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Continuing Professional Development
risk behaviours that people may have
adopted for stress reduction. The PSA
Anxiety, Depression, Post Traumatic
Stress Disorder and Sleeping Problems
Self Care Fact Cards are useful written
materials that pharmacists can provide
Pharmacists can provide practical advice
on simple relaxation techniques and
other strategies to help manage stress.
A range of stress management strategies
that may benefit those with conditions
exacerbated by stress (e.g. psoriasis, RA,
IBS) as well as those with psychological
symptoms. It is important that advice
on stress management techniques is
tailored to the needs of individuals. Stress
management can involve several different
approaches including regular exercise,
adequate sleep, engaging in relaxing
hobbies, and relaxation techniques
(e.g. meditation, imagery, progressive
muscle relaxation, diaphragmatic [deep]
breathing, tai chi or yoga).11 The PSA
Relaxation Techniques Self Care Fact Card
is useful for providing written advice on
relaxation techniques and exercises to
help reduce stress.
Case study continued
You ask Cassie to describe the different
things that are making her feel anxious.
Asking her to identify the specific sources
of her stress and then classify them ('Is
this an important stressor or a minor
"hassle"?') may help to reframe Cassie's
concerns so they appear manageable. You
offer Cassie some advice on ways to cope
• Identify the sources of stress in your
life -- be aware of your stress levels and
ask yourself whether they are getting
• Take charge -- deal with the things that
are increasing your stress before they
build up and become a bigger problem.
You can either change the situation or
change your reaction. When deciding
which option to choose, it's helpful to
think of the four A's: avoid, alter, adapt,
• Make choices -- look at areas in your life
where you could manage your situation
better or change the way you respond.
• Learn some good ways of dealing with
stress -- talk to someone you trust
and make time for things you enjoy.
Psychologists can help you to devise
strategies to help prevent, reduce and
cope with stress.
• Don't be scared to ask for help -- visit
your GP or consider seeing a counsellor
to talk about your worries or concerns
and find better ways to cope.
• Get adequate sleep and regular exercise,
and eat a healthy, balanced diet.
• Think about the ways you cope with
stress -- could you be causing damage
to your health in the long run? E.g.
by smoking, drinking too much, over
eating or under eating, using medicines
or drugs to help you relax or sleep.
management such as brochures and
Self Care Fact Cards.
• Opportunistically screening people
for signs and symptoms of anxiety
and depression (e.g. in situations
where people seek advice about OTC
or natural remedies for insomnia,
• Facilitating referral and/or linkage
to treatment or support services
• Collaborating with local community
groups and workplaces to raise
awareness of the link between
psychosocial stressors, mental health
issues and suicide.
Health promotion strategies
Potential pharmacy-based services and
health promotion strategies to assist
people to manage and become more
resilient to stress include:
• Mental health promotion -- pharmacists
can raise community awareness of
the physical and psychological harms
associated with stress through the
display of posters and distribution of
brochures, and provide advice and
information about stress management.
Health promotion activities can be
staged to coincide with corresponding
national awareness campaigns such as
Mental Health Week.
• Preventing anxiety and stress-related
harm -- the Kessler Psychological
Distress Scale (K10)15 is a simple
self-reported measure of psychological
distress and can be used by
pharmacists as a screening tool for
stress-related anxiety or depressive
symptoms. People who rate their
experience of anxiety or depressive
symptoms as 'some of the time' or 'all
of the time' for most categories require
referral for further assessment. People
who score 25 or less may also benefit
from advice and information about
strategies to prevent or minimise
stress-related mental health issues in
Pharmacists can also promote the
benefits of healthy lifestyle behaviours
such as regular exercise and adequate
sleep to improve stress levels,
and opportunistically screen for health
'It is important that
advice on stress
techniques is tailored
to the needs of
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