Stress Management Medical Students

8/4/2019 Stress Management Medical Students

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Dr.T.V.Rao MD

STRESS MANAGEMENT INSTUDENTS

DR.T.V.RAO MD 1


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THE CHALLENGES IN COLLEGE

The best years of your life? Expectations..

Even positive change is stressful

Greater academic demands Unstructured time

Decreased adult availability

Being on your own in a new environment

Changing relations with family

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CHALLENGES OF

COLLEGE: CHOICES

Alcohol and other drugs

Sex-identity, values, practices

Food

Sleep

Balancing Academic and Extracurricular

Roommates

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LIFE MANAGEMENT SKILLS:

DR.T.V.RAO MD 4

GENERAL: Life management skills, for thepurposes of this section, include stressmanagement, time management,

information management, financialmanagement, personal healthmanagement, and crisis management.Personal planning and adeptness at

managing each of these issues willincrease the serenity and reduce thestressors within a busy, productive life.


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DR.T.V.RAO MD 5


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Personal planning

and adeptness at

managing each of

issues will

increase the

serenity andreduce thestressors within a

busy, productive life.

PERSONAL PLANNING

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EVERY BODY IS UNDER STRESS

Every human on the earth will experience stress, even

medical students and physicians--it is a commondenominator in life. Some stress is good stress (eustress) that is

helpful and assists the drive toward achievement and success.Negative stress (distress) affects life in an adverse manner and

is a common cause of ill health in our society. Individuals who

ignore stress signals or who cope in a negative fashion will

experience escalating symptoms of stress. The symptoms may

appear as burnout, exhaustion, emotional illnesses such asdepression and anxiety, and physical illnesses such as ulcers,

heart attacks, hypertension, and abuse of alcohol and other

drugs with all the social and professional consequences.

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WHAT IS STRESS?Stress is your mind and bodys responseor reaction to a real or imagined threat,

event or change.The threat, event or change are commonly

called stressors. Stressors can be internal

(thoughts, beliefs, attitudes or external(loss, tragedy, change).

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ADOLESCENTS AND STRESS ?

Teens are under more stress

Since adolescence is a period of significant changes

physical,

emotional, social, and

academic changes

many than at any other time of life.


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It's important to remember

that stress is a natural part

of life. Experiencing stress

can be good, but it can also

have negative effects onone's well being. What

makes stress a positive or

negative factor lies with

how effectively the personexperiencing the stress is

able to manage it.

STRESS IS GOOD AND BAD TOO.

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Medical education has

deleterious consequences.

Trainees (students, interns, and

residents) suffer high levels of

stress, which lead to alcohol and

drug abuse, interpersonal

relationship difficulties

depression and anxiety, and

even suicide. Medical students

have mean anxiety scores one

standard deviation above thoseof non-patients, and their

depression levels increase

significantly

IMPACT OF MEDICAL EDUCATION AND

STRESS

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SIGNS AND SYMPTOMS OF STRESS

Physical

Poor appetite or overeating

Feeing tired and fatigued

Various aches and pains ---headache body achemuscle pain

Nausea & abdominal Pain

Sleep problems Falling sick very often e.g. fever cough cold

diarrhea

( because of lowering of immunity due to stress)


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Feeling low

Nervousness and Anxiety

Excessive Anger orDepression

Being easily upset

Poor self confidence

Low self esteem

Lack of Concentration Poor performance in

studies

MENTAL STRESS


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EXERCISE REDUCES STRESS

As a way of draining off stress energy, nothing beats aerobicexercise. To understand why, we need to review what stress is.People often think of stress as pressure at work, a demandingboss, a sick child or rush-hour traffic. All these may be triggers

but stress is actually the body's reaction to factors such asthese. Stress is the fight-or-flight response in the body,mediated by adrenaline and other stress hormones, andcomprised of such physiologic changes as increased heart rateand blood pressure, faster breathing, muscle tension, dilated

pupils, dry mouth and increased blood sugar. In other words,stress is the state of increased arousal necessary for anorganism to defend itself at a time of danger.

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Eustress or positive

stress occurs when

your level of stress is

high enough tomotivate you to

move into action to

get thingsaccomplished .

EUSTRESS

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Distress or negative

stress occurs when

your level of stress is

either too high or toolow and your body

and/or mind begin to

respond negatively to

the stressors.

DISTRESS

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As you begin to experiencea stressful event orperceive something to bestressful psychologicalchanges occur in yourbody. This experience orperception disrupts yourbodys normal balanceand immediately yourbody begins to respondto the stressor(s) aseffectively as possible.

ALARM STAGE

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THE PARADOX OF MEDICINE:BALANCING BETWEEN THE FACT THAT PEOPLE ARE

MOSTLY THE SAME & YET UNIQUELY DIFFERENT.

The Bell Curve

Individuals are all

Genetic Snowflakes

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Most people who need care dontseek it or receive it

Stigma, cultural pressure,mistrust, lack of information keeppeople out of care

So do lack of resources;treatment and medication areexpensive

Care is disjointed

Some schools dont seeemotional well-being and growthas in their mission

OBSTACLES

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Relationship problems

Depression

Anxiety

Eating Disorders

Substance Abuse

Sleep Problems

COMMON PROBLEMS

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Situational

Developmental

Generalized anxiety

disorder

Performance

Panic disorder, OCD,

phobias

ANXIETY

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35% of adult populationexperience insomnia

11% of college studentsget a good nights sleep

Loss of cognitivefunctioning, driving

Increased risk ofdepression

< 7 hours yields sleepdeprivation

SLEEP PROBLEMS

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LEARN STRESS MANAGEMENTEMOTION FOCUSED STRATEGIES

L

E

A

R

N

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LEARN STRESS MANAGEMENT

Laugh

E

A

R

N

SDR.T.V.RAO MD 24


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STRESS MANAGEMENT TIPS

Making little changesin your life can really add up to a big feelingof relief.

Learn to recognizewhen you are feeling stressed and simpleways you can relax.

Take a break. Have a cold drink, get some fresh air, or close youreyes for a minute to refocus.

Stay positive to help friends and family cope with stress.

Let others know you're feeling overwhelmed and tell them howthey can help.

Allow yourselfto simply say "no" to friends and family when youknow you cannot meet their demands without becomingoverwhelmed.


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Can you change yourstressors by avoiding oreliminating them?

Can you reduce their intensity(manage them over time

instead of immediately)

Can you shorten yourexposure to stress (take abreak, leave)

Can you devote the

time necessary to make

a change

RECOGNIZE WHAT YOU CAN CHANGE

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CULTURES, HUMOR & MEDICINE

Greeks home of the comediane

Native Americans Clown Doctors

Voltaire:

The Art of Medicine consists of amusing

the patient while nature cures thedisease.

Medicine today?DR.T.V.RAO MD 27


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An attitude toward life.

Taking your workseriously but yourselflightly.

Humor is healthy.

Humor connects us toothers!

It makes us MOREeffective!

WHAT IS HUMOR?

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HUMOR A GREAT TONIC TO STRESS

ENJOY IT

Humor is a wonderful stress reducer, an antidote to upsets.

Laughter relieves tension. In fact, we often laugh hardest when

we have been feeling most tense.

Humor is an individual thing - what is funny to one individual

may be hurtful to another. It is wonderful when patients can

poke fun at themselves. We can also do this with patients, but

we have to be careful and respectful in what we say. If you think

of something funny that may help the patient, say it if you feel it

will ease their tension and not be offensive. I will often throw ina quip or joke when I think it is appropriate. When it is done

sensitively, laughter is a great gift to people you care about.

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Gather Data

Provide Rapid Access toCare

Offer Education andOutreach

Involve Students

Coordinate Care

Be aware of communityresources

Understand your limits

WHAT SHOULD COLLEGES DO?

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Documentation

How busy is counseling? Identify

patterns and peak times of use.

Where else do students get

care?

How many students take time off

for medical reasons? Who comes

back?

How many students arehospitalized?

GATHER DATA

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EDUCATION AND OUTREACH

Be known. Get out in the community.

Train residence staff to recognize warning signs ofcommon problems.

Serve as liaisons/consultants to residence staff, deans,coaches.

Supervise student groups: peer counselors, wellnessreps, advocacy groups

Offer for-credit course to freshmen on stress and timemanagement

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WELLNESS ACTIVITIES

Start a Wellness Center on campus

Focus on prevention: Eat, Sleep, Exercise

Engage Students in community- study breaks, hikes,

massage

Teach yoga, sleep hygiene, relaxation response as part ofleading balanced life.

Have annual wellness or caring events or maximizeacademic potential, minimize stress

Student Wellness Reps.

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Practice time management

Learn relaxation exercises.

Rehearse and practice situations.

Learn practical coping skills.

Decrease negative self talk.

Learn to feel good with a workable resultDont be aperfectionist.

Build a network of friends.

Stress Management Plan


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Ultimately, the only people whocan get through to studentswith any consistency are thestudents themselves PeerCounseling/ EducationPrograms

Student Health Advisory Group

Wellness representatives in thedorms

Mental Health Advocacy Group

Involve in screenings andeducation

INVOLVE YOUR STUDENTS

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Legal issues

Confidentiality

What about parents?

How much care for whom?How are sickest students

cared for?

When should students take

a medical leave of

absence? Re-entry?

UNDERSTAND YOUR LIMITS

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Orient them and make thempartners

Dont say I cant talk toyou.

Process of communicationis key: dont shut them out

Invite them to getpermission

Discuss general concerns,suggestions withoutbreaching confidentiality

WHAT ABOUT PARENTS?

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Balancing needs of

individual and community

Balancing care and

education

How are sickest students

cared for?

When should students take

a medical leave ofabsence?

Re-entry

HOW MUCH CARE FOR WHOM?

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Emotional and physical

well-being are crucial for

academic success

The entire student body

benefits from a strong

counseling program

The institution benefits by

increased retention and

graduation, which enhance

reputation

RETURN ON INVESTMENT

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Get plenty of

exercise and

sleep. Improved

focus and

concentration help

increaseefficiency, so you

can complete

tasks in less time.

EXERCISE AND RELAXATION ARE

FOUNDATION FOR EFFICIENCY

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Even during their

medical colleges

careers, many students

take on extracurricularactivities and projects

that are not covered at

medical colleges.

Extracurricular activatesreduces the stress level

EXTRACURRICULAR ACTIVITIES REDUCES THE

STRESS

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Develop mutuallysupportivefriendships/relationships.

Pursue realistic goals which

are meaningful to you,rather than goals otherhave for you that you donot share.

Expect some frustrations,failures and sorrows.

Always be kind and gentlewith yourself be a friendto yourself.

MAINTAIN YOUR

EMOTIONAL RESERVES

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STRESS MANAGEMENT TIPS

Be prepared for unexpected problems such as traffic, alost pet or a family emergency.

Prioritize. Take control of your "to do" list by decidingwhat's really most important on your list.

Write down feelingsof sadness, frustration or anger toget a clearer perspective of your emotions.

Enjoy life's simple pleasures like colorful flowers,dancing, music, and social outings, etc.

Share your talents to better the lives of others as well asyour sense of well-being.

BEST TO WAY TO OVERCOME


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STRESS is verycommon

Use stress in apositive way Limit NOT eliminate

stress.

Use it to improveyour performance.

Learn CopingSkills

BEST TO WAY TO OVERCOME

STRESS


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THE TAKEAWAY

Academic performance is enhanced by physicaland emotional health

We can learn to recognize problems much earlier

Depression, Anxiety and Stress are treatable

Education, Psychotherapy and Medication are alleffective

Self Care--eat, sleep, exercise--is a cornerstone ofhealth (for all of us!)

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Being in control of your

life and having realistic

expectations about your

day-to-day challengesare the keys to stress

management, which is

perhaps the most

important ingredient toliving a happy, healthy

and rewarding life.

Marilu Henner

BE REALISTIC AND NOT BE

OVERAMBITIOUS

DR.T.V.RAO MD 46


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The programme created by Dr.T.V.Rao MD for

Students in the Developing World Email

[email protected]

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Stress Management Medical Students