Stress Symptom Checklist

Each of us experiences stress in different ways. It is useful to see if your stress symptoms are predominantly physical, emotional or behavioral. This will help you understand yourself better, develop more awareness and make best use of stress reduction techniques.

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Physical Symptoms

Headaches*

Never

Rarely

Sometimes

Often

Indigestion*

Never

Rarely

Sometimes

Often

Stomach Aches*

Never

Rarely

Sometimes

Often

Back Pain*

Never

Rarely

Sometimes

Often

Tight Neck or Shoulders*

Never

Rarely

Sometimes

Often

Racing Heart*

Never

Rarely

Sometimes

Often

Sweaty Palms*

Never

Rarely

Sometimes

Often

Trouble Sleeping*

Never

Rarely

Sometimes

Often

Restlessness (hard to sit still)*

Never

Rarely

Sometimes

Often

Dizziness*

Never

Rarely

Sometimes

Often

Ringing in the Ears*

Never

Rarely

Sometimes

Often

Total Physical Symptoms

Behavioral Symptoms

Smoke Excessively*

Never

Rarely

Sometimes

Often

Grind Teeth at Night*

Never

Rarely

Sometimes

Often

Trouble Thinking Clearly*

Never

Rarely

Sometimes

Often

Drink Alcohol Excessively*

Never

Rarely

Sometimes

Often

Forgetful*

Never

Rarely

Sometimes

Often

Can't Make Decisions*

Never

Rarely

Sometimes

Often

Bossiness*

Never

Rarely

Sometimes

Often

Compulsive Eating*

Never

Rarely

Sometimes

Often

Thoughts of Running Away*

Never

Rarely

Sometimes

Often

Critical of Others*

Never

Rarely

Sometimes

Often

Compulsive Gum Chewing*

Never

Rarely

Sometimes

Often

Can't seem to get things done*

Never

Rarely

Sometimes

Often

Total Behavioral Symptoms

Emotional Symptoms

Crying, sad*

Never

Rarely

Sometimes

Often

Overwhelmed with Pressure*

Never

Rarely

Sometimes

Often

Nervous, Anxious*

Never

Rarely

Sometimes

Often

Angry*

Never

Rarely

Sometimes

Often

Bored - can't find any meaning to things*

Never

Rarely

Sometimes

Often

Lonely*

Never

Rarely

Sometimes

Often

Can't Stop Worrying*

Never

Rarely

Sometimes

Often

On Edge - feeling ready to explode*

Never

Rarely

Sometimes

Often

Can't Laugh*

Never

Rarely

Sometimes

Often

Unhappy for no particular reason*

Never

Rarely

Sometimes

Often

Powerless to Change Things*

Never

Rarely

Sometimes

Often

Total Emotional Symptoms

Total Symptoms

Message*

Stress Reduction Checklist

Stress Symptom Checklist

Physical Symptoms

Behavioral Symptoms

Emotional Symptoms

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