Stress, Illness and Coping

Stress is a condition or feeling experienced when a person perceives that "demands exceed the personal and social resources the individual is able to mobilize.”

“Imbalance between demands and resources” or as occurring when "pressure exceeds one's perceived ability to cope."

Stress:

• It is what we feel when we think we've lost control of events.
• Experiencing events that we perceive as endangering to our physical and psychological wellbeing.

Stress is a fact of life (Normal stress), but being stressed out (Abnormal stress) is not.

Some important terms

• Stressor: Any event that leads to stress
• Stress Response: These are reactions of people to stressful events

Stress reactions may be:

• Adaptive: When you can flee or fight off the stressor
• Maladaptive: When the stressor is chronic or uncontrollable

Why we may be stressed

• We are constantly pressured to accomplish more and more in less and less time.
• When we face major or severe stressful events, e.g., Death of a loved one or Natural disaster (when there is a loss).
• The type of personality we have, e.g., when we interpret an event as threatening even if it is trivial, when our resources to cope become inadequate, when there is an imbalance between our expectation and what we are experiencing.

When we are at risk of becoming stressed

• When we are tired or sick.
• When driving through crowded traffic.
• When we are late for an important meeting.
• Or if we have taken on too many responsibilities.
• When circumstances are out of our control.
• When our basic needs are not being met and our safety is threatened, we tend to get anxious.
• At periods of transitions in life, e.g., leaving school, aging, getting married, last child leaving home (empty nest syndrome), etc.
• At periods of isolation or loneliness.

• Countless events create stress.
• Stress may be acute or persistent.
• Affect many people at a time, e.g., wars, natural disasters.
• Sometimes personal, especially those producing major changes in an individual's life, e.g., changing job, getting married, suffering an illness, etc.
• Everyday hassles may be experienced as stress.
• Stress may be in the form of conflicting motives or desires, i.e., Internal conflict.
• Sources of stress may be internal or external.

Good or Bad events could create stress.

1. General adaptation reaction is the initial reaction. It allows fight or flight response. It is controlled by autonomic nervous system.
2. Resistance stage - takes longer
3. Exertion stage

There are physiological responses to stress:

• Increased BMR
• Increased blood pressure
• Tachycardia
• Tensed muscles
• Pupillary dilation
• Hormones and chemicals such as ACTH, epinephrine are released
• Release of sugar from the liver

1. Physical disorders:

   Hypertension, ulcers, impairment of immune system, disturbance of sleep, increased consumption of fat and carbohydrate diet.

   Health-related behaviors such as smoking, alcohol, and these lead to compromised organs.

   May lead to a sedentary lifestyle.

2. Psychological:

   Anxiety, worry, anger, depression, cognitive impairment, deliberate self-harm, suicide, alcohol and drug abuse.

   Sexual dysfunction which can be damaging to relationships.

3. Social:

   Strain of interpersonal relationship, separation or divorce, educational underachievement.

   Can affect occupation - loss of job or underachievement.

   Can cause a decrease in the quality of life and increase the risk of violence.

   There is also an increased risk of death.

Mediators of stress response

• Psychoanalytic: getting anxious
• Behavioral
• Cognitive: learning to be helpless
• Type of personality

Consequences of stress

• Early death can occur through active or passive suicide.
• Initiate illness.
• Aggravate illness.
• Prolong illness.
• Delay recovery.

1. Communication with other people
   • Loosing temper easily
2. Sleep pattern
   • Sleeping less or sleeping more
3. Eating habits
   • Too little or too much
4. Worrying a lot
5. Biological changes

Coping - the process by which a person attempts to manage stressful demands.

Can be:

• Conscious efforts
• Unconscious efforts

Conscious efforts

Problem-focused coping - try to change or avoid the problem.

Emotion-focused coping - used to handle stressful events that cannot be changed/altered.

Problem-focused coping

1. Define the problem
2. Provide alternative possible solutions
3. Pick one of the solutions and try to implement it.

Check level of aspiration and alternative sources of gratification and if there’s a need to learn a new skill/knowledge, do so.

Factors that determine success when using problem-focused coping:

• How skillful are you
• Range of personal experience
• Capacity for self-control

Emotion-focused coping

1. Using emotions to deal with problems
2. Behavioral strategies - physical exercises, meditation, relaxation
3. Cognitive - reducing the threat, challenge negative thoughts that follow the events.

Unconscious methods

Sigmund Freud described defense mechanisms which are basically unconscious.

Mental defense mechanisms are strategies put in place to reduce anxiety, emotions generated by stress. They help the person to change their way of perceiving or thinking about the situation.

Mental defense mechanism becomes maladaptive when it is the predominant way of coping with stress.

Examples include denial, regression, repression, rationalization, etc.

Principle is to use multiple methods - Psychological, biological, physical.

How to avoid unnecessary stress

• Learn how to say no
• Avoid things/people that stress you
• Try to take control of your environment
• Avoid hot topics
• Try to cut down on your to-do list

How to alter stressful situations

• Learn to communicate, learn to express your feelings
• Be willing to compromise
• Learn to be more assertive
• Manage/distribute your time well

How to change your reaction to stressful events

• Adaptation
• Define what the problem is
• Take a positive standpoint
• Adjust your standard
• Learn to accept things you cannot change
• Do not try to control what you cannot
• Look for the advantage in a situation
• Learn from your own mistakes
• Share your feelings with a trusted friend
• Make time for fun and relaxation
• Learn to forgive

How to relax

1. Sit comfortably on a chair with armrest
   • Close your eyes
   • Breathe in through your nose
   • Hold the breath
   • Breathe out through your mouth
   • Say ‘relax’

Make time for relaxation by doing the following:

• Going for a walk
• Spend time in nature
• Call a good friend
• Physical exercise
• Play with a pet
• Read a good book
• Listen to music
• Watch a comedy
• Eat a healthy diet
• Decrease caffeine and sugar in food
• Avoid alcohol, cigarette, drugs
• Try to get enough sleep

Unhealthy ways to handle stress

• Eating too much/too little
• Using drugs
• Procrastination
• Do not smoke/use alcohol
• Do not take out your stress on other people

Inner attitudes that can harm you

• Anger
• Pride
• Jealousy
• Fear of people