HOW DO YOU SHOW YOUR STRESS?
Using the following scale, rate your current/recent experience each of these symptoms. Then total each column and add the column totals together.
always almost always most of the time sometimes rarely never
5 4 3 2 1 0
_____ Headaches _____ Insomnia _____ Fatigue _____ Muscle Tension _____ G. I. Distress _____ Racing Pulse _____ Hypertension _____ Can=t Breath _____ Total Column 1 _____ Column 2 _____ Column 3 _____ Grand Total _____ |
_____ Irritable _____ Crying Jags _____ Negativity _____ Confusion _____ Frustration _____ Nervous _____ Impatient _____ Indecisive _____ Total |
_____ Drug/Alcohol Abuse _____ Overeating _____ Social Withdrawal _____ Reckless Driving _____ Aggressiveness _____ Angry Outbursts _____ Sexual Problems _____ Clenching Jaw _____ Total
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List other ways in which you feel your stress impacts your life.
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WHAT CAUSES YOU STRESS?
What life changes are you going through, if any?
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What are your daily "hassles" (ie. routine/schedule, relationships, work)?
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What other stressors do you have (ie. long-term illness, loss of job, loss of loved one)?
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