Building Resilience to Stress

David L. Swihart M.C. LPC UA Life & Work Connections 621‐2493

Types of Stress 

Acute Sudden, intense, brief Acute ‐ Sudden intense brief

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Traumatic – The result of an experience  that provokes fear, horror and  p helplessness

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Chronic ‐ Ongoing, fluctuating in intensity

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Cumulative – Builds up over time

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Normal Dendrites

Dendrites Shortened due to Chronic Stress Source: McEwen, BS. www.cyberounds.com. Used by permission.

The above images demonstrate a comparison of a clinically depressed patient (right) compared to a matched control (left). In the color scheme, blue represents less activity (glucose metabolism) while red represents more (glucose metabolism). Source: http://www.musc.edu/psychiatry/fnrd/petdep.htm (Medical University of South Carolina). Used by permission.

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Stress: Immediate Effects 

Ischemic pts: 2x increase in risk for MI  Ischemic pts: 2x increase in risk for MI within 1 hour

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“Mental stress” induced ischemia  associated with  vascular resistance

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Exercise induced ischemia NOT associated with  vascular resistance. (Cacciapo, Tassmory & Bernstein, 2000)

Chronic Stress: Effects 

 Risk (2x) for Metabolic Syndrome  Risk (2x) for Metabolic Syndrome (Chandola, et  (Chandola et al., 2006)

 Hypertension : +15/+7 in “unfair” working  conditions. +10/+5 assoc. 16%  CHD risk, 38%   Stroke risk (Wager, et al., 2003)  Coping Ability can alter risk for CVD  p g y ((Keltikangas‐ g 

Jarvinen, et al, 2001)

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Anger 

Above median hostility => 9.5 x more  Above median hostility > 9 5 x more likely to have Ca score 20+ (ages 18‐30) (Iribarren, et al., 2000)

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Trait anger => (normotensive) 2.2 x  higher risk CHD (hypertensive) No Dif higher risk CHD, (hypertensive) No Dif (Williams, et al., 2000)

Depression 

11.6 x higher risk for development of  6 x higher risk for development of CHD. (Anda et al, 1993)

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Post‐MI depression increases risk of  death 4.1 x (Bush, et al., 2001)

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Sleep Problems 

Insomnia – Hard to get to sleep – Hard to get back to sleep

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Disrupted sleep – Poor quality of sleep q y p

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Productivity Cost: ~$2‐3,000/emp/year

LONG-TERM HEALTH CONSEQUENCES Heart Disease High g Blood Pressure Insulin Resistance Suppressed Immune System - infections Hyper Immune Response - autoimmune disorders Ulcers, GERD, IBS Osteoporosis Diabetes Rheumatoid Arthritis Neuron Death & Brain Shrinkage

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Social Support 

Social Support Social Support

– Protective factor – Alters perception of approaching stressors  Supportive Supervisors & Organizations –  Work‐family conflict (Goff, Mount, & Jamison,  1990 J 1990;Jones & Butler, 1980). & B tl 1980)

–  Employee job satisfaction (Parasuraman et al., 1992), –  Organizational commitment (Scandura &Lankau,  1993).

HOW FAT IS YOUR MARGIN?

Margin: Your moment by moment ability to cope with a new stressor

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Exercise:  Manifestations of Stress  Physical  Cognitive  Psychological/Emotional y g  Spiritual

Stress Response Process Stressors

Perception of stressor

Physical Responses

Behavioral Responses Health Outcomes

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Our Perceptions of Life E Events... t Determine Our Emotional Responses

Perception: Added Meaning  Meaning associated with  Meaning associated with

stressor event  Built historically  Meanings can be Changed  Ask “Dumb” Questions – Why…

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Common Perceptions?

Resilience  Identify (Mis)Perception Identify (Mis)Perception  Work to Change Your Perception

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Characteristics of Resiliency 

Playful Childlike Curiosity Playful, Childlike Curiosity – – – – – –

Asks lots of questions; Wants to know how things work; Plays with new developments; Makes mistakes Learns from experience Trusts intuition and hunches

Characteristics of Resiliency 

Mentally and Emotionally Flexible – Comfortable with contradictory personality  qualities, (e.g., Strong vs. Gentle, Logical vs. Intuitive,  Calm vs. Emotional) – Has Good Friendships, Loving Relationships – Can Have Feelings w/o Feelings Having Them – Reads Others with Empathy

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Characteristics of Resiliency 

Has Solid Self‐Esteem and Self‐Confidence – Self‐Confidence = Reputation with yourself – Expects Things to Work Out Well • “Its just a problem to be solved”

– Defends Self Well • Avoids/Blocks Attacks • Sees Through Cons • Sidesteps Games

Characteristics of Resiliency 

Positive Emotion and Laughter Positive Emotion and Laughter – – – –

Humor Gratitude Interest Love

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Characteristics of Resiliency 

Hardiness – The commitment to find meaningful  purpose in life; – The belief in one’s ability to influence  surroundings or outcomes; – The belief that one can grow and learn  Th b li f h dl from both positive and negative  experiences. Bonnano (2004), Siebert (2003)

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