Stress markedly increases symptoms. Symptoms are simply an indication that there is more stress than is desirable. If you have over 10 symptoms, you are on the way to disease. At 20 symptoms, you probably have some medically diagnosable disorder and at 30 or more symptoms, you are on the verge of a real problem! Do you have any of the following? PLEASE CHECK ONLY THOSE THAT YOU HAVE NOW OR RECENTLY

___ Depressed mood.

___ Loss of interest or pleasure in things you used to enjoy.

___ Significant weight change (loss or gain).

___ Frequent eating between meals.

___ Insomnia.

___ Snoring

___ Sleep walking

___ Hypersomnia.

___ Sleep walking.

___ Agitation.

___ Sluggishness, slow to function.

___ Fatigue, low energy, feeling tired all of the time.

___ Feelings of worthlessness or guilt.

___Difficulty concentrating, thinking, and remembering.


___Recurrent thoughts of death or suicide.

___ Suicide attempts.

___ Nervous exhaustion.

___Worrying excessively or being anxious.

___ Frequent crying.

___ Being extremely shy or sensitive.

___ Lumps or swelling in your neck.

___Blurring of vision.

___ Seeing double.

___ Seeing colored halos around lights.

___ Pains or itching around the eyes.

___ Excess blinking or watering of the eyes.

___ Loss of vision.

___ Difficulty hearing.

___ Ear ache.

___ Running ear.

___ Buzzing or other noises in the ears.

___ Motion sickness.

___ Teeth or gum problems.

___ Sore or sensitive tongue.

___ Change in sense of taste.

___ Nose stuffed up.

___ Runny nose.

___ Sneezing spells.

___ Frequent head colds.

___ Bleeding from the nose.

___ Sore throat even without a cold.

___ Enlarged tonsils.

___ Hoarse voice even without a cold.

___ Difficulty or pain in swallowing.

___ Wheezing or difficulty breathing.

___ Coughing spells.

___ Coughing up a lot of phlegm.

___ Coughing up blood.

___ Chest colds more than once a month.

___ High blood pressure.

___ Low blood pressure.

___ Heart trouble.

___ Thumping or racing heart.

___ Pain or tightness in the chest.

___ Shortness of breath.

___ Heartburn.

___ Feeling bloated.

___ Excess belching.

___ Discomfort in the pit of your stomach.

___ Nausea.

___ Vomiting blood.

__  Peptic ulcer.

___ Change in appetite.

___ Digestive problems.

___ Excess hunger.

___ Getting up frequently at night to urinate.

___ Urinating more than 5-6 times a day.

___ Unable to control your urine.

___ Burning or pains when you urinate.

___ Black, brown, or bloody urine.

___ Difficulty starting your urine.

___ Constant urge to urinate.

___ Constipation.

___ Diarrhea.

___ Black or bloody bowel movement.

___ Grey bowel movement.

___ Pain when you move your bowels.

___ Bleeding from your rectum.

___ Stomach pains which double you up.

___ Frequent stomach trouble.

___ Intestinal worms.

___  Hemorrhoids.

___ Yellow jaundice.

___ Biting your nails.

___ Stuttering or stammering.

___ Any kind of problem with your genital or sexual organs.

___ Sexual problems.

___ Hernia or rupture.

___ Kidney or bladder disease.

___ Stiff or painful muscles or joints.

___ Swelling joints.

___ Pain in your back or shoulders.

___ Painful feet.

___ Swelling in your armpits or groin.

___ Trouble with swollen feet or ankles.

___ Cramps in your legs at night or with walking.

___ Itching or burning skin.

___ Rash or pimples

___ Excess bleeding from a small cut.

___ Easy burning skin.

___ Dizziness or light headedness.

___ Feeling faint or fainting.

___ Numbness in any part of your body.

___ Cold hands or feet even in hot weather.

___ Paralysis.

___ Blacking out.

___ Fits, convulsions, or epilepsy.

___ Change in your handwriting.

___ Tendency to shake or tremble.

___ Tendency to be too hot or too cold.

___ Sweating more than usual.

___ Hot flashes.

___ Being short of breath with minimal effort.

___ Failure to get adequate exercise.

___ Being overweight.

___ Being underweight.

___ Having lost more than half of your teeth.

___ Bleeding gums.

___ Badly coated tongue.

___ A lot of small accidents or injuries.

___ Varicose veins.

___ Headaches.

___ Other aches and pains.

___ Feeling pessimistic or hopeless.

___ Have had any kind of surgery within the past year.

___ Being upset easily by criticism.

___ Having little annoyances get on your nerves

___ Getting angry easily.

___ Getting nervous around strangers.

___ Feeling lonely.

___ Having difficulty relaxing.

___ Being troubled by frightening dreams or thoughts.

___ Being disturbed by work or family problems.

___ Wishing that you could get psychological or psychiatric

___ Being tense or jittery.

___ Being easily upset.

___ Being in low spirits.

___ Being in very low spirits.

___ Believing that your life is out of your hands and controlled by external forces.

___ Feeling that life is empty, filled with despair.

___ Having no goals or aims at all.

___ Having failed to make progress towards your life goals.

___ Feeling that you are completely bound by factors outside yourself.

___ Feeling sad, blue, or down in the dumps.

___ Feeling slowed down or restless and unable to sit still.

___ Frequent illness.

___ Being confined to bed by illness.

For men only:

___ Having a urine stream that’s very weak or very slow.

___ Having prostate trouble.

___ Having unusual burning or discharge from your penis.

___ Having swelling or lumps in your testicles.

___ Having your testicles painful.

___ Having trouble getting erections

For women only:

___ Having trouble with your menstrual period.

___ Bleeding between your periods.

___ Having heavy bleeding with your periods.

___ Getting bloated or irritable before your periods.

___ Taking birth control pills (in the last year).

___ Having lumps in your breasts.

___ Having excess discharge from your vagina.

___ Feeling weak or sick with your periods.

___ Having to lie down when your periods start.

___ Feeling tense and jumpy with your periods.

___ Having constant hot flashes and sweats.

___ Have had a hysterectomy or on hormonal replacement.







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