Wednesday, September 3, 2008
Summary Post
In terms of my activities for the last session of the project, I used a stress intervention eleven times out of 49 days. I used yoga three times, mostly at the end of my session. I went on a cross-country driving trip and really enjoyed the yoga as both a nighttime destress activity and as a way to stretch out tired muscles. In this manner, it was a great intervention. I also used exercise 3 times during the last session. I think it was a rarely used intervention because July and August in North Carolina is very hot and humid. Also, the end of the summer semester was very busy with classes and finals that I could not find time to exercise. Mantram use was the most popular: five times. I think this was due to the ease of use and the stress of my cross-country trip. It's hard to deal with stress while locked in a car for hours upon hours--mantram use was the only intervention at my disposal and was used during that time period.
I'm not sure if I naturally gravitate towards one type of stress intervention or the other. In part, I feel like project is artificial from the start. The baseline was not normal for me. Nursing school is not a normal lifestyle, unless you're a nursing student. Then again, every person has a baseline that is not "normal" due to their unique lifestyles. When I compare my life and my stressors (namely nursing school induced) to the lives of patients with chronic diseases, I realize that everyone is different and has to build up the coping skills needed for their situations. For someone with cancer, exercise might not be a good coping skill, but mantrams might be perfect. The best thing about stress interventions is that they are as varied as the person's imagination and creativity will allow--which is something that I'm just beginning to appreciate.
Looking back over the past seven months, I am surprised to be here, in my last semester of nursing school and without having gone through a full-blown nervous breakdown. Maybe that's due to me, on my own. Maybe that's due to the fact that nursing school isn't that bad actually. Maybe its because, without me realizing it, this project has helped me. It has helped me realize when I'm stressed and how to deal with it. I pay attention to subtle cues more and am more ready to try something to help with my stress rather than ignore it, allowing stress to escalate to unmanageable levels. All in all, this project has been helpful. I'm not sure if it was a success in terms of specific outcomes, but for me it was successful for my personal goals and skills.
Friday, July 25, 2008
On my own.
The plus of yoga for stress relief is that it calms me down as well as provides me a way to stretch out my limbs. Stress can causes muscle knots and tension, as does poor sleep. Yoga is a great way to stretch out all the muscles. I find this especially useful for the legs muscles, because sometimes when those are tight the back muscles become tight as well. And who doesn't have back problems? I've found that stretching the legs really does help with the sore back. (In fact writing about this makes me realize that my back hurts and that I need to do a little yoga after this post is written).
Mantram is my big surprise. My last post I think I expound on mantrams and how much I don't like them because they're not active and only require your mind. I've since changed my mind. Mantrams are great because they are the ultimate in portable interventions. They don't require lots of floor space and no observers (like yoga) nor do they require a change of clothing and nice weather (like exercise). All you need is just to close your eyes (that's optional, if say you're using your mantram while driving) and focus on your mantram and consciously relaxing for 30 seconds at a minimum. I've been using the "in joy I am calm" mantram. I like it because I can alter the mantram to my situation at hand. If I'm walking, I say "In joy I walk." If I'm driving, I say "in joy I drive." It's great--very personalized and short enough for me to remember during frazzled moments.
Friday, July 11, 2008
Final Phase
Monday, June 16, 2008
More on mantrams
In other news, taking weekly tests about my stress levels is becoming very very hard to remember. I stopped using the Daily Stress Inventory a long time ago but it's hard to use the other inventories even. I feel that they are useful, but it is difficult to self-monitor and motivate to take tests as opposed to the relative ease of remembering to record my stress levels before and after an intervention.
Monday, June 2, 2008
Mistakes
When I reviewed my plan of action yesterday, I realized that I missed the date for switching from my yoga intervention to my mantram intervention by about 3 weeks (this is probably due to finals and break proving to be excellent distractions). This was very upsetting and made me feel like I failed at this project. Also, it was sad for me because I was really getting into the yoga and didn't want to switch to something else. But I had to follow my plan... After some rescheduling and revision to my proposal, I am newly back on track with my project.
That said, I started my mantram intervention. This is based on an article I read (and included in my portfolio) that looked at nurses who repeated mantrams (mini-prayers/words) during stressful situations to calm down. I wanted to include something very mental in the stress-reduction techniques, as opposed to the physical activities like exercise and yoga. This intervention differs from the others in that I will not be using my intervention on a regular basis (unlike exercise and yoga) but rather when I feel the need or are stressed and can use mantram repetition for immediate calming-down.
My tentative mantrams are included below. I would probably use part of one as opposed to the entire phrase. I did not have an occasion to use one today, so maybe tomorrow?
In beauty we are united, / through beauty we pray, / with beauty we conquer. (Nicholas Roerich)
…I am the aim of wisdom. / I am gained by wisdom. / In the heart am I set firm. (Bhagaved Gita 13: 34)
For it is in giving that we receive… (Part of the Prayer of Saint Francis of Assisi)
In joy I walk. In joy I cool down…In joy my head becomes serene. (Part of a prayer by Torkom Saraydarian)
Grant me, O Lord, the mastery of self! (Agni Yoga Society, Leaves of Morya’s Garden, Vol. I, para. 35)
From the book:
Prayers, Mantrams, and Invocations. Selections from Torkom Saraydarian and other sources. TSG Publishing Foundataion, Inc. Cave Creek, USA. 2001.
I think my favorite is the "in joy I walk" mantram because it includes phrases that specify cooling down from stress and being serene--just the words one needs when stressed out!
Sunday, June 1, 2008
Doing the yoga
The paucity of updates about stress relief by practicing yoga has been due to the added stress of having laptop problems. Now that the laptop is functioning again, I can write about my thoughts on yoga.
I think my biggest problem with yoga is that I am doing yoga to relieve stress on command rather than just doing it when I feel like relaxing. I got to the point where I was ready for bed and remembered that I had to do yoga to help my mental health status. So I would rush through some sun salutes and stretches then brush teeth and go to bed. At the point when I failed to keep my balance during a pyramid pose, I had to stop and think for a bit. I was realizing my problem with this yoga stress relief intervention. This was something that I actually had to work at to incorporate into my daily life, as opposed to exercise for stress relief. I am used to running on a semi-daily basis as is, which I continue to do to stay in shape even though I’ve switched interventions. But yoga is something that is new to my life and incorporating it has been a struggle. This is the goal of this project. I’m finally getting at the meat of this project and struggling with what I’m supposed to have been struggling with since the start of this project.
I am also finding it frustrating to feel like I’m being forced to do something for an extrinsic reason rather than an intrinsic reason. This mostly happens when I remember to do yoga before bed and rush through it. It’s also frustrating when my form is bad and I lose balance while doing yoga. I realize it’s because yoga is meant to be slow and focused on form and breath and when I rush through it so I can check off that I did yoga for the day I’m not actually succeeding at my intervention.
In retrospect I wish I had designed my project so that I would consistently use exercise as a means of stress relief because that would have fit better within my existing lifestyle. But that is not the point of this project. This project was meant to challenge me and force me to adopt a lifestyle change. Doing yoga has definitely been a change. It’s not the first thing my mind leaps to when I think of ways to calm down. But it makes sense that I’m trying new things in my life, which is the entire point of this project.
Monday, April 7, 2008
Starting up Yoga
Yoga on the other hand is not as physically intensive as running. I'm doing some basic poses on my own, a few sun salutes, stretching. Enough that by the time I work through my entire routine, my mind is usually calmed down and my body does feel the stretch and movement, which is necessary so I know I have some of the physical activity. I think that to have the mind fully relaxed and engaged, I need to have some form of mind-body interaction that fully engaged both spheres of Chelsea. My mind needs to be concentrating on something that my body is doing. I guess that's why yoga does work for stress relief--you need your mind to concentrate on enough for the body to let go of the daily stresses and wind down.
I'm also trying to think about how other people may be able to incorporate these stress management techniques into their lives. Yoga works if you can concentrate and have the courage to go with it even if you lack the flexibility. Running works if you don't care that you may be walking or going slow--you have to remember to not get competitive with the other people you may see outside with you and mentally encourage those around you to do their best, just like you are trying to do.
So for now, I'm working on this yoga thing, trying to connect my mind more to the yoga and let go of the stresses. I'm still running, but that's just for me, not the project. I was running before the project started so why stop now? Adding yoga to the mix is challenging but it is becoming a nice way to end my day.
Monday, March 3, 2008
East Campus
Friday, February 22, 2008
Rough Week
Oddly enough, it's been very hard for me to find the time to destress because I'm too busy being stressed about everything right now. My headaches are taking the cake right now, mostly because nursing school is making me a HUGE hypochondriac but also I'm moving this weekend so that's a big stress. And then just classes... So while I haven't been following up on my project this week, my lack of participation has just reaffirmed that I really really do need to work on my stress management and that this is the right project topic for me at this time in my life.
To do list: move, fix headaches, and actively work on de-stressing!
Monday, February 11, 2008
Starting the PPP
Officially started the project last night, with 45 minutes of elliptical while studying pharmacology. Not sure if that's a good way to reduce my stress, but it works. Today I did 35 minutes of elliptical while also studying pharm. I took my various self-administered tests (PSS, WSI, DSI, and the good old 1-10 scale how would I rate my stress level). I will not be publishing daily scores on the blog, but rather bimonthly score updates and preliminary statistical analysis. I think that's it for now.
Saturday, February 2, 2008
Proposal
Chelsea Glessner
Draft #2 (2-2-08)
I. Project Vision
Name: Staying Sane?
Project Identity: This project is designed to test various coping mechanisms with regard to daily stresses and use statistical analysis to determine the validity of distinct interventions upon my personal stress levels as measured by self-report (See I. A. a. for specific tests used).
Goal: To improve mental health and increase ability to use positive coping mechanisms
Healthy People 2010 Focus Area: Mental Health and Mental Disorders (#18)
Outcomes:
1. Show consistently lower stress measures upon completion
2. Reduce recurrence of stressful states
3. Show ability to lead a 10-30 minute teaching workshop on positive coping strategies and their benefits using first-hand knowledge
Secondary Outcomes:
1. Increase knowledge of mental health problems and diseases
2. Increase knowledge of positive coping mechanisms
3. Increase awareness of services for mental health
Level of Prevention: Secondary
Project Timeline: February 1 – August 24
Project Documented: blog found at http://stayingsaneppp.blogspot.com/ with weekly journaling, milestones, intervention plans, and assessment report as completed
Milestone Check: The specific interventions for stress management will change monthly. Upon this change, the Perceived Stress Scale (Cohen, 1983) will be completed to get data on the monthly stress level prior to starting an intervention and finishing another. Another check will be to obtain cathecolamine and cortisol tests (urine and saliva, respectively) from the Duke Student Health Center to get a physiologic picture of stress in between stress interventions. The milestone check will include assessment of compliance to interventions and a self-analysis of possible barriers to compliance as well as written suggestions to improve compliance. This will all be completed on the blog.
A. Assessment Parameters
a. Self-evaluation tests
b. Self-identified weekly stressors
c. Physiological Response to stress and interventions
i. Heart rate self-measured before and after every intervention
ii. Blood pressure weekly as measured by a student nurse
iii. Catecholamines (urine test) and cortisol (saliva) monthly
d. Statistical analysis on stress-measurement scores and any evidence of statistical correlation between self-assessment scores and intervention plans
B. Empirics
a. Bormann, J. E., Becker, S., Gershiwin, M., Kelly, A., Pada, L., Smith, T. L., et al. (2006). Relationship of Frequent Mantram Repetition to Emotional and Spiritual Well-Being in Healthcare Workers. The Journal of Continuing Education in Nursing , 218-224.
b. Brantley, P. J., Bodenlos, J. S., Cowles, M., Whitehead, D., Ancona, M., & Jones, G. N. (2007). Development and Validation of the Weekly Stress Inventory-Short Form. Journal of Psychopathological Behavioral Assessment , 55-60.
c. Brantley, P. J., Waggoner, C. D., Jones, G. N., & Rappaport, N. B. (1987). A Daily Stress Inventory: Development, Reliability, and Validity. Journal of Behavioral Medicine , 61-74.
d. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A Global Measure of Perceived Stress. Journal of Health and Social Behavior , 385-396.
e. Granarth, J., Ingvarsson, S., von Thiele, U., & Lundberg, U. (2006). Stress Management: A Randomized Study of Cognitive Behavioral Therapy and Yoga. Cognitive Behavior Therapy , 3-10.
f. Harris, A. H., Cronkite, R., & Moos, R. (2006). Physical activity, exercise coping, and depression in a 10-year cohort study of depressed patients. Journal of Affective Disorders , 79-85.
g. Roth, D. L., & Holmes, D. S. (1987). Influence of Aerobic Exercise Training and Relaxation Training on Physical and Psychological Health Following Stressful Life Events. Psychosomatic Medicine , 355-365.
C. Action Strategies
a. Participate in self-monitored predetermined interventions
b. Self-evaluate stress before and after every intervention action
c. Keep personal and professional journal
d. Attend therapy sessions at CAPS
e. Consult with Dr. Martin for self-assessment scales
f. Consult with CAPS therapist for self-therapies and interventions
g. Consult with Duke Integrative Medicine for self-therapies and interventions
D. Baseline Assessment
a. Self-evaluation tests
i. Perceived Stress Scale (Cohen, 1983)
ii. Heart rate and blood pressure measurements
iii. Catecholamine and cortisol measurements
b. Initial assessment visit with CAPS at Duke University
E. Implementation Plan
a. Use of different intervention strategies for predetermined amount of time
b. Self-evaluation during each intervention
i. Prior to and after intervention (monthly): Perceived Stress Scale (Cohen, 1983)
ii. Weekly Stress Inventory-Short Form (Brantley, 2007)
iii. Daily Stress Inventory (Brantley, 1987)
c. Intervention Schedule:
February: Daily Exercise
March: Meditation
April: Volunteer Work
May: Mantram Repetition
June: Yoga
July: Progressive Relaxation
August: Subject Choice
F. Evaluation
a. Descriptive Statistics of assessment scores
b. Statistical examination of correlation between interventions and assessment scores
c. Subjective opinion of intervention effectiveness
d. Peer Evaluation of Portfolio