnerable to negative suggestion so focus on positives;
5. Focus on your strengths
6. Learn from the stress you are under
7. Look for opportunities
8. Seek out the positive - make a change

Change Your Lifestyle

1. Diet:

 Healthy eating habits

 Caffeine (Stimulant)
 Salt

2.Smoking and Alcohol:

 Moderate your consumption

3.Benefits of 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

4.Sleep:

 Good stress reducer

 Difficult to cope when tired
 Wake refreshed after night’s sleep
 Plenty of daytime energy

STRESS MANAGEMENT

Most stress reduction techniques have their greatest utility as elements of prevention for
that remember 5 R for reduction of stress programme.

- Recognization of causes& sources of stress.

- Relationship identified for support, help.
- Removal from the threat stressor.
- Relaxation through techniques such as meditation, massage ect.
- Re engagement through managed re-exposure and desensitization.

NON PHARMACOLOGICAL MANAGEMENT

Alternatives Conventional

 Counseling & psychotherapy

 Relaxation
 Meditation
 Massage
 Yoga
 Acupuncture
 Aromatherapy
 Floatation
 Herbalism
 Biofeedback
 Homeopathy
  Hypnotherapy
 Osteopathy
 Pet Therapy
 Reflexology

PHARMACOLOGICAL MANAGEMENT OF STRESS

When patients will have prominent distress referable to the cardiovascular,

gastrointestinal or other organ system that time pharmacological management needed.

In many health care settings and rural areas where non pharmacological options for the
treatment of stress may not be available that time pharmacotherapy may be appropriate option.

1.Benzodiazepines (Diazepam) :

It is anti anxiolytic drugs & most commonly used for stress & anxiety management. And it is the
most widely prescribed drugs in the world. Diazepam is the proto type of the longer half-life,
accumulating benzodiazepines.

Alprazolam &lorazepam both are short to inter mediate acting drugs & to achieve a sustained
effect daily usually doses needed.

2.Barbiturates :

Barbiturates such as amobarbital, Phenobarbital not used for reducing stress but they are at least
expensive antianxiety agent. There has been some increase in their use in states controlling &
regulating benzodiazepine use.

3.Antipsychotic agent :

Antipsychotic agents prescribed for treatment of stress & anxiety in non-psychotic patients.
Their major use in the states of acute psychotic terror, but they may be helpful in certain anxious
bahaviour. This medication is prescribed to those patient whose stress and anxiety level
increased up to last stage.

4.Antihistamines :

Antihistamines are still prescribed by some physician. Some antihistamines have weak &non
specific CNS effects most of not also anti cholinergic effects. EX: Hydroxyzine most commonly
used drugs within this group. It helps in decrease the anxiety levels.

5.Anti depression :

Anti depression medication such as Imipramine may be beneficial for blocking panic attack due
to depression. It helps to reduce depression level by taking regular dosage of medication.
 CONCLUSION:-
Stress is a part of life. Everyone feels stress at one time or another. Nurses are in a key position
to assess stress in patients and families to assist them to identify high risk periods for stress and
to implement stress management strategies that can prevent the negative consequences of stress
on their health. The nurse can assume a primary role in implementing stress management
strategies. In our own country , “ life in the fast lane ” , a continuous drive for advancement ,
competitiveness and the search for “ the good life ” have created a stress epidemic that has
individuals , corporations and health professionals searching for ways to calm the collective
masses.
 BIBLIOGRAPHY

1. K.P. Neerja (2005), Essentials of mental health and psychiatry nursing (2nd edition) ,
Kumar Publishing House.

2. Townsend Mary C. (2012), Concepts of care in evidenced based practice, (8th

Edition) , Published by F. H. Davis.

3. R Sreevani (2015), A guide to mental health and psychiatry nursing,(3rd edition)

New delhi, Jaypee.

4. Basavanthappa B. T. (2005) Basic concepts of psychiatric mental health nursing

( 2nd edition) Med Res.

5. Kaplan HI, Sadock BJ. (1998) Synopsis of Psychiatry, Behavioral Sciences/ Clinical
Psychiatry (9th edition) Hong Kong: William and Wilkinson Publishers ;1998
 JABALPUR INSTIUTE OF NURSING
SCIENCES AND RESEARCH
SUBJECT ON –NURSING EDUCATION
MICRO-TEACHING ON
STRESS & ITS MANAGEMENT

Submitted To Submitted By
Mrs. SURBHI R.KEHERI miss PREETI SHARMA
Professor M sc (N) 1st year
Jinsar, Jinsar,