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Never
1 point
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Rarely
2 points
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Sometimes
3 points
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Fairly Often
4 points
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Always
5 points
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| I feel nervous, and shake or sweat a lot:
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| I feel tired or have a lack of energy:
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| I have headaches:
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| I have trouble sitting still or concentrating:
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| I have problems getting to or staying asleep at night:
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| I feel pain in my chest and shortness of breath:
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| I am constipated or have diarrhea:
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| I have an upset stomach and muscle aches, especially in my back, neck, or shoulders:
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| I have gained or lost more than 10 pounds:
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| YOUR TOTAL SCORE: |
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SCORING: |
10 to 20 points
This score suggests that you have a low level of stress and/or you are doing a good job of managing stress. While stress and anxiety are not currently affecting your health, you still need to be aware of the signs and symptoms.
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30 to 40 points
Stress is starting to affect your health in a negative way. Talk to your healthcare provider about ways to bring stress under control.
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20 to 30 points
This score suggests that stress may be starting to affect your health. You may want to discuss stress management techniques with your healthcare provider. In addition, examine those questions that earned a big score. Can you determine the source of these difficulties? Are there things you can do right away to help reduce stress in those areas?
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40 to 50 points
You are at risk for stress-related illnesses. It's time to take an action. See your doctor.
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