Indicators of Stress: Physiologic and Psychologic Indicators
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Indicators of Stress: Physiologic and Psychologic Indicators

Indicators of an individuals's stress may be physiologic, psychologic and cognitive.

Indicators of an individuals's stress may be physiologic, psychologic and cognitive.

Physiologic Indicators

Responses to stress vary depending on the individuals's perception of events. The physiologic signs and symptoms of stress result from activation of the sympathetic and neuroendocrine systems of the body.

Psychologic Indicators

Psychologic manifestations of stress include anxiety, fear, anger, depression and unconscious ego defense mechanisms. Some of these coping patterns are helpful; others are a hindrance, depending on the situation and the length of time they are used or experienced.

Anxiety and Fear

A common reaction to stress is anxiety, a state of mental uneasiness, apprehension, dread, or foreboding or a feeling of helplessness related to an impending or anticipated unidentified threat to self or significant relationships. Anxiety can be experienced at the conscious, subconscious, or unconscious level. As many as one-forth of Americans experience an anxiety disorder sometime in their lifetime, over half of which are debilitating.

Anxiety may be manifested on four levels:

1. Mild anxiety produces a slight arousal state that enhances perception, learning, and productive abilities. Most healthy people experience mild anxiety, perhaps as a feeling of mild restlessness that prompts a person to seek information and ask questions.

2. Moderate anxiety increases the arousal state to a point where the person expresses feelings of tension, nervousness, or concern. Perceptual abilities are narrowed. Attention is focused more on a particular aspect of a situation than on peripheral activities.

3. Severe anxiety consumes most of the person's energies and requires intervention. Perception is further decreased. The person, unable to focus on what is really happening, focuses on only one specific detail of the situation generating the anxiety.

4. Panic is an overpowering, frightening level of anxiety causing the person to lose control. It is less frequently experienced than other levels of anxiety. The perception of a panicked person can be affected to the degree that the person distorts events.

Fear is an emotion or feeling of apprehension aroused by impending or seeming danger, pain, or another perceived threat. The fear may be in response to something that has already occurred, in response to an immediate or current threat, or in response to something the person believes will happen. The object of fear may or may not be based in reality. For example, the beginning nursing student may be fearful in anticipation of the first experience in a client care setting. The student may fear that the client will not want to be cared for by the student or that the student might inadvertently harm the client.

Anxiety and fear differ in four ways:

1. The source of anxiety may not be identifiable; the source of fear is identifiable.

2. Anxiety is related to the future, that is, to an anticipated event. Fear is related to the present.

3. Anxiety is vague, whereas fear is definite.

4. Anxiety is the result of psychologic or emotional conflict; fear is the result of a discrete physical or psychologic entity.


Anger is an emotional state consisting of a subjective feeling of animosity or strong displeasure. People may feel guilty when they feel anger because they have been taught that to feel angry is wrong. However, anger can be expressed in a nonalienating verbal manner; it is then considered a positive emotion and a sign of emotional maturity because growth and beneficial interactions result from it.

A verbal expression of anger can be considered a signal to others of one's internal psychologic discomfort and a call for assistance to deal with perceived stress. In contrast, hostility is usually marked by overt antagonism and harmful or destructive behavior; aggression is an unprovoked attack or a hostile, injurious, destructive action or outlook; and violence is the exertion of physical force to injure or abuse. Verbally expressed anger differs from hostility, aggression, and violence, but it can lead to destructiveness and violence if the anger persists unabated.

A clearly expressed verbal communication of anger, when the angry person tells the other person about the anger and carefully identifies the source, is constructive. This clarity of communication gets the anger out into the open so that the other person can deal with it and help to alleviate it. The angry person "gets it off the chest" and prevents an emotional buildup.


Depression is a common reaction to events that seem overwhelming or negative. Depression, an extreme feeling of sadness, despair, dejection, lack of growth, or emptiness, affects millions of Americans a year. The signs and symptoms of depression and the severity of the problem vary with the client and the significance of the precipitating event. Emotional symptoms can include feelings of tiredness, sadness, emptiness, or numbness. Behavioral signs of depression include irritability, inability to concentrate, difficulty making decisions, loss of sexual desire, crying, sleep disturbance, and social withdrawal. Physical signs of depression may include loss of appetite, weight loss, constipation, headache, and dizziness. Many people experience short periods of depression in response o overwhelming stressful events, such as the death of a loved one or loss of a job; prolonged depression, however, is a cause for concern and may require treatment.

Ego Defense Mechanisms

Ego Defense Mechanisms are unconscious psychologic adaptive mechanisms or, according to Sigmund Freud, mental mechanisms that develop as the personality attempts to defend itself, establish compromises among conflicting impulses, and calm inner tensions. Defense mechanisms are the unconscious mind working to protect the person from anxiety. They can be considered precursors to conscious cognitive coping mechanisms that will ultimately solve the problem. Like some verbal and motor responses, defense mechanisms also release tension.

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