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ANXIETY REWIRED Self-Assessment

Grab a pen and paper✍️ — you’ll be keeping track of your own points!
Note: This assessment does NOT track your score for you, so make sure you're tallying as you go!

✍️ YOU NEED TO GRADE YOUR ASSESSMENT !

Start

Question 1 of 24

1. How often do you feel nervous, anxious, or on edge?

 

A

Never (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

All Day (4 pts)

Question 2 of 24

2. How often do you focus on symptoms or how you feel?

 

A

Never (0 pts)

B

Rarely (1 pts)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

All day (4 pts)

Question 3 of 24

3. How often do you experience panic attacks, sudden episodes of intense fear or discomfort?

 

A

Never (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Pretty much all day (4 pts)

Question 4 of 24

4. Do you avoid certain situations, foods, places or activities because of anxiety or fear of symptoms?

 

A

No, never (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Everyday (4 pts)

Question 5 of 24

5. How often do you experience a racing heartbeat, heart palpitations, shortness of breath or chest discomfort?

 

A

No, Never (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Multiple times a day (4 pts)

Question 6 of 24

6. How often do you experience sleep disturbances, such as difficulty falling asleep, staying asleep, or waking up feeling tired?

 

A

Never, I sleep great! (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Every night (4 pts)

Question 7 of 24

7. How often do you feel irritable, restless, scattered, or rush around even when there is no apparent reason?

 

A

Never, I am calm and relaxed (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Everyday (4 pts)

Question 8 of 24

8. How often do you feel easily overwhelmed by daily life?

 

A

Never (0 pt)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Everyday (4 pts)

Question 9 of 24

9. How often do you find it difficult to concentrate or focus on tasks or activities?

 

A

Never, I have great focus (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Pretty much all the time (4 pts)

Question 10 of 24

10. How often do you experience negative thoughts, such as worry about the future, or fear of losing control?

 

A

Never (0 pts)

B

Rarely (1pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Everyday (4 pts)

Question 11 of 24

11. How often do you experience sensitivities, to light, sound, chemicals or EMF exposure?

 

A

Never (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Everyday (4 pts)

Question 12 of 24

12. Do you experience sensitivities to foods you used to enjoy?

 

A

No, Praise God! (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Yes (4 pts)

Question 13 of 24

13. How often do you experience dizziness, lightheadedness, dizziness upon standing?

 

A

Never (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

All the time (4 pts)

Question 14 of 24

14. Do you find you are prone to illness, or frequently catching colds or other infections?

 

A

No, I haven't been sick in years (0 pts)

B

I rarely get sick-maybe once a year or less (1 pt)

C

I get sick a few times a year but I usually recovery quickly (2 pts)

D

I get sick frequently-more than a few times a year and it tends to linger. (3 pts)

E

I am almost always battling something-colds, infections, flares (4 pts)

Question 15 of 24

15. How often do you struggle with headaches or migraines?

 

A

Never (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Everyday (4 pts)

Question 16 of 24

16. How often do you experience pain, burning, sore, or tense muscles or joint aches?

 

A

Never, or only after a good workout (0 pts)

B

Rarely (1 pt)

C

Sometimes in the morning (2 pts)

D

Frequently (3 pts)

E

Everyday (4 pts)

Question 17 of 24

17. How often do you wake up in the morning feeling exhausted or with increased symptoms

 

A

I feel great in the morning (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Every Morning (4 pts)

Question 18 of 24

18. How often do you turn to medications, supplements or substances for symptom control?

 

A

Never (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Everyday (4 pts)

Question 19 of 24

19. How often do you feel stuck in a ruminating thought cycle, unable to quiet the mind?

 

A

Never (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Mostly All day and night (4 pts)

Question 20 of 24

20. How often do you experience fatigue that is not relieved by rest?

A

Never (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Everyday (4 pts)

Question 21 of 24

21. How often do you experience a depressed mood, apathy, or flat affect?

A

Never (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Everyday (4 pts)

Question 22 of 24

22. How often do you experience nausea or gastrointestinal distress?

A

Never (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

Everyday (4 pts)

Question 23 of 24

23. How often do symptoms hinder your ability to work or do the things you enjoy

 

A

Never (0 pts)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

I cannot work, at this time (4 pts)

Question 24 of 24

24. How often do you feel disconnected from God?

A

Never (0 pt)

B

Rarely (1 pt)

C

Sometimes (2 pts)

D

Frequently (3 pts)

E

I haven't felt connected in a long time (4pts)

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