Posted by: Thixia | July 3, 2008

Stress 5 of 9

Do you know your signs of stress?

People often ask “How do I know when I’m having stress?” The question always reminds me of an old song title, “Am I in Love – Or Is This Just Asthma?”

Recognizing stress is important because we can’t deal with it if we don’t know when it’s happening.  Other people are often aware of our stress before we are.  We might be brusque or abrupt without realizing it.  Often, other people can read stress on our face that we ourselves don’t notice.

So, what are the manifestations of stress we should watch for?

Stress shows up in four ways: physical, mental, emotional, and behavioural.

1.  Physical symptoms

In a classic stress reaction, (the “fight or flight response”) our heart speeds up, muscles tense, breathing gets faster, mouth goes dry, and we may start sweating or feel a knot in the stomach.  These are manifestations of acute stress.

Chronic stress shows up a bit differently.  When I go through my checklist with patients, I start at the head and work down.

I inquire about headaches, dizziness, clenching the jaw or grinding the teeth, tight or sore neck muscles or across the tops of the shoulders, chest pains, palpitations, abdominal symptoms such as indigestion, cramps, constipation or diarrhea.  The hands and feet might tremble or feel cold–or moist.  Sweating of the palms or soles of the feet is referred to as “emotional sweating”.  Back pain and tightness are very common.

Fatigue is one of the most common symptoms of stress, but is often overlooked or blamed on something else.  Under stress, your appetite may be lost or may increase.  Lots of people have trouble sleeping.  There are three kinds of insomnia: trouble falling asleep, trouble staying asleep (frequent waking in the night) and early morning awakening (e.g.  4:30 or 5:00 a.m.) Loss of interest in sex (decreased libido) is often reported.

You’ve probably noticed that virtually all these symptoms can be caused by other factors.  For example, fatigue can result from diabetes or anemia; rapid heartbeat may reflect an overactive thyroid gland.  You may need a doctor to help you decide if your symptoms are stress-related or not.  However, you can learn to look for patterns or groups of symptoms that usually indicate stress as the cause.

2.  Changes in mental function

Do you have difficulty concentrating on mental tasks?  That’s a common stress symptom.  I ask patients about problems with memory.  Occasionally they respond: “What was the question again?”

I inquire about trouble making decisions.  One patient turned to his wife and said, “I don’t know.  Do I have trouble making decisions?”

Your mind might race or go blank.  A prominent politician was noted to be under a lot of stress and strain when it was observed that he’d lost his usually terrific sense of humour.

3.  Emotional symptoms

It’s common for stressed people to feel nervous, anxious, tense, jittery, on-edge, restless or agitated.  Or they may feel irritable, frustrated, impatient or short-tempered.  On the other hand, individuals may find themselves slowing down, feeling flat, apathetic, depressed, sad, or blue.

4.  Behavioural symptoms

When I was younger, I was a “knee jiggler.” It used to drive my twin sister crazy at the dinner table when I’d sit there with my knee rapidly bouncing up and down.  Often she’d put her hand firmly on my knee to get me to stop.  There were two fascinating parts to this.

1.  I was totally unaware I was doing it.
2.  I could never move my knee that fast voluntarily.

This habit results from excessive stress energy that the body tries to dissipate through muscular activity.  Other people fidget or can’t sit still, pacing back and forth.  My wife calls this, “feeling like I’m going to jump out of my skin.”

Other behaviours include nail-biting, compulsive eating, smoking, drinking, talking loudly, blaming or swearing.  Stress can manifest itself in dozens of ways.  But for most of us it shows up with five to ten symptoms that are characteristic for us (our own galaxy of symptoms which we can learn to recognize).  For example, I get low back pain but rarely get headaches.  Other people get headaches, but never chest pains, etc.  Your pattern is usually the same each time and you can learn to spot it.

It might be helpful if we had unmistakable signals when we’re experiencing stress: smoke coming out of our ears, hands going bright red or hair standing on end.  However, if we learn to recognize our individual stress profile, we can become as good at detection as we’d be if there was steam coming out our ears.  And identifying stress is the first step to doing something about it.


Compliments of and written by:


Dr. David Posen


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