Stress Management and Ayurveda

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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.

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.

The most beautiful experience in life is mysterious.

It is this fundamental emotion which standsat the cradle of true art and true science.

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

Stress and Coping —the science and the art

• What stress is, how it is caused, and yourresponsibility for your stress levels.

• Optimum levels of stress and the effects of longterm 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.

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.

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.

Sources of Stress

• Too much change too quickly can be a cause ofstress

• Stress can be caused by pleasant and unpleasantevents.

• The cause of stress may not always be apparent.

• Usually stress is a result of build-up of related andunrelated events.

• Often your stress is more apparent to others than toyourself.

• Reactions to stress can be emotional, physical andbehavioural.

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

Stress and Coping

• A certain level of stress is good for us.

• One person’s stress may be someone else’senjoyment.

• Too much stress affects our health and well-being.

• There is every reason to be optimistic that youwill be able to overcome stress in your life.

Stress – the Types

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.

Developmental

Situational

Acute (short intense)

Chronic (prolonged)

STRESSOR PERCEIVED ANXIETY THREAT

STRESS

(situation characterizedby some degree ofphysical/ psychologicaldanger)

(anticipation ofharm, thought, memory, judgementand interpretationof situation)

tension,apprehension,worry, palpitationdizziness

Intensity ofreaction

Perceived dangeror threat

How Stress Adds Up

Degreeof Stress

Potentiallystressfulevents

Response to the events (physical, emotional or behavioural)

Significance of the events to us (happy, sad or indifferent)

Adapting to StressStress

Hypothalamus

Pituitary Autonomic Nervous System

Adrenalin

Flight/ Fight response

(Breathing , Heartrate ,Blood supply to muscles .)

ALARMREACTION

II STAGE OF RESISTANCE

III STAGE OF EXHAUSTION

I

THE PATHWAY OF STRESSOR EFFECTSThe Stressor

Hypothalamus

Pituitary

ACTH

Adrenal catecholaminesEffects : Peptic ulcers

Corticoids

GluconeogenesisThymusLymph nodes

Blood cellsImmune reactionsInflammation

Effects :

Effects :

Blood pressureMetabolismCentral nervous system

Autonom

ic

nerve

s

Psychological Reactions to Stress

• Feeling under pressure

• Feeling tense and unable to relax

• Feeling mentally drained

• Being constantly frightened or worried

• Increasing irritability and complaining

• Feelings of conflict

• Restlessness, increasing inability to concentrate or to complete tasks quickly

• Frustration and aggression

• Increased tearfulness

• Become more fussy, gloomy or suspicious

• Being unable to take decisions

• Impulses to run an dhide

• Fears of social embarrassment or failure

• Lacking in ability to feel pleasure or enjoyment

Physical Reactions to Stress

• Muscle tension

• Rapid, uneven or pounding heartbeat

• Fast, shallow breathing

• Change in appetite

• Sleep problems

• Headaches

• Indigession

• Frequent urge to pass urine

• Chest discomfort

• Constipation or diarrhoea

• Backache

• ‘Butterflies’ in the stomach

Negative Stress at work place :

• interferes with clear judgement in makingeffective decisions.

• Reduced enjoyment of work.

• Causes difficult situations to be seen as athreat, not a challenge.

• Consumes mental energy in distraction, anxiety,frustration and temper.

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 bossor colleagues

• responsibility for people, budgets or equipment

The Human Personality

Type A

Type B

Nature

Nurture

Faulty Coping Mechanisms used

• Denial

• Displacement

• Fixation

• Introjection

• Projection

• Rationalisation

• Regression

• Withdrawal

Five mainUNREALISTIC desires or beliefs :

• The desire always to have the love andadmiration of all people important to you.

• The desire to be thoroughly competent at alltimes.

• The belief that external factors cause allmisfortune.

• The desire that events should always turn outthe way that you want them to, and that peopleshould always do what you want.

• The belief that past bad experience willinevitably control what will happen in the future.

• The difficult thing about stress isrecognising it; doing something about itis relatively easy.

• Once you have recognised that you aresuffering a stress response, you shouldbe able to identify and tackle anyunderlying causes, not just thesymptoms.

• And you can ask someone youtrust and respect to help.

STRESS AWARENESS....

Tackling the Problem

• Once you have recognised that you aresuffering a stress response, then you should be able to identify and tackle any underlyingcauses.

• List your signs of stress

• List the probable causes of your stress

Tackling the Problem

• Monitor the changes in the nature, severity orduration of the signs of your stress.

• Look out for unhelpful thoughts, and think ofnew solutions to them.

• Plans and activities are powerful weapons toovercome stress.

Defences against Stress

• We can defend against stress byunderstanding its causes.

• The principal defences against stress arephysical and mental fitness.

• Physical fitness is improved by healthylifestyle, adequate sleep, eating a balanceddiet and taking regular exercise.

• Our mental fitness to deal with stress ishelped by self-instruction and self-control.

• Relaxation techniques are useful when youfell stressed.

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

STOP ….. FOR A THOUGHT

How to help yourself

• Many people find their own ways of tacklingstress

• Anxiety attacks always go away after a time.

• Worry is a pointless activity and never solvedanything.

• Confront your problems, and make plans tosolve them.

• Everybody has setbacks – and they can beovercome.

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

Getting Help

• Family and friends can provide valuablesupport in dealing with stress.

• If you are worried about stress, the earlier youtackle it and help begins the better.

• There are three main types of professionalhelp available : medical, psychological andsocial.

• Give a treatment a fair chance to help youbefore trying something else.

• Self-help groups and the media can provide awealth of information, advice and practicalhelp.

Your Stress Diary

• Keeping a stress diary is an effective way offinding out both what causes you stress, andwhat level of stress you prefer.

• In this diary note down your stress levels andhow you feel throughout the day.

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

When stressful eventsoccur…… 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?

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.

‘False Friends’

• Smoking, drinking alcohol and taking drugs ofdependence are not a cure for stress – they allmake stress, and coping with stress, harder.

• While alcohol in moderation can be a pleasure,heavy drinking carries serious risks to healthand well-being-personal, family and at work.

• Stress is the most common reason smokersgive for not stopping smoking.

• Nicotine is one of the fastest-acting addictivedrugs known to humankind.

• Smoking is not only capable of ruining yourhealth, it also ruins your finances.

Pills, potions andcomplementary methods

• Becoming dependent on pills and potions creates further problems.

• Many people find complementary methodssuch as yoga of benefit.

• Overcome stress by understanding andcontrolling your response to it.

• Remember to use the golden rules forreducing stress.

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 notoverly aggressive or passive

• Decrease negative self talk

• Rehearse and practice situations that cause stress

The Advantages ofRegular Relaxation

• Improves sleep

• Increases mental and physical performance

• Combats tiredness

• Decreases anxiety and tension

• Is not addictive

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.

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

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

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.