Dr. Ramez N. Bedwani. Life is not going smooth all the time. we are subjected most of the time to...

STRESS Dr. Ramez N. Bedwani

Life is not going smooth all the time. we are subjected most of the time to

different kinds of pressureضغط and stressful situationsمواقف.

We normally cope / نتأقلم: with stress byنتكيف

physiological And psychological ways.

Outcome

Definition Examples Severity (Major / Minor) General Adaptation Syndrome GAS( متالزمة

العامة (التأقلم Coping with stress ( الضغوط مع ( التكيف(healthy C./ unhealthy C.) Failure of coping mechanisms Psychosomatic disorders

DEFINITIONS*• Stress (الضغط) : it is The response ( فعل / رد of the body to an (إستجابة

unpleasant ( مستحب (غيرمرغوب) unwelcomed ( غيرstimulus (مثير)

• Stressors (الضواغط): The environmental, physical or social situations

the (تثير) which elicit (األحداث) or events ,((المواقفstress responses of the body.

(Challenging our capacity of adaptation) على مقدرتنا تتحدىالتأقلم

EXAMPLES• Changes in one’s life ( المرحلية : التغيرات

/ اإلنجاب/ / الزواج الدراسة شهادات (كالبلوغ• Injury (اإلصابات)• Infection (العدوى)• Exercise ( العضلى (المجهود• Noise(الضوضاء) • Climate (الطقس)• job loss or promotion ( الوظيفة فقدان أو (الترقية• Social / family troubles ( العائلية و اإلجتماعية (اإلضطرابات

( death of a member, Divorce, major illness etc.)• Natural disasters ( الطبيعية ( الكوارث

SEVERITY

• stresses :• could be major or minor & the response is usually

appropriate to the severity

• factors affecting response to stress : Personality characteristics الشخصية مقومات Hereditary factors وراثية عوامل Early childhood experience الطفولة خبرات Preparatory information ( إعداد (معلومات

a minor environmental event may have massive effect according to the psychological meaning for a sensitive individual (حساس)

e.g: an anxious (قلق)adolescent who becomes disorganized ( يتشتت upon leaving his family to(تفكيرهcollege(المغتربين) .

General adaptation syndrome(GAS*)

GAS : the stages of normal body response to stressors

• This syndrome has three stages: “A.R.E”a- The Alarm reaction (اإلنتباه): which is the emergency (الطارئة)response of the

body due to Sympathetic Nervous system stimulation

b- The stage of Resistance (المقاومة) : Characterized (تتميز)by hormonal response andFunctional recovery to pre stress stage due toACTH (adreno corticotrophic hormone) , cortisol from

Adrenal cortex الكظرية – الكلوية جار Endorphins & ( الغدة( الجسم و بالمخ الطبيعية (األفيونات

c- The stage of exhaustion ( اإلستنفاذ و :(اإلرهاق During which the body’s ability to respond to stressors

breaks down (إنهيار) .

stress summary ضغط Alarm: توتر و إنتباه

بيعد اللى السيمباثاوى العصبى للجهاز تحفيز والتصرف و للتحرك Actionالجسم

لزيادة) : تؤدى الحلول التكيف و التأقلم طرق) لشخصيتى أكتر نضج و نمو و الخبرة

Resistance المقاومة : مرحلةاألفيونات المسكنات و الكورتيزون هرمونات

جسمنا فى اللى الطبيعيةExhaustion المقاومة :إنهيار

Chronic stress / الخلفة / الجواز مستنىالهجرة / أتغنى

السلوكية اإلضطرابات و النفسجسمية األمراض) إلدمانات) تصل

I- Normal healthy coping:individuals differ in their ability and ways to cope with stress,using normal devices to cope with stressors.So healthy (األصحاء)individuals (األفراد)may resolve the crisis

) growth promoting(تأقلم) in an adaptive(األزمات) النمو (تحفزway by :(F.P.N.S)

(a) Facing reality ( الواقع seeing reality in a balanced way (مواجهة(pros and cons) and respecting (إحترام ) its demands ) by doing effort(متطلباته) الجهد (بذل

(b) Problem solving attitude ( المشاكل حل (إتجاه(c ) New ways of adaptation to overcome obstaclesالتعلم ( ) للتأقلم طرق إستحداث(d) Social support :

Coping with stress*

(d) Social support : (continued)we need external support ( مساندة و from the( دعم

surrounding members of the family or society. Such support is increased in stressful situations and is very

helpful.examples: visiting sick people the habits (عادات)and ritual (تقاليد)of funeral (الجنازة) ,

where relatives (األقارب) gather (يجتمعوا) together to help overcome(التغلب) the loss.

II. Unhealthy coping : aiding for(مساعدة)

improvement(للتحسن) if A person is intolerable to

most stresses whatever minor. Encourage ( شجعه) him to try

certain techniques that could help him to relax then train (تدربه) him to become more capable ( أكثر to manage stress (مقدرةsituations using healthy coping

Techniques aiding people with unhealthy coping to relax الواعى : الهدؤ

(Meditation/ Relaxation T/ Biofeedback/ systematic desensitization / Hypnosis)

1- meditation (التأمل)through praying , meditation . Relax the mind, by

special attention to and repeating religious words.

2-Relaxation training ( اإلسترخاء (تمارين+ Music, yoga, …..

3- Biofeedback: ( الحيوية للعالمات التغذية (إعادة -a procedure is learnt to modify internal responses such

as heart rate and body temperature ( also used in Lie detector)

-Involuntary physiological responses could be brought under voluntary control through conditioning (شرطى )

4- Systematic desensitization ( منتظمة و متدرجة بطريقة للمخاوف (إزالةإلحساسية Gradual exposure to fearful stimuli

5-Hypnosis: (التنويم) - In this device deep trance state in which one is very

suggestible ( اإليحاء (سهل

- Now, it is believed that it is better to modify the behavior while individuals are in the normal state of consciousness, to achieve more lasting results.

Failureإنهيار of coping *mechanismsالتكيف

Cognitive معرفيةand Emotional عاطفية:Irritability

Indecisiveness,(اإلرتياب)suspiciousness,(توتر)(decide, تردد قرار، إتخاذ على القدرة (عدم

Decreased concentration ( التركيز فى , (صعوبةimpaired memory الذاكرة إضطراب

Behavioral سلوكية:Overeatingالشراهة , sleep disturbance,

النوم المكيفاتdrugs ,التدخينsmoking) إضطراب, sexالجنس) Physical جسدية:Headache, Migraine, نصفى أسفل Backpain صداع آالم

هضم body aches, indigestion ,الظهر ,عسرtremors أألطراف ,رعشة

Psychosomatic disorders*( نفسجسمية إضطرابات أو (أمراض

• These are true body lesions ( حقيقية that result (إصاباتfrom emotional hyperactivity or accumulating تراكمstress, (to produce pathological مرضية changes in a specificتغيراتorgan) محددة أعضاء فى

especially:• Gastrointestinal الهضمى peptic ulcer :الجهاز المعدة قرحة• cardiovascular الدورى ضغط hypertension :الجهاز إرتفاع

coronary artery disease ,الدم التاجى الشريان أمراض• respiratory systems التنفسى حساسية )Asthma :الجهاز

(الصدر• skin الجلد: alopecia areata ((الثعلبة