Please read each question or statement and place a circle in the column which indicates how much the question or statement applied to you over the past few weeks. There are no right or wrong answers. It is best not to spend too much time on any question. Some questions are repeated, please answer them all.
Rarely or Never | Some of the time | Often | Always/ constantly | |
1. Do you worry excessively? | 0 | 2 | 4 | 6 |
2. Do you cry easily? | 0 | 2 | 4 | 6 |
3. Are you a light sleeper? | 0 | 2 | 4 | 6 |
4. Do you have many dreams each night? | 0 | 1 | 2 | 3 |
5. Do you find it hard to make decisions? | 0 | 1 | 2 | 3 |
6. Would you describe yourself as introverted? | 0 | 1 | 2 | 3 |
7. Are you easily upset? | 0 | 1 | 2 | 3 |
8. Do you speak softly or quietly? | 0 | 1 | 2 | 3 |
9. Do your muscles feel weak at times? | 0 | 1 | 2 | 3 |
10. Does your heartbeat feel irregular, where you are conscious of it beating (palpitations)? | 0 | 1 | 2 | 3 |
11. Do you feel short of breath? | 0 | 1 | 2 | 3 |
12. Do you feel the cold easily? | 0 | 1 | 2 | 3 |
13. Are you forgetful, or have a poor memory? | 0 | 1 | 2 | 3 |
14. Do you tend to brood over and over the same concerns? | 0 | 1 | 2 | 3 |
15. Do you feel quite unmotivated at times, or feel like you can’t be bothered at all? | 0 | 2 | 4 | 6 |
16. Do you feel you have a poor memory, or are you quite forgetful? | 0 | 2 | 4 | 6 |
17. How often does poor mental function affect your ability to do your work or other activities? | 0 | 2 | 4 | 6 |
18. Do you forget things like names, dates or facts easily? | 0 | 1 | 2 | 3 |
19. Do you find it very difficult to concentrate? | 0 | 1 | 2 | 3 |
20. Do you feel physically lethargic or fatigued? | 0 | 1 | 2 | 3 |
21. Do you feel mentally lethargic or fatigued? | 0 | 1 | 2 | 3 |
22. Do you find it difficult to learn new things? | 0 | 1 | 2 | 3 |
23. Does your brain feel foggy? | 0 | 1 | 2 | 3 |
24. Do you repeatedly reach for coffee, tea, sweets or other pick-me-ups throughout the day? | 0 | 1 | 2 | 3 |
25. Do you have chronic aches and pains? | 0 | 1 | 2 | 3 |
26. Do you have an increased sensitivity to pain? | 0 | 1 | 2 | 3 |
27. Do you find it difficult if people talk to you when you’ve just woken up? | 0 | 1 | 2 | 3 |
28. Do you struggle with mental tasks which you used to find easy? | 0 | 1 | 2 | 3 |
29. Do you feel very fatigued in the afternoon or night? | 0 | 1 | 2 | 3 |
30. Do you feel anxious or worried? | 0 | 2 | 4 | 6 |
31. Do you feel tired or lethargic? | 0 | 2 | 4 | 6 |
32. Do you feel flushed, hot or sweating in the afternoon or night? | 0 | 1 | 2 | 3 |
33. Have you been anxious or worried for many years? | 0 | 1 | 2 | 3 |
34. Do you feel burnt out? | 0 | 1 | 2 | 3 |
35. Does your mind feel restless, like you can’t shut it down? | 0 | 1 | 2 | 3 |
36. Are your bowel movements difficult, hard, dry or infrequent? | 0 | 1 | 2 | 3 |
37. Do you have headaches? | 0 | 1 | 2 | 3 |
38. Do you have a lack of interest in sex? | 0 | 1 | 2 | 3 |
39. Do you find it difficult to lose weight? | 0 | 1 | 2 | 3 |
40. Do you tend to avoid facing problems? | 0 | 1 | 2 | 3 |
41. Do you have difficulty completing projects? | 0 | 1 | 2 | 3 |
42. Do you lack stamina, or tire easily? | 0 | 2 | 4 | 6 |
43. Do you have cold hands or feet? | 0 | 2 | 4 | 6 |
44. Do you feel restless, fidgety or unable to sit still? | 0 | 2 | 4 | 6 |
45. Do you feel edgy or highly strung? | 0 | 2 | 4 | 6 |
46. Does your appetite tend to decrease with stress or depression? | 0 | 1 | 2 | 3 |
47. Do you tend to lose weight when stressed or depressed? | 0 | 1 | 2 | 3 |
48. Do you find it difficult to fall asleep? | 0 | 2 | 4 | 6 |
49. Do you wake early in the morning and find it hard to get back to sleep? | 0 | 2 | 4 | 6 |
50. Do you feel you have a short fuse or a quick temper? | 0 | 1 | 2 | 3 |
51. Do you feel so angry at times that you feel like you might lose control? | 0 | 1 | 2 | 3 |
52. Do you tend to over-react to situations? | 0 | 1 | 2 | 3 |
53. Do you find it hard to get to sleep or stay asleep? | 0 | 1 | 2 | 3 |
54. Do things easily trigger you to explode with anger or frustration? | 0 | 1 | 2 | 3 |
TOTAL: ____________
Are you surprised by your results? I know I was. I scored a total of 88! What did you score? I now know I need to take further action when it comes to my stress and anxiety in the way of nutrients, herbal medicine, and diet as well as relaxation techniques. What are you going to do in order to lower your score?
Discuss!!!