CIRCLE OR HIGHLIGHT ANY OF THE FOLLOWING SYMPTOMS THAT APPLY TO YOU:
Headaches; dizziness; fainting spells; racing heart; shortness of breath; feeling of choking; chest
pain; nausea; dizziness; stomach trouble; no appetite; increased appetite; weight gain in the last month, weight loss in the
last month, fatigue; nightmares; alcoholism; feel tense; anger irritability; panicky; tremors; sweating; fear of losing control;
fear of going crazy; fear of dying; anxious, trembling; feel in a "daze"; unwanted repetitive thoughts; avoidance of crowded
places, unwanted repetitive habits; difficulty falling asleep; difficulty remaining asleep; awakening earlier than intended;
difficulty waking up; sleeping for long periods
experienced or witnessed a life threatening event or serious injury; experienced fear, hopelessness
or horror during the event; distressing recollections of the event; distressing dreams of the event; acting or feeling as
if the event is recurring; difficulty talking about the event; difficulty seeing anything that reminds you about the event
depressed; suicidal ideas; past suicide attempts; feeling detached from others; feeling void of emotions;
drug use; unable to relax; sexual problems; less interest in pleasant activities; unable to enjoy self; not like weekends
or vacations; difficulty with decision making; inferiority feelings; lack of interest in doing things; feeling helpless;
feel hopeless; feel like there is no future for you; guilt; memory or concentration difficulty; crying spells; unable to control
anger; low energy; mood swings;
over_ambitious; shy; feel lonely; money problems; can't keep a job; difficulty keeping friends; difficulty
with romantic relationships; bad home conditions; work stress; paranoia; hear voices; food binging; food purging; legal problems;
constantly on guard for anything dangerous that could happen
difficulty paying attention; easily distracted; disorganized; losing items; often making careless mistakes;
caffeine having little impact; impatient; difficulty waiting in lines; starting projects and not finishing; reading several
books at the same time; difficulty remaining still; have been told by others that you don't listen well; difficult to not
interrupt others; tendency to be very talkative; often "on the go"; act as if "driven by a motor"; feel as if thoughts are
racing; periods where you feel "on top of the world" and can accomplish anything; unrestrained buying sprees, periods where
car is driven at high speeds
feeling empty; feeling life has no meaning; a history of purposely cutting or physically hurting your
body; suspecting that your partner is unfaithful; need a lot of reassurance from others; feel as if people will abandon you;
always needing to be in a relationship; like to be the center of attention; perfectionistic