1. Stress Management and Ayurveda

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3. Dr. Jitendra Nagpal is a Senior Consultant Psychiatrist with Moolchand Medcity
hospitals, New Delhi. He has worked extensively in the area of school health. He is
the Programme Director for Expressions India, a life skills education & school health
programme. He is also associated with a number of institutes in an advisory capacity.
Dr. Nagpal is a member of various national and international associations. He is a life
member of the American Psychiatry Association.
Dr. Nagpal is also the author and editor for Adolescent Counselling Course, IGNOU,
New Delhi. He was awarded the ‘Delhi State Child Welfare Award’ for distinguished
services in child development (2006-07) by the Department of Social Welfare, Govt.
of NCT of Delhi.

4. Dr. Jitendra Nagpal is a Senior Consultant Psychiatrist with Moolchand Medcity
hospitals, New Delhi. He has worked extensively in the area of school health. He is
the Programme Director for Expressions India, a life skills education & school health
programme. He is also associated with a number of institutes in an advisory capacity.
Dr. Nagpal is a member of various national and international associations. He is a life
member of the American Psychiatry Association.
Dr. Nagpal is also the author and editor for Adolescent Counselling Course, IGNOU,
New Delhi. He was awarded the ‘Delhi State Child Welfare Award’ for distinguished
services in child development (2006-07) by the Department of Social Welfare, Govt.
of NCT of Delhi.

6. The most beautiful experience in life is mysterious.
It is this fundamental emotion which stands
at the cradle of true art and true science.

7. Holistic Health – Finding a balance
The way stress affects us depends on a balance
between the demands made and our ability to cope.
Physical

Psychological Social

8. Stress and Coping —the science and
the art
• What stress is, how it is caused, and your
responsibility for your stress levels.
• Optimum levels of stress and the effects of long
term exposure to it.
• What can happen if stress gets out of control
• How to analyse the causes of stress accurately
and plan to control them
• Increasing stress when you are under-motivated.

9. Stressed or Challenged?
Different people react to events in different
ways. A situation that one person regards as
an exciting and challenging opportunity – like
a tight deadline at work – may be seen by
another as unbearably stressful.

10. What causes stress?
Anything that makes you tense, angry, frustrated or
unhappy. It may be thinking about next week’s driving
test or a visit from a difficult relative, the choices you
have to make when moving house or getting married,
an accident or injury, the seemingly unrelenting
pressures of work or the unavoidable burden of
coping with a death in the family.

11. Sources of Stress
• Too much change too quickly can be a cause of
stress
• Stress can be caused by pleasant and unpleasant
events.
• The cause of stress may not always be apparent.
• Usually stress is a result of build-up of related and
unrelated events.
• Often your stress is more apparent to others than to
yourself.
• Reactions to stress can be emotional, physical and
behavioural.

12. Specific Events
• School demands and frustrations
• Negative thoughts & feelings about
themselves
• Changes in their bodies
• Problems with friends.
• Unsafe living environment
• Separation or divorce of parents
• Chronic illness or severe problems in the
family
• Death of a loved one
• Moving or changing schools
• Taking on too many activities
• Having too high expectations

13. Stress and Coping
• A certain level of stress is good for us.
• One person’s stress may be someone else’s
enjoyment.
• Too much stress affects our health and well-
being.
• There is every reason to be optimistic that you
will be able to overcome stress in your life.

14. Stress – the Types
Developmental
Situational
Acute (short intense)
Chronic (prolonged)
We would all become exrtemely bored if nothing different or
challenging ever happened in our lives. However, any major
change needs to be balanced with our ability to cope with that
particular change at the time in question.

15. STRESS
STRESSOR PERCEIVED ANXIETY
THREAT
(situation characterized (anticipation of tension,
by some degree of harm, thought, apprehension,
physical/ psychological memory, judgement worry, palpitation
danger) and interpretation dizziness
of situation)
Intensity of Perceived danger
reaction or threat

16. How Stress Adds Up
Degree Potentially Response Significance
of Stress stressful to the of the events
events events to us (happy,
(physical, sad or
emotional or indifferent)
behavioural)

17. Adapting to Stress
I Stress
Hypothalamus
Pituitary Autonomic ALARM
Nervous REACTION
System
Adrenalin
Flight/ Fight response
(Breathing , Heartrate ,
Blood supply to muscles .)
II STAGE OF RESISTANCE
III STAGE OF EXHAUSTION

18. THE PATHWAY OF STRESSOR EFFECTS
The Stressor
Hypothalamus
ic
o m Pituitary
t on es
A u er v
n
ACTH
Effects : Peptic ulcers Adrenal catecholamines
Effects :
Blood pressure
Corticoids Metabolism
Central nervous
system
Effects :
Gluconeogenesis Blood cells
Thymus Immune reactions
Lymph nodes Inflammation

19. Psychological Reactions to Stress
• Feeling under pressure • Frustration and aggression
• Feeling tense and unable to • Increased tearfulness
relax
• Become more fussy, gloomy or
• Feeling mentally drained suspicious
• Being constantly frightened • Being unable to take decisions
or worried
• Impulses to run an dhide
• Increasing irritability and
complaining • Fears of social embarrassment
or failure
• Feelings of conflict
• Lacking in ability to feel
• Restlessness, increasing pleasure or enjoyment
inability to concentrate or to
complete tasks quickly

20. Physical Reactions to Stress
• Muscle tension • Indigession
• Rapid, uneven or pounding • Frequent urge to pass urine
heartbeat
• Chest discomfort
• Fast, shallow breathing
• Constipation or diarrhoea
• Change in appetite
• Backache
• Sleep problems
• ‘Butterflies’ in the stomach
• Headaches

21. Negative Stress at work place :
• interferes with clear judgement in making
effective decisions.
• Reduced enjoyment of work.
• Causes difficult situations to be seen as a
threat, not a challenge.
• Consumes mental energy in distraction, anxiety,
frustration and temper.

22. Job Related Stress ….. !!
Expectations and Accountability
• too much or too little work
• having to perform beyond your abilities
• time pressures and deadlines
• keeping up with new developments
• changes in procedures and policies
• lack of relevant information & clear objectives
• unclear expectations of your role from your boss
or colleagues
• responsibility for people, budgets or equipment

23. The Human Personality
Nature Type A
Nurture Type B

24. Faulty Coping Mechanisms used
• Denial
• Displacement
• Fixation
• Introjection
• Projection
• Rationalisation
• Regression
• Withdrawal

25. Five main
UNREALISTIC desires or beliefs :
• The desire always to have the love and
admiration of all people important to you.
• The desire to be thoroughly competent at all
times.
• The belief that external factors cause all
misfortune.
• The desire that events should always turn out
the way that you want them to, and that people
should always do what you want.
• The belief that past bad experience will
inevitably control what will happen in the future.

26. STRESS AWARENESS....
• The difficult thing about stress is
recognising it; doing something about it
is relatively easy.
• Once you have recognised that you are
suffering a stress response, you should
be able to identify and tackle any
underlying causes, not just the
symptoms.
• And you can ask someone you
trust and respect to help.

27. Tackling the Problem
• Once you have recognised that you are
suffering a stress response, then you should
be able to identify and tackle any underlying
causes.
• List your signs of stress
• List the probable causes of your stress

28. Tackling the Problem
• Monitor the changes in the nature, severity or
duration of the signs of your stress.
• Look out for unhelpful thoughts, and think of
new solutions to them.
• Plans and activities are powerful weapons to
overcome stress.

29. Defences against Stress
• We can defend against stress by
understanding its causes.
• The principal defences against stress are
physical and mental fitness.
• Physical fitness is improved by healthy
lifestyle, adequate sleep, eating a balanced
diet and taking regular exercise.
• Our mental fitness to deal with stress is
helped by self-instruction and self-control.
• Relaxation techniques are useful when you
fell stressed.

30. STOP ….. FOR A THOUGHT
We can defend ourselves against stress in our lives by
understanding what causes Stress in us, by learning
how to avoid it or adjust and adapt better.
The Principal DEFENCES are within ourselves

31. How to help yourself
• Many people find their own ways of tackling
stress
• Anxiety attacks always go away after a time.
• Worry is a pointless activity and never solved
anything.
• Confront your problems, and make plans to
solve them.
• Everybody has setbacks – and they can be
overcome.

32. Optimising LIFE & STYLE
• Improving your working and living environment
• Adjusting your lifestyle
• Adjusting negative elements of your personality
• Looking after your body and health
• Using physical stress reduction techniques
• Using mental stress reduction techniques

33. Getting Help
• Family and friends can provide valuable
support in dealing with stress.
• If you are worried about stress, the earlier you
tackle it and help begins the better.
• There are three main types of professional
help available : medical, psychological and
social.
• Give a treatment a fair chance to help you
before trying something else.
• Self-help groups and the media can provide a
wealth of information, advice and practical
help.

34. Your Stress Diary
• Keeping a stress diary is an effective way of
finding out both what causes you stress, and
what level of stress you prefer.
• In this diary note down your stress levels and
how you feel throughout the day.

35. Record the following information in
your stress diary at a regular interval :
• the time
• the amount of stress that you fell
• how happy you feel
• whether you are enjoying your work
• how efficiently you are working

36. When stressful events
occur…… note :
• What the event was?
• When and where did it occur?
• What important factors made the event
stressful?
• How stressful was the event?
• How did you handle the event?
• Did you tackle the cause or the symptom?
• Did you deal with the stress correctly?

37. Your stress diary ….. Analysis :
• You should be able to understand
• the level of stress you are happiest with
• the level of stress at which you work most
effectively
• that your performance is good even when you
feel upset by stress.
• You should know
• what the main sources of unpleasant stress
• what circumstances make the stresses
particularly unpleasant.
• whether your strategies for handling the
stresses are effective or not.

38. ‘False Friends’
• Smoking, drinking alcohol and taking drugs of
dependence are not a cure for stress – they all
make stress, and coping with stress, harder.
• While alcohol in moderation can be a pleasure,
heavy drinking carries serious risks to health
and well-being-personal, family and at work.
• Stress is the most common reason smokers
give for not stopping smoking.
• Nicotine is one of the fastest-acting addictive
drugs known to humankind.
• Smoking is not only capable of ruining your
health, it also ruins your finances.

39. Pills, potions and
complementary methods
• Becoming dependent on pills and potions
creates further problems.
• Many people find complementary methods
such as yoga of benefit.
• Overcome stress by understanding and
controlling your response to it.
• Remember to use the golden rules for
reducing stress.

40. Promotion of Healthy Life-style ...
• Exercise and eat regularly
• Avoid excess caffeine
• Avoid illegal drugs, alcohol, tobacco
• Learn breathing exercises
• Take a break from stressful situation
• Build a network of friends
• State feelings in a positive way not
overly aggressive or passive
• Decrease negative self talk
• Rehearse and practice situations that cause stress

41. The Advantages of
Regular Relaxation
• Improves sleep
• Increases mental and physical performance
• Combats tiredness
• Decreases anxiety and tension
• Is not addictive

42. Meditation …..
Meditation is a very effective method of relaxation.
The idea of meditation is to focus your thoughts for a
sustained period of time.
This rests your mind by diverting it from thinking
about the problems that have caused stress.
It gives your body time to relax and recuperate and
clear away toxins that may have built up through
stress and mental or physical activity.

43. Meditation is useful where :
• you have been under long term stress
• you have been under short term stress
• you have been worrying about problems
• you have been physically active

44. Effects of meditation :
• slow breathing
• reduce blood pressure
• helps muscles relax
• gives the body time to eliminate waste products
• reduce anxiety
• eliminates stressful thoughts
• helps with clear thinking
• helps with focus and concentration
• reduces irritability
• reduces stress headaches

45. Dr. Ritu Sethi, MD (Kaya Chikitsa) is an Ayurvedic Physician having more than 12
years of experience in the areas of Ayurvedic Medicine, Panchakarma, Clinical
Management, Research and Development. Presently at Holy Family Hospital , New
Delhi as Associate Consultant. She was also involved in various community healthcare
programme including AYUSH. She has numerous publication to her credit.