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Welcome back. Introduce the session topic. *Facilitator Note: If you intend to use the link to the Relax Relax website included on slide 4, make sure that you have access to the internet and sound available.
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Suggested time: 2 min. Before we discuss today’s topic, let’s review last week’s discussion. *Facilitator Note: Use the questions on the slide to review the items of the participant’s Take Home Action Plan from last week to see how they did and if there are questions or concerns.
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Suggested time: 1 min. The purpose of this session is to help you better understand stress and stress management. This includes understanding what stress is, how the body responds to stress, the impacts stress can have on the body, and techniques for successful stress management. At the end, each of you will also be able to work on your own stress management plan. Before we dive into the details of stress, let’s start off the session with an exercise to relieve some stress and introduce a helpful relaxation technique.
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Suggested time: 5 min. Handout: Diaphragmatic Breathing *ACTIVITY: Deep Breathing is a helpful relaxation technique that can be done almost anywhere. It signals your body that it is time to relax, and can easily be incorporated into daily activities. *Facilitator Note: There are two options for this activity: 1. Walk the participants through a deep breathing exercise using the Diaphragmatic Breathing handout. 2. Use one of the recordings on the Relax Relax Toolkit: http://www.med.navy.mil/sites/nmcphc/health-promotion/psychological-emotionalwellbeing/relax-relax/pages/breathing.html - The following recordings are short enough to easily fit into the session: - “Breathing Relaxation Exercise 4-6-8”
- “Deep Breathing Relaxation Sample 5”
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- “Stress and Relaxation: Quick Fix Breathing Exercise”
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Suggested time: 2 min. Now that we are all a bit more relaxed, we can get into the discussion on stress. *Facilitator Note: Use the questions below to facilitate a brief discussion about how participants currently think about stress. If possible, consider writing down some of the participants answers on a board or easel. *Ask-First off, how do you define stress? Is stress something positive or something negative? How do you typically respond to stress? Now that we’ve talked through some of our own thoughts about stress, let’s take a look at a more formal definition.
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Suggested time: 2 min. Handout: Just the Facts: Life Stress The Navy defines stress as “the process by which we respond to challenges to the body or mind.” In general, stress is the response to a demand placed upon the body and mind. When we experience stressors, our body and mind prepare for action, whether the threat or situation requires physical action or not. It’s the way we are built. It is important to note that a stress response can be triggered for what is seen as a positive reason (this is called eustress) or a negative one (this is called distress). For example: -
It can provide motivation and make you more productive. (positive)
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It can be due to positive events such as a job interview, life transitions such as a promotion, going to college, training program, a wedding, a deployment. (positive)
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It can alert you to physical threats and danger such as a robbery, attacks, unsafe people and places. (negative)
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It can alert you to what your mind sees as a threat such as a family member having cancer. No physical harm to you, but the “alarm state” is often triggered. (negative)
While its easy to see that stress plays an important role in our lives, too much stress can overwhelm our resources - taking a toll on the mind and body. Our perceptions and reactions are critical to managing stress. What you say and do makes all the difference in handling stress in a way that is helpful or harmful to you.
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Many of you may also be familiar with the Operational Stress Control Model shown on the slide. This color system reminds us that with a fit mind and body, we are able to maintain a ready state or stay in the green zone. When stress enters our life, it may trigger the yellow or reacting state. When stress is intense, episodic, or chronic (the orange and red states) it is important to learn to take care of yourself mentally and physically with the goal of getting back to the green zone. Another useful resource is the Just the Facts: Life Stress handout, which was introduced during Session 5 of the program when we discussed mental reframing. This is a helpful guide for understanding the basics of stress and stress management. Now that we have looked at the basics, let’s take a look at the specific steps in how the body responds to stress.
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Suggested time: 2 min. Handout: Indicators of Overstress The human body is designed to be able to meet stressful situations and rise to the challenge. However, chronic or prolonged periods of stress often have negative consequences and can jeopardize your health. The body reacts to stress in three stages: The first is the Alarm stage: -
This is when something stressful first happens or is thought. Physiological changes occur including an increased heart rate, breathing and blood pressure
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Also, blood flow moves to major muscle groups and away from internal organs, breathing quickens, and muscles tighten
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The alarm state could be brought on by something as simple as forgetting your gym bag or losing your key
The next stage is Resistance: -
In this stage, the body moves to cope with the added stress. As the body devotes resources to adapt to the stress, changes may be noticed in our health and behavior.
The last stage is Exhaustion: -
Exhaustion can occur when long term stress or repeated short term stress push the body to a state where it is depleted of resources and is no longer able to adapt and bounce back.
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Typically there will be signs and symptoms on a regular basis that let you know it is time to regroup, make a change, spend some time relaxing and recharging your body.
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This theory of stress reaction is known as General Adaptation Syndrome (GAS). There are resources available online if you wish to research this further. In addition to the examples we have discussed, weight loss can create stress too.
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Suggested time: 1 min. Trying to lose weight often creates added stress in our lives. *Facilitator Note: Ask: How do you view the process of losing weight? Do you find it stressful? What are some of the sources of that stress? For example the added effort of tracking food and activity could be a source of stress. What are some others? *Facilitator Note: - Other suggestions might include: - Stress from tracking food intake and physical activity - Feelings of being deprived (impact on socialization or physically) - Financial stress from thinking you may have to spend more money on food - Stress from having to fit more shopping, physical activity, etc. into an already busy schedule - The fear that you will regain any weight lost - Stress about how others perceive you Now that we understand stress a bit better, let’s take a look at some of the ways it can affect us.
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Suggested time: 3 min. One common reaction to stress is stress eating. Eating as a response to anxiety, anger, and frustration is not uncommon, but it can quickly undermine any weight loss effort. Additionally, stress eating can be a response to feelings of deprivation and restraint – feelings that often result from dieting. Therefore it is important to balance the need for restraint for successful weight loss with the importance of not depriving yourself to the point of overeating/binge eating. Some important strategies are: To choose snacks carefully. To identify what types of food (salty, sweet, savory) you eat when stressed, and try to substitute a healthier option. And to not let others tell you what is off limits – you have to make these choices for yourself. It is also important to identify patterns of eating as a response to certain emotions and stress. Identifying what triggers stress eating will help you to recognize it and find other emotional outlets. Also, identifying and getting a handle on your emotions will go a long way in curbing emotional eating, by allowing you to acknowledge that you can have a feeling without responding to it in a harmful way. *Facilitator Note: Ask-Can anyone here share a personal experience with stress eating? For those of you that have experienced this, what were some of the short term and long term impacts?
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Suggested time: 2 min. Handout: Food and Stress In addition to eating more as a result of stress, we often also make unhealthy food choices as a result of stress. Often stress makes us more prone to eat more junk and empty calories. Unfortunately, this is when our body needs healthy food options to perform the extra functions it needs while stress is high and to bolster the immune system. Many of these will look familiar from previous sessions, but some general healthy eating tips that are particularly relevant to stress are: 1. Eat at regular times 2. Don’t skip meals 3. Limit caffeine. It can cause anxiety. 4. If you drink alcohol, do so in moderation 5. Drink more water each day In addition to the relationships between stress and eating, the relationships between stress and sleep are also important… Facilitator Note: Per the FDA, moderate alcohol consumption is defined as: Up to 2 drinks a day for men and 1 drink a day for women and persons age 65 and older. One drink is: 12 oz. of regular beer; 4 to 5
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oz. of wine; or 11/2 oz. of 80-proof whiskey, gin, etc.
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Suggested time: 3 min. Stress can also lead to fatigue and lack of sleep. Often, the reason for this is that stressful thoughts and emotions can make it harder to fall asleep and stay asleep. Unfortunately, fatigue and lack of sleep can undermine our motivation and our ability to adapt to future stress, which only compounds the problem. On top of that, many of us are prone to snacking when we can’t sleep. This can quickly increase the calories in your diet and may make it even harder to get to sleep. Additionally, research indicates that a lack of sleep can lead to hormone imbalances that may increase weight gain and obesity. Specifically, lack of sleep may lead to imbalances in specific hormones related to energy balance, feelings of fullness and appetite suppression. (http://www.ncbi.nlm.nih.gov/pubmed/17212793)
*Facilitator Note: Ask-Has anyone experienced a lack of sleep as a result of stress? Are there any sleep strategies you found especially successful? Now let’s take a look at a ways that sleep can help reduce stress.
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Suggested time: 2 min. Handout: Tips for Better Sleep Getting enough sleep is incredibly important. Sleep helps the body replenish its resources so it can continue to adapt to future stress. Also, getting enough rest helps us have the energy to stay motivated to meet our healthy eating and physical activity goals. Furthermore, sleep may help regulate hormones that can lead to weight gain when out of balance. A great resource to help you find ways to get more sleep and better quality sleep is the handout Tips for Better Sleep. Even if you are not experiencing a lack of sleep right now, these tips are still helpful for getting higher quality sleep. Now that we have looked at both stress and its impacts, we a going to take a quick look at some general strategies for stress management.
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Suggested time: 2 min. The first strategy is to stay active. This is especially effective for dealing with stress related to weight loss, as it helps you de-stress while helping you reach your goals. Additionally, physical activity provides a healthy release for coping with stress and it burns energy, helping you sleep better. Finding ways to relax is also important for managing stress.
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Suggested time: 5 min. In this table you will find a list of different relaxations techniques and activities. These offer ways for your body and mind to restore itself and move back to a state of equilibrium (going from the yellow to green zone) . With any form of relaxation, deep breathing is often part of the initial calming of the body. By taking over the rhythm and depth of the breath your body is given the message to clear the mind and let go of muscle tension. Feel free to try the exercise we did earlier on your own! While this list is certainly not all inclusive, these relaxation techniques and activities offer a great starting point. For more information on any of these, please refer to the NMCPHC HPW Relaxation Resources website at: http://www.med.navy.mil/sites/nmcphc/health-promotion/psychological-emotionalwellbeing/Pages/relaxation.aspx as well as the NMCPHC Relax Relax toolkit: http://www.med.navy.mil/sites/nmcphc/health-promotion/psychological-emotional-wellbeing/relaxrelax/pages/index.html
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Suggested time: 5 min. Handout: Stress Navigation Plan for Weight Loss *ACTIVITY: Before we wrap-up this session, I would like you all to take a few minutes to work on your individual Stress Navigation Plan for Weight Loss. This plan will help you to be proactive in planning ahead, instead of waiting until you are already treading water in stressful times. A great reference to refer back to for this is the Just the Facts: Life Stress handout introduced earlier – specifically, the 8 steps that are listed on it. Additionally, there is a list down the right hand side of the handout with some ideas you may find helpful. Overall, the key question to consider when you start to feel your stress level rise is: “What positive things can I say or do right now to make a difference?” Together, these two handouts can assist in formulating your plan, helping you shield yourself from unnecessary stress and exhaustion. *Facilitator Note: give the participants a few minutes to complete the Stress Navigation Plan for Weight Loss handout.
And please remember, it is important to understand what you can resolve and what you cannot. Your
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actions matter, but some issues are out of your control. Know the difference to help lower your stress level by focusing on those things you can do something about.
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Suggested time: 1 min. To summarize what we covered in this session: - Stress is part of life and it can be positive or negative - Stress can impact health and weight, especially if it is not managed effectively - Identifying the patterns of stress and stress responses in your life is critical to effectively managing that stress - Planning instead of reacting will help you make better choices in how you respond to stress
- Healthy eating, physical activity and getting enough sleep will all help you manage your stress, stay healthy and meet your weight loss goals
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Suggested time: 2 min. Nutrition: Track successful coping strategies you practice in place of eating or drinking Physical Activity: Add an exercise or activity for balance or flexibility Mindset: *Read to the class: “Your calm mind is the ultimate weapon against your challenges. So relax.” - Bryant McGill *Ask: Think about at least one new relaxation technique you will try at least twice this week to help control the stress in your life.
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Links to the resources listed on the slide are available on the NMCPHC ShipShape Web page on the Participants subpage at: http://www.med.navy.mil/sites/nmcphc/health-promotion/Pages/ShipShapePart.aspx. On the NMCPHC HPW Relaxation Resources Page highlight: - Relax Relax toolkit (http://www.med.navy.mil/sites/nmcphc/health-promotion/psychological-emotionalwellbeing/relax-relax/pages/index.html) - Breathe 2 Relax Mobile Application (http://t2health.dcoe.mil/apps/breathe2relax)
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