Unita Werdi Rahajeng, M.Psi., psi | unita@ub.ac.id STRES DAN KESEHATAN Unita Werdi Rahajeng, M.Psi., psi | unita@ub.ac.id http://www.youtube.com/watch?v=4KbSRXP0wik

Apa itu Stress….?? Stress adalah sesuatu alamiah dan dapat dikelola dalam kehidupan sehari-hari Dampak dari reaksi kita (fisik dan mental) terhadap berbagai kondisi, utamanaya perubahan dan tuntutan hidup Ketika kita menganggap bahwa sesuatu itu “menuntut” atau “mengancam” diri kita Erat dengan respon “fight & flight”  dijelaskan terpisah

Contemporary Views of the Nature of Stress The Process of Stress Stressor Stress Appraisal Outcome Coping This slide shows a contemporary view of stress. This model acknowledges that stress effects people differently. Everyone is exposed to stressors but we might vary in how we appraise a stressful situation and how we cope with that stress

Macam-macam Stressor Stressor lingkungan: Misal: kesesakan, suara berisik, panas Stressor fisiologis Misal: obat-obatan, kafein, tembakau Stressor psiko-sosial Misal: tuntutan hidup, hubungan interpersonal, perubahan hidup There are different types of stressors: Environmental: heat, noise, crowding Physiological: drugs, caffeine, tobacco, alcohol, exertion Emotional (Psycho-social): Life events, relationships, responsibility, pressures Of the three , psychosocial stressors generally are considered to be the most stressful. 6

Karakteristik yang Mempengaruhi Appraisal Stress Negatif >< positif Lebih susah diterima Misal: kehilangan pekerjaan, perceraian, tidak lulus Uncontrollable >< can Tidak dapat dikendalikan atau malah mengendalikan diri kita Misal: menghadapi supervisor, pertama bertemu calon mertua Ambiguous >< expectations Tidak mengenali tuntutan apa yang diharapkan bagi diri kita Misal: berada di lingkungan asing dan tidak kenal siapa-siapa These are some common characteristics of stressful events. Negative stress is considered harder to accept than positive stress. So while the stress of getting ready for a wedding may be high it is not as bad as worrying about losing a job Uncontrollable stress is worse than something that you can control. In general, taking what control you have in a situation is about the best way to reduce your level of stress Ambiguous stress is also harder to accept. This related to the question about job stress. With poorly defined or vague expectations stress is more likely. 8

Appraisal of Stressors High Stress See stressor as a threat Stressor Stress Appraisal This slide shows the details of the appraisal process. A given stressor can lead to high or low stress depending on how it is appraised. Seeing stress as an opportunity for success versus an opportunity for failure are key aspects of the appraisal process. See stressor as a challenge Low Stress

Stress Continuum Burnout Boredom Eustress Burn Out (Distress) Eustress Over-stimulation, ineffective problem solving, exhaustion, illness, low self- esteem Eustress Creativity, problem solving, change, satisfaction Rust Out (Boredom) Fatigue, frustration, dissatisfaction Burnout Boredom Eustress

REAKSI FISIOLOGIS TERHADAP STRESS Aktivasi SAM  sympathetic-adrenal medulla  faster-shorterm reaction Aktivasi HPA  hypothalamus-pituitary-adrenal  slower-longer lasting

STRESS DAN SISTEM IMUNITAS Stres mempengaruhi sistem imunitas. Stres mendorong produksi leukosit, sitokin dan menimbulkan gejala-gejala penyakit umum. Misal: merasakan demam dan kurang selera makan ketika akan ujian masuk perguruan tinggi Dampak stres terus menerus seperti penyakit yang menahun.

Respon Perilaku Terhadap Stress Fight vs Flight

Fight and Flight Sebagian besar perilaku emosional intensif terbagi menjadi dua kategori: Menyerang (fight) atau Menghindar (flight) Emosi yang terkait dengan menyerang  kemarahan Emosi yang terkait dengan menghindar  ketakutan http://www.nottingham.ac.uk/counselling/documents/podacst-fight-or-flight- response.pdf http://cmhc.utexas.edu/stressrecess/Level_One/fof.html

COPING STRESS Fight Response  Problem Focussed Coping usaha untuk merubah situasi (modifikasi stressor) redefinisi permasalahan aktif mencari solusi permasalahan (mengalahkan stressor) aktif mengevalusasi pilihan penyelesaian masalah Flight Response  Emotion-focussed coping mengendalikan respon emosional terkait dengan stressor menghindari stressor atau meminimalkan kontak dengan stressor berdamai dengan stressor

Manajemen Stress Stress adalah bagian tak terelakkan dalam kehidupan. Dengan teknik manajemen stress yang baik membantu kita menghadapinya dengan lebih efektif Use this statement as a good summary of the stress relationships You may not be able to smooth out the surf, but you can learn to ride the waves!

Langkah Manajemen Stress 1. Mengenali sumber stress (stressor) dan tanda-tanda stress 2. Mengukur kemampuan diri untuk menghadapi stressor (can changed or can’t be changed) 3. Menerapkan strategi menghadapi stressor Accept what can't be changed Act on what can be changed 4. Menerapkan pola hidup sehat (pola makan, olahraga, gaya hidup sehat)

Common Stress Reduction Techniques Quick "time out" Jacobson's progressive relaxation Autogenic training Biofeedback Meditation / imagery Exercise These are some common stress reduction techniques A separate slide covers each of the techniques in greater detail. 11

POST TRAUMATIC STRES DISORDER Individu mengalami kejadian yang traumatis, misal perang, kecelakaan, dll Kadar kortisol penderita PTSD menurun. Tidak punya pertahanan menghadapi stres sehingga rentan terhadap stres berulang. Penderita PTSD memiliki ukuran hipokampus lebih kecil. Apakah ini predisposisi atau stres mengkerutkan ukuran hipokampus...?? http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder- ptsd/index.shtml