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STRESS AND COPING

NAIMODU EVANS LEPISH

INTRODUCTION

• Stress is a state of severe physiological and psychological response to harmful or potentially harmful circumstances.
• It is a state of severe physiological and psychological tension or It can be also defined as a non-specific response of the body to any demand.
• A stressor is a stimulus which causes stress e.g. bereavement, divorce, new job, marriage or a critical event such as robbery or the demand in life
• One’s responses to stress are influenced by: personality (our strength), the burden/type of stressor, subjective interpretation of the stressors.

Responses to Stress

• Stressors and to some extent stress are normal and at times are necessary for one to achieve certain goals in life. It becomes abnormal if they produce signs and symptoms that become the problem.
• Individuals can be helped to cope with or minimize life stressors and still lead a relatively normal lives with health education and support systems.

Physiological Responses

• The body prepares itself either to fight or for flight.
• All the body’s reactions to stress affect health.
• Prolonged stress may cause high BP, ulcers, heart diseases, autoimmune disorders such as rheumatoid arthritis & allergies

STRESS IN PATIENTS

Admission to hospital Operations Prolonged duration of treatment Sharing a ward with strangers Use of bedpans Injections and Being done tests/investigations.

SIGNS AND SYMPTOMS OF STRESS

 On the body

• Headache
• Muscle tension or pain
• Chest pain
• Fatigue
• Change in sex drive
• Stomach upset
• Sleep problems

SIGNS AND SYMPTOMS

On behaviour

• Overeating or under eating
• Anger outbursts
• Drug or alcohol abuse
• Tobacco use
• Social withdrawal

Stress Coping Mechanisms

 Confronting the stressor  Avoiding situations that may cause stress  Change your stressors e.g. take a break, switch job  Maintain a reasonable work and personal schedule  Engage in a Physical activity  Meditation, relaxation techniques e.g. slow music  Discussing situations with a spouse / close friend/priest or Praying/going to church  Taking a bath or shower  Laughing or crying  Seeking counseling.

Degrees of Anxiety

Mild anxiety

• Motivates the person to be more physically and mentally alert. Panic states
• Very high levels of anxiety that incapacitate an individual.

CONFLICT AND ADJUSTMENT

 Frustration:

• Is the blocking of a motive by some kind of obstacle. An obstacle could be like a traffic jam, personal shortcoming, conflicting motives or conflicts.
• The frustrated individual becomes intolerant and physically aggressive, more prone to misunderstanding while others are more likely to speak hurtful words.

 Conflict

• Is the simultaneous arousal of more incompatible motives, resulting in unpleasant emotions, such as anxiety or anger. It’s a pair of goals that cannot be attained.

TYPES OF CONFLICT

 Avoidance-avoidance conflict

• Both alternatives are unpleasant and yet one has to choose either. E.g. a patient has an abdominal tumour, which causes unbearable pain and discomfort.
• Alternatively, surgery, which has very little success rate is the only available remedy, yet the patient needs to be relieved of the pain. It becomes naturally difficult for the patient to choose either of these two.
• A woman trying to choose between an unwanted pregnancy and getting an abortion done. She may morally be opposed to abortion.

TYPES OF CONFLICT

 Approach-avoidance conflict

• Occurs when fulfilling a motive which will have both pleasant and unpleasant consequences. E.g. a young male doctor is torn between getting married or not. Being married is attractive and socially fulfilling, but it also means added responsibilities and restrictions.

COPING STRATEGIES

 EMOTION FOCUSED

• These are used when the problem is uncontrollable. They are two types: A) Behavioural strategies Exercising Using alcohol or other drugs Venting anger Seeking emotional support from friends

COPING STRATEGIES

b) Cognitive strategies:

Temporarily setting aside thoughts about the problem Changing the meaning of the situation Reappraising the situation

Other coping strategies:

Isolating oneself Avoiding Thinking about how badly one feels Worrying Repetitively thinking about how bad things are Engaging in a pleasant activity like going to parties