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Cardiac Rehabilitation Programme Stress Management Andrea


Cardiac Rehabilitation Programme Stress Management Andrea Papitsch-Clark Clinical Health Psychologist Stress in everyday life What does it feel like to be stressed? – PowerPoint PPT presentation

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Title: Cardiac Rehabilitation Programme Stress Management Andrea

Cardiac Rehabilitation ProgrammeStress
  • Andrea Papitsch-Clark
  • Clinical Health Psychologist

Stress in everyday life
  • What does it feel like to be stressed?
  • What does it feel like not to be stressed?
  • What causes YOU stress?
  • Emergencies (e.g. fall, emergency stop, being
    startled by something etc.)
  • Life events (e.g. bereavement, illness,
    marriage, holiday, change job)
  • Daily hassles (e.g. stuck traffic jam,
    arguments, queue in supermarket etc.)

What is stress?
  • What is stressful differs from one person to the
    next, and also how we experience stress may
    differ from person to person.
  • Definition of stress stress is a condition or
    feeling, experienced when a person perceives that
    demands exceed the personal and social resources
    the individual is able to mobilize (according to
    Richard S Lazarus)

Symptoms of stress
Physiological effects of stress
  • Adrenaline is released when our brains perceive
    we are under threat or in danger. Evolutionary
    fight or flight response.
  • Body's reaction The effect
  • Pupils dilate
  • Heart rate increases to send o2 to muscles
  • Blood pressure rises
  • Breathing faster
  • Digestion slows down
  • Muscles tense, ready for action
  • Blurred vision
  • Palpitations, heart pounding
  • Light-headed
  • Dry mouth, short of breath
  • Indigestion, butterflies, nausea
  • Tremor, jelly legs

Useful in real emergencybut not in everyday
Stress thermometer
Panic Fear Worried Bad tempered Tense
Too much adrenaline Bad
Most people have raised adrenaline levels after a
cardiac event - normal to feel worried. Any
other worries or events can be enough to put
adrenaline levels even higher
Some adrenaline Good
Excited Alert Wide awake Calm Sleepy Very relaxed
Does stress cause heart disease?
  • It is recognised that stress contributes
  • to CHD, but we cant say for certain whether
  • stress directly causes CHD.
  • .BUT Long-term stress can make us feel
    miserable, drained and unwell.
  • It can affect our attitude or state of mind
    and make us rely on short-term fixes like
    smoking, drinking, not exercising, unhealthy
  • all of which DO contribute to heart disease

Does stress cause heart disease?
  • .ALSO stress can affect the heart by releasing
    certain hormones that increase blood pressure and
    can encourage clotting of the arteries.
  • Stress can also make us feel less motivated to
    spend time on healthy behaviours such as
    relaxation or exercise.

Unhelpful thoughts/interpretations
  • Being under stress can lead to unhelpful thoughts
    such as
  • Theres nothing that will help me
  • Im not getting better, Im getting worse
  • Its dangerous for people with heart problems to
  • I should be able to cope

This can lead to a vicious cycle, with unhelpful
thoughts raising adrenaline and producing
unpleasant physical effects, which leads to more
worrying thoughts, in turn leading to more stress
and so on
  • Trigger stimulus
  • Internal
  • external

Thoughts Theres not much you can do about
heart problems Theres something wrong with my
Feelings Raised anxiety, fear, frustration
Behaviour Stop what doing, reduce overall
activity, lose fitness etc.
Physical effects e.g. increase adrenaline
(increase HR, faster breathing, tension etc.)
Coping with stress
1. Learning to spot when stress levels are
building up
  • Feeling stressed and tense can become a habit
  • Be aware of daily hassles and strains increasing
    stress levels
  • What was I thinking about, or doing or what had
    happened just before I started to feel like this?
  • Are there other ways of looking at the situation?

Panic Scared Worried Bad tempered Tense
Excited Alert Wide awake Calm Relaxed
Challenging unhelpful thoughts
  • Remember that unhelpful thoughts can raise
    adrenaline levels, and in turn increase stress.
    BUT can try to challenge unhelpful thoughts
  • Ask yourself
  • Is this thought really true/true all the time?
  • Am I considering all the evidence?
  • Am I ignoring any strengths or positives?
  • Am I jumping to conclusions?

2. Challenge unhelpful thoughts
  • Having considered these questions, can you come
    up with a different, more balanced, more positive

My heart is not worn out Most people make a
full recovery after a heart attack There are
many things I can do to prevent CHD It was a
blockage in an artery not the heart that
caused the problem Relaxation is not just
being lazy its important for health and

Thoughts There are many things I can do to
fight CHD
Behaviour Healthy lifestyle changes, active, see
friends, set goals
Feelings Positive, calm, optimistic, motivated
Physical effects More relaxed
3. Problem-solving
  • For example.
  • Are you managing your time effectively?
  • Can you cut back on some things if youve taken
    on too much?
  • Are your goals/expectations realistic?
  • Can you speak to somebody about it?
  • Can you prioritise the most important things that
    need to be done?
  • Can you say NO to some things?

Adopting Low stress ways of living and working
  • Making time for enjoyable activities
  • Switching off from thoughts/worries
  • Slowing down, taking your time
  • Taking a break
  • Being relaxed practising relaxation
  • Thinking about what you have achieved, not
    worrying about what you havent
  • Talking about how youre feeling
  • Leading a healthy lifestyle

4. Relaxation
  • Important for everyone to have times when they
    relax during the day stick to them it doesnt
    mean youre being lazy.
  • Lowers adrenaline
  • Reduces stress
  • Lowers blood pressure
  • Increases feelings of being in control
  • Reduces pain
  • Improves sleep
  • Reduces tension
  • Helps us feel better able to cope with problems
  • Helps reduce fears and anxieties
  • Improves well-being
  • Rest and relaxation are as important as work.
    Relaxation is more than just watching TV!

Things you can do
  • 1. Learn to recognise when you are stressed
    before it becomes a long-term problem. Be aware
    of daily hassles keeping adrenaline levels high.
  • 2. Be aware of unhelpful thoughts and how they
    can increase adrenaline. Try and replace with
    more balanced alternative ways of thinking.
  • 3. Make time for yourself for relaxation and
    enjoyable activities and stick to them. Practice
    breathing exercises everyday
  • 4. Change ways of doing things to lower stress
    levels and anxiety
  • 5. If things are too much to cope with, remember
    there is help and support available. Talk to the
    CR team.

  • Any questions?