TERM PAPER ON STRESS AND ITS MANEGEMENT

INTRODUCTION

Stress is a pervasive, chronic and relentless psychosocial situation.it is the chronic response that
maintains the body in the aroused condition for extended periods that promotes susceptibility to
disease of adaptation. Stress is the way human beings react both physically and mentally to
changes, events and situations in their lives. People experience stress in different ways and for
different reasons. The reaction is based on your perception of an event or situation. If you view
a situation negatively, you will likely feel distressed—overwhelmed, oppressed or out of
control. Distress is the more familiar form of stress. The other form, eustress, results from a
“positive” view of an event or situation, which is why it is also called “good stress.” Eustress
helps you rise to a challenge and can be an antidote to boredom because it engages focused
energy. That energy can easily turn to distress, however, if something causes you to view the
situation as unmanageable or out of control. Many people regard public speaking or airplane
flights as very stressful—causing physical reactions such as an increased heart rate and a loss of
appetite—while others look forward to the event. It’s often a question of perception: A positive
stressor for one person can be a negative stressor for another.

The word stress is hailed from the Latin word “strictus”, which means “to tighten”. Stress, in
common, can be defined as the response of a person to demands (stressors) forced upon him/her
(Erkutlu & Chafra, 2006)[3]. The researchers explained the term stress, as a situation where the
well-being of an individual is affected due to his failure to cope with the demands of the
situation.

DEFINITION

Adaptive response as behaviour that maintains the integrity of the individual. Adaptation is
viewed as positive & correlated with a healthy response. When behaviour disrupts the integrity
of the individual, it is perceived as maladaptive. Maladaptive response by the individual are
considered to be negative or unhealthy.

Stress: The non-specific response of the body to any demand placed upon it. (Hans Selye)
Stress should be restricted to conditions where an environmental demand exceeds the natural
regulatory capacity of an organism. (Bruce McEwen and Jaap Koolhas)

CONCEPT OF STRESS

To explain stress in conceptualising form is a very difficult task, which is one of the major
issues of various analyses. Stress is becoming a topic for continuous discussion among experts,
beyond this continuous debate, a general conclusion can be drawn with regard to the concept of
stress, which is the key point, on the idea of a perceived imbalance in the interface between an
individual and his surroundings. When people face different demands from others or demands
from the physical/psycho-social environment or outside environment, where they are unable to
respond effectively, an effort is required to cope up with the situation. There are mainly three
concepts of stress that includes stress as a biological response, stress as an environmental event,
& stress as a transactional between individual & the environment.

STRESS AS A BIOLOGICAL RESPONSE

Hans selye defined stress as a calling it the state manifested by a specific syndrome
which consist of all the non-specifically induced changes within a biological system. This
syndrome of symptoms has come to be known as the fight or flight syndrome.

Selye called this general reaction of the body to stress the general adaptation syndrome. He
described the reaction in three distinct stages

 Alarm reaction stage:- During this stage the physiological responses of the “ fight or
flight” syndrome are initiated.
 Stage of resistence:-The individual uses the physiological responses of the 1 st stage as a
defense in the attempt to adapt to the stressor.if adaptation occurs, the third stage is
prevented or delayed.physiological symptoms may disappear.
 Stage of exhaustion:-This stage occurs when there is a prolong exposure to the stressor
to which the body has become adjusted. The adaptive energy has depleted, & the
individual can no longer draw from the sources for adaptation described in the first 2
stages. Diseases of adaptation (eg. Headache ,mental disorders, coronary artery
disease ,colitis) may occur
These biological changes occur due to stimulation of sympathetic nervous system are
following-
 Adrenal medulla-Norepinephrine &epinephrine is released .
 Eyes – Pupils dilated
 Lacrimal gland-Secretion increased
 Respiratory system-Bronchioles dialate & Respiration rate is increased
 Cardiovacular system-
Increase force of cardiac contraction

Increased cardiac output

Increased heart rate

Increased blood pressure

 G.I. system-Decreased gastric & intestinal motility

Decreased secretions & sphincter contract

 Liver- Increased glycogenolysis & decreased gluconeogenesis.

 Urinary system- Increased ureter motility, bladder muscle contracts ,sphincter relaxes.
 Sweat glands- increased secretions.
 Fat cells-Lypolysis
 Resistance Reaction initiated by regulating hormones secreted by hypothalamus. It
regulating hormones
o Corticotropin Releasing Hormone (CRH)
o Growth Hormone Releasing Hormone (GHRH)
o Thyrotrophic Releasing Hormone(TRH)
 CRH stimulates the anterior pituitary to increase its secretion of adrenocorticotrophic
hormone(ACTH). The action of these hormones helps to control bleeding, maintain blood
pressure etc.

GHRH stimulates anterior pituitary to secrete human growth hormone(HGH).

TRH causes the anterior pituitary to secrete thyroid stimulating hormone (TSH). The combined
action of HGH and TSH help to supply additional energy to the body

STRESS AS AN ENVIRONMENTAL EVENT:-

The event creates change in life pattern of the individual , requires significant adjustment in life
style, & taxes available personal resources. The change can be either positive, such as
outstanding personal achievement, or negative such as being fired from a job. The emphasis is
here on change from the existing steady state of the individual’s life pattern.
Miller & rahe (1997) have updated the original social readjustment rating scale devised by
holmes & rahe in 1967. Just as in the earlier version, numerical values are assigned to various
events, or changes, that are common in peoples lives. The updated version reflects an increased
number of stressor not identified in the original version in the new study miller & rahe found
that women reacts to life stress events at higher level than men, & unmarried peoples have
higher score than married people for most of the events. Younger subjects rated more events at
a higher stress level than older subject. A score on the RLCQ place the individual at greater
susceptibility to physical & psychological illness. The questionnaire may be completed
considering life stressor with in a 6 month or 1 year period 6 month total equal to or greater
than 300 life changes units(LCUs), or 1 year total equal to or than 500LCU, are considered
indicative of high recent life stress, thereby increasing the risk of illnesses for the individual.

STRESS AS A TRANSACTIONAL BETWEEN THE INDIVIDUAL & ENVIRONMENT

The definition of stress emphasizes the relationship between the individual & the environment.
Personal characteristic & the nature of the environmental event are considered.

PRECIPITATING EVENT

A precipitating event is a stimulus arising from the internal or external environment & is
perceived by the individual in a specific manner. Determination that a particular person /
environment relationship is stressful depends on the individual’s cognitive appraisal of the
situation. Cognitive appraisal is an individual’s evaluation of the personal significance of the
event or occurrence.

The cognitive response consists of primary appraisal & a secondary appraisal.

PRIMARY APPRAISAL

Lazarus & folkman find three types of primary appraisal irrelevant, benign positive & stressful.
An event is judged irrelevant when the outcome hold no significance for individual. A benign
positive outcome is perceived as producing pleasure for the individual .Stress appraisals
includes harm/loss, threat & challenge.
Harm loss appraisal refers to damage or loss already experienced by the individual. Appraisals
of a threatening nature are perceived as anticipated harms or losses. When an event is appraised
as challenging, the individual focuses on potential for gain or growth rather than on risk
associated with the event. Challenge produces stress, although the emotions associated with it
(eagerness & excitement) are viewed as positive, & coping mechanism must be called on to
face the encounter. Challenge & threat may occur together when an individual experiences
these positive emotions along with fear & anxiety over possible risks associated with the
challenging event.

When stress is produced in response to harm or loss, threat, or challenge, a secondary appraisal
is made by the individual.

SECONDARY APPRAISAL

It is an assessment of skills, resources and knowledge that the person posses to deal with the
situation .The individual evaluates by considering the following:-

 What coping strategies are available to me?

 Will the option I choose be effective in this situation?
 Do I have the ability to use that strategy in an effective manner?

PREDISPOSING FACTORS

Predisposing factor strongly influence whether the response is adaptive or maladaptive, types of
predisposing factor includes are-

Genetic influences:-It includes family history of physical & psychological conditions &
temperament.
Past Experiences:-These are occurrence that results in learned patterns that can influence an
individual’s adaptation response. They include previous exposure to the stressor or other
stressors, learned coping responses, & agree of adaptation to previous stressors.
Existing conditions:-These conditions may include current health status, motivation,
developmental maturity, severity & duration of the stressor, financial & educational resources,
age , existing coping strategies, & a support system of caring others.
STRESS ADAPTATION MODELS

1. Stuarts Stress Adaptation Model

2. Transactional model of stress and coping

3. Psychosomatic model

 Stuarts Stress Adaptation Model

Bio psychosocial approach - a holistic perspective that integrates biological, psychological, and
sociocultural aspects of care.

Predisposing factors -risk factors such as genetic background.

Precipitating stressors - stimuli that the person perceives as challenging such as life events.

Appraisal of stressor - an evaluation of the significance of a stressor.

Coping resources - options or strategies that help determine what can be done as well as what is
at stake.

Adaptation/maladaptation -

Levels of Prevention

Primary : primary cognitive appraisal may be irrelevant, benign-positive or stressful.

Secondary: secondary cognitive appraisals include assessment and evaluation by the individual
of skills, resources and knowledge to deal with the stressful situation.

Four stages of psychiatric treatment & nursing care

Crisis stage

Acute stage

Maintenance stage

Health promotion stage

Transaction model

Transactional model of stress and coping precipitating event predisposing event cognitive
appraisal irrelevant benign positive stress appraisal no response pleasurable response

Stress appraisal harm threat challenge secondary response availability of coping strategies
perceived effectiveness of coping strategies, perceived availability to use coping strategies
effectively quality of response adaptive

 Psychosomatic model

Psychic phase: It is marked by mild, but persistent psychological and behavioural symptoms of
stress like irritability, disturbed sleep, anorexia etc.

Psychosomatic phase: If stress condition continues, these symptoms become more pronounced
along with beginning of generalized physiological symptoms like occasional hypertension,
tremors etc.

Somatic phase: It is marked by increased function of organ. At this stage, one begins to identify
beginning of a disease stage.

Organic phase: It is marked by full involvement of a so called disease state with physiological
changes like ulcerated stomach or chronic hypertension.
CAUSES OF STRESS

1.Catastrophs

2.Major life changes

3.Daily hassles

A catastrophe is a sudden, often life- threatening calamity or disaster that pushes people to the
outer limits of their coping capability. Catastrophes include natural disasters—such as
earthquakes, tornadoes, fires, floods, and hurricanes—as well as wars, torture, automobile
accidents, violent physical attacks, and sexual assaults. Catastrophes often continue to affect
their victims’ mental health long after the event has ended.

 Major life changes The most stressful events involve major life changes, such as death of a
spouse or family member, divorce, imprisonment, losing one’s job, and major personal
disability or illness.

 Daily hassles living in a noisy neighbourhood, commuting to work in heavy traffic, disliking
one’s fellow workers, worrying about owing money, waiting in a long line, misplacing, losing
things. When taken individually, these hassles may feel like only minor irritants, but
cumulatively, over time, they can cause significant stress.

 Symptoms of stress

• Feelings

• Behaviour

• Physiology

Feelings - The individual becomes anxious and is scared. The person feels that he has got
something to loose or something wrong will take place. The person becomes irritable and
moody. Individual develops a negative frame of mind and suffers from low self-esteem. The
person loose faith in his capabilities and is afraid of the failures. Not able to concentrate and is
involved in his own plans and thoughts.

 Physiological and behavioural changes -Speech problems, Impulsive Behavior, Crying for no
apparent reason Laughing in a high pitch and nervous tone of voice, Grinding of teeth,
Increasing smoking and use of drugs and alcohol. Being accident-prone, Perspiration /sweaty
hands, Increased heartbeat, Trembling, Nervous ticks, Dryness of throat and mouth. Tiring
easily, Urinating frequently, Sleeping problems, Diarrhoea / indigestion / vomiting/ nausea,
Butterflies in stomach, Headaches, Premenstrual tension, Pain in the neck and or lower back,
Susceptibility to illness and Loss of appetite or over eating

 EFFECTS OF STRESS

• Stress response
• Disease

• Decreased immune response

• Mental illness

MANAGEMENT

If you’re living with high levels of stress, you’re putting your entire well-being at risk. Stress
wreaks havoc on your emotional equilibrium, as well as your physical health. It narrows your
ability to think clearly, function effectively, and enjoy life. It may seem like there’s nothing you
can do about stress. The bills won’t stop coming, there will never be more hours in the day, and
your work and family responsibilities will always be demanding. But you have a lot more
control than you might think. Effective stress management helps you break the hold stress has
on your life, so you can be happier, healthier, and more productive. The ultimate goal is a
balanced life, with time for work, relationships, relaxation, and fun—and the resilience to hold
up under pressure and meet challenges head on. But stress management is not one-size-fits-all.
That’s why it’s important to experiment and find out what works best for you.

Stress management involves the use of coping strategies in response to stressful situations.
Coping strategies are adaptive when they protect the individual from harm or strengthen the
individual’s ability to meet challenging situation.

Identify the sources of stress in your life

Stress management starts with identifying the sources of stress in your life. This isn’t as easy as
it sounds. Your true sources of stress aren’t always obvious, and it’s all too easy to overlook
your own stress-inducing thoughts, feelings, and behaviours. Sure, you may know that you’re
constantly worried about work deadlines. But maybe it’s your procrastination, rather than the
actual job demands, that leads to deadline stress.

To identify your true sources of stress, look closely at your habits, attitude, and excuses:

 Do you explain away stress as temporary (“I just have a million things going on right
now”) even though you can’t remember the last time you took a breather?
 Do you define stress as an integral part of your work or home life (“Things are always
crazy around here”) or as a part of your personality (“I have a lot of nervous energy,
that’s all”).
 Do you blame your stress on other people or outside events, or view it as entirely normal
and unexceptional?

Until you accept responsibility for the role you play in creating or maintaining it, your stress
level will remain outside your control.
Start a stress journal

A stress journal can help you identify the regular stressors in your life and the way you deal
with them. Each time you feel stressed; keep track of it in your journal. As you keep a daily log,
you will begin to see patterns and common themes. Write down:

 What caused your stress (make a guess if you’re unsure).

 How you felt, both physically and emotionally.
 How you acted in response.
 What you did to make yourself feel better.

Look at how you currently cope with stress

Think about the ways you currently manage and cope with stress in your life. Your stress
journal can help you identify them. Are your coping strategies healthy or unhealthy, helpful or
unproductive? Unfortunately, many people cope with stress in ways that compound the
problem.

Unhealthy ways of coping with stress

These coping strategies may temporarily reduce stress, but they cause more damage in the long
run:

 Smoking
 Drinking too much
 Overeating or undereating
 Zoning out for hours in front of the
TV or computer
 Withdrawing from friends, family,
and activities

 Using pills or drugs to relax

 Sleeping too much
 Procrastinating
 Filling up every minute of the day to avoid facing problems
 Taking out your stress on others (lashing out, angry outbursts, physical violence)

Learning healthier ways to manage stress

If your methods of coping with stress aren’t contributing to your greater emotional and physical
health, it’s time to find healthier ones. There are many healthy ways to manage and cope with
stress, but they all require change. You can either change the situation or change your reaction.
When deciding which option to choose, it’s helpful to think of the four As: avoid, alter, adapt,
or accept.
Since everyone has a unique response to stress, there is no “one size fits all” solution to
managing it. No single method works for everyone or in every situation, so experiment with
different techniques and strategies. Focus on what makes you feel calm and in control.

Dealing with Stressful Situations: The Four A’s

Change your reaction:

Change the situation:
 Adapt to the stressor.
 Avoid the stressor.  Accept the stressor.
 Alter the stressor.

Stress management strategy 1: Avoid unnecessary stress

Not all stress can be avoided, and it’s not healthy to avoid a situation that needs to be addressed.
You may be surprised, however, by the number of stressors in your life that you can eliminate.

 Learn how to say “no” – Know your limits and stick to them. Whether in your personal
or professional life, refuse to accept added responsibilities when you’re close to reaching them.
Taking on more than you can handle is a sure-fire recipe for stress.
 Avoid people who stress you out – If someone consistently causes stress in your life and
you can’t turn the relationship around, limit the amount of time you spend with that person or
end the relationship entirely.
 Take control of your environment – If the evening news makes you anxious, turn the
TV off. If traffic’s got you tense, take a longer but less-travelled route. If going to the market is
an unpleasant chore, do your grocery shopping online.
 Avoid hot-button topics – If you get upset over religion or politics, cross them off your
conversation list. If you repeatedly argue about the same subject with the same people, stop
bringing it up or excuse yourself when it’s the topic of discussion.
 Pare down your to-do list – Analyze your schedule, responsibilities, and daily tasks. If
you’ve got too much on your plate, distinguish between the “shoulds” and the “musts.” Drop
tasks that aren’t truly necessary to the bottom of the list or eliminate them entirely.

Stress management strategy 2: Alter the situation

If you can’t avoid a stressful situation, try to alter it. Figure out what you can do to change
things so the problem doesn’t present itself in the future. Often, this involves changing the way
you communicate and operate in your daily life.

 Express your feelings instead of bottling them up. If something or someone is

bothering you, communicate your concerns in an open and respectful way. If you don’t voice
your feelings, resentment will build and the situation will likely remain the same.
 Be willing to compromise. When you ask someone to change their behaviour, be willing
to do the same. If you both are willing to bend at least a little, you’ll have a good chance of
finding a happy middle ground.
 Be more assertive. Don’t take a backseat in your own life. Deal with problems head on,
doing your best to anticipate and prevent them. If you’ve got an exam to study for and your
chatty roommate just got home, say up front that you only have five minutes to talk.
 Manage your time better. Poor time management can cause a lot of stress. When you’re
stretched too thin and running behind, it’s hard to stay calm and focused. But if you plan ahead
and make sure you don’t overextend yourself, you can alter the amount of stress you’re under.

Stress management strategy 3: Adapt to the stressor

 If you can’t change the stressor, change yourself. You can adapt to stressful situations and
regain your sense of control by changing your expectations and attitude.

 Reframe problems. Try to view stressful situations from a more positive perspective.
Rather than fuming about a traffic jam, look at it as an opportunity to pause and regroup, listen
to your favorite radio station, or enjoy some alone time.

Look at the big picture. Take perspective of the stressful situation. Ask yourself how
important it will be in the long run. Will it matter in a month? A year? Is it really worth getting
upset over? If the answer is no, focus your time and energy elsewhere.

 Adjust your standards. Perfectionism is a major source of avoidable stress. Stop setting
yourself up for failure by demanding perfection. Set reasonable standards for yourself and
others, and learn to be okay with “good enough.”
 Focus on the positive. When stress is getting you down, take a moment to reflect on all
the things you appreciate in your life, including your own positive qualities and gifts. This
simple strategy can help you keep things in perspective.

Adjusting Your Attitude:-How you think can have a profound effect on your emotional and
physical well-being. Each time you think a negative thought about yourself, your body reacts as
if it were in the throes of a tension-filled situation. If you see good things about yourself, you
are more likely to feel good; the reverse is also true. Eliminate words such as "always," "never,"
"should," and "must." These are tell-tale marks of self-defeating thought

Stress management strategy 4: Accept the things you can’t change

Some sources of stress are unavoidable. You can’t prevent or change stressors such as the death
of a loved one, a serious illness, or a national recession. In such cases, the best way to cope with
stress is to accept things as they are. Acceptance may be difficult, but in the long run, it’s easier
than railing against a situation you can’t change.

 Don’t try to control the uncontrollable. Many things in life are beyond our control—
particularly the behaviour of other people. Rather than stressing out over them, focus on the
things you can control such as the way you choose to react to problems.
 Look for the upside. As the saying goes, “What doesn’t kill us makes us stronger.”
When facing major challenges, try to look at them as opportunities for personal growth. If your
own poor choices contributed to a stressful situation, reflect on them and learn from your
mistakes.
 Share your feelings. Talk to a trusted friend or make an appointment with a therapist.
Expressing what you’re going through can be very cathartic, even if there’s nothing you can do
to alter the stressful situation.
 Learn to forgive. Accept the fact that we live in an imperfect world and that people make
mistakes. Let go of anger and resentments. Free yourself from negative energy by forgiving and
moving on.

Stress management strategy 5: Make time for fun and relaxation

Beyond a take-charge approach and a positive attitude, you can reduce stress in your life by
nurturing yourself. If you regularly make time for fun and relaxation, you’ll be in a better place
to handle life’s stressors when they inevitably come.

Healthy ways to relax and recharge

 Savor a warm cup of coffee or tea.

 Go for a walk.  Play with a pet.
 Spend time in nature.  Work in your garden.
 Call a good friend.  Get a massage.
 Sweat out tension with a good  Curl up with a good book.
workout.  Listen to music.
 Write in your journal.  Watch a comedy
 Take a long bath.
 Light scented candles

Don’t get so caught up in the hustle and bustle of life that you forget to take care of your own
needs. Nurturing yourself is a necessity, not a luxury.

 Set aside relaxation time. Include rest and relaxation in your daily schedule. Don’t allow
other obligations to encroach. This is your time to take a break from all responsibilities and
recharge your batteries.Relaxation techniques have been shown to have immediate relaxation
effects on children and youth, both physiologically as well as subjectively.12,13,14 Relaxation
techniques are found to be especially effective for situations that are not under the personal
control of the child. In addition, relaxation techniques may be particularly beneficial for
children who worry a lot, who can’t settle down, who are distractible or hyperactive, who have
difficulty falling asleep, or who have depression or anxiety.4,14,15 Some techniques that have
been found to be effective with children are detailed below. When choosing a technique, keep
in mind the child’s personal preferences and developmental stage. Resources (text, audio and
video) of some of the relaxation strategies described below can be found in the resource section.
 Connect with others. Spend time with positive people who enhance your life. A strong
support system will buffer you from the negative effects of stress.
 Do something you enjoy every day. Make time for leisure activities that bring you joy,
whether it be stargazing, playing the piano, or working on your bike.
 Keep your sense of humour. This includes the ability to laugh at yourself. The act of
laughing helps your body fight stress in a number of ways.
 Learn the relaxation response You can control your stress levels with relaxation
techniques that evoke the body’s relaxation response, a state of restfulness that is the opposite
of the stress response. Regularly practicing these techniques will build your physical and
emotional resilience, heal your body, and boost your overall feelings of joy.
Stress management strategy 6: Adopt a healthy lifestyle You can increase your resistance to
stress by strengthening your physical health.

 Exercise regularly. Physical activity plays a key role in reducing and preventing the
effects of stress. Make time for at least 30 minutes of exercise, three times per week. Nothing
beats aerobic exercise for releasing pent-up stress and tension.
 Eat a healthy diet. Well-nourished bodies are better prepared to cope with stress, so be
mindful of what you eat. Start your day right with breakfast, and keep your energy up and your
mind clear with balanced, nutritious meals throughout the day.
 Reduce caffeine and sugar. The temporary "highs" caffeine and sugar provide often end
in with a crash in mood and energy. By reducing the amount of coffee, soft drinks, chocolate,
and sugar snacks in your diet, you’ll feel more relaxed and you’ll sleep better.
 Avoid alcohol, cigarettes, and drugs. Self-medicating with alcohol or drugs may
provide an easy escape from stress, but the relief is only temporary. Don’t avoid or mask the
issue at hand; deal with problems head on and with a clear mind.
 Get enough sleep. Feeling tired will increase your stress because it may cause you to
think irrationally
 Deep breathing. Deep breathing (‘belly breathing’) is one of the easiest and quickest
ways to relax, as it can be done anywhere and at anytime. It allows young people to visit their
‘calm centre’ whenever they start to feel overwhelmed by stress.5 In order to help children and
youth understand deep breathing, you can. Describe the difference between how we breathe
when we are stressed (fast and shallow) and how we can breathe when we are relaxed (slow and
deep). Fast/shallow breathing is breathing that comes from your chest, while deep/ slow
breathing comes from your stomach/belly
 Progressive muscle relaxation: Progressive muscle relaxation (PMR) is a method of
systematically tensing and relaxing muscle groups throughout the body. This technique can be
done during the day or in the evening to relax or aid sleep. PMR has been found to benefit
children experiencing stress and has been used as one of several techniques to treat a variety of
childhood difficulties, including anxiety disorders, sleep disturbance, hyperactivity and
impulsivity.
 Massage therapy: Massage therapy may help to reduce stress levels in children and
youth with certain mental health conditions. Massage therapy has been shown to be effective in
reducing stress levels in child and adolescent psychiatric patients.
 Visualization (or mental imagery) is a potent method of stress management, especially
when combined with physical relaxation methods such as deep breathing. There are different
ways of practicing visualization – some may be more effective for general feelings of stress,
while others may be more effective for specific worries.

Contact with nature: Contact with nature can reduce feelings of stress and increase well-
being. Try encouraging children and their families to spend time outdoors, and if possible in or
near nature. A hand out for families at the back of Module 3 provides some ideas for being
active outdoors. In addition to actually being in nature (e.g. parks, wilderness, areas with trees
or water), studies show that viewing images of nature also helps to relieve stress and improve
well-being.

Focusing on strengths and resources: Stress can be seen as a badly tipped scale, with more
demands on one side than personal coping resources to deal with them. Stress management can
look at decreasing the demands, but it can also look at boosting the personal resources to cope.
When discussing stress with children or youth, it is important to help them identify their
internal and external resources for coping with stress. For instance, internal resources could
include believing they can handle stress, or having high self-esteem or a sense of humour.
External resources could include support from friends, family or teachers.

Mindfulness: Mindfulness is the practice of “paying attention in a particular way: on purpose,

in the present moment, and nonjudgmentally”. Thus, if a child/youth was walking to school
‘mindfully’, they would practice maintaining a continuous awareness of their breathing, pay
attention to the feeling of their bag on their shoulder, and perhaps the mild tension associated
with approaching the school

Music: it is true that music can soothe the savage beast. Creating and listening to music
stimulate motivation, enjoyment and relaxation. Music can reduce depression and bring about
measurable changes in mood and general activity.

TIME MANAGEMENT

Some top time management tips include

• Writing out a weekly schedule and looking for ways to make it more balanced

• Practicing the ‘ABC Method’ of time management (see text on the left hand side of this page)

• Practicing saying no to tasks that are unimportant or that there simply isn’t enough time for

• Getting enough sleep – this ensures you have enough energy to get all necessary tasks done

REVIEW OF LITERATURE

A Study of Learning Stress and Stress Management Strategies of the Students of Postgraduate
level in Islamia University of Bahawalpur, Pakistan by Abid Shahzadb and Muzammil
Nisac(2018). The objectives of the study were to find out the common symptoms of stress,
causes of stress and to suggest stress management strategies used by students for coping with
stress. For collecting data, survey method was adopted. This study was completed by following
the procedure of descriptive method of research. 39 questions were used for data collection. 200
students. This study concluded that majority of students felt fatigue during stress. Burden of
study, assignments were major causes of stress and they agreed that they reduce stress by
watching T.V/Movies, listen to music or take part in other leisure time activities. It was
recommended that burden of study may be reduced by conducting co-curricular activities in
academic area. The study result shows Significant majority of the respondents (82%) agreed
that they feel fatigue/tired under stress. Majority of the respondents (68%) agreed that they feel
muscle/pain. Majority of the respondents (62%) agreed that they feel difficulty to concentrate
under stress . Majority of the respondents (75.5%) agreed that they feel difficulty to remember
thing when under stress. Slight majority of the respondents (59%) agreed that they feel dryness
of mouth and throat when stressed. Slight majority of the respondents (52%) agreed that they
feel irritable and anxious when stressed.(51%) respondents agreed that they feel anxiety without
knowing when stressed. Majority of the respondents (60.5%) agreed that they feel restless when
stressed. (50%) respondents disagreed that they feel diarrhoea, indignation, upset stomach,
vomiting. Slight majority of the respondents (57.5%) agreed that they often feel headache when
under stress. Slight majority of the respondents (54.5%) agreed that they often feel get angry
quickly when stressed. Slight majority of the respondents (57%) disagreed that they often feel
they dream when stressed. (42.5%) respondents disagreed that they often feel loss of
appetite/eat more then used when under stress and ( 24.5) were uncertain about the statement.
Slight majority of the respondents (55.5%) said that university environment create stress. Slight
majority of the respondents (59%) agreed that different educational setup increases stress level
among university students. Slight majority of the respondents (54%) agreed that competitive
environment create stress. Majority of the respondents (75%) agreed that burden of study
increase stress level among university students. Majority of the respondents (73%) agree that
exam create stress. Majority respondents (66.5%) agreed that assignments increase stress level
among university students .Slight majority of the respondents (59.5%) agreed that stress arises
due to poor time management. Slight majority of the respondents (58.5%) agreed that lack of
origination skills create stress. Slight majority of the respondents (57.5%) agreed that lack of
facilities for study researches create stress. Majority of the respondents (74.5%) agreed that
difficulty to understand the teacher create stress in students. Slight majority of the respondents
(57.5%) agreed that teacher-student relationship create stress. Slight majority of the respondents
(57%) agreed that presentations create stress in students. Majority of the respondents (65%)
agreed that they remove attention to humor laugh when stressed. Majority of the respondents
(63.5%) agreed that they accept the things and facts that they cannot change when they stress.
Majority of the respondents (63.5%) agreed that stress can be controlled with proper time
management. Majority of the respondents (60%) agreed that they reduce stress by properly
hydrate body/ drinking water. Slight majority of the respondents (53%) agreed that they take
balance diet to reduce stress. Slight majority of the respondents (57%) agreed that they talk to
themselves in stress. Majority of the respondents (77%) agreed that they get support of friends
& family when in stress. (50%) respondents disagreed that they go for exercise when stressed.
Slight majority of the respondents (57%) agreed that they reduce stress by getting an adequate
amount of sleep. Slight majority of the respondents (55%) agreed that they take a break from
work when stressed. Majority of the respondent (64%) agreed that watching TV/movies could
reduce stress, listen to music or take part in other leisure time activity/hobby. Majority of the
respondents (65%) agreed that they take deep breath and relax to reduce stress. Result related
to the two open-ended questions states in the questionnaires are: - Causes of stress (32%)
respondents feel stress due to lack of facilities to study. (41%) respondents feel stress due to
burden of study and research work in semester system. Strategies to cope with stress (68%)
respondents release their stress by remaining busy in various activities of interest.

A quasi-experimental study of the effectiveness of stress management skills training on

academic vitality and psychological well-being of college students by Alborzkouh P, Nabati M,
Zainali M, Abed.Y, Shahgholy Ghahfarokhi F(2016)objective of the study to assess the
effectiveness of stress management training on the academic life and mental well-being of the
students with pretest-posttest plan and control group. Therefore, a total of 40 students of Shahed
University of Tehran were selected by a convenience sampling method and were organized into
two groups: experimental and control group. Both groups were pretested by using an academic
vitality inventory and an 84-question psychological well-being inventory. Then, the
experimental group received stress management skills training for ten sessions, and the control
group did not receive any intervention. Next, both groups were post-tested, and the data were
analyzed with SPSS-21 software by using descriptive and inferential statistical methods.
Findings: The findings showed that the stress management skills training significantly
contributed to promoting the academic vitality and psychological well-being of students (p <
0.001). Conclusions: It was concluded from this research that teaching the methods for dealing
with stress was an effective strategy to help students exposed to high stress and pressure, and
this was due to its high efficiency, especially when it was held in groups, had a small cost, and
it was accepted by the individuals. the significance level was p < 0.001, the hypothesis of the
difference between the academic vitality and the psychological well-being with its components
in the two groups was confirmed. It stated that 0.54, 0.25, 0.52, 0.64, 0.60, 0.59, 0.45 and 0.81
percent change in the academic vitality, individuals’ purpose in life, positive relations with
others, personal growth, self-acceptance, autonomy, environmental mastery, and psychological
well-being scores were due to the independent variable (stress management skills training).
Therefore, it could be said that stress management skills training increased the academic vitality
and the psychological well-being and all of its components.

A cross sectional study of Causes of Stress and Stress Management among Youth from the area
Rajasthan, Punjab, Uttarpradesh and Gujarat region of India by Dr. Deepti Bhargava & Hemant
Trivedi(2015). The objectives of the study to study the symptoms of stress among Youth, to
measure the level of stress among the Youth and to know the strategies to cope up with stressor by
the Youth. The sample is collected from the young male and female on random basis. The
questionnaire was distributed among 300 young people and got 225 responses. Tools for data
collection A questionnaire is designed with the three sections. The result indicates that students do
experience stress and symptoms as shown in Table 3 below. The highest percentage is 81.60% suffering
from depression followed by Insomnia (79.82%) and bad eating habit (78.22%). It is observed that most
of the youth suffering from depression, tension etc. The cause of stress is stressor psychological
factors have 73.40%, young generation have 72.55% of financial stress and 68.395 having career stress.
The different strategies used by the students to maintain the stress level according to students are -
Most of the students want to make friends (80.89%). Students want to become live on social
networking sites to cope up with stress (76.00%). Students want to talk with family members to cope
up with family members (74.67%). Other strategies are watch movies, play games and use internet.

Conclusion

Stress has become a chronic and pervasive condition in world wide. Adaptive behaviour is
viewed that maintains the integrity of the individual, with a timely return to equilibrium. It is
viewed as positive and is correlated with a healthy response. When behaviour disrupts the
integrity of the individual, with a timely return to equilibrium. It is viewed as positive and is
correlated with a healthy response.
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