“Normally we do not so much look at things as overlook them.” - Alan Watts
Real People, Real Stories
Several years ago author Richard Carlson created a very catchy title for his best-selling book, Don't Sweat the Small Stuff…It Is All Small Stuff. He offered some important advice for our over-stressed society. We need to step back and relax. That is great advice. The problem is, not all stuff is small stuff. Some things are worth sweating over. The tricky part is determining what is really important and worthy of your energy and what is the “small stuff” that causes needless worry and decreases the quality of your life.
One of the great challenges for successful stress management is determining what it is that causes you stress. A certain level of stress can energize and motivate you to deal with the important issues in your life. You want to focus your energy on those things in your life that are truly important. How do you determine what factors are causing unnecessary stress? Is my stress level normal? These are important questions we will answer in this chapter.
Where Are You Now?
How do you assess stress? How do you measure stress? In this chapter, you will find a variety of tools to help assess your stress. Some of these tools are simple and fun. Some are more scientific and complex. Each of them has been selected to increase your understanding of stress in your life. Each of these tools will provide information that you can use to develop a stress management program that works for you. The first step in developing a plan is assessment. Assessing where you stand right now is critical to making progress in achieving a balanced life. As Alan Watts stated in our chapter quote, “Normally we do not so much look at things as overlook them.” This quote contains real truth. You may be so busy living your life that you don't take time to stop and assess. You just keep doing what you are doing.
There is not one best tool for assessing stress, in part because reactions to events vary from person to person. What absolutely frazzles one person may excite and positively challenge another. Research supports the idea that it is not the actual stress that matters most, but our ability to control how we perceive and react to the situation that contributed to the stress. External events do not cause stress; how we perceive and cope with them does.
It is important to know that the information you gain from the assessments in this chapter is for you to take and use as it seems relevant to you and your life. These assessments and surveys are not intended to be diagnostic, but only to guide you in understanding yourself better. Taken together you will discover an overall picture of your current stress status. This will help you decide where you want to go and how you can get there.
Begin with a few simple, yet informative, measures of potential stress. Using the Assess Stress Table, fill in your response for each item based on the instructions following the table.
Assess Stress Table
Resting Heart Rate
Try this second technique to see if you get the same results. First, breathe out and empty your lungs. Count to three as you inhale deeply. Now, hold it. Did your shoulders go up? Did you feel like the air filled the upper part of your lungs? If so, you probably lean toward chest breathing. If you are a diaphragmatic breather, you would feel your abdominal area expand, your belt tighten, and fullness in the lower part of your lungs and chest. Record your results on the Assess Your Stress Table.
Considering the last month as one single period of time, it is most likely that you would rank yourself somewhere between these two extremes. If you were to average the month (we all have highs and lows), what number would you give yourself on this scale from 1 to 10? Make a note of this number on the Assess Your Stress Table. We will refer to this number again later.
Assess Your Stress Results
Were you primarily a chest breather or an abdominal breather? Many of us are primarily chest, or thoracic, breathers. Chest breathers tend to take shallower breathes. Diaphragmatic, or abdominal, breathing involves the abdominal muscles to facilitate deeper breathing. This allows you to take in more oxygen with each breath. Later you will learn more about why deep breathing is effective as an important relaxation technique.
Your perception of stress primarily determines how your body responds. The Stress-o-meter increases your awareness of the level of stress you perceive in your life. When we exercise we can follow a perceived exertion scale that will give us some idea of how hard we are exercising. We can determine our intensity level. Similarly, we can use the Stress-o-meter to assess our general levels of perceived stress over the past month. You will learn later in the book how your perception of stress relates to your health and your physiological responses. Your body responds the same, whether the stress is real or imagined, so your perception becomes your reality.
Now, look back over your results recorded in the Assess Your Stress Table. What does this information tell you about your stress level?
Research Highlight - Stress Seems to Block Deep Sleep
Stress may disrupt the natural rhythms of the body's nervous
system during various stages of sleep, according to a
Researchers monitored the heart rates of 59 healthy undergraduate students while they slept. Heart rate variations can provide clues about the activity of the autonomic nervous system, which controls the function of organs such as the heart and lungs. To trigger stress during sleep, the researchers told half of the students they would have to deliver a 15-minute speech when they woke up. The topics would be chosen for them upon awakening, the students were told.
The researchers detected significant heart rate variations
between the stressed and non-stressed students as they slept. The stressed
group had changes in heart rate patterns during REM, or rapid-eye-movement,
sleep - the sleep phase when dreaming occurs - and non-REM sleep. The
heart rate variability patterns detected in the stressed students were
similar to those seen in people with insomnia, the study revealed, suggesting
similar pathways of nervous system disruption. (
Symptoms of Stress
The more often you experience these symptoms of stress, the more likely stress is having a negative impact on your life. Like Angie in our opening vignette, you may be so used to feeling a certain way that you assume this is normal. Look back over the Symptoms of Stress Table. Are there symptoms of stress that you would like to eliminate or change? In later chapters you will learn proven strategies to help eliminate the negative symptoms of stress.
FYI - Lesson From the Titanic
The blockbuster movie Titanic has a health lesson for us all. The captain of that mighty ship was warned six separate times to slow down, change course and take the southern route because icebergs had been sighted. But, he ignored all six specific warnings, lulled into complacency of believing that the ship was unsinkable. The lesson is listen to your body when it sends you signals. Symptoms and changes are warnings that you should slow down, change course, or take another route.
Perceived Stress Scale
A more precise measure of personal stress can be determined by using a variety of instruments that have been designed to help measure individual stress levels. The first of these is called the Perceived Stress Scale
The Perceived Stress Scale (PSS) is a classic stress assessment instrument. This tool, while originally developed in 1983, remains a popular choice for helping us understand how different situations affect our feelings and our perceived stress. The questions in this scale ask about your feelings and thoughts during the last month. In each case, you will be asked to indicate how often you felt or thought a certain way. Although some of the questions are similar, there are differences between them and you should treat each one as a separate question. The best approach is to answer fairly quickly. That is, don't try to count up the number of times you felt a particular way; rather indicate the alternative that seems like a reasonable estimate.
For each question choose from the following alternatives:
0 - never
1 - almost never
2 - sometimes
3 - fairly often
4 - very often
____ 1. In the last month, how often have you been upset because of something that happened unexpectedly?
_____ 2. In the last month, how often have you felt that you were unable to control the important things in your life?
_____ 3. In the last month, how often have you felt nervous and stressed?
_____ 4. In the last month, how often have you felt confident about your ability to handle your personal problems?
_____ 5. In the last month, how often have you felt that things were going your way?
_____ 6. In the last month, how often have you found that you could not cope with all the things that you had to do?
_____ 7. In the last month, how often have you been able to control irritations in your life?
_____ 8. In the last month, how often have you felt that you were on top of things?
_____ 9. In the last month, how often have you been angered because of things that happened that were outside of your control?
_____ 10. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?
Figuring your PSS score:
You can determine your PSS score by following these directions:
First, reverse your scores for questions 4, 5, 7, & 8. On these 4 questions, change the scores like this: 0 = 4, 1 = 3, 2 = 2, 3 = 1, 4 = 0.
Now add up your scores for each item to get a total. My total score is ______.
Individual scores on the PSS can range from 0 to 40 with higher scores indicating higher perceived stress.
Scores ranging from 0-13 would be considered low stress.
Scores ranging from 14-26 would be considered moderate stress.
Scores ranging from 27-40 would be considered high perceived stress.
The Perceived Stress Scale is interesting and important because your perception of what is happening in your life is most important. Consider the idea that two students, John and Dan, could have the exact same events and experiences in their lives for the past month. Depending on their perception, John's total score could put him in the low stress category and Dan's total score could put him in the high stress category. Consider the words of Ralph Waldo Emerson, “Nothing can bring you peace but yourself.”
The Inventory of College Students' Recent Life Experiences
Another useful scale used to measure stress levels in a different way is called The Inventory of College Students' Recent Life Experiences (ICSRLE). The ICSRLE was designed to identify individual exposure to sources of stress or hassles and allow for an identification of the extent to which those stressors are experienced over the past month. The ICSRLE was developed uniquely for college students. As you know, the sources of stress in a university environment can be unique and different from other settings.
What do college students typically perceive to be the major sources of stress? The ICSRLE is helpful in assessing the major sources of stress and in identifying individual exposure to sources of stress or hassles. This inventory also allows for an identification of the extent to which those stressors are experienced over the past month.
The following is a list of experiences which many students have some time or other. Please indicate for each experience how much it has been a part of your life over the past month. Mark your answers according to the following guide:
Intensity of Experience over the Past Month
0 = not at all part of my life
1 = only slightly part of my life
2 = distinctly part of my life
3 = very much part of my life
____1. Conflicts with boyfriend's/girlfriend's/spouse's family
____2. Being let down or disappointed by friends
____3. Conflict with professor(s)
____4. Social rejection
____5. Too many things to do at once
____6. Being taken for granted
____7. Financial conflicts with family members
____8. Having your trust betrayed by a friend
____9. Separation from people you care about
____10. Having your contributions overlooked
____11. Struggling to meet your own academic standards
____12. Being taken advantage of
____13. Not enough leisure time
____14. Struggling to meet the academic standards of others
____15. A lot of responsibilities
____16. Dissatisfaction with school
____17. Decisions about intimate relationship(s)
____18. Not enough time to meet your obligations
____19. Dissatisfaction with your mathematical ability
____20. Important decisions about your future career
____21. Financial burdens
____22. Dissatisfaction with your reading ability
____23. Important decisions about your education
____25. Lower grades than you hoped for
____26. Conflict with teaching assistant(s)
____27. Not enough time for sleep
____28. Conflicts with your family
____29. Heavy demands from extracurricular activities
____30. Finding courses too demanding
____31. Conflicts with friends
____32. Hard effort to get ahead
____33. Poor health of a friend
____34. Disliking your studies
____35. Getting “ripped off” or cheated in the purchase of services
____36. Social conflicts over smoking
____37. Difficulties with transportation
____38. Disliking fellow student(s)
____39. Conflicts with boyfriend/girlfriend/spouse
____40. Dissatisfaction with your ability at written expression
____41. Interruptions of your school work
____42. Social isolation
____43. Long waits to get service (e.g., at banks, stores, etc.)
____44. Being ignored
____45. Dissatisfaction with your physical appearance
____46. Finding course(s) uninteresting
____47. Gossip concerning someone you care about
____48. Failing to get expected job
____49. Dissatisfaction with your athletic skills
Scoring the ICSRLE
Add your total points: ________
Your score on the ICSRLE can range from 0 to 147. Higher scores indicate higher levels of exposure to hassles. Focus on two key outcomes from your results. First, you can determine your current level of stress by adding your score for each hassle and getting a total. Second, you can discover which of the hassles play a greater part in your life. Higher scored items that you rated with a 3 indicate those stressors are more of an issue for you.
The Ardell Wellness Stress Test
Don Ardell developed a stress assessment that is unique in its holistic approach to stress. In chapter one, you learned about the importance of incorporating all dimensions of health in your understanding of stress. The Ardell Wellness Stress Test incorporates physical, mental, emotional, spiritual, and social aspects of health for a balanced assessment.
Rate your satisfaction with each of the following items by using this scale:
+ 3 = Ecstatic -1 = Mildly disappointed
+ 2 = Very happy - 2 = Very disappointed
+ 1 = Mildly happy - 3 = Completely dismayed
0 = Indifferent
_____ 1. Choice of career
_____ 2. Present job/ business/ school
_____ 3. Marital status
_____ 4. Primary relationships
_____ 5. Capacity to have fun
_____ 6. Amount of fun experienced in last month
_____ 7. Financial prospects
_____ 8. Current income level
_____ 9. Spirituality
_____ 10. Level of self-esteem
_____ 11. Prospects for having impact on those who know you and possibly others
_____ 12. Sex life
_____ 13. Body, how it looks and performs
_____ 14. Home life
_____ 15. Life skills and knowledge of issues and facts unrelated to your job or profession
_____ 16. Learned stress management capacities
_____ 17. Nutritional knowledge, attitudes, and choices
_____ 18. Ability to recover from disappointment, hurts, setbacks, and tragedies
_____ 19. Confidence that you currently are, or will in the future be, reasonably close to your highest potential
_____ 20. Achievement of a rounded or balanced quality in your life
_____ 21. Sense that life for you is on an upward curve, getting better and fuller all the time
_____ 22. Level of participation in issues and concerns beyond your immediate interests
_____ 23. Choice whether to parent or not and with the consequences or results of that choice
_____ 24. Role in some kind of network of friends, relatives, and/or others about whom you care deeply and who reciprocate that commitment to you
_____ 25. Emotional acceptance of the inescapable reality of aging
Ardell Wellness Stress Test Interpretation
+ 51 to + 75 You are a self-actualized person, nearly immune from the ravages of stress. There are few, if any, challenges likely to untrack you from a sense of near total well-being.
+ 25 to + 50 You have mastered the wellness approach to life and have the capacity to deal creatively and efficiently with events and circumstances.
+ 1 to + 24 You are a wellness-oriented person, with an ability to prosper as a whole person, but you should give a bit more attention to optimal health concepts and skill building.
0 to - 24 You are a candidate for additional training in how to deal with stress. A sudden increase in potentially negative events and circumstances could cause a severe emotional setback.
- 25 to - 50 You are a candidate for counseling. You are either too pessimistic or have severe problems in dealing with stress.
- 51 to - 75 You are a candidate for major psychological care with virtually no capacity for coping with life's problems.
(Adapted from High Level Wellness: An Alternative to Doc, Drugs and Disease by Don Ardell)
Look back at the items in the Ardell Wellness Stress Test. Identify which items related more to physical health, to mental health, to emotional health, to spiritual health, and to social health. Do you see any patterns develop? For instance, are more areas of disappointment related to physical health than to social health? Remember, for holistic health we are seeking a balance in all dimensions of health.
Student Stress Scale
This chapter offers a variety of stress assessment tools to assist you in assessing stress from several different perspectives. The Student Stress Scale focuses on events that may occur in the life of a student to offer you a different perspective for evaluating stress. The Student Stress Scale is an adaptation for college students of the Life Events Scale developed originally by Holmes and Rahe. This popular stress assessment measured the amount of change, using Life Change Units, a person was required to adapt to in the previous year. It was designed to predict the likelihood of disease and illness following exposure to stressful life events. Each life event is given a score that indicates the amount of readjustment a person has to make as a result of change. Some studies have found that people with serious illnesses tend to have higher scores on similar assessments.
For each event that occurred in your life within the past year, record the corresponding score. If an event occurred more than once, multiply the score for that event by the number of times the event occurred and record that score. Total all the scores.
Total Stress Score ________
Researchers determined that if your total score is:
300 or more - statistically you stand an almost 80 percent chance of getting sick in the near future.
150 to 299 - you have a 50-50 chance of experiencing a serious health change within two years.
149 or less - you have about a 30 percent chance of a serious health change.
This scale indicates that change in one's life requires an effort to adapt and then an effort to regain stability. Stress is a natural by product of adapting and then regaining internal homeostasis. Take note that this assessment considers only the events that occur, not individual perception of these events in life. Perception is a critical part of the ultimate stress experience, so while the Student Stress Scale has value in increasing awareness of potential stress-producing events, ultimately individual perception of the event is an important variable.
When all is said and done, one of the most important assessments may be the Tombstone Test. How do you want to be remembered? Do you want to be remembered for being a workaholic? Do you want to be remembered as the one who always won the argument? Do you want to be remembered for making more money than your neighbor? Do you want to be the one who never forgave someone who wronged you? Or, do you want to be remembered as a good parent, spouse, and friend? Do you want to be remembered as someone who was whole and balanced in body, mind, and spirit? Do you want to be remembered for the service you provided to those who needed help?
Take a few minutes right now to write down how you want to be remembered. What do want others to say and think about you when your life is over? Make a list of the qualities and characteristics you want to be remembered for. Are you living your life in a way that demonstrates the qualities and characteristics you value?
The choices you make every single day determine to a large extent the stress you experience. Your daily work, which at times can feel like drudgery, can actually become a significant stress managing mechanism when you view your work as part of your contribution to bigger priorities. Thinking about today, this minute, the task at hand in a positive manner can bring peace and contentment. There is a story about two people laying bricks. A man passing by asks, “What are you doing?” The first worker answers, “Laying bricks.” The other worker answers, “Building a cathedral.”
Assess what is most important in your life. When your choices are guided by the values and goals that are most important to you, your life can be full and active, yet not stressful. Decide how you want to be remembered - and then live your life so that happens.
Daily Stress Log
The final activity in this chapter is the Daily Stress Log. Chances are many of you have completed a Food Diary at some time. The purpose of the food diary is to record everything you eat to increase your awareness of what you are eating. The information you enter in your diary can be analyzed for its calorie level and nutritional content. This information helps you evaluate your diet.
The Daily Stress Log serves the same purpose only relating to your stress. For several days, you will make a note of any and all activities that put a strain on energy and time, trigger anger or anxiety, or precipitate a negative physical response. You can also note your reactions to these stressful events.
When you have completed a daily log for a few days, review the log and identify 2 or 3 stressful events or activities that you can modify or eliminate. It has been said that awareness is half the battle. As you keep track of all of the events that happen during a day, and you notice patterns in which you find yourself getting more stressed, you can begin to take steps to make adjustments in those damaging patterns. The following is an example of a Daily Stress Log.
Daily Stress Log
*Tension level .........................1 = Slight 2 = Moderate 3 = Strong 4 = Intense
Major source of stress today: ______________________________
Assessment of how you managed stress
The Daily Stress Log can be a real eye-opener in helping you become aware of triggers of stress throughout your day. Watch for patterns that develop. Do you notice that your stress level rises every time your roommate's boyfriend comes over and plops himself down in your favorite chair? Do you find that you always feel stressed after you and your friend consume an entire family-sized pizza? Do you notice that the days that seemed filled with stress and the days you seem least able to cope with the stressors that occur are the days after your stay up late enjoying the all-you-can-drink specials at the bar?
Take a moment to summarize the results of each of the self-assessments in this chapter in the table below. Circle either “High” or “Low” according how much each assessment indicates high or low levels of stress for you. For example, a higher resting heart rate may indicate higher stress levels; chest breathing rather than stomach breathing may indicate higher stress levels; increased number of breaths per minute might indicate higher stress levels. If you are consistently circling the “High” indicator, extra effort in the chapters of this book may be helpful in reducing the potentially harmful effects of stress.
Personal Self Assessment Summary
Assessing stress is a complex and challenging process. In this chapter you have had the opportunity to assess your stress from many different perspectives. Look back over each of the assessment surveys and tools. You will see that these tools measured stress from a variety of perspectives including:
· Physiological indicators of stress
· Your perception of what is happening in your life
· Sources of stress and frequency of hassles
· Your level of satisfaction with events in your life
· Type of life events you have experienced
The real impact of this chapter is in what you do with the information you learned about yourself. It is like putting a puzzle together. Each of the assessments is like a piece of the puzzle. When you put all the pieces together you have a complete picture. Stress Management for Life will provide you with all the tools and information you need to develop a plan that will help reduce stress and enhance the quality of your life.
· Assessment is the first important step in developing a plan to reduce and manage stress.
· Stress can trigger physiological changes like increased pulse and increased respiration rate.
· Symptoms of stress can include headache, muscle tension, insomnia and a host of other warning signs.
· Perception is key when assessing stress. The same situation can elicit a very different stress response in different individuals due to the individual's perception of the experience.
· Frequency of exposure to different stressors and hassles can be another way to measure stress.
· For a balanced picture of stress in your life, consider all dimensions of health, physical, mental, emotional, spiritual, and social.
· A daily stress log can be a valuable tool for increasing your awareness of stress in your life.
· No single survey or tool can tell the whole picture when it comes to assessing stress. Consider the results from all the assessments to gain a better understanding of your personal stress level.