1.2 Describe signs that may indicate an individual is distressed

This guide will help you answer 1.2 Describe signs that may indicate an individual is distressed.

Distress is a strong, uncomfortable feeling that affects mental or physical health. It can be emotional, such as anxiety or sadness, or physical, such as pain or discomfort. A person may not always say when they feel distressed. Some people cannot communicate using words, so staff need to observe their behaviour and physical state.

Distress may be short term, for example during a hospital visit, or ongoing, such as after a painful loss or due to chronic illness.

Physical Signs of Distress

Physical signs are noticeable changes in a person’s body or appearance. These are often the first signals that something is wrong, especially in those who do not speak about their problems.

Key physical signs include:

• Crying or tears
• Flushed or pale skin
• Shaking or trembling
• Sweating more than usual
• Rapid breathing or panting
• Clenching fists or jaw
• Withdrawing from touch
• Fidgeting, wringing hands or pacing
• Stiff posture or hunched shoulders
• Poor personal hygiene, including lack of washing or grooming
• Sudden changes in appetite—eating much less or much more
• Complaints of headaches, stomach aches or other aches with no obvious cause
• Tiredness or looking exhausted
• Fainting or dizziness

People may show one or more of these signs if they are distressed. Physical distress often goes together with changes in behaviour or appearance.

Behavioural Signs of Distress

Behavioural signs are changes in how someone acts or conducts themselves. These can be obvious or subtle. Individuals who are usually friendly and relaxed might suddenly become distant or uncooperative.

Common behavioural signs include:

• Becoming withdrawn or avoiding others
• Refusing to take part in usual activities
• Restlessness, needing to move or walk around
• Aggression, lashing out or shouting
• A sudden loss of interest or motivation
• Difficulty following instructions
• Refusing support or care
• Frequent use of the toilet, unusual for the person
• Repeating words or questions (repetition can signal anxiety or confusion)
• Disrupted sleep patterns or complaining about not sleeping
• Arguments or conflict with others

For children or people who cannot express themselves verbally, behaviour may be the only clue that they are distressed.

Emotional Signs of Distress

Emotional symptoms show how a person feels inside, but sometimes these can be seen even when they are not spoken.

Watch for these emotional signs:

• Tearfulness or crying for no obvious reason
• Anger, irritability or frustration
• Becoming easily upset
• Fear or anxiety—seeming constantly worried or stressed
• Mood swings, changing from happy to sad quickly
• Loss of confidence or saying negative things about themselves
• Talking about feeling hopeless, trapped or alone
• Lack of enjoyment in things they once liked
• Feeling overwhelmed or unable to cope

These emotional states can impact a person’s behaviour and their ability to interact with others. In some cases, a person might try to hide their distress, but clues can still appear in the way they talk or behave.

Communication Changes as Signs of Distress

How people communicate can change when they are distressed. Some individuals become quiet, while others may speak rapidly or struggle to find words.

Look out for:

• Speaking much less than normal or becoming silent
• Raised voice or shouting
• Stuttering, mumbling or not making sense
• Reluctance to answer questions
• Changing subject quickly or avoiding conversations
• Talking about feeling overwhelmed or using words like “can’t cope”
• Using humour to cover up their real feelings

Non-verbal communication, such as facial expressions and gestures, can also indicate distress. A person might look tense, frown or have a blank expression.

Social Signs of Distress

Distress can affect a person’s relationships. Socially, they may act in ways that are not typical for them.

Notice if a person:

• Stops seeing friends or family
• Refuses group activities they once enjoyed
• Becomes isolated—spending long periods alone
• Avoids eye contact
• Is less willing to communicate with others
• Gives up teamwork or shared meals
• Has conflicts with family, other residents or colleagues

Sudden changes in social behaviour are important signs. Long-term withdrawal may indicate a deeper problem.

Signs of Distress in People with Communication Difficulties

People with conditions like dementia, learning disabilities or autism may have trouble identifying or explaining their feelings. This makes it important for workers to look for non-verbal indicators.

These signs may include:

• Sudden change in usual routines
• Unexplained crying, screaming or shouting
• Hitting, biting or scratching themselves or others
• Rocking, pacing or banging objects
• Refusing food or medication
• Tugging at clothes or hair
• Unusual noises, such as humming or moaning
• Being unusually still or not responding

Care workers should be familiar with each person’s normal behaviour so they can see when something changes.

Signs Related to Self-Harm or Neglect

Distress may sometimes show as self-harm or signs that a person is neglecting themselves.

Warning signs include:

• Unexplained bruising, cuts or burns
• Wearing long sleeves or extra clothes to hide injuries
• Refusing food for a long time
• Poor hygiene, dirty clothes or strong body odour
• Sudden weight loss or gain
• Repeatedly expressing feeling worthless or unwanted

If someone shows these signs, they may be experiencing intense distress. Always follow safeguarding policies if you suspect self-harm or neglect.

Situational Signs of Distress

You might notice distress after certain events or changes, such as:

• Moving into a care home
• Loss of a loved one
• Hospital stays or health scares
• Changes in routine or staff
• Being separated from family or friends
• Facing a diagnosis of a serious illness
• Conflict with others
• Experiencing abuse or mistreatment

Be aware of these situations as possible triggers. People may show distress in different ways depending on the cause.

The Role of Observation

Observing people carefully helps detect signs of distress. This means watching for small changes over time, not just dramatic behaviour. Knowing what is ‘normal’ for each person is key.

Useful observation methods include:

• Keeping daily notes
• Checking appearance and hygiene
• Monitoring eating and sleeping habits
• Listening for changes in tone of voice
• Noticing changes in social activity
• Asking colleagues if they have seen changes

Observation should be ongoing, respectful and discreet, avoiding invading privacy.

Responding to Signs of Distress

When you see indicators of distress, respond with understanding and care:

• Speak calmly and gently
• Use reassuring words
• Give the person time to talk if they want
• Offer privacy
• Avoid arguing or raising your voice
• Respect the person’s space
• Check for injuries or pain
• Ask if they want support or someone to talk to

If you see signs of severe distress, especially if a person talks about harm, follow your workplace policies and report promptly.

Final Thoughts

Identifying distress is a key skill in health and social care. Watch for physical, emotional, social and behavioural changes. Different people show distress in different ways. Some need extra support to communicate what they feel. If you notice signs of distress, act with empathy and follow your workplace procedures. Record all observations carefully.

By staying alert to signs of distress, you support people’s health, safety and quality of life. Your observation and prompt action protect those in your care and show respect for their individual needs.