welcome to medical matters i'm here with doktor bottom welcomed after bottom what is today subject it we're going to talk about stress today it would just come through the holiday season and polypi powerfully in building a fair bit of stress related the holidays and now we can talk glibly about maybe some of the pros and cons of stress i brought along one of our stress experts from the family health team bar frazier whose social worker and i would imagine that data and go by and her professional life that she doesn't help somebody work through stressors were welcomed by arab and i might say that you're probably trying to figure out how you can get rid of your stress this morning i would say that's very true i had to use my usual routines to kind of bring myself down but it's important to be just a little bit you know on the edge timely action to be focused and composed and you know to be prepared and awake what's funny i've been in a lot of places and a lot of times they say when you are really uptight about getting on stage that's when you do your best performance and for some reason nobody seems to know why would you get out there and you do it i think that's true i think it's true for for acting like you say and also for professional athletes you know that you want just enough to give you that extra energy and focus and concentration to much and if you might forget lines or too much if you're an athlete you might crash or of figure skating when they start fall you're over the edge you know and you you got too much of the although stress hormones moving through you say it's about balance really and figuring out how to make stress work best for you are those that stress response without it doing you in here i was a barbershop for many years and one of the things they always signal for you know you're getting ready to get on stage for the for the contest and one of the things they always say is don't peak to world through that's true because it takes a lot of your body to be in that state when the stress response hits it does take a lot out of you and you know you can be very fatigued after that or too relaxed actually and then you're not focused now doktor bottom you do a lot of referrals what do you find the one of the biggest things that you have to refer people to her with regards to stress sure again it's as this balance between the positive and negative is everybody s dress me life we should talk about examples of entertainers are athletes but everybody and i think of my own professional career through my training ready exams learning to do this the other thing and even today no working them rented apartment some becomes in with a cardiac arrest her current hasn't it i've got a deal to focus very quickly so when people come to me and then i refer the nabob somehow they ve developed a difficulty coping with their stress this trust has become counterproductive to and as a whole host of symptoms also rattled through a whole bunch of moments how can you recognize it maybe you're not coping well with the stress you could probably say that this becomes the norm rather than something happens once in awhile well for some people it is a repetitive thing every time they come up with a stressful situation they use the same they dropped the same symptoms same defence mechanisms and they really don't get through it very well so what has happened either once in its been severe or it's happened multiple times and they just not feeling like they're moving forward then it's a good opportunity to sit down and and review that and again barbie's quite helpful in helping people learn to work through those stress or so simple somebody common symptoms languages again difficulties refocusing difficulty staying on task difficulty multitasking difficulty sleeping difficulty eating difficulty with relationships difficulty staying com maybe being easily angered frustrated lashing out it can manifested in many different ways and each person is unique in individual that way so that the common denominator is that there is an underlying strasser in developing other more positive ways of coping with that stress so barf what do you do about all these problems when when people come to me yeah we're gonna refer when i get over for a well you know essentially i want people to tell me what's going on because when they come to me it's like you're sort of taking stock it's like ok what tip the balance because sometimes people carry on and there there often managing quite well with the you know the dated eight stressors but at some point something tip the balance and they you know just feel overwhelmed or they feel tents there holding all attention they might be having had some of the symptoms that doctor bottom referred to and so we have to figure out ok what is it is it work is it relationship is it having wage many responsibilities sometimes it's the way you approach things or how you think about them in that you just our very reactive all the time for many people like lots of times we can't change what is happening to us if someone has a coworker they don't get along with or difficult boss or they have a family member that they ve always had a hard relationship with or theirs financial structures like some things you can't always change that we have to figure out how you gonna take the best care of yourself within the context of there are a lot of these things external rhythm of the city in the family some of the things that are working from outside let's see maybe a job related thing or a anything that's happening outside i think its end both because sometimes it is the external stressors like these a work setting or family relationship but sometimes it is also the way like people's own way they ve learned koper manage over the years like we learn a lot about physical first aid over our lives most of us have done like seeps our first date but we don't learn emotional first aid and so in own sort of turning the attention back to yourself for some self care many people put everybody else in their life first and not themselves and so you know for me it's it's figuring out ok what's the problem to be solved like do you need to figure out how you gonna bet better manage our finances or or perhaps you know do you need to address an issue and be more assertive with a family member or do you really need to figure out how to take better care of yourself you know that's all reminds me of something it up i ve often wondered when you get married you have your first child you haven't got a clue what to do with their first child like what happens as the child progresses through those early stages and is it's almost something like that you gotta learn how to manage stress exactly exactly we do need to learn how to how to manage it and and some people their personality cell they just more easygoing like you can take the same stress or give it to two people and it'll just roll off somebody's back and the other one it's like sticks to them like thou croak and sell us like ok well what's the difference they're in and how can you begin to look at things differently chain is changing the way you're thinking as much as changing what you're doing now when someone were to come to you with with stress related problems how long would it take perhaps to go through life would you go through an hour a day or once a month or once a week and then maybe you know sort of get all extra starting to move away how long does it really take to get rid of it depends on the person depends how entrenched they are because for some people the stress has grown gradually over many many years like a little snowball building and rolling rolling unrolling so it it really depends and it depends what they're willing know how committed we are to changing something one small change you know what is it and and its different for everyone like somebody might decide they're gonna go for a walk every day or another person might decide that they are going to drink less coffee or drinks with caffeine or chocolate in those kinds of things so it depends how committed the person really is to making some changes but re realizing you don't do everything all at once you start with one small change it might be deep breathing i teach lots of people either deep breathing or we look at some line for listen meditation it is up to them to come up with a planning is variable sometimes even just that one visit where they come in to see me in their presenting centre might be i just can't sleep not recognising a distress but then as we sort of talk about sleep it becomes obvious to me anyway then hopefully eventually to the patient that nobody talking through things this is why you not sleeping we stress issue so comes like another the bell let's talk programme sometimes that is the best thing is to recognise that your coping with stress because some people just don't realise that they have physical symptoms the gas indigestion herbert had a bite but they are thinking it suddenly physical when we sit down and talk about it there's the emotional issue is going on here that we need deal with and sometimes once a patient recognize it there's an aha moment that gad this this is what's going on i need to deal with some people will take that and run with that unveiled us solve it on their own whence they recognise that soul can let's talk versus people maybe it's been more chronic or they get multiple issue so go as far as treatment some people will solve it on their own very quickly and others can take months or years very sort really is an individual thing but the first step is to recognise that stress is playing a negative role in my second its akin to maybe if you take a resolution at the beginning of the year say i'm gonna stop eating all these different things because i want to lose some weight be stopped in their tracks and the next thing you know two days later i've gone right back to the old habit because you didn't take it in very small little steps i agree i think small steps help and making sure it's really manageable goal rather than some big drastic change and sometimes it does help to have kind of somebody on your side i think sometimes when people see me i can help them to kind of put a simple plan in place that they want but then they come back right so we check in on it and because i know that's true for me if i'm checking in with someone about it or if i'm working regularly with a friend or you know maybe a little more accountable for it and and then and you make it manageable scares you you want to plan for success right so if you know you're not going we don't run a marathon in a week right so you start with the russian at boston again and so you you have to to grow slowly so you put a plan together that you know in in this week you don't change your whole diet you changed one thing and then you gained some success with that and then that leads to more and pino to other changes and but having a body or someone to talk to you about it to kind of coach you along can be very useful and you are the coach i can be the corleone family has something physicians their names it's what friend nurses france social worker and other social worker counselor minister the most important things to talk but sometimes if you're not moving forward maybe you need somebody with more professional expertise but you know we ve talked bourbon i were talking beforehand about person and even self help as so many self help books and tapes and things out there that many people reach for those first as a really not comfortable talking to other people and sometimes those work for other people than on barb runs a group my from stress reduction so some people do very well in a group scenario so it's can tailoring movie needs and wants to the patient and some of some of the watch her from one end of the spectrum to the other should a sugar they are but and sometimes it's something you know when i talk about is it a problem to be solved because some people like they'll come in to me with a pile of paperwork that they're just stressed about something like maybe there you know on canada pension or on terror disability or or it has something to do with the training drug plan or any kind of thing but they're so overwhelmed by the paper that they can't see the forest for the trees and sometimes if i just help them organise thought or somebody else help them organise it it's it's a huge weight lift or you clarifier get information but there are there are lots of folks out there that can help and resources like doktor bottom set is there any mention have because the our daughters going through divorce right now it's him real it's just a bad basket of all bad things and she had when going nuts and we finally talked we said look go and talk to somebody about it go see somebody so she went to her doctor the doktor refer her to someone who looked after things such as that in stressful situation she's in and mind you she has started to realise that what she's been doing in solving the problem of making it would be right for admitting that situation and sometimes i refer patient to a lawyer could now i'm just having that knowledge that you ve got some financial stability what your rights are is enough to sought com stress you don't need a social worker doctor you need other provision professional help other than yes the medical side ever so what else can you tell us about stress well i think i could speak to the resources available in our community can sometimes people might not get in to see me or the tiny isn't right but i've been working a little bit with the librarian on different things and looking at some of the resources they have and so i checked and they have excellent excellent materials everything from some really good some excellent books they have some wonderful dvds on stress or cds like people wanted to do some relaxation and just want to do it on their own behalf to actually do it you can sign out these things we actually have to use them having said that now would it be more advantageous to someone who is in a stressful situation to come and see you first and then you can recommend what they should possibly read or how they should probably approach this option should they just go out and do themselves it is up to them whatever works best for them some people just want to figure out if they can take care something's on their own and that's fine sometimes i just meet with people once and say you know these are the opportunities these are the things that are available to you where do you want to start and i'm not the only one we have haliburton highlands mental health services and like doktor bottom said there's there's ministers theirs in others other sources of support for sure that's really good now if they wanted to go let's see you or see somebody's house services would it be wise to get in touch with family health centre and say look here's the problem can you suggest where should go or should it come in and see somebody first or how does it work they can they can just call our office for shore and sometimes i talked people first and then refer them on or sometimes they just spoken of paint industry me first they don't always having to see their non fermented mental health is a self referral services whilst you don't have to be referred to in a mental health or another one so they would have come to see you were known arbiters offer for all in fact if i won refer patient a minimum health patient ass to initiate that referral i cannot refer them make sure people are engaged and willing to participate but they have trained social workers as well which again there probably doing the people would stressful situations on a daily basis as well and these are both free like our service at the family how team and however enhancement of how services are all free they're doing some great things down there in terms of they also offer unmindfulness programme they do they're doing some gentle yoga with people which is great which is low cost or free the other thing to keep a minor folk should keep in mind as many people are are part of an employment situation where they have employ assistants benefits so they can get linked up with a cancer for forty succession sometimes by phone sometimes buy skype and that's quite under utilised by many employees and lots of the bigger employers in our community have that some people also have means and they can afford to pay somebody privately if they had to wait too long say to see me yosemite a mental health or they just want to go privately and so we can make recommendations as to what is available in that regard and what's funny should mention that the employer can and is part of their probably their medical their benefits and it's funny should mention that because i think a lot of people are afraid to do that because they think of the possibilities of the employer saying hey wait a minute some wrong with you you know this type of thing so there's a little bit of apprehension there i guess maybe the thing to say is there really isn't a problem because a lot of people do have problems that they don't recognize and they can't get rid of them if they want to get rid of them there are apprehensive about doing it but they shouldn't be i agree with you i think they're sums stigma about getting help and yet really we want people to be proactive to get help soon and most of us we have information and expertise to share and we want to share it and many the services are under utilised but if you use a benefit through your employer whether team play assistance programmer you have coverage to say see a therapist that's private your employers not entitled to that and i think most employers would like to see their staff using the services to keep themselves healthy and well before it spins out of control and then they need you know a gazillion sick days or something you need attended early and it's entirely doable i would say that mental health workers in general will bend over backwards to make sure their strict confidentiality so that patients are bottom who want counselling and haliburton because i know that more but i know that you have to go through fort knox sometimes too get any information even as a patient's physician act to make sure those patients fill out forms and it's in writing and i've had permission more so than any other service i provide if i'm sending somebody to an internist general surgeon usually we can share information back and forth but again mental health therapists whether its parliament and mental health or an independent counts sir psychiatrist they'll bend over backwards to keep your information confident i have again so that you can feel comfortable and and the same of the eap programmes they set those up that these councils are independent from the employers and they provide the employers how pay for it but they don't actually have privy to the information and i guess maybe the one thing we can say is that there is no stigma attached to it and it's really shall we say ultimately confidential traffic the stigmas improved alive through a lot of this online stuff on tv that the bell let's talk in talking about people post concussion and you know some of the athletes have had depression afterward some notable people you guys becomes more aware of how prevalent ideas in our society and more understanding there is probably still some stigma but like a lot of things i think it's moving in the right direction and people are becoming more confident money a lot of people i know in toronto they always related to the year nine ninety nine queen street west think there's something wrong with you they send you an eye ninety nine will that's not the case anymore no there's there's better community resources and the reality is throughout the course of our life everybody has staff at some point something overwhelms us somebody dies were diagnosed or a friend dies or is diagnosed with a serious illness or we just you know we get overworked we got lots of family responsibilities are there's a job change and to its important to take care of ourselves on a regular basis so we built and resilience to ride the wave of that but the reality is we're all hate with that at some point or other that something you know the wheels fall off the wagon essentially and down so it's figuring out how to screw them back on one wheel at a time so if you could sum this up by how it just sum it up as to what people can do if they have a problem we have this old quote that i like that stress is like tension on a violin string you need enough tension say can make music but not so much that the string snaps very good advice i make that up in doktor barton waiting you can add no i think a poor thing is this let's talk let's talk about it tongue if you're concerned let's talk about it with its your physician social worker mental health worker friend family member and librarian because they develop a therapeutic library so that you talk to labor in working to get information on stress that i think that's when you said let's talk is that something that bell has done so with the catch phrases their people are understanding that but let's not be afraid to do that and if they need help they can call the family medical center or get in touch with her own physician correct tracked great thank you very much barbed thank you for coming in doktor bottom thanks again and every saves a great day thank you for this addition of medical matters if you have a topic you'd like us to discuss email us at medical matters canoe fm dot com it will do our best to discuss it on leader programme medical matters can be heard every monday at eleven forty five a m thirsty at five forty five pm on sunday at ten a m on canoe fm one hundred point nine your community radio station for the halibut nine point aim is very wilhelm thanks for listening