Instructions: Look at the following symptoms of stress. Score each between 1-5.
(1=rarely; 2=monthly; 3=weekly; 4=several times a week; 5=almost daily)
_______1. Headaches
_______2. Stomach problems – pain, diarrhea, constipation, nausea
_______3. Fast heart beat
_______4. Pain in body –legs, neck, lower back, shoulders, jaw
______ 5. Muscle jerks or tics
_______6. Eating problems-no appetite, constant eating, full feeling without eating
_______7. Sleeping problems-unable to fall asleep, up in middle of the night, bad dream
_______8. Tiredness
_______9. Can’t get your breath
_______10. Dry throat or mouth
_______11. Teeth grinding
_______12. Hyperactive -unable to sit-extra energy
_______13. Uncontrollable crying or not being able to cry
_______14. Smoking
_______15. Drinking alcohol
_______16. Use drugs
_______17. Nervous feelings or tenseness
_______18. Dizziness and weakness
_______19. Irritable and easily angered
_______20. Sad and depressed
_______21. Accident prone
_______22. Feeling angry in general
_______23. Feeling overwhelmed and unable to cope
_______24. Feeling like you want to run away or disappear
_______25. Doing weird things without thinking
_______26. Nervous laughter
_______27. Easily startled and jumpy
_______28. Worried about disease and death
_______29. Bored with life
_______30. Always worried about money
_______31. Afraid of weekends or vacations
_______32. Think there is no one to talk to about your problems
_______33. Afraid of heights or closed spaces-elevators, swings
_______34. Feel rejected by family and friends
_______35. Never laugh
_______36. Unable to concentrate or finish things you start
_______37. Allergies
_______38. Sleep a lot
_______39. Don’t have friends
_______40. Don’t want to be with people
· If you score is below 66=low stress/ 67 to 120=moderate stress/ above 120=High stress and you need to talk to an adult or your counselor
