Stress Management

Stress: What is the definition of stress?

The non-specific response of the body to any demand placed upon it.

Stress: What types of stress exist?

Physical stress and psychological stress.

What is eustress?

Moderate or normal psychological stress interpreted as beneficial for the experiencer.

Example of eustress?

Strength training workout that feels exciting.

What is distress?

An aversive state in which a person shows maladaptive behaviors.

Example of distress?

Death of a family member or unemployment.

What is moral distress?

Tension when a moral agent is unsure of the best action or is blocked from doing what is known to be right.

How does the body react to stress?

Through activation of the sympathetic nervous system.

Physiological stress response: What increases?

Heart rate, blood pressure, blood glucose, respiratory rate, muscle tension, blood clotting.

Physiological stress response: What decreases?

Digestive processes.

Long-term stress: What happens to the brain?

It can change brain plasticity and lead to maladaptive circuitry.

Which brain areas are affected by long-term stress?

Hippocampus, HPA axis, prefrontal cortex.

What can chronic stress cause in the brain?

Dendritic shrinkage and brain atrophy.

What makes a healthy brain resilient?

Adaptive neural circuitry.

What makes an unhealthy brain maladaptive?

Altered or dysfunctional plasticity due to chronic stress.

Assessment of stress: What is external stress?

Life events perceived as stressful.

Assessment of stress: What is internal stress?

The individual's reaction to stress.

Burnout: What is the ICD-11 definition?

A syndrome resulting from chronic workplace stress not successfully managed.

Burnout: What are the three dimensions?

Energy depletion/exhaustion; mental distance/cynicism; reduced professional efficacy.

Burnout: What context does it apply to?

Occupational context only.

What are the 12 stages of burnout?

Compulsion to prove oneself; working harder; neglecting needs; displacement of conflicts; revision of values; denial of problems; withdrawal; behavioral changes; depersonalization; inner emptiness; depression; burnout syndrome.

Stress management: What is the core principle?

Managing your reaction to stress rather than eliminating stressors.

Why is stress management empowering?

It gives individuals a sense of control.

OT stress management: What must interventions be?

Client-centered.

OT stress management: What should be identified?

How the individual reacts to stressors and which occupations are meaningful.

Healthcare worker stress management: What strategies help?

Employee involvement, addressing work stressors, EAP programs, flexible scheduling.

How does sleep affect stress?

Poor sleep increases distress.

What percentage of adults get less than 7 hours of sleep?

40%.

What fraction of Americans take sleep aids?

One quarter.

Exercise and sleep: What does vigorous exercise before bedtime do?

Increases alertness.

Exercise timing for insomnia?

Morning workouts.

Gentle exercises that promote relaxation?

Yoga and Tai Chi.

Other sleep hygiene strategies?

Warm baths, avoiding heavy meals, reducing light and noise.

Self-management vs skilled intervention: What is the difference?

Self-management is independent coping; skilled intervention requires OT expertise.

Self-management: Why offer multiple options?

To improve patient adherence.

What is positive self-talk?

A CBT technique where individuals give themselves positive messages.

Examples of cognitive distortions?

All-or-nothing thinking and expecting the worst.

What is the relaxation response?

A physiological state elicited through biofeedback or transcendental meditation.

What is PMR (Progressive Muscle Relaxation)?

Tightening and releasing muscle groups to achieve automatic relaxation.

Where should PMR begin?

At the head due to greater upper-body tension (or at the feet).

What is autogenic training?

A self-hypnosis relaxation technique using the mind to calm the body.

Autogenic training: What does it reduce?

Heart rate.

Breathing exercises: Why are they widely accepted?

They reduce heart rate and blood pressure and have no contraindications.

Basic issues underlying stress response: What is control?

Achieving a sense of self-efficacy.

Basic issues underlying stress response: What are expectations?

Establishing neutral or positive expectations.

Basic issues underlying stress response: What is ANS balance?

Achieving the relaxation response.

Why is self-stress management sometimes insufficient?

People with psychological or chronic conditions may need skilled intervention.

OT referrals for stress management?

Mental health professionals and exercise programs.

Chronic disease: How is it linked to stress?

Stress contributes to cardiovascular diseases including hypertension.

Which populations are most affected by stress-related chronic disease?

Marginalized groups.

Consequences of chronic stress-related disease?

CVAs, MIs, CHF, PVD, premature death.

OT role in medication management?

Establishing routines and facilitating home BP monitoring.

OT role in physical activity?

Home exercise programs, walking programs, Sit & Be Fit.

Depression: What is the lifetime prevalence?

13%.

Depression: What is the #1 cause of YLD?

Depression.

Depression increases risk of what conditions?

Physical disability, CAD, DM, all-cause mortality.

Economic cost of depression in the US?

$83 billion.

Screening question 1 for depression?

“Over the past 2 weeks, have you felt down, depressed, or hopeless?”

Screening question 2 for depression?

“Over the past 2 weeks, have you felt little interest or pleasure in doing things?”

What does a positive answer to either depression question indicate?

Further assessment is needed.

Effective depression interventions?

Psychotherapy, antidepressants, physical activity, self-guided CBT.

OT occupation-based interventions for stress?

Leisure exploration, sensory modulation, activity scheduling, mindfulness-based ADLs, environmental modification, time management coaching, values-based goal setting.

Life balance reflection: What should be considered?

Routines, habits, boundaries, and needed changes.

Stress management reflection: What strategies do you use and share with others?

Personal coping techniques and supportive strategies for family, friends, classmates.