What is the definition of stress?
condition experienced when the physical, mental, emotional, or social environment makes unwanted inescapable demands
What are the main physiological components of the stress system response
activation of the hypothalamic-pituitary-adrenal axis, autonomic nervous system arousal, and adrenaline secretion in the “fight or flight”
when are damaging stress levels reached?
perceived threats or dangers upset the biopsychosocial balance
what are the 3 response stages of stress
1) what is the first response and what functions increase?
startle response and orientating reflex as the patient becomes aware of the stress and is alarmed –> adrenal, cardiovascular, respiratory, MSK functions increase
2nd stage –> attempt to cope and problem-solve biologically, psychologically, and socially –> mobilize resources to meet and resist the stress.
3) exhaustion –> it depletes adaptive reserves and resistance disappears. experience SD and present requesting treatment for symptoms.
if the patient is able to cope and problem solve, what happens?
what if they fail?
mastery and learning occur
they become exhausted physically, mentally, and emotionally
What concept of stress dominates the current thinking about stress?
Adopting to change
What “type” of person is more likely to have stress in their lives and why?
A –> competitiveness, impatience, and difficulty dealing with anger.
treatment strategy for stress?
palpatory diagnosis
manipulative treatment
exercise, diet, smoking, alcohol, drug cessation
medication
coping strategy education
4 most common behavioral consequences of stress?
Depression
Anxiety
Substance Abuse
Insomnia
what happens physically to those who have prolonged depression, anxiety, or fear
increased tone, altered biomechanics, lack efficient postural mechanics.
what lifestyle choices can affect the MSK system
poor sleeping, chemical dependency.
what is cognitive behavioral therapy?
structured, goal-oriented, problem-focused and time-limited intervention
helps the patient develop new and adaptive ways of behaving.
What two patient centered things can the physician do to help mitigate stress
problem solving and patient education
What five other supports can people do to help mitigate stress?
muscle relaxation
support network
group support
spiritual support
biofeedback (use monitors to correlate your levels of stuff)
What is almost more critical than taking a good history for decision making?
what can be done during the history to help elicit patient centered questioning?
what about the plan?
what can the doctor do without the patient?
great empathetic listening.
open-ended questions,
involving patients in the plan helping them be more active in the decision making process
talk to other physicians to Gain additional insight on the diagnosis and development of a plan of care
