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The Chat with Dr.

Dave
Therapeutic Thoughts of the Week

Stress Management: Stress 101

As we are immersed already in the holiday season it is imperative as providers to be mindful of


how the holiday season may exacerbate psychological symptoms and impact our patients
abilities to self-regulate in positive ways. It is also equally imperative that as providers we are
assessing ourselves to determine our individual stress level to identify the need for us to partake
in our own self-care, to be mindful of our own level of fatigue and how this may impact our
ability to effectively manage our own counter transference and our ability to be effective service
providers. This weeks Dr. Daves Therapeutic Thoughts of the Week will define stress,
identify the causes of stress, highlight signs of burnout, offer recommendations for stress control,
present stress management mistakes, and provide a stress test to assess your personal level of
stress.
Stress Management: Stress 101 as suggested by Melissa C. Stoppler, M.D.
What is stress?
Any physical, chemical, or emotional factor that causes bodily or mental tension and that may
be a factor in disease causation. (Social scientists use the term stress to denote any force that
impairs the stability and balance of bodily functions.)
What causes stress?
Physical and chemical factors such as trauma, infections, toxins, illnesses, and injuries of any
kind.
Are all stresses bad?
Not necessarily. A mild form of stress may be beneficial while completing tasks or carrying
out an assignment as it compels us to do a good job and work energetically.
Who is most susceptible to stress?
Stress comes in various forms affecting persons of all ages and ethnicities. No external
standards can be applied to predict stress levels in individuals.

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What are the symptoms of excess stress?
Headaches, sleep disturbances, feelings of anxiety or tension, anger, lack of concentration,
increased appetite, loss of appetite.
13 Signs of Burnout as suggested by Henry Neils
1) Chronic fatigue-exhaustion, tiredness, a sense of being physically run down
2) Anger at those making demands
3) Self-criticism for putting up with the demands
4) Cynicism, negativity, and irritability
5) A sense of being besieged
6) Exploding easily at seemingly inconsequential things
7) Frequent headaches and gastrointestinal disturbances
8) Weight loss or gain
9) Sleeplessness and depression
10) Shortness of breath
11) Suspiciousness
12) Feelings of helplessness
13) Increased degree of risk taking
For a more in-depth discussion of Henry Neils 13 Signs of Burnout please access website
address http://www.assessment.com/mappmembers/avoidingburnout.asp?Accnum=06-5210010.00.
Five Essential Habits for Stress Control as suggested by Melissa C. Stoppler, M.D.
1) Develop your relaxation skills.
Stress Control requires your being able to put aside the demands and stressors in
your daily life, at least temporarily. Many people have actually lost the ability to
relax and create emotional distance from troubling thoughts and may need to re-train
their body and mind to relax effectively.
2) Pay attention to physical health.
Remember that stress results from a combination of physical and mental factors. If
your body isnt able to handle these challenges, you arent going to be capable of
effective stress management.
3) Become a time management expert.
Finding extra minutes in your day need not be an insurmountable task, and those
daily minutes add up.
4) Exercise Regularly.

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Exercise not only stimulates release of endorphins, the bodys natural stress-fighters,
but it also helps lower cortisol and other stress hormone levels. Youll also be
healthier and better prepared to deal with both physical and mental demands.
5) Prioritize commitments and responsibilities.
Learn to differentiate between mandatory obligations and commitments you made due
to guilt, to satisfy others, or to fulfill unrealistic expectations of yourself. Learning to
say no can help reduce the stress of excessive demands on your time and energy.
Top Five Stress Management Mistakes as presented by Dr. Melissa C. Stoppler
1) Poor Calendar Habits.
Writing down each demand on your time is essential when you want to limit
stress brought on by overscheduling, forgotten appointments, disappointed friends
and family members, and irritated coworkers.
2) Clutter.
Eliminate any unnecessary items from your home or desk such as your high school term
papers, your soda can collection, or your 1980s leg warmers.
3) Perfectionism.
Put aside your halo and wings and remember that you are not SuperWoman or
Superman. True perfectionism is a set-up for disappointment since it is unattainable.
4) Self-Treatment.
Remind yourself to self-care and ask yourself what healthy stress relieving habits do you
utilize throughout your day or week.
5) Following Others Expectations.
Stress may be associated from tasks, responsibilities, relationships, or other aspects of
life that dont resonate with your innermost wishes and preferences. Remind yourself
why you are participating in activities, which may help alleviate thoughts of stress and
anxiety.
Unconventional Stress Relievers as suggested by Dr. Melissa C. Stoppler
1) Sing.
Sing in your car, in the shower, at home, or wherever you feel comfortable.
2) Try a repetitive activity.
Participate in an activity which requires soothing movements such as pottery making or
knitting. Remind yourself that you are not creating a masterpiece.
3) Start a garden.
Cultivating flowers and plants is a rewarding way to observe life bloom.

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4) Play with a dog or cat.
Stroke a dog or a cat. Its a form of social interaction with no pressure to meet anyones
expectations.
5) Gaze at the stars.
Preferably in a still, dark, and quiet area, sit back and observe the heavens. Try creating
a tranquil place in your work environment where you may allow yourself to get lost in a
relaxing space.
Take the stress test
How is your stress level? Answer the questions below to see just how many of the stress
indicators apply to you.

1.
2.
3.
4.

How frequently have you had this feeling?


My frequency or experience in the past month? 0, 1, 2 or 3?

Felt tense, nervous, anxious or upset


Felt sad, depressed, down in the dumps or hopeless
Felt low energy, exhausted, tired or unable to get things done
Couldnt turn my thoughts off long enough at nights or on weekends to feel relaxed
and refreshed the next day
5. Found myself unable to sit still, and had to move around constantly
6. Was so upset that I felt I was losing control of my feelings
7. Have been preoccupied with a serious personal problem
8. Have been in unpleasant situations that I felt hopeless to do anything about
9. Felt tired in the morning, no energy to get up or face daily activities
10. Have had problems concentrating on things, or remembering names
11. Feel I could be doing a great deal more to take care of myself and keep healthy
12. Dont feel I have much control over the events in my life
13. No matter how hard I try, I cant seem to accomplish what I want
14. Have been continually frustrated in my life by bad breaks and people not living up to
my expectations
15. My standards are very high for my own activities
16. When something difficult or stressful is coming up, I find myself thinking about all the
ways that things can go poorly for me
17. My life is empty and has no meaning
18. Often run into problems I cant solve
19. Am not able to give what I would like to the people closest to me
20. Have not felt close to or accepted by the people around me, both family and friends

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Scroll back up the page and add up the numbers youve placed in each box.
If your total score is between 0 and 20, your stress level is relatively low. That does not mean
you wont feel the effects of stress, but beginning stress-management techniques now will go a
long way to improving your sense of well-being.
If your total is between 20 and 40, your stress level is moderate. Taking steps to manage stress
now will help to prevent serious physical, psychological and emotional problems.
If your total is between 40 and 60, you are stressed out.
To access the Stress Test on-line please refer to http://powertochange.com/life/stresslevel/.
This weeks Dr.Daves Therapeutic Thoughts of the Week is to acknowledge and draw
attention to the concept of stress and to highlight preventative ways to manage stress in hopes of
promoting healthy emotional regulation in our patients as well as to identify signs of burn out
within ourselves and to implement strategies to reduce professional burnout.