Go through each category and keep track of how many of symptoms apply to you

PHYSIOLOGICAL RESPONSE

  • Feelings of warmth
  • Heart palpitations
  • Rapid, pounding heartbeat
  • Tightness of chest
  • Butterflies in stomach
  • Hyperventilation
  • Weakness all over
  • Tremors
  • Dizziness
  • Dry mouth
  • Sweaty all over
  • Confusion
  • Sped up thoughts
  • Muscle tension / aches
  • Fatigue
  • Slow cognitive response
  • I can't do it
  • What if I make a fool of myself?
  • People are looking
  • I could faint
  • It's a heart attack
  • Get Me Out Of Here
  • No One Will Help
  • I Can't Breathe
  • I'm Going To Die
  • I'm Going Crazy
  • I'm Trapped
  • I'm Not Going Out
  • Worrying, what if someone Is hurt, sick, fired, Etc.?

 

EMOTIONAL RESPONSE

  • Fear
  • Keyed Up / On Edge
  • Panic
  • Excessive Worry
  • Uneasy
  • Trapped-No Way Out
  • Isolated-Lonely
  • Loss of Control
  • Embarrassed
  • Criticized
  • Rejected
  • Angry
  • Depressed

Summary: If you checked 3 or more from each response list, ask yourself: Is the fear of an anxiety attack limiting my involvement in life?
Am I avoiding every day situations?
Do I worry and feel tense most of the time?

Request a Refill

2 + 0 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.