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Stress Management ...

May 1, 2007
Summer is coming and we’re supposed to feel relaxed, look forward to vacation, and spend time with family.

Summer is coming and we’re supposed to feel relaxed, look forward to vacation, and spend time with family. Instead, we’re worried about sending our children to camp, harried because school-time routines are upset, and rushed to find that perfect vacation spot. In short, we feel stressed out.

Stress is not merely a case of anxiety or aggravation. It is a contributing factor to disease, dissatisfaction with life, and lowered productivity in the workplace. Stress is estimated to cost employers and workers $300 billion annually in health care costs and lost time. For dental professionals, stress impacts health and the ability to motivate clients toward positive health behaviors.

This issue of “Your Comfort Zone” addresses the basic causes of stress and three approaches to manage stressors. Although we may not be able to eliminate stressors, we can control our behaviors and how we react to these stressors.

What are the effects of stress?

Hans Selye first described stress as a natural fight-or-flight response that allows us to respond effectively to emergency situations. The brain increases the flow of stress hormones such as adrenaline and norepinephrine to the body, which increases heart rate and blood pressure and readies muscles for action. When an emergency is over, our body systems return to a resting state.

In our fast-paced world, many of us live in a constant state of stress and lose the ability to downshift, or return to a calm, resting state. We remain constantly alerted and experience physical (insomnia, headache, or backache) and emotional (irritability, impatience, difficulty with decisions, forgetfulness, or difficulty with concentrating) signs of stress. Over a long time, chronic stress may contribute to more serious conditions such as cardiovascular disease, hypertension, irritable bowel syndrome, tension headaches, and musculoskeletal disorders. The ability to manage stress is important to health.

What are the causes of stress?

Stressors are situations that cause us to feel stress. Stressors include major life events such as changing jobs, major illness, and loss of loved ones. The smaller, daily hassles such as commuting to work, rushing to get children ready for school, and disagreements with others, however, present even greater sources of stress for some. Dental professionals might experience work-related stressors in treating anxious clients, dealing with insurance companies, encountering difficulties with scheduling, communicating with coworkers, and other stressors.

How can we manage stressors?

The best way to manage a stressor is to eliminate the root cause. That may not be possible, though. Therefore, we need to develop coping mechanisms to increase our overall resilience. First, we must become aware of our bodily signs that indicate stress and identify the stressors causing these symptoms. For example, we might find ourselves clenching our jaws, gripping the steering wheel tightly, or developing trigger points in our shoulders during daily commutes. We then need to develop our own strategies to effectively handle these stressors. Stress-management strategies can be grouped into three categories: changing our thinking (perception of the stressor), changing our behavior (reaction to the stressor), and changing our lifestyle (e.g., routines, diet, sleep patterns).

Change thinking

Cognitive behavioral approaches, or reframing, teach us to manage stress by changing our view or perception of a stressor. For example, instead of viewing the commute as a source of frustration, we could view it as alone time and listen to calming music or books on CD. Reframing does not change the commute, but it helps us view it in a less stressful way.

Change behaviors

Relaxation techniques enable us to control our bodies’ responses to stress by eliciting a rest-and-repair mode rather than a fight-or-flight response to a stressor. A relaxed state enables us to think clearly and focus on a specific issue. Many techniques manage both on-the-spot stressors and more long-term methods of relaxation. Short-term, stress-release methods include deep breathing, humor, and taking a timeout (walk away, calm down, then return to the stressor once emotions are calmer).

Other techniques, such as deep relaxation, guided imagery, or the relaxation response, require more time in a quiet environment. The well-known Jacobson’s Progressive Muscle Relaxation, or PMR, teaches participants to become aware of muscle tension and guides them through a protocol of systematically contracting and relaxing muscles in the body to achieve relaxation. Yoga has become increasingly popular in decreasing stress through proper breathing and eliminating muscle tensions.

Assertiveness training also helps minimize stress by teaching us to state our needs. Assertiveness promotes open communication in work relationships and increases self-confidence. Because women are socialized to please others and comply with others’ requests, we tend to take on increasing numbers of tasks rather than prioritize our needs and delegate tasks to others. Assertiveness allows us to make choices for ourselves rather than allow others to decide for us.

Change lifestyle

As discussed in my previous WDJ e-newsletter column on wellness, a healthy lifestyle increases physical and emotional resilience. A healthy lifestyle includes eating a balanced diet, getting regular exercise and adequate sleep, planning ahead, and pacing the day. Regular exercise decreases blood pressure and heart rate and helps relieve stress by burning off excess energy generated during a fight-or-flight response. Finally, because poor organization is one of the most common causes of stress, time-management techniques help us organize responsibilities.

In summary, we are quick to blame external causes for stress. When we recognize that we create most of our own stress, we will take the important first step toward coping. This summer, let’s take those restful walks with friends, incorporate yoga into our weekly routines (try a yoga video if classes are not an option), and plan ahead to socialize with others - but let them bring the food. We’ll supply the smiles.

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Martha J. Sanders, MA, MSOSH, OTR/L
Sanders is an assistant professor of occupational therapy at Quinnipiac University in Hamden, Conn. She has worked with dental practitioners for more than 15 years in rehabilitation and prevention of musculoskeletal disorders. Sanders is the editor of a textbook on ergonomics, “Ergonomics and the Management of Musculoskeletal Disorders.” E-mail her at [email protected].