Inspired by
Professional
and
Personal Life
Experiences
    
 

Dr. B. Keith Comeau
Medical Doctor/Family Practitioner

» About Dr. Comeau
»
Our Nutritionist
 

"Transform: A
Personal Evolution"

(Transcending
Stress & Anxiety)

» Understanding Stress & Anxiety
» Self Evaluation Form
» 2 Minute "Stress Test"/ Mental Health Assessment
» What Happens when Stress and Anxiety Become Too Much
» Preventing Stress and Anxiety
» The Truth about Panic Attacks
» Program Information
» Testimonials
» Program Schedule

"Managing Stress in the Work Place
(and in your life) "

» Effects of Stress on Your Personal, Professional and Business Life
» Testimonials

Transformation Strategist
/Executive Coach

» Introduction
» The Strategist
» The Program
» Evaluation Scorecard
» Benefits of the Program
» Program Applications
» Client Profile

 

 


"Transform" A Personal Evolution
Transforming Stress and Anxiety into Strong Personal Power

STRESS & ANXIETY SELF EVALUATION FORM PART I

Stress & Anxiety Diary

Over the past week how much:
not at alla littlemoderatelymarkedlyextremely

1. have you worried excessively and been anxious about several things?

 

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2. difficulty did you have controlling the worries or how much do they interfere with your ability to focus on what you are doing?

 

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3. did you feel restless, keyed up or on edge?

 

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4. did you feel tense?

 

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5. did you feel tired, weak or exhausted easily?

 

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6. difficulty did you have concentrating or find your mind going blank?

 

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7. irritability did you feel?

 

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8. difficulty did you have sleeping (difficulty falling asleep, waking up in the middle of the night, early morning wakening or sleeping excessively)?

 

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STRESS & ANXIETY SELF EVALUATION FORM PART I I
(PDF version for print)

The Different Stress & Anxiety Conditions: A Brief Overview

There are several types of anxiety disorders. The following questions may help you identify the particular anxiety disorder you are dealing with.

a) When you were anxious over the past 6 months, did you, most of the time:

i) Feel restless, keyed up or on edge?

yesno

ii) Feel tense

yesno

iii) Feel tired, weak or exhausted easily?

yesno

iv) Have difficulty concentrating or find your mind going blank?

yesno

v) Feel irritable?

yesno

vi) Have difficulty sleeping (difficulty falling asleep, waking up in the middle of the night, early morning waking or sleeping excessively)?

yesno
   

If you answered yes to 3 or more of the above questions, you may have Generalized Anxiety Disorder (GAD).

b) Do you get anxiety attacks (periods of extreme panic)
that occur out of the blue?

 

yesno

c) Did you have at least one anxiety attack in the
past month?
If you answered yes to (b) or (c), you may be suffering from Panic Disorder.

 

yesno

d) Does fear of a panic attack cause you to avoid
certain situations?
If you answered yes to (d), you may be dealing with agoraphobia.

 

yesno

e) Do you feel anxious in social situations or avoid situations for fear of being humiliated or embarrassed?
It you answered yes to (e), you may be suffering from social phobia.

 

yesno

f) Do you fear a specific object (e.g., insects, animals, bridges)
or situation (e.g., flying, heights, dental visits)?
If you answered yes to (f), you might be experiencing specific phobia. Most people have a phobia, the question is whether it affects your ability to function normally.

 

yesno

g) Do you have anxiety related to a traumatic event
(e.g., personal trauma, personal traumatic experience, combat, sexual abuse, car crash, natural disaster) that has lasted more than one month and involves flashback,
dreams or memories?
If you answered yes to (g), it is likely that you are suffering from post traumatic stress disorder.

 

yesno

h) Do you have recurring, unwanted thoughts such as preoccupation with germs, fear of forgetting to lock your door or harming someone close to you.

 

yesno

i) Do you perform rituals such as washing your hands, repeatedly checking locks, etc.?
If you answered yes to (h) and/or (i), you may be suffering from Obsessive-Compulsive Disorder.

yesno

 

(PDF version for print)

 

Email info@drkcomeau.com