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Stress: The difference between Wellness and Illness Stephen Amos, PhD KUSM-W Dept of Pediatrics
 
Definitions ,[object Object],[object Object],[object Object],[object Object]
 
[object Object],[object Object],[object Object],Definitions  (Continued)
The Stress Response ,[object Object]
This response is governed by the Autonomic Nervous System   (rules involuntary body functions) ,[object Object],[object Object],[object Object],[object Object]
Stress begins in the Brain ,[object Object],[object Object],amygdala (crucial early warning system & emotional regulation) hypothalamus (major command center for hormone activation)
 
Inside the Stress Response
Inside the Stress Response ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Another Look  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Positive Side of Stress ,[object Object],[object Object],[object Object]
Yerkes-Dodson Law As stress increases, performance initially rises and then declines. Performance Performance or efficiency Stress or anxiety
[object Object],[object Object],[object Object]
Factors Affecting the Stress Response ,[object Object],[object Object],[object Object]
Distress vs. Eustress ,[object Object],[object Object],EVENT  SCORE Spouse’s death  100 Divorce  73 Marriage separation  65 Jail term  63 Injury or illness  53 Pregnancy  40 Retirement  45 Change in finances  38 EVENT  SCORE Trouble with in-laws  29 Difficulty with boss  23 Shift in job hours or conditions  20 Change in residence  20 Change in recreation  19 Shift in sleep habits  16 Vacation  13 Christmas  12
 
Personality and Stress ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Individual Differences ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Physical Difference between  Anxiety  (Irrational Fear)  and Fear itself. ,[object Object],[object Object],Anxiety Fear Unknown or ill defined threat. Well defined threat.
[object Object],Anxiety vs. Fear
When Stress is Chronic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
When Stress is Chronic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Another way to Assess Stress
Stress and Sleep ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chronic Disease Status ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chronic Disease Status ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How do we participate? ,[object Object],Activating Event (A) Consequent Feeling/Behavior (C) We Believe that Belief system (Personal Perspective) (B) Causes There is a living organism between A-(Activating Event) and C-(Consequent Feeling/Behavior).  This “living organism” is an information processor governed by a complex system of attitudes, beliefs, and expectations concerning how life does and should work.  So it is the perceptual experience of the individual that predetermines psychological (Cognitive/Behavioral) outcomes. REALITY  = To get form A to C, A must go through B.
A BEHAVIORAL COGNITIVE DISPLAY (ABCD’S) A B C D ACTIVATING EVENT: BELIEF SYSTEM CONSEQUENT FEELINGS/BEHAVIORS DECISION POINT (Deal with it/Do it right) (Antecedent i.e. comes before)  Something happens representing some triggering event to an emotional state Personal Perspective: Private ideas and attitudes that occur spontaneously and seem more like automatic thinking Negative Emotional State  (and resultant negative behavioral actions) which tend to lead to self-fulfilling negative personal positions To overcome the negative effects of “B” (Belief System) we must engage in a cognitive/behavioral (thoughtful and active) shift in our personal perspectives. THE FOUR WAYS THINGS GO WRONG: Distorted Thinking Irrational Beliefs Unrealistic Expectations Family Scripting Problem Feedings: Depression Anxiety Panic Anger Resentment Phobias, etc. DEVICES FOR PERSPECTIVE SHIFTING= Meditation and/or visualization, thought stopping, relaxation, Prayer, etc. & BEHAVIORS: Acting out  Avoidance Withdrawal Substance abuse Unfair fighting Verbal abuse, etc. DISTRACT: Do a different physical activity such as gardening, playing an instrument, cleaning house, begin a painting, etc. DIVERT: Do a different mental activity such as listen to tapes, do crossword puzzle, write a poem/song. Etc. DISPUTE/DEBATE: Challenge the “enemy” within i.e. the gremlin/negative self talk by using the scientific method of the friend within (the “baker of your own cake metaphor”).  Remember that the language of the self talk of the friend within is logical, objective, practical, realistic, common sense, beneficial, adult/adult conversation.
Lets Look at Anger 2 X 2 Table of Anger Appropriate Expression Inappropriate Expression Appropriate Anger Inappropriate Anger 100 %
Lets Look at Anger 25 % 25 % 25% 25% 2 X 2 Table of Anger Appropriate Expression Inappropriate Expression Appropriate Anger Inappropriate Anger 100 % Note the Four Cells – Leaving only one cell (25%) appropriate both for anger and expression of anger
But its even more complicated ,[object Object],[object Object]
Four Ways Things Go Wrong ,[object Object],[object Object],[object Object],[object Object]
When these are active, the appropriate expression  of appropriate anger cell is depleted. ? 25% 25% Appropriate Expression Inappropriate Expression Appropriate Anger Inappropriate Anger 100 % ?
So what to do?
Managing Stress ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Managing Stress
Managing Stress  (continued) ,[object Object],[object Object],[object Object]
 
Managing Stress  (continued) ,[object Object],[object Object],[object Object],[object Object]
“ My wife left me for health reasons. She was sick of me.”
Managing Stress  (continued) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Managing Stress  (continued) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
X X X X
Stress over time with Meditation X X X
Managing Stress  (continued) ,[object Object],[object Object],[object Object]
 
 
Questions ?

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  • 1. Stress: The difference between Wellness and Illness Stephen Amos, PhD KUSM-W Dept of Pediatrics
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  • 7.
  • 8.
  • 9.  
  • 10. Inside the Stress Response
  • 11.
  • 12.
  • 13.
  • 14. Yerkes-Dodson Law As stress increases, performance initially rises and then declines. Performance Performance or efficiency Stress or anxiety
  • 15.
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  • 17.
  • 18.  
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  • 20.  
  • 21.
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  • 23.
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  • 26. Another way to Assess Stress
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  • 30.
  • 31. A BEHAVIORAL COGNITIVE DISPLAY (ABCD’S) A B C D ACTIVATING EVENT: BELIEF SYSTEM CONSEQUENT FEELINGS/BEHAVIORS DECISION POINT (Deal with it/Do it right) (Antecedent i.e. comes before) Something happens representing some triggering event to an emotional state Personal Perspective: Private ideas and attitudes that occur spontaneously and seem more like automatic thinking Negative Emotional State (and resultant negative behavioral actions) which tend to lead to self-fulfilling negative personal positions To overcome the negative effects of “B” (Belief System) we must engage in a cognitive/behavioral (thoughtful and active) shift in our personal perspectives. THE FOUR WAYS THINGS GO WRONG: Distorted Thinking Irrational Beliefs Unrealistic Expectations Family Scripting Problem Feedings: Depression Anxiety Panic Anger Resentment Phobias, etc. DEVICES FOR PERSPECTIVE SHIFTING= Meditation and/or visualization, thought stopping, relaxation, Prayer, etc. & BEHAVIORS: Acting out Avoidance Withdrawal Substance abuse Unfair fighting Verbal abuse, etc. DISTRACT: Do a different physical activity such as gardening, playing an instrument, cleaning house, begin a painting, etc. DIVERT: Do a different mental activity such as listen to tapes, do crossword puzzle, write a poem/song. Etc. DISPUTE/DEBATE: Challenge the “enemy” within i.e. the gremlin/negative self talk by using the scientific method of the friend within (the “baker of your own cake metaphor”). Remember that the language of the self talk of the friend within is logical, objective, practical, realistic, common sense, beneficial, adult/adult conversation.
  • 32. Lets Look at Anger 2 X 2 Table of Anger Appropriate Expression Inappropriate Expression Appropriate Anger Inappropriate Anger 100 %
  • 33. Lets Look at Anger 25 % 25 % 25% 25% 2 X 2 Table of Anger Appropriate Expression Inappropriate Expression Appropriate Anger Inappropriate Anger 100 % Note the Four Cells – Leaving only one cell (25%) appropriate both for anger and expression of anger
  • 34.
  • 35.
  • 36. When these are active, the appropriate expression of appropriate anger cell is depleted. ? 25% 25% Appropriate Expression Inappropriate Expression Appropriate Anger Inappropriate Anger 100 % ?
  • 37. So what to do?
  • 38.
  • 39.
  • 40.
  • 41.  
  • 42.
  • 43. “ My wife left me for health reasons. She was sick of me.”
  • 44.
  • 45.  
  • 46.
  • 47.  
  • 48. X X X X
  • 49. Stress over time with Meditation X X X
  • 50.
  • 51.  
  • 52.  

Editor's Notes

  1. The hypothalamus, pituitary gland, and adrenal glands make up the HPA axis, which plays a pivotal role in triggering the stress response. By releasing certain chemicals, such as adrenocorticotropic hormone (ACTH) and cortisol, the HPA axis rouses the body for action when it’s faced with a stressor. As the illustration reveals, the effect of this release of hormones is widespread. Senses become sharper, muscles tighten, the heart beats faster, blood pressure rises, and breathing quickens. All of this prepares you to fight or flee in the face of danger.
  2. What Happens? Senses Sharpen Blood pressure rises Breath quickens and we take in more oxygen Heart beats faster Muscles tighten Glucose & Fats are released into the bloodstream Adrenal Glands release Cortisol, adrenaline and noradrenaline Pituitary releases adrenocorticotropin (ACTH Reproductive, digestive and other growth systems are shut down. (energy conservation in the face of crisis) Energy resources are redirected to the elimination of the stressor