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Microsoft word - clearing the decks.doc
You now know a lot more about stress and how it affects you
(Part A & B of Week 1 handouts). The information in this
section will help you to make changes that will put you in a
better position to learn how to manage stress.
Clearing the decks
Before you learn new ways to get on top of stress, you must get rid of the things that might be making it worse. These may include:
Many people with drink problems start down that road by using drink to
calm their nerves. Having a drink is fine but if you drink to cope with
stress, you may start to depend on it. If you can't go to certain places or
do certain things unless you have a drink inside you, you are storing up
Symptoms such as nausea, sweating and shaking may be related to
alcohol. Drinking too much will mess up your sleep and make you more
prone to stress the next day. Panics may be related to drinking. Heavy
drinking makes stress worse - Stop it now.
The UK government recommends that men do not drink more than between 3 to 4 units per day, and that women do not drink more than between 2 and 3 units per day. A unit is just a bit less than a small glass of wine or a half pint of beer. It is also recommended that you have at least two days each week where you take no alcohol.
Caffeine is a stimulant
that affects the central nervous system (CNS).
Low levels of caffeine can help you think more clearly, keep you alert and
help you work for longer. But too much can be stressful for your body and
therefore make you feel on edge and uncomfortable.
Caffeine can be found in coffee (especially fresh), tea, fizzy drinks like
Coke, Pepsi, Iron-Bru (diet versions have more caffeine), painkillers such
as aspirin, cold remedies, and headache tablets such as Askits. Energy
tablets like Lucozade have very high levels, as do energy drinks such as
Red Bull. Chocolate has caffeine, though at quite a low level. Many other
products contain caffeine so check the packet if you are concerned.
The effects of too much caffeine can be very similar to those of stress. As
rough guide, about 6 cups of fresh coffee or 10 cups of instant
coffee or 12 cups of tea a day could be enough to make you feel worse.
As we all have our own limit at which we can be affected, you should
check from the list on the next page if you think caffeine might make your stress worse:
Effects of too much caffeine:
feeling nervous, irritable, agitated, shaky, headaches, muscle twitch,
flushed face, upset stomach, increased heart rate, speeded up
breathing, poor sleep (especially if you take caffeine at night).
Your body can get so used to caffeine that, if you just cut it out dead, you can get:
throbbing headache, tiredness or drowsiness, anxiety, depression and
These feelings could last up to one week
If you think caffeine may affect you, you should:
• Wean yourself off it slowly. This will stop withdrawal effects
• Switch to decaffeinated
tea and coffee
• Switch from fizzy drinks to caffeine-free drinks or pure fruit juice
• Take as few pain killers, etc. as you can (check this with your GP if
• Stay clear of all energy drinks or tablets The 'Miracle Cure'
It does not exist. Stress often takes a long time to build up so it is not
going to clear up overnight. No one else can control your stress. To get
on top of stress takes a great deal of hard work on your
part. So the
answer lies within you. ‘Stress Control’ aims to put you on the right track
but, at the end of the day, it will be you, through your hard work, who
controls the stress.
This may be nice in the short term but you can become dependent on it.
If you ask people at home or at work for reassurance a lot, they may
quickly get fed up with you. This can lead to friction and, hence, more
stress. You have to feel strong enough to supply your own answers and
reassure yourself that you can cope. Self-criticism
People under stress are highly skilled at self-criticism. Beating yourself
up doesn't help. If things go wrong, accept them. You can learn from
your mistakes, and this can help you deal with things in the future. You
have to learn to pat yourself on the back every time you try to combat
your stress. This will help your self-confidence to pick up.
Common sense says that if doing something makes you more tense, you
should avoid it. COMMON SENSE IS WRONG
. Avoiding may help in the
short term but in the long run, you just build up more trouble for yourself.
You have to face up to the problems in your life. Facing up to stress will
be hard in the short term but, in the long run, will greatly help you control
Finding hidden problems
You must check that your stress is not trying to tell you that there is
something wrong in your life. Check to see if you need to face up to
any problems at this stage. These problems could include:
Not taking responsibility Being too dependent
Drink or drugs
Not everyone who feels stressed has a hidden problem, but you should check to see if there are any in your life. Examples might be: ⇒ your partner is drinking and treating you badly ⇒ you are being bullied at work ⇒ you are in a lot of debt ⇒ you need to patch up a quarrel with a family member There may not be an easy answer to hidden problems but you must at least look for one. If you don’t face up to them, they will keep your stress alive.
Getting on top of stress takes time. While you are learning to do this, it
can help to learn these simple skills that can help you in the short term: Keep your life as normal as you can
You might find that stress invades many areas in your life. Try to put up
barricades to stop it. It will help a lot if you keep a routine going in your life
even if you don’t feel like doing so. If you go to the football at the weekend, keep going
; if you visit your mother's house during the week, keep going
you go to the bingo twice a week, keep going
. As work is an important part
of our routine, try to keep going to it if you can.
You should always discuss tablets with your GP. You should only really take
medication when symptoms of stress, anxiety or depression are significantly
affecting your life and making it difficult for you to function, e.g., go to work,
take care of the house, look after the children. Whether or not you are taking
medication, it is essential that you learn skills that will help you manage
stress. Stress is an inevitable part of life from time to time so you need to
know how to cope with it. Talking
If you bottle up your feelings, you will build up pressure inside yourself. Don’t
hide stress - accept it. Talking to a trusted friend or loved-one can allow you
to get rid of this stress. You should focus on ways to control the stress.
Others may also be able to give you good advice that you have not thought
of. Get your worries off your chest.
Sit alone in a quiet, dark room. Try to clear your mind as much as possible.
Think of a word or phrase e.g. : “I am calm"
"I am in control"
Close your eyes and slowly repeat the word or phrase in your mind over and
over again. Do this for ten minutes each day or when you feel stressed. If
unwanted thoughts come into your mind just let them float out and gently re-
focus back on your mantra.
Describing your setting
As soon as you feel your stress rise, describe (out loud if you want)
something you can see in great detail. For example: “I can see a picture on the wall. There is a boat on a river. There is a
mountain to the left of the river. Two people are walking along the
riverbank. The sky is clear and it looks like it is sunset. The picture has a
If outside, you can focus on certain things for example, all the sounds you
can hear. You should do this in as much detail as you can as this will help
distract your mind from stressed thoughts. Breathing retraining
This is a quick method to use to calm your body. It can also be used to help
Sit in a comfy chair and relax as much as you can. Take a slow normal
breath (not a deep breath) and think "1
" to yourself. As you breathe out, think
"; breathe in again and think "2
", breathe out and think "relax
doing this up to 10
. When you reach 10
, reverse and start back down to 1
Try to put all else out of your mind. It may help to see the numbers and the
word 'relax' in your mind's eye.
Don't be put off if you can't do this straight away. You can boost the benefits
of this by breathing from the diaphragm: Diaphragmatic breathing
Place one hand on your chest and the other over your belly button. As you
breathe in, the hand on your stomach should be pushed out while the hand
on your chest should not move. As you breathe out, your stomach should
pull in. Your chest should not move.
To help, breathe in through your nose, purse your lips and breathe out slowly
through your mouth. If you are a chest breather (as we tend to be when we
are stressed), you may find this difficult at first. If you can't get the hang of
this, lie on your back on the floor and practise as it is easier to do in this
Put these two exercises together and do them twice a day. Once you get
good at them you wont need to place your hands on your stomach and chest.
You can then use this when you are at work, sitting on the bus, watching TV
etc. The aim is to be able to do this no matter where you are. No one will
notice that you’re breathing slowly.
This approach is summarised overleaf.
Take a breath in and think "1
Breathe out and think "relax
Take a breath in and think "2
Breathe out and think "relax
Repeat up to 10
and then back down to 1
Concentrate only on breathing and on the number and "relax
the minds eye.
Use slow normal breathing (10-12 breaths per minute). Breathe
in through nose. Purse your lips and breathe out slowly through
Use the diaphragm - as you breathe in, your stomach should
push out while your chest should not move.
As you breathe out, your stomach should pull in. Your chest
should not move when you breathe out.
Practise twice a day in different places.
OFFICE OF THE CHIEF DISTRICT MEDICAL OFFICER NAWRANGPURletter no ___147___/2008 dated CS Nabarangpur the 21.11.2008 Quotation call paper Sl.No ITEM NAME Specification GURANTY NAME OF THE COSTincl REMARKS / Strength WARANTY MANUFACTURE/ uding PERIOD MARKETED 1 Window screen2 Door screen Double 3 Door screen Single 4 Grouping ABDH5 VDRL RPR6 Creatinine7 Chlostral8 Glucosti
PREPARACIÓN PARA pH-METRÍA ESOFÁGICA AMBULATORIA. Debe presentarse a su examen con un ayuno de 6-8 horas y una comida liviana el día anterior a la phmetría. Porfavor no fume 6 horas antes de realizar el procedimiento. Como usted ya sabe por la información que ha recibido de su médico, y como resultado de los estudios que le han sido realizados hasta ahora, existe la sospecha de una en