SOMATIC:
Reflecting back on the last 2 weeks, how often has each of the following symptoms been occurring?
I GRIND MY TEETH
MY THROAT FEELS CONSTRICTED AS IF THERE WAS SOMETHING STUCK INSIDE (E.g., lump in my throat)
I FEEL PAIN IN MY LOWER ABDOMEN (in the absence of a physical cause or condition)
I GET KNOTS IN MY STOMACH (in the absence of a physical cause or condition)
I HAVE NO APPETITE
I FEEL HUNGRY BUT IT IS HARD TO SWALLOW FOOD (in the absence of a physical cause or condition)
I CANNOT HAVE A RESTFUL SLEEP (I cannot fall asleep, stay asleep, or I wake up too early)
I FEEL EXHAUSTED, AS IF DRAINED OF MY ENERGY (without physical activity)
I AM RESTLESS OR FIDGETY
I AM UNUSUALLY COLD (e.g., shivering, teeth chattering, not able to warm up)
I FEEL TERRIFIED AND I DON’T KNOW WHY
I AM AFRAID OF BEING ALONE, EVEN THOUGH IT HAS NEVER BOTHERED ME BEFORE
I AM AFRAID OF DARKNESS/ I NEED TO KEEP THE LIGHTS ON AT NIGHT (this is unlike me)
I AM CONSTANTLY PAYING ATTENTION TO MY THOUGHTS/INTERNAL DIALOGUE
I FEEL THE NEED TO REASSURE MYSELF
I AM AFRAID THAT I MAY BE LOSING CONTROL OF MY MIND/THAT I MAY BE GOING MAD
I AM UNUSUALLY FORGETFUL (E.g., I forget simple things like what I had for breakfast the day before, where I left my keys, or whether I washed my hair or not)
I FIND IT HARD TO CONCENTRATE (E.g., school or work)
I AM UNUSUALLY INDECISIVE/ I HAVE A HARD TIME DECIDING ON THINGS
I AM UNUSUALLY IRRITABLE (I.e., everything annoys me, I have low tolerance for frustration)
I AM UNUSUALLY IMPATIENT (E.g., I cannot sit through a whole movie)
I FEEL DEPRESSED
I TEND TO ISOLATE MYSELF (E.g., I tend to cancel my plans, I choose to “hide” at home)
MY HEART IS POUNDING OUT OF THE BLUE, AND I START BREATHING FAST OR I FEEL I CANNOT BREATHE ANYMORE
I HAVE HOT FLASHES/ I START SWEATING PROFUSELY/ I HAVE CLAMMY HANDS (Without physical activity)
I WORRY A LOT
THE FUTURE/THE NEXT MOMENT TERRIFIES ME (I.e., when I think about tomorrow or the next moment, I feel scared or uncomfortable for no obvious reason)
Time's up