Relaxation and Stress Management
- Stress is a change in the environment that is perceived as a threat, challenge, or harm to the person's dynamic equilibrium. In times of stress, the sympathetic nervous system is activated to produce immediate changes of increased heart rate, peripheral vasoconstriction, and increased blood pressure. This response is prolonged by adrenal stimulation and secretion of epinephrine and norepinephrine, and is known as the fight-or-flight reaction.
- A limited amount of stress can be a positive motivator to take action; however, excessive or prolonged stress can cause emotional discomfort, anxiety, possible panic, and illness.
- Prolonged sympathetic-adrenal stimulation may lead to high blood pressure, arteriosclerotic changes, and cardiovascular disease; stress has also been implicated in acute asthma attack, peptic ulcer disease, irritable bowel syndrome, migraine headaches, and other illnesses.
- Stress management can help patients control illnesses, improve self-esteem, gain control, and enjoy life more fully.
- Stress management involves the identification of physiologic and psychosocial stressors through assessment of the patient's education, finances, job, family, habits, activities, personal and family health history, and responsibilities. Positive and negative coping methods should also be identified.
- Relaxation therapy is one of the first steps in stress management; it can be used to reduce anxiety brought on by stress. Relaxation techniques include:
- Relaxation breathing- the simplest technique that can be performed at any time. The patient breathes slowly and deeply until relaxation is achieved; however, it can lead to hyperventilation if done incorrectly.
- Progressive muscle relaxation- relieves muscle tension related to stress. The patient alternately tenses, then relaxes muscle groups until the entire body feels relaxed.
- Autogenic training- can help relieve pain and induce sleep. The patient replaces painful or unpleasant sensations with pleasant ones through self-suggestions; may require extensive coaching at first.
- Imagery- uses imagination and concentration to take a mental vacation. The patient imagines a peaceful, pleasant scene involving multiple senses. It can last as long as patient decides.
- Distraction- uses the patient's own interests and activities to divert attention from pain or anxiety and includes listening to music, watching television, reading a book, singing, knitting, doing crafts or projects, or physical activities.
-
- To assist patients with relaxation therapy, follow these steps:
- Review the techniques and encourage a trial with several techniques of the patient's choice.
- Teach the chosen technique and coach the patient until effective use of the technique is demonstrated.
- Suggest that the patient practice relaxation techniques for 20 minutes per day to feel more relaxed and to be prepared to use them confidently when stress increases.
- Encourage the patient to combine techniques such as relaxation breathing before and after imagery or progressive muscle relaxation along with autogenic training to achieve better results.
-
- Additional steps in stress management include dealing with the stressors or problem areas and increasing coping behaviors.
- Help the patient to recognize specific stressors and determine if they can be altered. Then develop a plan for managing that stressor, such as changing jobs, postponing taking an extra class, hiring a babysitter once per week, talking to the neighbor about a problem, or getting up 1 hour earlier to exercise.
- Teach the patient to avoid negative coping behaviors, such as smoking, drinking, using drugs, overeating, cursing, and using abusive behavior toward others. Teach positive coping mechanisms, such as continued use of relaxation techniques, fostering of support systems- family, friends, church groups, social groups, or professional support groups.
-