Medically Reviewed By: Morgan Blair, MA, LPCC, NCC
Stress is an interesting beast, to say the least. It’s something that we can’t physically see, but we can certainly see the results it produces. And if we’re all being honest, we can 100% feel the effects that stress takes on our minds, bodies, and souls. But that leads us to an interesting question. How do you measure stress?
Are there different degrees of stress? Do different stress measurement systems exist? Are they reliable? Is it important? We’re going to address all of these questions and more today as we take a look at exactly how to measure stress in ourselves, our lives, our patients, and in others.
Why Measuring Your Stress is Important
- It offers understanding. – When you can measure stress levels in your life, you can start to better understand how it affects you.
- We can better treat stress. – Stress is a medical condition that takes a heavy toll on people that let it get the best of them. By better measuring stress and its effects, we can develop stronger coping mechanisms and strategies to handle stress.
- You can gauge your progress. – If you’re able to measure how much stress you have in your life now, you can gauge how well you’ve done to manage your stress in the future. It provides the ability to benchmark and measure successes.
Challenges to Measuring Stress
- You can’t touch or hold onto stress. – You can measure your weight because it’s tangible, and you can hold it. Unfortunately, you can’t hold onto stress in the same way. You can see the results of the stress, but you can’t see the stress itself.
- There are several different and accepted ways to measure it. – When it comes to the right way to measure stress, there are several schools of thought. Over the past few decades, though, there has been some consolidation in support behind one method of measurement, which we do outline in detail further down in this article.
Stress Vs. Anxiety – What’s the Difference?
Stress and anxiety are often mixed up or misunderstood. Stress is a term used to cover a wide range of demands that may overwhelm you to the point where it’s very difficult to cope with it properly.
On the other hand, Anxiety is a prolonged experience of stress where it seems that even in non-stressful situations, it is difficult to cope. Anxiety can lead to panic attacks, and fear, can affect social life, and cause you to avoid situations you think may be stressful.
Qualitative Measures – When the Numbers Don’t Matter
Before we talk about the ways to quantify your levels of stress, we want to make an important point. The best judge of how stressed you are is you. The best judge of how stressed someone else is would be that person. According to the National Library of Medicine, the effectiveness of person-centered therapy really depends on the self-awareness and willpower of the patient, so keep that in mind moving forward. While scales, quizzes, questionnaires, and devices can help to put things into a measurable context, your view of how stressed you are is generally the more correct assessment.
That being said, other methods of how to measure stress, which we’ll cover shortly, may be helpful to see progress in situations where your view or the patient’s view may be obstructed by other conditions or life events. These methods can offer an outside perspective.
The Perceived Stress Scale – What Researchers Use
While there are several different scales that doctors, researchers, and interested parties might use, there is one that rises above the rest—The Perceived Stress Scale (PSS).
Key Takeaways of the Perceived Stress Scale
- The PSS is the most widely accepted instrument for accessing the degree to which a person is feeling stressed.
- While used by researchers, the Perceived Stress Scale was designed to be able to be utilized by anyone with at least a middle school education.
- The PSS is a 10-question analysis that asks the person to rate how often they felt something over the last month. The scale goes from a 0 (I never felt that way) to a 4 (I felt that way often.)
- There is a shorter 4-question version of the questionnaire if there are time constraints or reasons you can’t complete the full 10 questions (Use questions 2, 4, 5, and 10)
- The validity of the results is generally respected as applicable for up to about 3-4 weeks after the questions are answered. A sharp drop-off in predictive validity is expected to occur after 4-8 weeks, and a new assessment should be conducted
- The PSS was created by Sheldon Cohen of Mind Garden.
Benefits of Using the Perceived Stress Scale
- A powerful tool for benchmarking successes and failures in stress management
- A tangible way to begin recording stress levels
- An instrument for comparing levels of stress against similar populations
Below, we’ve included a copy of the PSS, as well as how to score the questions. And as a side note, if you are currently experiencing high levels of stress, we do encourage you to reach out to a medical professional for help.
Instructions for Scoring
- Answer each question with either a 0, 1, 2, 3, or 4
- 0 = Never
- 1 = Almost Never
- 2 = Sometimes
- 3 = Fairly Often
- 4 = Very Often
- Score the total number of points by reversing each answer and adding up that total. Note: While it might seem logical to do this beforehand, it can lead to people unintentionally putting incorrect answers.
- 0 = 4 points
- 1 = 3 points
- 2 = 2 points
- 3 = 1 point
- 4 = 0 points
- Lower numbers equate to a higher perceived level of stress.
A Suggestion for Easier Scoring
If you are only using the scoring internally, there’s no real need to reverse the numbers before calculating the score. Instead, add up the raw answers, and instead of a lower number meaning a higher perceived level of stress, a higher number now means a higher perceived level of stress.
The original instructions for the PSS would have someone answer a 0 for no stress, which you would then have to convert to a 4 for scoring, which would then mean that a higher number means lower stress. Instead, we’re suggesting having them answer a 0 for no stress and then leave that score as a 0 and look at a lower total score meaning lower total perceived stress.
Keep in mind that if you do use these adjusted scores to compare to an outside population that uses the traditional scoring method, you will need to make an adjustment. But for internal purposes, the more intuitive method of using the raw data where higher = higher is a worthwhile option.
The PSS 10 Questions
- In the last month, how often have you been upset because of something that happened unexpectedly?
- In the last month, how often have you felt that you were unable to control the important things in your life?
- In the last month, how often have you felt nervous and “stressed”?
- In the last month, how often have you felt confident about your ability to handle your personal problems?
- In the last month, how often have you felt that things were going your way?
- In the last month, how often have you found that you could not cope with all the things that you had to do?
- In the last month, how often have you been able to control irritations in your life?
- In the last month, how often have you felt that you were on top of things?
- In the last month, how often have you been angered because of things that were outside of your control?
- In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?
Watches, Apps, and Gadgets
If you’ve looked at or bought a smartwatch, fitness tracker, or heart rate monitor over the past few years, the chances are high that you’ve probably seen many of these devices advertising stress measurement technology.
Heart Rate Variability
The way these gadgets work is by looking at something called heart rate variability. According to studies, heart rate variability (HRV) may be linked to cortical regions of the brain that are used with appraising stressful situations. Studies show a link between increased stress and changes in HRV. In other words, your heart rate jumps around more when you’re in stressful situations. Measuring these changes works as an objective method to assess levels of stress. Note that increased heart rate does not always mean you are under stress, it can be caused by things like exercise, medication, age, and feelings of euphoria.
Using Online Stress Quizzes
A quick Google search turns up literally hundreds of quizzes you can take to see if you’re stressed or not. And while some of these quizzes might help to open your eyes to things that are making you stressed, they tend to be more for entertainment purposes.
If you’re looking for a quiz you can take to self-assess your levels of stress, the Perceived Stress Scale (PSS) mentioned earlier may serve as an effective option.
Talking to a Professional – The Best Measuring Instrument
The best thing you can do if you’re worried about your stress levels and stress management is to speak to a professional. Counselors, therapists, psychologists, and psychiatrists are trained to assess where you are when it comes to stress. Not only do they have methods of measuring your stress, but they also have other patients and experiences that they can benchmark you on.
If you’re considering speaking to someone, your options include in-person sessions, or you can take advantage of online therapy options. With the latter, you can get help measuring and managing your stress without the need to leave your home.