If
you want your results sent to your email address,
be sure to include your email address in the appropriate
space below. Name and email address fields are
optional and not required.
First
Name ::
Email
Address ::
Answer the following questions
according to how you truly feel.
1.
Do you experience episodes of
intense fear or panic, that may be accompanied
by one or more of the following sensations:
racing heart, sweating, lightheadedness, a
feeling like something very bad is going to
happen (impending doom), shortness of breath,
chest pains, extreme nervousness, shaking,
and you feel like you have to get out.
2.
Do you ever experience
persistent mind chatter including irrational
but fearful thoughts, thoughts that seem to
get stuck, melodies replaying themselves over
and over, thoughts that you feel you are going
crazy, or thoughts that you think you are going
to lose control?
3.
Do you find yourself
worrying or being afraid more than you used
to?
4.
Do you find yourself
avoiding social situations or environments
because you are afraid you might become sick
or have a panic attack?
5.
Do you get panicky
when standing in a line, stuck in traffic,
in a crowd, or at a place where you feel you
can’t escape or get out if you need to?
6.
When you go to a
new place, do you find out where the exits
and washrooms are, just in case?
7.
Do you think you
have obsessive thoughts?
8.
I have one or more
anxiety symptoms regularly (daily or weekly)
9.
Do you feel nervous
a lot more than before?
10.
Do you find yourself
obsessing about your health?
11.
Are you impatient,
or easily frustrated or angered?
12.
Do you sometimes
feel like you are losing your mind, and then
become afraid that you may be?
13.
Do you sometimes
feel like you are living in a dream, or that
your life doesn’t seem real?
14.
Do you often feel
overwhelmed?
15.
Do you say yes to
people's requests when you'd rather say no?
16.
How would you rate
your self-esteem (how you feel about yourself)?
17.
Do you sometimes
feel disinterested with life or that your emotions
feel blunted (you don’t care about anything
anymore)?
18.
Do you consider
yourself to be an anxious person?
19.
Has nervousness
or anxiety prevented you from doing something?
20.
Do you like to be
in control?
Be
sure you've answered every question according to
how you truly feel. When you are finished, click
on the "See Results " button to see your
results.