By Dr Suryani SKp MHSc

Stress
Stress is a word used to describe experiences that are challenging emotionally and physiologically Hans Selye mendefinisikan stres sebagai respon nonspesifik tubuh terhadap setiap kebutuhan yg terganggu

Reaksi thd. situasi yg. menimbulkan tekanan, perubahan, ketegangan emosi, kegiatan pertumbuhan, maupun kerusakan (Selye )
.

Symptom or manifestation of stress (Keegan, 2012)

1.Physical signs of stress include fatigue and exhaustion, headaches or migraines, neck and back pains or stiffness, gastrointestinal problems (nausea, diarrhea, constipation, or colitis), chest pains or palpitations, vulnerability to colds and flu (weakened immune system), and sleep disturbances. 2. Social manifestations of stress include family conflicts, job tensions, and change in sexual energy. 3. Psychological manifestations: gejala emosi seperti frustasi, apathy gejala intelektual seperti pelupa, suka melamun, slower thinking, gejala perilaku seperti susah menyelesaikan tugas, mood swing

Types of Stress

Eustress (Good stress) generally refers to those experiences that are of limited duration and that a person can master and which leave a sense of exhilaration (kegembiraan) and accomplishment.
Distress (bad stress) or being stressed out, refers to experiences where a sense of control and mastery is lacking and which are often prolonged or recurrent, irritating, emotionally draining, and physically exhausting or dangerous

Faktor pencetus stres disebut stressor Secara umum stressor terdiri dari 2 jenis: Eksternal (dari luar diri ) termasuk dari lingkungan, keluarga dan masyarakat Internal (dari dalam diri)

Stressor psikososial
PERKAWINAN HUB. INTERPERSONAL PEKERJAAN LINGKUNGAN HIDUP KEUANGAN SEKOLAH HUKUM PERKEMBANGAN PENY. FISIK/CEDERA FAKTOR KELUARGA

Respon terhadap Stressor dipengaruhi oleh:

1. 2. 3. 4. 5. 6. Sifat stressor Lamanya stressor Jumlah stressor Pengalaman masa lalu Tipe Kepribadian Tingkat perkembangan

Some of the harmful effects of chronic stress

Chronic stress can depress cognitive functioning leading to problems with attention and concentration, memory, decision-making, and abstract thinking. Chronic stress has been found to cause serious effects in the body in general and in the brain in particular (Burke, 2009) Chronic stress causes excessive amounts of cortisol to be produced from the adrenal cortex which in turn causes damage to arteries with subsequent increased risk of myocardial infarction (MI, heart attack) and stroke and damage to the hippocampus (an area critical for memory and for controlling levels of cortisol). Furthermore, virtually every aspect of the immune system is depressed by excessive amounts of cortisol. White blood cells are literally decreased in number and in function. This is why individuals often get sick when stressed (Burke, 2009).

Homeostasis
Homeostasis merupakan suatu keadaan tubuh untuk mempertahankan keseimbangan dalam mempertahankan kondisi yang dialaminya. Proses homeostasis terjadi apabila tubuh mengalami stres sehingga tubuh secara alamiah akan melakukan mekanisme pertahanan untuk menjaga kondisi yang seimbang, Homeostasis adalah suatu proses perubahan yang terus-menerus untuk memelihara stabilitas dan beradaptasi terhadap kondisi lingkungan sekitarnya. Homeostasis yang terdapat dalam tubuh manusia dapat dikendalikan oleh suatu sistem endokrin dan syaraf otonom. Secara alamiah proses homeostasis dapat terjadi dalam tubuh manusia.

Homeostasis
Contoh : Secara tiba-tiba temperatur tubuh naik, mekanisme homeostasis compensatori menyebabkan kontriksi pembuluh darah perif er, karena itu merupakan reaksi dalam pembuluh darah, menyebabkan peningkatan kontraksi otot, serta merasakan menggigil akibat panas yang timbul, sehingga suhu tubuh dipertahankan tetap stabil

ADAPTATION
Adaptation: is the change that takes place as a result of the response to a stressor
Adaptasi melibatkan refleks, mekanisme otomatis untuk perlindungan, mekanisme koping dan idealnya dapat mengarah pada penyesuaian dan penguasaan (Selye, 1976) Mansen (1992) adaptasi bisa terjadi jika individu berhasil menetralisir stress melalui perubahan tingkah laku dan proses berfikir sehingga dia kembali berfungsi sebagai individu yang utuh

Macam - macam Adaptasi

A. Adaptasi Fisiologis Menurut Hans Selye terdapat 2 adaptasi fisiologis terhadap stres yaitu : 1. LAS (Local Adaptation Syndrom) 2. GAS (General Adaptation Syndrom)

LAS
LAS adalah respon dari jaringan, organ, atau bagian tubuh terhadap stres karena trauma, penyakit atau perubahan fisiologis lainnya Responnya setempat, adaptif, berjangka pendek, restoratif, LAS membantu dalam memulihkan homeostasis region atau bagian tubuh

contoh
Respon nyeri Respon ini adalah respon adaptif dan melindungi jaringan dari kerusakan lebih lanjut Respon inflamasi (radang) Respon ini memusatkan inflamasi sehingga menghambat penyebaran dan meningkatkan penyembuhan

GAS (general adaptation syndrome)

Alarm Reaction Resistence Exhaustion

Alarm reaction
Person perceives stressor, defense mechanisms activated Fight-or-flight response Hormone levels rise, body prepares to react Activates the sympathetic nervous system Shock and counter-shock phases (1 min - 24 hrs)

Resistence
If the stress continues and/or more stress occurs it becomes more difficult and forces the body to use more and more energy. As the stress doesnt end, the body is almost constantly in the fight or flight response and the nervous system and the adrenal glands cannot rest and heal. Over time, this can cause damage not only to the nervous system, the adrenal glands, and other glands in the endocrine system [ex. the thyroid, the pancreas], but also other organs that have to work harder when there is continued stress [ex. the heart]

 Results when adaptive mechanisms are exhausted Body either rests and mobilizes its defenses to return to normal or dies Depletion (kehabisan/penipisan) of resources brings on diseases and disorders (e.g., chronically high heart rate and blood pressure increase chances of heart attack and stroke). Finally die

Exhaustion

B. Adaptasi Psikologis
Merupakan proses penyesuaian psikologis terhadap stressor, melalui mekanisme pertahanan diri (coping mechanism) agar dapat melindungi atau bertahan dari serangan2 atau hal2 yang tidak menyenangkan

Adaptasi Psikologis
1. Task Oriented Reaksi ini merupakan koping yang digunakan dalam mengatasi masalah dengan berorientasi pada proses penyelesaian masalah, meliputi afektif (perasaan), kognitif dan psikomotor

2. Ego Oriented Reaksi berorientasi pada ego pertama kali duraikan oleh Sigmund Freud, adalah perilaku tidak sadar yang memberikan perlindungan psikologis terhadap peristiwa yang menegangkan. Mekanisme ini digunakan oleh setiap orang dan membantu melindungi terhadap perasaan tidak berdaya

Lazaruss Cognitive Theory

Selye assumed that stress depended only on the intensity of the stressor.

Lazarus proposed that a mental process determines whether stress occurs.

Terapi modalitas mengatasi stres

Relaxation Technique The parasympathetic nervous system predominates, the individuals autonomic system is not in an emergency mode, and the body is in a more rebuilding, healing mode.

Relaxation Technique (practice)

Find a quiet place where you will not be disturbed for at least 10 minutes, and turn down the lights if possible. Take off or loosen your shoes. Assume a comfortable sitting position with your relaxed hands resting on your thighs, and close your eyes. Focus on slow, relaxed breathing; and breathe through your nose if possible. When inhaling, let your abdomen push outward so that your diaphragm can settle down allowing the lungs to fully expand. For the first few minutes, try the following routine. Inhale to the count of 2 and exhale to the count of 4. Inhale to the count of 3 and exhale to the count of 6. Inhale to the count of 4 and exhale to the count of 8. Repeat this routine

Cognitive therapy
This form of psychotherapy helps patients to replace dysfunctional, inaccurate thoughts and images (causing the experience of stress) with thoughts and images that are more accurate and that decrease stress Biasanya dilakukan oleh expert atau trainer Juga dikenal sebagai tehnik Reframing

Hypnosis
hypnosis assists the client in entering an extremely relaxed but focused state so that subconscious processes of healing can occur. This relaxed state not only reduces immediate stress, but it also reduces chronic stress http://www.youtube.com/watch?v=_TP1oaKA jzM&feature=related

Meditation/praying
Apart from specific religious or philosophical beliefs associated with different types of meditation or prayer, these experiences can have a very calming and healing effect. http://www.youtube.com/watch?v=BIfNjpr0m OY&feature=related

Terapi musik
involves passive relaxation combined with listening to soothing, relaxing music for the purpose of changing behavior, physiological responses, and emotions; it affects physiologicalresponses through mind modulation. http://www.youtube.com/watch?v=wEd8t4fJdk&feature=fvwberel

Massage (pijat)
Massage is one of numerous physical touch interventions designed to reduce stress, alleviate anxiety, promote circulation, generally stimulate a state of well-being

Aroma therapy
Use of essential oils to stimulate bodily responses via the sense of smell. These essential oils are commonly used in aromatherapy: citrus, lavender, peppermint, and rosemary

SEFT (spiritual emotional freedom technique)

SEFT dikembangkan dari Emotional Freedom Technique (EFT), oleh Gary Craig (USA), yang saat ini sangat populer di Amerika, Eropa, & Australia sebagai solusi tercepat & termudah untuk mengatasi berbagai masalah fisik, dan emosi, serta untuk meningkatkan penampilan kerja.