Stress Management

Speaker 1: The material contained in this video presentation provides general information on the management of chronic obstructive pulmonary disease. This information is for reference purposes only and should not be considered medical advice. For specific information and recommendations based on your health condition, please consult your medical provider.

Jayme Hodges: Hi. My name is Jayme Hodges and I'm the director for the Behavioral Health Center and Addiction Medicine Offices here at Lee Health. And I'm here to talk to you about stress management.

Let's talk about stress. What is it? Stress, if you think about it, is made up of two components. You have the stressor, which is anything that happens in your day-to-day life that is outside of the norm. It can be real or it can be perceived. Then you have the stress response, which is your body's natural reaction towards that stressor.

The stress response can actually occur in anticipation of a stress as well, those what ifs. The what if of the future, the what if of tomorrow, "What if this is going to happen again?"

When we talk about stress, there's typically three different types of stressors that we focus on. We have acute stress, which is frequently occurring, very episodic, but short-lived. Then we have episodic acute stress, which is just a lot of the acute stressors occurring. And then we have chronic stress.

So, when you think about acute stress, I think of rush hour traffic. When I drive home, there's always the same spot in the same place that takes a long time to get through.

Then I think of episodic acute stressors when a season occurs and there is more traffic at more times of the day and it takes me even longer to get through.

But chronic stress we think about when you talk about chronic medical conditions, chronic poverty, chronic situations that occur for long periods of time. Stress is something that is also considered a normal, everyday reaction to situations. It is the survival response to any perceived threat, and it is something that can become unhealthy over time if it's not managed or appropriately handled in the best possible way.

According to the APA's 2019 survey on stress, more than three quarters of adults reported having some sort of emotional symptom of stress. And about half of adults indicated that they laid awake at night because of stress.

So, stress is something that can occur in every facet of life, it is a normal part of life. But it also is something that we need to learn how to handle effectively.

And when we talk about stress, it's important to understand what some of the sources of stress are.

Sources of stress could include finances, worries about, "Do I have enough money? Do I not have enough money? Will I have include money later?"

Also include health and wellness. I may have a chronic health condition or going through testing about possible chronic health condition, or an uncertainty related to a medical diagnosis.

Relationships. Not everybody has good relationships with their family or friends and they're often a big source of stress.

And natural disasters. We here live in Florida and every year we have hurricane season.

And then you get into thoughts and perceptions. A lot of times, a big source of stress is actually how we choose to perceive a situation. We get into expectations of ourselves, of situations and other people. Those shoulda coulda woulda. "I should have done this. You should have done that. If it only could have been this. If this would have happened." A lot of that leads to a feeling of a loss of control or a lack of control, which leads to that uncertainty and fear.

And when we think about those thoughts and perceptions, it's important to understand our own cognitive biases, otherwise known as cognitive distortions or just simply unhelpful thinking styles. Some of those thinking styles are all or nothing thinking. We see things either all good, all bad, all black, all white, no gray. "I never can do something. This always happens to me." So, we tend to think in the all or nothing generalities of things.

Other unhelpful thinking styles include mental filtering or discounting the positives. We tend to focus solely on the negatives of a situation, rather than giving any sort of credence to any positives of that.

You also have mind reading or fortune telling. We often assume we know what the other person is thinking, without them having to say something, and we project that into the future.

These are just different examples of unhelpful thinking styles that play into our overall stress response.

When you talk about stress in lung disease such as COPD, during times of acute stress, the ability to manage situations is affected because of the difficulty of breathing. And the difficulty in breathing can lead to increased stress response as well. This leads to an increased likelihood of flare ups with chronic lung disease.

When you talk about chronic stress, stress can worsen the symptoms of chronic lung disease, and this can lead to more frequent flare ups of symptoms.

This brings me to something that's very common with chronic lung disease called the dyspnea cycle. Essentially, stress and anxiety can make breathing harder, and difficulty breathing can then lead to increased anxiety and panic. Okay? Anxiety and panic lead to worsening of shortness of breath, so it becomes this vicious cycle.

One of the most important things about stress management is learning about various coping strategies. The American Psychological Association provided some tips for managing stress, and they include understanding how you stress, identifying your sources of stress, learning your own stress signals and recognizing how you deal with stress.

All of this leads to an increased awareness and insight in finding healthier ways of managing stress. And they include taking care of yourself and reaching out for support if you need it.

Other coping strategies include developing and maintaining social supports. It's important to recognize and understand that we are not islands unto ourselves, that we need to be surrounded by people that care about us and that we care about them.

We need to learn how to challenge and reframe our thinking. Going back to that unhelpful thinking style, being able to recognize how is it that we're viewing the world around us so we can learn to challenge our own thought processes. Other coping strategies involve practicing relaxation skills. They include meditation, mindfulness, visualization exercises and some breathing exercises, including pursed lipped breathing and diaphragmatic breathing.

Coping strategies also include taking breaks, breaking down tasks into smaller steps, pacing ourselves so that we learn to find the middle ground between doing too much and not enough, and being able to ask others for help. A lot of times we don't like to ask others for help, but it's important when we're looking at coping strategies to deal with chronic illness, especially chronic lung disease, that it's okay to ask others for help.

And most importantly, to be able to talk to your healthcare provider. If you want to learn more about various breathing exercises like pursed lipped breathing and diaphragmatic breathing, I would encourage you to speak directly with your healthcare provider.

And what you see now on the screen is going to be a list of resources for you, both locally and nationally. And I encourage you to take the time to look into these various resources to educate ourselves, to educate your loved ones. Understanding how to manage your stress more effectively as it relates to your underlying illness is going to be a key to living a happy and healthy lifestyle.

I want to take this minute to thank you for allowing me to be here with you, to provide some of this educational information for you. I hope you find it useful and helpful. And please understand that you are not alone in this, that help is here for you. So, if you need anything please reach out to those around you.