CHAPTER I

INTRODUCTION
1.1 BACKGROUND
Stress management is a popular term and has been in common use by the lay-public and
mental health professionals for many years. The term stress has appeared in medical and
medically related literature since 1956 about the concept of stress to explain the
physiological response of people to various environmental stimuli. Considerable research
was conducted in the area of epidemiology in public health departments throughout the
country. A later development in stress research concerns the personality type and other
psychological characteristics of individuals, particularly men, who respond to stressful
situations with physiological breakdown, e.g., cardiac disease, peptic ulcer, and other
psychosomatic disorders.
When something happens to us, we automatically evaluate the situation mentally. We
decide if it is threatening to us, how we need to deal with the situation, and what skills we
can use. If we decide that the demands of the situation outweigh the skills we have, then we
label the situation as stressful and react with the classic stress response. If we decide that
our coping skills outweigh the demands of the situation, then we dont see it as stressful.
Stress can come from any situation or thought that makes you feel frustrated, angry, or
anxious. Everyone sees situations differently and has different coping skills. For this reason,
no two people will respond exactly the same way to a given situation.
Stress is a normal part of life. In small quantities, stress is good; it can motivate you and
help you become more productive. However, too much stress, or a strong response to stress
can be harmful. How we perceive a stress provoking event and how we react to it determines
its impact on our health. We may be motivated and invigorated by the events in our lives, or
we may see some as stressful and respond in a manner that may have a negative effect on
our physical, mental, and social well-being

1.2 PROBLEM FORMULATION

Based on the above, the formulation of the problem is:
1. What is stress?
2. What is stress management?
3. How do we manage stress?

1.3 DESTINATION

The purpose of this paper is:

1. Understand what is meant by stress
2. Understand how to overcome their feelings of stress
3. Understand how to manage stress
1.4 BENEFIT
The benefits that we can get as a student in this paper, namely:
1. Can understand what is stress
2. Can understand what stress management
3. Could understand how to manage stress

CHAPTER II

REVIEW OF THEORY
2.1 DEFINITIONS
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 distressedoverwhelmed, oppressed, or out of
control.
When you perceive a threat, your nervous system responds by releasing a flood of stress
hormones, including adrenaline and cortisol. These hormones rouse the body for emergency
action.. Your heart pounds faster, muscles tighten, blood pressure rises, breath quickens, and
your senses become sharper. These physical changes increase your strength and stamina,
speed your reaction time, and enhance your focuspreparing you to either fight or flee from
the danger at hand.
2.2 CAUSES
There are many causes of stress in life including:
Death: of spouse, family, friend
Health: injury, illness, pregnancy
Crime: Sexual molestation, mugging, burglary, pick-pocketed
Self-abuse: drug abuse, alcoholism, self-harm
Family change: separation, divorce, new baby, marriage
Sexual problems: getting partner, with partner
Argument: with spouse, family, friends, co-workers, boss
Physical changes: lack of sleep, new work hours
New location: vacation, moving house
Money: lack of it, owing it, investing it
Environment change: in school, job, house, town, jail
Responsibility increase: new dependent, new job
2.3 TYPES OF STRESS
Three Different Kinds of Stress
Aiming for effective stress management initially includes the proper recognition of
stress, the stressor, the manifestations, and its effect in ones well-being.

For a better understanding of stress and its influence to an individual, psychologists

categorize stress into three different types: acute stress, episodic stress, and chronic stress. In
this article, we will discover the characteristics and attributes of each type of stress.
1. Acute Stress
Of all forms of stress, acute stress is the most widely experienced one, since it
typically is caused by the daily demands and pressures encountered by each one of us.
While the word stress connotes a negative impression, acute stress is what actually
brings about excitement, joy and thrill in our lives. Riding a roller coaster in a theme
park, for instance, is a situation that brings about acute stress, yet brings excitement.
However, riding a higher and longer roller coaster can bring so much stress that you wish
it would end sooner, or that you should have not gone for the ride in the first place. When
the long and windy ride is over, you might feel the effects of too much acute stress, such
as vomiting, tension headaches, and other psychological and/or physiological symptoms.
Because acute stress occurs only at a very short period of time, these symptoms might
only come out when the stress has already accumulated:

Emotional distress, such as anger, anxiety, irritability, and acute periods of

depression
Physical problems, such as headache, pain, stomach upset, dizziness, heart
palpitations, shortness of breath, hypertension and bowel disorders

2. Episodic Stress
Acute stress that is suffered too frequently is called episodic stress. This type of
stress is usually seen in people who make self-inflicted, unrealistic or unreasonable
demands which get all clamoured up and bring too much stress in their attempt to
accomplish these goals. Episodic stress is not like chronic stress, though, because this
type of stress ceases from time to time yet not as frequently as acute stress does.
Episodic stress is also typically observed in people with Type A personality,
which involves being overly competitive, aggressive, demanding and sometimes tense

and hostile. Because of this, the symptoms of episodic stress are found in Type A persons.
These include:

Longer periods of intermitted depression, anxiety disorders and emotional distress

Ceaseless worrying
Persistent physical symptoms similar to those found in acute stress
Coronary heart diseases, or other heart problems

3. Chronic Stress
Chronic stress is the total opposite of acute stress; its not exciting and thrilling,
but dangerous and unhealthy. Chronic stress tears the life of a person apart his mind,
body or spirit.
This type of stress is brought about by long-term exposure to stressors, such as
unhappy marriage, traumatic experiences, unwanted career or job, stress of poverty,
chronic illnesses, relationship conflicts, political problems, and dysfunctional families.
These stressful situations seem to be unending, and the accumulated stress that results
from exposure to them can be life-threatening, and can even lead a person to resort to
violence, suicide and self-harm. Serious illnesses like stroke, heart attack, cancer, and
psychological problems such as clinical depression and post-traumatic disorder can
originate from chronic stress.
a. Common physical signs and symptoms of chronic stress are:
dry mouth
difficulty in breathing
pounding heart
stomach ache
headache
diaphoresis
frequent urination
tightening of muscles, and many more
b. Mental signs and symptoms include:
sudden irritability
tension
problems with concentration
difficulty in sleeping
narrowed perception

frequent feelings of fatigue

2.4 STRESS MANAJEMEN

Stress Management is methods of controlling factors that require a response or change
within a person by identifying the stressors, eliminating negative stressors, and developing
effective coping mechanisms to counteract the response constructively.
A set of techniques and programs intended to help people deal more effectively with
stress in their lives by analyzing the specific stressors and taking positive actions to minimize
their effects. Most stress management programs deal with job stress and workplace issues.
2.5 Stress Management Purpose and Plan
A. Factors Stress Triggers occurrence in the Workplace.
Stress in the workplace has become a serious problem for the company because it
can degrade the performance of the employee and the company. There are three main
groups of stressors (commonly called a stressor) in the workplace.
1. Personal factors:
Family, existence of problems in marriage, divorce and children who are
undisciplined and unruly can make a person stress and bring the problem to the

place of work.
Economic, which lack sufficient income households meet the needs of today
while on the higher cost of living can make a person stress and bring the problem

to the place of work.

Personality characteristics, as well as a closed personality, irritability
perfectionist, very oriented to time and make the results of its work shall be in
accordance with what he wanted, a few examples of personal factors that may

trigger stress in the workplace.

2. Organizational and environmental factors:
Work, Employment routine, monotonous, need a speed in work, with a space or

work location noisy and hot

The role and dynamics of the relationship or interaction between employees;
demands of the role unclear or conflicting with the system's values; as well as the
working relationship between colleagues is not suitable, especially when tinged
with mental or physical conflict, a few examples of organizational factors that
may trigger stress in the workplace.

3. Environmental Factors:
Economy, politics, and technology. Political uncertainty, prolonged state of
economic crisis, as well as technological developments that threaten the
continuity of the work are some examples of environmental factors that may
trigger stress in the workplace.
1) The purpose of stress management at work :
Stress management aims to improve the performance of employees and the company,
improve job satisfaction, commitment to the organization, and of course improve
financially.
2) Strategies or Plan to Handle Stress in the Workplace:
The individual's ability to handle stress in the workplace is different. In the face of
the same stressor, such deadline a task completion time, the level of stress experienced or
the consequences could be different. Employees are one reacts to these stressors with
remain relaxed and focused. While his look of panic and tension in the completion of the
task, and become irritable.There are some things you can do to control stress employees
in the workplace. How to include the following:
a) Plan your activities well: what, why, how, when and who is responsible for the
tasks. It is important to create not only a long-term planning but also short-term
(monthly plan, daily plan).
b) Surely you in the past have experienced problems in the workplace. Try to
remember back there any ways that you can use to troubleshoot problems that you
face today.
c) Follow build a pleasant working climate, by being open and communicating with
co-workers.
d) Make sure you understand the tasks and responsibilities of you, and do not
hesitate to ask.
e) Make some time break for a few minutes while you work. Relaxed and do not
anything.. Take a deep breath.
f) Have an attitude of tolerance to fellow co-workers. Remember that each person is
unique, as an example: some people actually perform better under pressure while
others need more time to finish the job.
g) Delegate some of your responsibilities to your subordinates.
h) Keep your team spirit, for example by doing small celebrations, sports or
recreation together.

i) Provide a good working environment. Minimize distractions such as noise,

ventilation, light and temperature.
j) In addition to stress in the workplace, in life in general, we too can experience
stress for several reasons.
B. Stress in life became a serious problem for someone because it can interfere with the
physical, psychological and emotional. For example in some issues such as:
1. Family, existence of problems in marriage, divorce and children who are undisciplined
andunruly can make a person stress and bring the problem to the place of work. There
are several things you can do to control stress in dealing with family issues and the
economy.
1) The purpose of stress management for physical problems because of stress in the
family:
Stress management aims to help overcome the physical problems that arise as a
result of stress in life such as family, marriage and financial problems.
2) Strategies or Plan to Handle Stress in the family:
a) Do pemijitan body (body massage), because pemijitan great for relaxation and
normalization of blood pressure. After pemijitan, you will experience improved
quality of sleep which of course would be better recover your fatigue
b) Exercising regularly is very important in combating stress. Exercising will
mobilize our muscles, accelerate blood flow and open mangambil lungs for more
oxygen. The impact you will get a good night's sleep and better health.
c) Make your hobbies, such as fishing, hiking or whatever you like. You can also do
adventure
d)

you've

never

experienced

before

like

rafting

suppose.

Doing activities like this can eliminate thoughts that cause stress.
Many of the assumption that beer, wine or whiskey can relieve stress. In fact,
white water who can relieve stress. Research shows that drinking a glass or two
glasses of wine can indeed cause us to relax at the time, but once the effects of
alcohol disappear, stress will likely wake you up in tengahmalam. By drinking
lots of water will help restore our body from lack of fluids, because of lack of

fluids can cause fatigue.

e) Perform meditation. Health experts say that a very powerful tool in overcoming
stress is meditation. Meditation helps cleanse our mind and improve
concentration. Has proven that meditation for 15 minutes together with us to rest
for 1 hour. Even if you only do meditation for 2 minutes, still would be helpful.
Meditation will help you forget about the things that can cause stress.

f) When a person experiences stress, a natural reaction if the person then take it out
by eating a lot of food. You should know that consuming a high carbohydratecontaining foods can increase levels of insulin in the body, where it can make the
body's insulin becomes tired and your mood becomes bad .
g) If your body is tired, it is not easy for us in controlling stress. Not getting enough
sleep affects our whole day, and usually we have a bad day because of lack of
sleep causes us to not be able to concentrate and see a problem worse than it
should be. Good sleep for adults is seven hours a day.

2. Economy, which is not adequate income households meet the needs of today while on
the higher costof living can make a person stress and bring the problem to the place of
work. There are several things you can do to control stress in dealing with family
issues and the economy. How to include the following:
1) The purpose of stress management for economy problems :
Stress management aims to help overcome the financial problems in the household
which if not addressed will lead to quarrels in the household so that it appears
stress.
2) Strategies or Plan to Handle Stress because economy problems:
a) Open, the first thing that must be done to avoid finance is to be open. Both
couples alike looking for money or simply one who is making money, there
should be no hidden spending problem. Always discuss all decisions related to
finance, such as expenses, income, savings, and other.
b) Make a Deal, Before spending your money, it is better to make the rules agreed.
Suppose determine what percentage should be saved, how much budget is used to
pay bills, and more.
c) Determine the long- goal, in financial terms, you also must be careful and wise in
looking at the future. Decide on a few things in the future that require a lot of
money. Suppose the children's education expenses, vacations, and more. This will
help you save money and not overwhelmed when the time comes.
d) Saving, you do not have to save a lot in the bank, but provide little savings in the
home that can fill every week. It may sound trivial, but the money collected can
be very handy when needed.

e) Saving together, actually it does not matter you will use shared or private savings.
But before deciding, you should be alert to the risks and effects. You should also
discuss this issue with your partner, because it is well adapted to the nature of the
couple
f) Keep track of expenses, Prior divide the money, you should begin to keep track of
your daily expenses. This is very useful if done since the beginning of the
wedding, as you can guess how household expenses each month. It also helps you
find out if you are too extravagant or thrifty.
g) Make a realistic budget that, make sure your budget is realistic and can be done
well. Do not create a budget that is too little, until you have to be very frugal and
can not enjoy life. Do not also set a budget that is too loose to make your life
h)

wasteful.
Set aside money for fun, Save some money for entertainment or fun. Not a lot
that is not too extravagant. You can use the money for a dinner together, watch a
movie, or buy something for the family. Let's just say this money is a reward for

the hard work you and your partner.

i) Cooperate to manage finance Make sure you and your partner work together to
manage finances. Do not be too dominating or even passive when it comes to
spending or financial arrangements. May initially be awkward, but if you are
going to get accustomed to the benefits of managing finances as a team with your
partner.
2.6 Tehnique manajemen stress
a. Relaxation Techniques

Take a Deep Breath

Take a deep breath. Hold it for three seconds. Then let it out slowly. As you exhale, let
your jaw relax, your shoulderdxs relax and think calm as you let the tension flow
through your body and out your finger tips and toes.

Deep Breathing
Sit comfortably, with your eyes closed and bring your attention to your breathing.
Imagine that you have a balloon in your stomach. Every time you breathe in, the
balloon inflates. Each time you breathe out, the balloon deflates. Breathing from your
abdomen, inhale through your nose slowly to a count of four. Pause and hold your
breath to a count of four and then slowly exhale through your mouth to a count of four.

Repeat for 3 to 5 minutes, placing a hand on your stomach to feel it rising and falling
as you breathe.
There are many ways to practice deep breathing. Here is an example of a deep
breathing exercise:
Sit comfortably with your back straight. Place one hand on your chest and the
other on your stomach. Breathe in through your nose. Try to make the hand on
your stomach rise, while keeping the hand on your chest still. Exhale through your
mouth, pushing out as much air as you can while contracting your abdominal
muscles. The hand on your stomach should move in as you inhale, but your other
hand should move very little. Continue to breathe in through your nose and out
through your mouth. Try to inhale enough so that your lower abdomen rises and
falls. Count slowly as you exhale. If you have a hard time breathing from your
abdomen while sitting up, try lying on the floor.
Sit back in your seat. Close your eyes. Take a deep breath. Breathe again. Now
make your hands comfortable while keeping your eyes closed. You have a choice
of any comfortable hand positions such as:
- One hand on your belly
- One on your chest
- Palms of hands on your knees
- Hands folded in your lap
Now sit back, feet on the floor, hands comfortable. Inhale slowly and deeply
through your nose. Feel your stomach expand as your lungs fill with air. Now
exhale through your mouth to the count of five. Pause. Repeat while inhaling
through the nose and exhaling through your mouth and slowly count to five. Stress
& Stress Management 22
Again, in through your nose and out through your mouth counting to five. Sit and
enjoy the calmness for a few minutes.
Turn your attention to breathing your tensions away. Focus on your feet. Feel all of
the sensations there, feet and socks inside of your shoes, pressure on the floor, and
any other sensations. Now, as you take a deep breath, breathe all of those feelings
and sensations up into your lungs and then exhale them away. Go ahead. Deep
breath in, bringing all of those sensations into your lungs, then exhale them away.
Now, breathe in all those tensions in your legs and hips; big breath in and exhale
those tensions away.

All the tensions into your lungs and exhale them away. Your shoulders, arms, and
hands go ahead, and breathe the tensions in them away. Now your neck, jaw,
eyes, and forehead. Breathe away the tensions in them. Now with two last, deep
breaths, you can go back and breathe away any residual tensions.
Sit up straight. Do not arch your back. First, exhale completely through your
mouth. Place your hands on your stomach, just above your waist. Breathe in

slowly through your nose, pushing your hands out with your stomach. This ensures
that you are breathing deeply. Imagine that you are filling your body with air from
the bottom up. Hold your breath to a count of two to five, or whatever you can
handle. It is easier to hold your breath if you continue to hold out your stomach.
Slowly and steadily breath out through your mouth, feeling your hands move back
in as you slowly contract your stomach, until most of the air is out. Exhalation is a
little longer than inhalation. You can also do this exercise lying on your back. Deep
breathing exercises can help you to relax before you go to sleep for the night, or
fall back asleep if you awaken in the middle of the night. You can also practice
deep breathing exercises standing (e.g., while standing in line at the grocery store),
If you are really tense and feel as if you are holding your breath, simply
concentrate on slowly breathing in and out.

Mindfulness Meditation
Focus your awareness on the present moment with all of your senses. Notice in detail
what it looks like, feels like, smells like, sounds like and tastes like (if applicable).
Give the activity at hand your full attention free from distractions. Breathe slowly
while experiencing the activity and do not focus on any particular though.
Simple Meditation Exercise:

When you practice meditation at home, you will need to choose a quiet place
where you will not be disturbed. If you wish you may sit cross-legged on a cushion
on the floor, you may kneel, or sit in a chair with your back straight. You should
feel comfortable, but not so comfortable that you fall asleep. While practicing
mindfulness, it is important to stay alert.
Remain seated in your chair. Sit with your back straight, feet flat on the floor,
hands in your lap. Now close your eyes.
Just breathe normally through your nose. As you continue breathing normally
through your nose, begin to focus your attention on the sensations in and around
your nostrils, and on your upper lip just below your nostrils, that are caused by the
breath passing in and out. You might feel a slight tickle, or a feeling of warmth or
coolness, or heaviness or lightness. Just keep your concentration fixed there. This
area is your Stress & Stress Management 16 anchor; the place you will always
return to. Observe the changing sensations you experience in that area as the breath
passes over your anchor.
At the beginning of every breath, try noticing everything you can about the
sensations caused by just that one breath. Do the same for the next breath, just one
breath at a time.

If thoughts arise, as they most certainly will, gently but firmly bring your
awareness back to your anchor and remain focused on the in an out breath, one
breath at a time. (Pause for a few seconds).
Again, focus all of your attention on the changing sensations around your nose and
upper lip that are caused by the breath as it goes in and out. Notice whether the
breath is long or short. Does the air pass through one or both nostrils? Is the air
cool or warm?
If your mind wanders again, just note, mind wandered away and immediately
return it to your anchor. It is the minds nature to wander and your job to train it, so
just keep bringing it back. Gently but firmly bring it back. If you are having
difficulty bringing it back, you can try counting your breaths, just up to 10.
Continue focusing on the in and out breaths for another four minutes. I will let you
know when the time is up.
Following the meditation exercise ask yourself these question:
1)
2)
3)
4)
5)
6)
7)
8)

Open your eyes.

How was that for you?
Were you able to keep your attention focused on your anchor?
Could you experience your breath?
Where did you feel it?
What sensations did you feel?
Did you experience the wandering mind? It is very persistent isnt it?
Can you see how the wandering mind might get you into trouble if you are not
aware of where it has wandered off to?
Were you able to bring your attention back to your anchor each time it has
wandered away? It takes a lot of practice doesnt it? Stress & Stress Management.

Guided Imagery
Guided imagery is a convenient and simple relaxation technique that can help you
quickly and easily manage stress and reduce tension in your body. It is virtually as
easy as indulging in a vivid daydream and, with practice, this technique can help you
to ease the tension and stress that you feel. When used as a relaxation technique,
guided imagery involves imagining a scene in which you feel at peace, free to let go of
all tension and anxiety. Choose whatever setting is most calming to you, whether a
tropical beach, a favorite childhood spot, a therapists chair, or a quiet place in the
woods.
Heres how to get started with guided imagery:

Get into a comfortable position. If lying down will likely put you to sleep, trying
sitting cross-legged, or recline in a comfy chair. Close your eyes and breathe

deeply, focusing on breathing in feelings of peace, and breathing out feelings of

stress. Stress & Stress Management 23
Once you get to a relaxed state, begin to envision yourself in the midst of the most
relaxing environment you can imagine. For some, this could be floating in the
cool, clear waters on a tropical beach, listening to smooth music playing in the
background. For others, this might be sitting by a fire in a secluded snow cabin,
deep in the woods, sipping hot chocolate and reading a good novel while wrapped
in a plush blanket and fuzzy slippers.
As you imagine your scene, try to involve all of your senses. What does it look
like? How does it feel? What special scents are involved? What is around you?
Who is there or not there with you? What sounds do you hear? Focus your
attention on the smells in the area. What does the air feel like on your skin? Do you
feel any other sensations?
Stay here for as long as you like. Enjoy your surroundings and let yourself be far
from what stresses you. When youre ready to come back to reality, count back
from ten or twenty, and tell yourself that when you get to one, youll feel more
calm and refreshed, like returning from a mini-vacation, but you wont have left
the room!
Tips: You may want to use ambient sounds that accompany your imagery. You may
feel more immersed in your environment. You may also want to set a gentle radio
alarm just in case you loose track of time or fall asleep. This might allow you to
relax and let go, knowing your schedule wont be in jeopardy.

b. Physical Activity
Physical activity increases your overall health and sense of well-being. It also has stressbusting benefits like pumping up your endorphins, improving your mood, providing a
break from your stressors and increasing self-esteem. Try to walk or do something active
for 20 minutes a day. To gain additional benefits from aerobic and muscle strengthening
activities, find a more intense physical activity that you enjoy and do that a few times a
week too.
Sleep
Good sleep habits reduce stress and help your body recover from stress. Everyone
needs a different amount of sleep, however it is recommended to get 7-8 hours of
sleep a night. Short naps can also re-energize you and improve your mood. It is
suggested that naps not exceed 30 minutes or you may feel groggy.

Massage
Massage is a great way to reduce stress. It releases a hormone called oxytocin, which
turns off your stress response and promotes a sense of relaxation. Try to make time
for self-massage, exchange massage with a friend, or visit Wellness Education
Services for a free 10 minute chair massage once per month.

Aromatheraphy
Aromatherapy is a scientifically proven technique which uses your sense of smell to
trigger areas in your brain that affect mood. Use the guide below to relieve stress,
energize your mind and body, and encourage better health overall.

CHAPTER III
CLOSING
3.1 CONCLUSION
Stress is a source of negative conditions experienced by people of all ages from of variety
of cultures the popular view points to stress as a basis for or factor in headaches,
premenstrual tension Stress can have consequences far beyond temporary feelings of
pressure. While you cant avoid stress, you can learn to manage it and develop skills to cope
with the events or situations you find stressful. Stress management refers to the wide
spectrum of techniques and psychotherapies aimed at controlling a person's levels of stress,
especially chronic stress, usually for the purpose of improving everyday functioning.
3.2 SUGGESTION
For that as a candidate for medical personnel, especially for prospective nurses we need
to know how to handle the stress that can be found in our patient care. So that we can create a
healthy community life without distracting thoughts that will lead to disease easily come.
Therefore we make makalah not solely up to the task alone but can be applied in life.

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Anonim (2008). Introduction to stress management. [Online]. Tersedia:
http://www.mc.edu/rotc/files/5713/1471/5877/MSL_101_Personal_Dev_Sect_01_Intro_to_Stres
s_Management.pd. [ 5 Mei 2015]
Klinic community health centre.(2010). Stress and stress management. [Online]. Tersedia:
http://hydesmith.com/de-stress/files/StressMgt.pdf [5 mei 2015]
Eva H. Saragih. (2010). Manejemen Stress di tempat kerja. [online] Tersedia: http://ppmmanajemen.ac.id/manajemen-stres-di-tempat-kerja/ (10 Mei 2015)