Staying Healthy By Managing Stress

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Staying Healthy By Managing Stress

• Frank J. Tortorella, M.D.
• Director, Employee Health Services
• Virginia Commonwealth University and VCU Health
  System

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Managing Stress in Tough Times

• Frank J. Tortorella, M. D.
• Director, Employee Health Service
• Virginia Commonwealth University

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Stress It Just Might Be a Laughing Matter!

• Frank J. Tortorella, MD
• Director, Employee Health Service
• Virginia Commonwealth University
• Richmond, Virginia

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Whats In a Name?

• A type of foreign car?
• A type of spider?
• A type of Italian dance?
• A type of bacteria?
• A type of small marcaroni?

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OBJECTIVES

• Understand Stress Response
• Identify Causes of Stress
• Learn Personal Reactions to Stress
• Develop Positive Coping Mechanisms
• Laugh and Have Fun

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Questions to ask yourself

• How do I deal with personal stress during tough
  times at work?
• How do I identify stress in my staff?
• How do I help my staff to cope with the stress?
• Who helps me?

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STRESS MODEL
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STRESS REDUCTION

• Eliminate the stressor
• Manage your reaction for positive results

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Traditional Stressors

• Health
• Family
• Money
• Work

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Pain and Stress

• Acute vs. Chronic Pain
• Types of Pain
• Ice vs. Heat
• OTC vs. Rx
• Types of analgesics
• What happened to my Vioxx?
• Modalities and Local Injections
• Complimentary Therapies

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Stress at Work-NIOSH Report

• 40 of workers report their job as very or
  extremely stressful.
• 26 feel often or very often burned out.
• 1/4 view their jobs as the number one stress in
  their lives.
• 3/4 believe the worker has more on-the job stress
  than a generation ago.
• Problems at work are more strongly associated
  with health complaints, compared to marital or
  financial problems.

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Old Stressors vs. New Stressors

• The 90s
• Going Postal
• Techno-Stress
• Road Rage
• Holiday Madness
• Y2K
• 9-11-01

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Up to the Minute Stressors

• War with Iraq
• BioterrorismSmallpox , Threat Levels
• Global InfectionsSARS
• Local Infections--- West Nile Virus
• Personal---Do I have a job?
• Personal---Do I want this job?
• Personal---Is this job good for my health?

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Stressors post-9/11

• War with Iraq
• BioterrorismSmallpox , Threat Levels
• Global InfectionsSARS , Avian Flu
• Local Infections--- West Nile Virus
• Influenza and Vaccine Shortage

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Seasonal Stressors

• Hurricanes

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Stressor of the Month.

• Gas Prices

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Time Compression

• Im running to the Walmart.
• The car as powder room, breakfast nook and
  office.
• Lets tape it and watch it later

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Layoff Survivor Syndrome

• Job Insecurity
• Unfairness
• Depression, Stress Fatigue
• Reduced Risk Taking and Motivation
• Distrust and Betrayal
• Lack of Reciprocal Commitment

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Survivor Syndrome-2

• Dissatisfaction with Planning and Communication
• Anger over the Layoff Process
• Lack of Strategic Direction
• Lack of Management Credibility
• Sense of Permanent Change

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Effects of Survivor Sickness

• Stress, Fatigue,Extra Workload,Decreased
  Motivation,Sadness Depression
• Insecurity,Anxiety Fear
• Loyalty to Job-Not to Company
• Sense of Unfairness and Anger
• Resignation and Numbness
• Need for Honest Communication
• Resentment over being made to feel guilty

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Signs Symptoms of Stress

• Physical
• Emotional
• Cognitive
• Behavioral

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A Model of Grieving

• Denial
• Anger,including rage,envy and resentment
• Bargaining
• Depression which includes sadness,gloominess,pessi
  mism,guilt worthlessness
• Acceptance,which is not equated with happiness

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Physical

• Increase in heart rate,blood pressure
• Muscular pains
• GI symptoms
• Headache
• Sleep disturbances

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Emotional

• Angry outbursts
• Overalertness
• Being critical of others
• Narrowed focus
• Reduced self-esteem
• Obsessive rumination

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Cognitive

• Forgetfulness
• Reduced creativity
• Lack of concentration
• Diminished productivity
• Orientation to the past
• Lack of control/need for too much control
• Negative self-statements

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Behavioral

• Aggressive behaviors
• Increased alcohol use
• Increased smoking
• Changes in eating patterns
• Carelessness
• Compulsive behavior

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Early Warning Signs of Job Stress

• Headache
• Sleep Disturbances
• Difficulty in concentrating
• Short temper
• Upset Stomach
• Job Dissatisfaction
• Low Morale

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Overload Burnout

• Absenteeism or tardiness for work
• Tired and fatigued for no reason
• Procrastination and indecision
• Social withdrawal with cynicism
• Resentful,indifferent,defiant
• Chronic stress related illnesses

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The Stress Response

• Is it my nerves,Doc?
• Hormones to the rescue!!
• Genetics countbut not for everything.
• Target Organs

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Stress and Aging

• May not respond as vigorously to stress or may
  have too much of a response.
• May have trouble turning off the stress response
  or may have more stress hormones in their normal
  nonstressed states.
• Can stress make you age faster?
• Can stress affect memory and learning?

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Stress and Ergonomics

• Voluntary muscles and stress.
• Postures--standing,sitting
• Arms and hands--carpal tunnel syndrome
• Low Back Pain
• Stretching exercises

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STRESS CHANGE

• It may be immaterial whether the stressors are
  positive or negative.
• What matters is the need for accommodation to the
  changes.

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STRESS CHANGE

• Compute your life change risk

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LIFE CHANGES SCALE

• 0-150 No Significant Risk
• 151- 199 35 Mild Life Crisis
• 200- 299 50 Moderate Life Crisis
• Over 300 81 Major Life Crisis

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Dr. Ts Top Ten Tips Revisited Revised

• Provide positive reinforcement for those around
  you.
• Take care of yourself
• Get enough sleep
• Slow down
• Learn to relax
• Look at your exercise nutrition status

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• Get away from it all
• Take your lunch breaks
• Take your vacations
• Revise your rules
• Simplify your life
• Look at your musts shoulds

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• Seek support
• Spiritual
• Family
• Friends
• Colleagues
• Professional

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Dr. Ts Top Ten Tips for Stress Reduction

• Create your personal Rx

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Dr. Ts Top Ten Tips

• 13. Get a flu shot annually!!
• 12. Take your lunch break.
• 11. Get enough sleep.
• 10. Pray.

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• 13- Get your flu shot annually.

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• 12-Take your lunch break.

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• 12. Slow down and sit down to eat your meals.

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• 11-Get enough sleep.

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• 10-Pray.

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• 9-Simplify your life.

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• 8-Make one dietary change.

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• 7-Take your vacation.

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• 7. If you are retired, then think about working
  part time or volunteering with young peopleor
  younger people.

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• 6-There is no 6. I decided to simplify!!

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• 5-Increase your daily exercise.

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• 4-Have something you do for relaxation.

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• 3- God told me to repeat the one about praying
  and Im listening to HER.

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• 3 AGAIN- Try thought relaxation.

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• 2 ½-Practice positive self-talk.

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• 2-Get help if you need it.

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• 9. Simplify your life.
• 8. Make one dietary change.
• 7. Take your vacation.
• 6. There is no 6. I decided to simplify!!

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• 5. Increase your daily exercise.
• 4. Have something you do for relaxation.
• 3.God told me to repeat the one about prayingand
  Im listening to HER !

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• 3.AGAIN- Try thought relaxation.
• 2 1/2. Practice positive self talk.
• 2.Get help if you need it.

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• 1- Laugh and have a sense of humor!!