DR.PRASANNA KHATAWKAR M.B.B.S., D.P.M., F.A.G.E., D.N.B (Psychiatry)

Consultant Psychiatrist

SolapurMobile No. 932 681 30 48

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The concept of Stress entered psychological & medical vocabularies from engineering with Hans Selye's work in 1950's

Stress is an environmental pressure, strain is its effect on something or someone

“Stress is the nonspecific response of the body to any demand made upon it” — Hans Selye, MD

Stress is a fact of life, a universal condition, and therefore unavoidable

If we cannot eliminate stress, how can we come to terms with it?

No stress: promotes Stagnation — no challenge, no spur to action, no adaptation

Prostress (or “eustress”): promotes Growth — pleasant, challenging exciting conditions that offer fulfillment and arousal without the harmful consequences of negative stress.

Distress: Negatively perceived event or trigger that promotes upset, suffering, illness — at the extreme it can lead to psychosis, even death

Stress runs along a continuum from None to Total — neither extreme is healthy

Stagnation Growth Death

1. Outpouring of adrenaline and other hormones2. "Fight or flight" response3. Impacts health by modulating rate of cellular aging4. Increase in heart rate & blood pressure5. Faster breathing6. Muscle tension7. Increased alertness and sensory sensitivity8. Increased blood flow to brain, heart and muscles9. Decreased blood flow to skin, digestive tract, kidneys and liver10. Increase in blood sugar, fats and cholesterol

The Distress Reaction

Physical:◦ Fatigue, headaches, insomnia, muscle aches/stiffness, heart

palpitations, chest pains, abdominal cramps, nausea, trembling, flushing, sweating, frequent colds

MeNtal:◦ Decreased concentration and memory, indecisiveness, racing

thoughts, confusion, loss of humor eMotioNal:◦ Anger (short temper, irritability, impatience), Anxiety (nervousness,

worry, fear), Sadness (grief, anguish, depression) Behavioral:◦ Pacing, fidgeting, nervous habits, increased eating, smoking, drinking

or drug abuse, crying, yelling, swearing, throwing things

Symptoms of Distress

exterNal:◦ Physical Environment: noise, heat, bright lights, traffic◦ Social: rudeness, bossiness, aggression◦ Organizational: rules/regulations, red tape, deadlines, dysfunction◦ Major life events: births, deaths, weddings, job loss, promotion◦ Daily hassles: commuting, mechanical breakdowns, misplaced keys

iNterNal:◦ Lifestyle choices: caffeine, lack of sleep, overloaded schedule◦ Negative self-talk: pessimistic thinking, self-criticism, over-analyzing◦ Mind traps: unrealistic expectations, black-or-white thinking, over-

personalizing, rigid standards◦ Personality traits: perfectionism, workaholism, people-pleaser, “Type

A”

Sources of Distress

PANIC DISORDERPHOBIAS

FEARFULNESS BREATHING DIFFICULTY RACING HEART SWEATING TREMLOUSNESS FEAR THAT SOMETHING MAY GO WRONG ABDOMINAL DISCOMFORT ----------MANY MANY MORE

FAMILIAL PROBLEM WORK RELATED STRESS WORRIES OF VARIOUS THINGS PERFORMANCE ANXIETY COMORBID ILLNESS --OR-----

WITHOUT ANY REASON!!!

ITZ ALL IN YOUR MIND!!!

ANY PROBLEM IS AS BIG AS THE IMPORTANCE

U ATTACH TO IT

U CAN

LEARN TO CONTROL YOUR MIND

WRITE DOWN - ALL SITUATIONS / REASONS WHICH PRODUCE ANXIETY - YOUR OWN GOALS ACKNOWLEDGE IDENTIFY YOUR RESOURCESPLAN YOUR STRATEGYREALISTIC APPROACHGOAL DIRECTED EFFORTS

1. Decrease or discontinue caffeine2. Regular exercise3. Relaxation/Meditation4. Sufficient Sleep5. Time-outs and Leisure (pacing & work/leisure balance)6. Realistic expectations7. Reframing/Reinterpreting stressful situations8. Belief/Value systems9. Ventilation/Support system10. Humor11. Balanced diet

Lifestyle Changes

Breathing Exercises Meditation Guided Imagery Visualizations Self-hypnosis Progressive Muscle Relaxation Music Yoga

1. Time and money management2. Practicing healthy assertiveness in social

relationships3. Creative Problem-solving4. Consider leaving a job or relationship that

has become unsustainable or destructive

Situational Changes

1. See problems as opportunities2. Refute negative thoughts3. Focus on the positives4. Take the long-term view

Cognitive Changes

Avoiding ‘burnouts’ Introspection Only work till you enjoy it Avoid comparisons Knowing ones own limitations Avoid getting carried away Whom are you trying to satisfy ?! Understand that you and everybody around are

going to have your share of success and failure.

The other students around are there only for short duration, so don’t worry much about them

Your competition is not with your classmates , but with thousands of students appearing for the exam from many institutions around

Having good students in the class is in-fact beneficial

Aim at improving your own earlier performance Study throughout the year, not only during exam

period

Make realistic time-tables Don’t loose the steam after performing well in

preparatory exam Adjust sleep-wake schedule as per your exam paper

timings REMEMBER – THERE IS NO ALTERNATIVE TO

STUDING HARD !!

JPMR CYCLIC RELAXATION VISUAL IMAGERY SELF – SUGGESTIONS SELF MOTIVATING SENTENCES COMBINING ABOVE WITH TRUE PRAYERS

THERE ARE MANY OTHER TECHNIQUES ALSO MUSIC , PAINTING, DANCE ETC.

EFFECTIVE MEDICINES ARE AVAILABLE NEEDED FOR ONLY A SHORT DURATION

JPMR

FOR NEXT FEW MINUTES - STOP ASKING QUESTIONS

- JUST OBEY COMMANDS - TELL YOURSELF ‘NOT

NOW, LATER!!!’

CYCLIC CYCLIC

RELAXATIONRELAXATION

VISUAL VISUAL IMAGERYIMAGERY

SELF – SUGGESTIONSSELF – SUGGESTIONS

SELF MOTIVATINGSELF MOTIVATING

SENTENCESSENTENCES

COMBINING ABOVE COMBINING ABOVE

WITH TRUE PRAYERSWITH TRUE PRAYERS

5 TO 7 MINUTES DAILY FOR JPMR 5 TO 7 MINUTES DAILY FOR PRAYERS AND

GUIDED IMAGERY 5 TO 7 MINUTES FOR PLANNING YOUR DAY AFTER

DOING ABOVE THINGS

BELIEF

A FAIRLY GOOD CHANCE THAT YOU

MAY SUCCED!!!!

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