Indicate the word that describes how often you
experience each stress sign.
Perspiration: increased sweating or cold clammy hands.
Never
Seldom
Sometimes
Often
Always
Frequent need to urinate.
Never
Seldom
Sometimes
Often
Always
Voice changes; stuttering, shaky, strained, high pitch laughter.
Never
Seldom
Sometimes
Often
Always
Anxiety or panic: feeling things getting out of control.
Never
Seldom
Sometimes
Often
Always
Hyperactivity: sudden bursts of energy.
Never
Seldom
Sometimes
Often
Always
Poor diabetic control (if not diabetic mark never).
Never
Seldom
Sometimes
Often
Always
Difficulty falling asleep; insomnia; nightmares.
Never
Seldom
Sometimes
Often
Always
Fatigue, feeling tired.
Never
Seldom
Sometimes
Often
Always
Neuromuscular dysfunction; trembling, shaking, nervous tics,
frowning, wrinkling forehead.
Never
Seldom
Sometimes
Often
Always
Impulsive behavior and/or accident proneness.
Never
Seldom
Sometimes
Often
Always
Daydreams; preoccupied, indecisiveness.
Never
Seldom
Sometimes
Often
Always
Skin changes; rashes, pimples, acne, temperature.
Never
Seldom
Sometimes
Often
Always
Re-occurring herpes.
Never
Seldom
Sometimes
Often
Always
Gastrointestinal symptoms: indigestion, gas pains, diarrhea,
constipation, nausea, ulcers, rectal hemorrhoids.
Never
Seldom
Sometimes
Often
Always
Muscular tension: bruxism (grinding or clenching teeth), pain in
jaw, neck, shoulders, back.
Never
Seldom
Sometimes
Often
Always
Low grade infections, flu.
Never
Seldom
Sometimes
Often
Always
Self-conscious: feelings of guilt, inadequacy, poor self-esteem.
Never
Seldom
Sometimes
Often
Always
Sexual dysfunction.
Never
Seldom
Sometimes
Often
Always
Migraine headaches.
Never
Seldom
Sometimes
Often
Always
Mental confusion, poor judgment, poor memory.
Never
Seldom
Sometimes
Often
Always
Women: menstrual difficulties(premenstrual tension/missed
menstrual cycle, infertility. Men: infertility.
Never
Seldom
Sometimes
Often
Always
Cardiovascular symptoms: rapid heartbeat, chest pains, high blood
pressure.
Never
Seldom
Sometimes
Often
Always
Tension headaches.
Never
Seldom
Sometimes
Often
Always
Kidney imbalance: bloating, water retention, excessive thirst.
Never
Seldom
Sometimes
Often
Always
Pessimistic attitude, conviction everything turns out for the
worse.
Never
Seldom
Sometimes
Often
Always
Difficulty sitting still: pacing, finger or foot tapping.
Never
Seldom
Sometimes
Often
Always
Respiratory symptoms: shortness of breath, dizziness,
hyperventilation.
Never
Seldom
Sometimes
Often
Always
Allergies, sores in mouth, hives.
Never
Seldom
Sometimes
Often
Always
Inability or difficulty concentrating, racing thoughts.
Never
Seldom
Sometimes
Often
Always
Arthritic joint pain.
Never
Seldom
Sometimes
Often
Always
Upper respiratory: colds, strep throat, mono.
Never
Seldom
Sometimes
Often
Always
Emotional tension and alertness: feeling frustrated, angry,
restless, irritable, resentment.
Never
Seldom
Sometimes
Often
Always
Drymouth or throat; difficulty swallowing.
Never
Seldom
Sometimes
Often
Always
Emotional instability: feeling depressed, helpless, hopeless
overpowering urge to cry and/or run and hide.
Never
Seldom
Sometimes
Often
Always
Loss or excessive appetite.
Never
Seldom
Sometimes
Often
Always
Signs of Distress
What are your signs of distress? See if you can identify which of
these early warning signals precede your distress symptoms.
Feelings/Disposition
Behaviors
Body Reactions
