Stress Management

1. Stress Management in the
Workplace

2. Stress: What is it?

3. Stress as a response:
- is the way you feel when pressure is placed on
you.
-- it’s the meeting of the individual with an external
event.
Stress is not simply a function of what you do. It's
also a function of how you react.

4. The Understanding of the physiological basis of stress is pioneered by three men:
Claude Bernard
Walter B. Cannon
Hans Selye

5. According to Claude Bernard (1800’s) , all living organisms
attempt to maintain internal constancy (milieu interieur) or
balance and how this struggle goes on despite changes in the
environment.
Walter B. Cannon’s “homeostasis” [ Greek ‘homios’ (similar);
‘stasis’ (position) – steady position or state of being is the
normal pattern of internal functioning under which living
things operate.
Eg. Balance in heart rate (60 - 100 bpm) , temperature
(90/100), respiration (12 - 20 bpm)
If the body did not maintain its internal balance and fluctuated greatly
with the weather, it would begin to malfunction and breakdown.

6. Hans Selye, endoctrinologist (1926),
with his further studies confirmed that “ when an
organisms operating systems (respiration, circulation,
digestion, and temperature regulation) were thrown too far
out of their normal range of functioning, the organism was in
danger of dying. The demands created by the need to adapt
to these external stimuli were far too great for their bodies
to cope with.
The concept of Eutress and Distress

7. Eutress is a positive stress
response
stress that is deemed healthful,
beneficial or giving one the feeling of
fulfillment.
Word Origin. from Greek eu 'well, good'
+ stress,

8. Distress is a negative stress response
distress is anxiety, sadness, fear,
suffering or pain, or a state of being
in trouble.

9. Stress is the feeling of being under
too much mental or emotional
pressure.
Pressure turns into stress when you
feel unable to cope.

10. Both kinds of demands (eutress and
distress) tax the body’s ability to
stay in balance (maintain
homeostasis).
In order to maintain homeostasis in
the face of such demands, the body
mobilized energy by initiating stress
response. In a sense, the stress
response can be viewed as energy-
intensive process needed to
maintain homeostasis in the face of
eutress or distress that threaten to
throw the body out of balance.

11. If your mind and body are constantly on edge because of excessive stress in your life, you may
face serious health problems. Chronic emotional stress can affect virtually every organ system
in negative ways, according to NIH. Prolonged stress has been shown to cause numerous health
problems, including:
• Weakening of the immune system, making you more likely to have colds or other
infections
* High blood pressure
* Upset stomach, ulcers and acid reflux
* Anxiety
• Increased rapid heart beat and heart
palpitations
* Panic attacks
* Cardio-vascular problems
* Increase in blood sugar levels
* Irritable bowel problems
* Backaches
* Tension headaches or migraines
* Sleep problems
* Chronic fatigue syndrome
* Respiratory problems and heavy breathing
* Worsening of skin conditions, such as eczema

12. How do we Adapt to Stress Signals?
General Adaptation Syndrome (GAS).
Selye created a model for describing this nonspecific response and
adaptations it forces the body to make.
It has three distinguishable phases: alarm, resistance, and
exhaustion. These three phases are sequential; that is, the source of
stress sounds the alarm to initiate the GAS and if the stress is not
removed or coped with, the body progresses to resistance and
eventual exhaustion. However, recovery is an alternative outcome to
exhaustion when the source of stress is removed or coped with
effectively.

14. Fight or Flight instinct
Acute stress response
Walter Cannon 1920’s

15. Fight or Flight
mechanism in the
body that enables
humans and animals
to mobilize a lot of
energy rapidly in
order to cope with
stressors or threats
to survival.

16. Fight or Flight: How does it work?
1. A threat is perceived
2. The autonomic nervous system automatically puts body on alert.
3. The adrenal cortex automatically releases stress hormones.
4. The heart automatically beats harder and more rapidly.
5. Breathing automatically becomes more rapid.
6. Thyroid gland automatically stimulates the metabolism.
7. Larger muscles automatically receive more oxygenated blood.

17. Symptoms of stress:
Anger
Depression
Anxiety
changes in behavior
food cravings
lack of appetite
frequent crying
difficulty sleeping (mental)
feeling tired and difficulty concentrating,
unable to manage things
unable to think clearly
having uncomfortable emotions. It affect
your mental capacity bec. body and mind is
inseparable.
Emotions are disturbed.

18. Stress affects everybody, it is inevitable,
but what is interesting is that what is stressful
for one, may not affect another very much.
Therefore stress is individual perception, a
meeting of the individual personality with an
external event.
In this light, it is therefore very important
for you to know or recognize the things or
events that makes you stressful.

19. Stress in the Workplace
One of the common stressors of people
aside from pressures at home, family,
relationships and financial issues is
pressures in the workplace or employment
or career issues.
And stress at work is a major issue.
It can be a significant cause of illness, and
is known to be linked with high levels of
sickness absence, staff turnover,
productivity issues of organizations.

20. Work-related stress is the second most
common compensated illness/injury in
Australia, after musculoskeletal disorders.
Research commissioned by the Health and
Safety Executive in the UK has indicated that:
stress-related illness is responsible for the loss
of 6.5 million working days each year that costs
society about £3.7 billion every year (at 1995/6
prices) (Cartwright and Cooper 2002)
In the US, Three-fourths of employees believe the worker has more on-the-job stress
than a generation ago.
-Princeton Survey Research Associates
Problems at work are more strongly associated with health complaints than are any
other life stressor-more so than even financial problems or family problems.
-St. Paul Fire and Marine Innsuance Co.

21. Work-related or job stress

22. The concept of job stress is often confused with
challenge, but these concepts are not the same.
Challenge energizes us psychologically and physically, and
it motivates us to learn new skills and master our jobs.
When a challenge is met, we feel relaxed and satisfied.
Thus, challenge is an important ingredient for healthy
and productive work. The importance of challenge in our
work lives is probably what people are referring to when
they say "a little bit of stress is good for you.
With stress, job demands cannot be met, relaxation has
turned to exhaustion, and a sense of satisfaction has
turned into feelings of stress. In short, the stage is set for
illness, injury, and job failure.
Challenge Vs. Stress

23. The National Institute for Occupational Safety and Health (NIOSH)
Nearly everyone agrees that job stress results from the interaction of the worker and the conditions of work. Views differ,
however, on the importance of worker characteristics versus working conditions as the primary cause of job stress. These differing
viewpoints are important because they suggest different ways to prevent stress at work.
According to one school of thought, differences in individual characteristics such as personality and coping style are most
important in predicting whether certain job conditions will result in stress-in other words, what is stressful for one person may not
be a problem for someone else. This viewpoint leads to prevention strategies that focus on workers and ways to help them cope
with demanding job conditions.
Although the importance of individual differences cannot be ignored, scientific evidence suggests that certain working
conditions are stressful to most people. The excessive workload demands and conflicting expectations described in David's and
Theresa's stories are good examples. Such evidence argues for a greater emphasis on working conditions as the key source of job
stress, and for job redesign as a primary prevention strategy.

24. What are the main work-related stressors?
All the following issues have been identified as potential stressors at workplaces. A
risk management approach will identify which ones exist in your own workplace and
what causes them. They include:
Organization culture
Bad management practices
Job content and demands
Physical work environment
Relationships at work
Change management
Lack of support
Role conflict
Trauma.

25. Causes of Work-related Stress
Some of the factors that commonly cause work-related stress
include:
Long hours
Heavy workload
Changes within the organization
Tight deadlines
Changes to duties
Job insecurity
Lack of autonomy
Boring work
Insufficient skills for the job
Over-supervision
Inadequate working environment
Lack of proper resources
Lack of equipment
Few promotional opportunities
Harassment
Discrimination
Poor relationships with colleagues or bosses
Crisis incidents, such as an armed hold-up or workplace death.

26. Symptoms of work-related stress
The signs or symptoms of work-related stress can be physical, psychological and behavioural.
Physical symptoms include:
Fatigue
Muscular tension
Headaches
Heart palpitations
Sleeping difficulties, such as insomnia
Gastrointestinal upsets, such as diarrhoea or constipation
Dermatological disorders.
Behavioural symptoms include:
An increase in sick days or absenteeism
Aggression
Diminished creativity and initiative
A drop in work performance
Problems with interpersonal relationships
Mood swings and irritability
Lower tolerance of frustration and impatience
Disinterest
Isolation.
Psychological symptoms include:
Depression
Anxiety
Discouragement
Irritability
Pessimism
Feelings of being overwhelmed and unable to
cope
Cognitive difficulties, such as a reduced ability to
concentrate or make decisions.

27. Work-Related Stress is a Management Issue
It is important for employers to recognize work-
related stress as a significant health and safety
issue.
A company can and should take steps to ensure
that employees are not subjected to unnecessary
stress.

28. Work-related stress is a management issue
Ensure a safe working environment.
Make sure that everyone is properly trained for their job.
De-stigmatize work-related stress by openly recognizing it as a genuine problem & a significant
health & safety issue.
Discuss issues and grievances with employees, and take appropriate action when possible.
Devise a stress management policy in consultation with the employees.
Encourage an environment where employees have more say over their duties, promotional
prospects and safety.
Organise to have a human resources manager.
Cut down on the need for overtime by reorganizing duties or employing extra staff.
Take into account the personal lives of employees and recognize that the demands of home will
sometimes clash with the demands of work.
Seek advice from health professionals, if necessary.

29. How to Manage Stress at Work
Self-help for the individual:
Think about the changes you need to make at work in order to reduce your stress levels and then take action. Some
changes you can manage yourself, while others will need the cooperation of others.
Talk over your concerns with your employer or human resources manager.
Make sure you are well organized. List your tasks in order of priority. Schedule the most
difficult tasks of each day for times when you are fresh, such as first thing in the morning.
Take care of yourself. Eat a healthy diet and exercise regularly.
Consider the benefits of regular relaxation. You could try meditation or yoga.
Make sure you have enough free time to yourself every week.
Don’t take out your stress on loved ones. Instead, tell them about your work problems and ask for their support and
suggestions.
Drugs, alcohol and tobacco, won’t alleviate stress & can cause additional health problems. Avoid excessive drinking
& smoking.
Seek professional counseling from a counselor or psychologist
If work-related stress continues to be a problem, despite your efforts, you may need to consider another job or a
career change. Seek advice from a career counselor or psychologist.

30. Benefits of preventing stress in the workplace
Reduced symptoms of poor mental and physical health
Fewer injuries, less illness and lost time
Reduced sick leave usage, absences and staff turnover
Increased productivity
Greater job satisfaction
Increased work engagement
Reduced costs to the employer
Improved employee health and community wellbeing

31. Where to get help
Your doctor
Psychologist
Your manager/direct superior
Human resources manager at your workplace
WorkCover Advisory Service Tel. 1800 136 089 USA

33. Disasters/Calamities/Emergencies

34. Disasters, calamities and emergencies are
emotionally charged events that occur with little, if
any, warning. Typically they unexpected, sudden and
overwhelming. They can involve:
- severe, life threatening situations;
-cause widespread disruptions that deny shelter, food, water, and
medical care to vast segments of the population;
- and interfere with communication and transportation.
For many people, there are no outwardly visible signs of physical
injury, but there can be nonetheless an emotional toll. It is common
for people who have experienced disaster to have strong emotional
reactions. Understanding responses to distressing events can help
you cope effectively with your feelings, thoughts and behaviors, and
help you along the path to recovery.

35. Natural Disasters/
Calamities/
Emergencies
Man-made

36. Affected residents often experience confusion,
fear, hopelessness, sleeplessness, anxiety,
grief, shock, guilt, and shame.
The effects of a disaster, terrorist attack, or
other public health emergency can be long-
lasting, and the resulting trauma can
reverberate even with those not directly
affected by the disaster

37. What to do during disasters?
Most of the things we do during disasters are reactive because usually they
come without warning

38. How to Minimize Stress in Disasters, Calamities
or Emergencies
1. Anticipate – do advance preparation
2. Over-react
Mobilizing local public health workers and emergency
responders who shoulder the responsibility for ensuring the
health and safety of affected people; helping them to cope
with these devastating situations; and re-establishing normal
function. However, this responsibility can take a heavy toll on
public health workers and emergency responders as well,
particularly in emotionally charged situations with widespread
turmoil.

39. How to Cope
Understanding responses to distressing events
can help you cope effectively with your feelings,
thoughts and behaviors, and help you along the
path to recovery.

40. What are common reactions and responses to disaster?
Following disaster, people frequently feel stunned, disoriented or unable to integrate
distressing information. Once these initial reactions subside, people can experience a
variety of thoughts and behaviors.
Common responses can be:
Intense or unpredictable feelings. You may be anxious, nervous, overwhelmed or grief-stricken.
You may also feel more irritable or moody than usual.
Changes to thoughts and behavior patterns. You might have repeated and vivid memories of the
event. These memories may occur for no apparent reason and may lead to physical reactions such
as rapid heartbeat or sweating. It may be difficult to concentrate or make decisions. Sleep and
eating patterns also can be disrupted — some people may overeat and oversleep, while others
experience a loss of sleep and loss of appetite.
Sensitivity to environmental factors. Sirens, loud noises, burning smells or other environmental
sensations may stimulate memories of the disaster creating heightened anxiety. These “triggers”
may be accompanied by fears that the stressful event will be repeated.
Strained interpersonal relationships. Increased conflict, such as more frequent disagreements with
family members and coworkers, can occur. You might also become withdrawn, isolated or
disengaged from your usual social activities.
Stress-related physical symptoms. Headaches, nausea and chest pain may occur and could require
medical attention. Preexisting medical conditions could be affected by disaster-related stress.

41. How do I cope?
Fortunately, research shows that most people are resilient
and over time are able to bounce back from tragedy. It is
common for people to experience stress in the immediate
aftermath, but within a few months most people are able to
resume functioning as they did prior to the disaster. It is
important to remember that resilience and recovery are the
norm, not prolonged distress.
:

42. There are a number of steps you can take to build emotional well-being and gain a
sense of control following a disaster, including the following
Give yourself time to adjust. Anticipate that this will be a difficult time in your life. Allow yourself to mourn the
losses you have experienced and try to be patient with changes in your emotional state.
Ask for support from people who care about you and who will listen and empathize with your situation. Social
support is a key component to disaster recovery. Family and friends can be an important resource. You can find
support and common ground from those who've also survived the disaster. You may also want to reach out to others
not involved who may be able to provide greater support and objectivity.
Communicate your experience. Express what you are feeling in whatever ways feel comfortable to you — such as
talking with family or close friends, keeping a diary or engaging in a creative activity (e.g., drawing, molding clay,
etc.).Find a local support group led by appropriately trained and experienced professionals. Support groups are
frequently available for survivors. Group discussion can help you realize that you are not alone in your reactions and
emotions. Support group meetings can be especially helpful for people with limited personal support systems.
Engage in healthy behaviors to enhance your ability to cope with excessive stress. Eat well-balanced meals and get
plenty of rest. If you experience ongoing difficulties with sleep, you may be able to find some relief through
relaxation techniques. Avoid alcohol and drugs because they can be a numbing diversion that could detract from as
well as delay active coping and moving forward from the disaster.
Establish or reestablish routines. This can include eating meals at regular times, sleeping and waking on a regular
cycle, or following an exercise program. Build in some positive routines to have something to look forward to during
these distressing times, like pursuing a hobby, walking through an attractive park or neighborhood, or reading a
good book.
Avoid making major life decisions. Switching careers or jobs and other important decisions tend to be highly
stressful in their own right and even harder to take on when you're recovering from a disaster.

43. When should I seek professional help?
If you notice persistent feelings of distress or
hopelessness and you feel like you are barely able to
get through your daily responsibilities and activities,
consult with a licensed mental health professional
such as a psychologist. Psychologists are trained to
help people address emotional reactions to disaster
such as disbelief, stress, anxiety and grief and make a
plan for moving forward.

44. Post Traumatic Stress Disorder
PTSD

45. PTSD
PTSD, or Posttraumatic Stress Disorder, is
a mental health condition or a psychiatric
disorder that can occur following the
experience or witnessing of a life-threatening
traumatic events such as military combat,
natural disasters, terrorist incidents, serious
accidents, or physical or sexual assault in
adult or childhood.

46. Symptoms may include
flashbacks, nightmares and
severe anxiety, as well as
uncontrollable thoughts about
the event.
Post-traumatic stress disorder
symptoms may start within three
months of a traumatic event, but
sometimes symptoms may not
appear until years after the event.
These symptoms cause significant
problems in social or work
situations and in relationships.

47. PTSD symptoms are generally grouped into four types:
intrusive memories, avoidance,
negative changes in thinking and mood,
or changes in emotional reactions.
Intrusive memories
Symptoms of intrusive memories may include:
Recurrent, unwanted distressing memories of the
traumatic event
Reliving the traumatic event as if it were happening again
(flashbacks)
Upsetting dreams about the traumatic event
Severe emotional distress or physical reactions to
something that reminds you of the event

48. Avoidance
Symptoms of avoidance may include:
Trying to avoid thinking or talking about the traumatic event
Avoiding places, activities or people that remind you of the
traumatic event
Negative changes in thinking and mood
Symptoms of negative changes in thinking and mood may
include:
Negative feelings about yourself or other people
Inability to experience positive emotions
Feeling emotionally numb
Lack of interest in activities you once enjoyed
Hopelessness about the future
Memory problems, including not remembering important
aspects of the traumatic event
Difficulty maintaining close relationship

49. Changes in emotional reactions
Symptoms of changes in emotional reactions (also called arousal symptoms)
may include:
Irritability, angry outbursts or aggressive behavior
Always being on guard for danger
Overwhelming guilt or shame
Self-destructive behavior, such as drinking too much
or driving too fast
Trouble concentrating
Trouble sleeping
Being easily startled or frightened
Intensity of symptoms
PTSD symptoms can vary in intensity over time. You may have more PTSD
symptoms when you're stressed in general, or when you run into reminders
of what you went through. For example, you may hear a car backfire and
relive combat experiences. Or you may see a report on the news about a
sexual assault and feel overcome by memories of your own assault.

50. When to see a doctor
If you have disturbing thoughts and feelings about a traumatic
event for more than a month, if they're severe, or if you feel
you're having trouble getting your life back under control, talk
to your health care professional. Get treatment as soon as possible
to help prevent PTSD symptoms from getting worse.
If you have suicidal thoughts
If you or someone you know is having suicidal thoughts, get help right away through one or more of
these resources:
Reach out to a close friend or loved one.
Contact a minister, a spiritual leader or someone in your faith community.
Call a suicide hotline) to reach a trained counselor.
Make an appointment with your doctor, mental health provider or other health care professional.
When to get emergency help
If you think you may hurt yourself or attempt suicide, or your local emergency number immediately.
If you know someone who's in danger of committing suicide or has made a suicide attempt, make
sure someone stays with that person. Call your local emergency number immediately. Or, if you can
do so safely, take the person to the nearest hospital emergency room.

51. Treatments and Drugs
Post-traumatic stress disorder treatment can help you regain a sense of control over your life.
The primary treatment is psychotherapy, but often includes medication. Combining these treatments
can help improve your symptoms, teach you skills to address your symptoms, help you feel better
about yourself and learn ways to cope if any symptoms arise again.
Psychotherapy and medications can also help you if you've developed other problems related to your traumatic
experience, such as depression, anxiety, or misuse of alcohol or drugs. You don't have to try to handle the burden of
PTSD on your own.
Psychotherapy
Several types of psychotherapy, also called talk therapy, may be used to treat children and adults with PTSD. Some
types of psychotherapy used in PTSD treatment include:
Cognitive therapy. This type of talk therapy helps you recognize the ways of thinking (cognitive patterns) that are
keeping you stuck — for example, negative or inaccurate ways of perceiving normal situations. For PTSD, cognitive
therapy often is used along with exposure therapy.
Exposure therapy. This behavioral therapy helps you safely face what you find frightening so that you can learn to
cope with it effectively. One approach to exposure therapy uses "virtual reality" programs that allow you to re-enter
the setting in which you experienced trauma.
Eye movement desensitization and reprocessing (EMDR). EMDR combines exposure therapy with a series of guided
eye movements that help you process traumatic memories and change how you react to traumatic memories.
All these approaches can help you gain control of lasting fear after a traumatic event. You and your health care
professional can discuss what type of therapy or combination of therapies may best meet your needs.
You may try individual therapy, group therapy or both. Group therapy can offer a way to connect with others going
through similar experiences.

52. Medications
Several types of medications can help improve symptoms of PTSD:
Antidepressants.
These medications can help symptoms of depression and anxiety. They can also help
improve sleep problems and concentration. The selective serotonin reuptake inhibitor
(SSRI) medications sertraline (Zoloft) and paroxetine (Paxil) are approved by the Food
and Drug Administration (FDA) for PTSD treatment.
Anti-anxiety medications. These drugs also can improve feelings of anxiety and stress for
a short time to relieve severe anxiety and related problems. Because these medications
have the potential for abuse, they are not usually taken long term.
Prazosin. If symptoms include insomnia or recurrent nightmares, a drug called prazosin
(Minipress) may help. Although not specifically FDA-approved for PTSD treatment,
prazosin may reduce or suppress nightmares in many people with PTSD.
You and your doctor can work together to figure out the best treatment, with the fewest
side effects, for your symptoms and situation. You may see an improvement in your
mood and other symptoms within a few weeks.
Tell your health care professional about any side effects or problems with medications. You may need to try more than one or a
combination of medications, or your doctor may need to adjust your dosage or medication schedule before finding the right fit for
you.

53. epilogue
• Stress is everywhere and anywhere, you can have small
stresses, big stresses, or extreme life-threatening stresses.
Whatever it is at any level, you should be able to recognize
and accept that you are under such duress to be able to
do something about it as a response.
• The important thing is to know that there are ways to
avoid it or to minimize its impact, and that there are ways
to cope with it and treatments for it are available if
needed.

54. -Fin-
May Flerida Martinez-Culango, RGC, MA
CTU-San Francisco Campus
February 8, 2015