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1
Stress Factors Self-Assessment
2
The first step is to determine your stress factors.
3
How does stress affect you physically?
4
What are some ways you react to stress beyond physical symptoms?
5
What kind of company do you usually like to keep when you want to de-stress?
6
Pick your favorite relaxing activity.
7
What are the most important things in your life?
Everyone is unique. That means we all have different challenges, and different things that help us cope with those challenges. Use this self-assessment tool to help you better understand your unique stress factors. You’ll learn
facts about stress,
like where your stress is coming from, what’s causing it, and how you can Change to Chill.
Your Name
The first step is to determine your stress factors.
Hidden Fields
Select one
Dating
Fitting in/not fitting in
Friendships
Grades
Homework
Job/work
Life changes
Money
My mental health
My physical health
Not enough responsibility
Not enough to do
Other family
Parents
School
Self esteem
Siblings
Social media
Social situations
The future
Too much responsibility
Too much to do
Worrying about my personal safety
Worrying about someone else’s safety
Select one
Dating
Fitting in/not fitting in
Friendships
Grades
Homework
Job/work
Life changes
Money
My mental health
My physical health
Not enough responsibility
Not enough to do
Other family
Parents
School
Self esteem
Siblings
Social media
Social situations
The future
Too much responsibility
Too much to do
Worrying about my personal safety
Worrying about someone else’s safety
Select one
Dating
Fitting in/not fitting in
Friendships
Grades
Homework
Job/work
Life changes
Money
My mental health
My physical health
Not enough responsibility
Not enough to do
Other family
Parents
School
Self esteem
Siblings
Social media
Social situations
The future
Too much responsibility
Too much to do
Worrying about my personal safety
Worrying about someone else’s safety
Identify up to four things that stress you out
*
Select one
Parents
Siblings
Other family
Dating
Friendships
Fitting in/not fitting in
School
Grades
Homework
Job/work
Money
Life changes
My mental health
My physical health
Not enough responsibility
Too much responsibility
Self esteem
Social media
Social situations
Too much to do
Not enough to do
Worrying about my personal safety
Worrying about someone else’s safety
The future
Select one
Parents
Siblings
Other family
Dating
Friendships
Fitting in/not fitting in
School
Grades
Homework
Job/work
Money
Life changes
My mental health
My physical health
Not enough responsibility
Too much responsibility
Self esteem
Social media
Social situations
Too much to do
Not enough to do
Worrying about my personal safety
Worrying about someone else’s safety
The future
Select one
Parents
Siblings
Other family
Dating
Friendships
Fitting in/not fitting in
School
Grades
Homework
Job/work
Money
Life changes
My mental health
My physical health
Not enough responsibility
Too much responsibility
Self esteem
Social media
Social situations
Too much to do
Not enough to do
Worrying about my personal safety
Worrying about someone else’s safety
The future
Other
Recognizing the symptoms of stress can help you manage it.
How does stress affect you physically?
Choose up to five
Body aches
Change in appetite
Dizziness
Headaches
Heart races
Heartburn
Hungry all the time
Lose my appetite
Migraines
Muscle twitches
Sleep more than usual
Too hot
Too cold
Trouble breathing
Trouble concentrating
Trouble sleeping
Upset stomach
I don’t have physical stress signs
Other
How does stress affect you physically?
*
Select one
Body aches
Change in appetite
Dizziness
Headaches
Heart races
Heartburn
Hungry all the time
Lose my appetite
Migraines
Muscle twitches
Sleep more than usual
Too hot
Too cold
Trouble breathing
Trouble concentrating
Trouble sleeping
Upset stomach
I don’t have physical stress signs
Other
Select one
Body aches
Change in appetite
Dizziness
Headaches
Heart races
Heartburn
Hungry all the time
Lose my appetite
Migraines
Muscle twitches
Sleep more than usual
Too hot
Too cold
Trouble breathing
Trouble concentrating
Trouble sleeping
Upset stomach
I don’t have physical stress signs
Other
Select one
Body aches
Change in appetite
Dizziness
Headaches
Heart races
Heartburn
Hungry all the time
Lose my appetite
Migraines
Muscle twitches
Sleep more than usual
Too hot
Too cold
Trouble breathing
Trouble concentrating
Trouble sleeping
Upset stomach
I don’t have physical stress signs
Other
Choose up to three
People also have different mental and emotional responses to stress.
What are some ways you react to stress beyond physical symptoms?
Choose up to five
I withdraw
I try to surround myself with other people
I feel sad
I feel angry
I feel anxious
I become forgetful
I become easily annoyed or aggravated
I have trouble concentrating
I feel helpless
I feel worthless
I doubt myself
I have bad dreams
I feel agitated
I stop caring about things that are important to me
I try to find ways to make myself feel better, whether they are good for me or not
I don’t have mental or emotional stress signs
What are some ways you react to stress beyond physical symptoms?
*
Select one
I withdraw
I try to surround myself with other people
I feel sad
I feel angry
I feel anxious
I become forgetful
I become easily annoyed or aggravated
I have trouble concentrating
I feel helpless
I feel worthless
I doubt myself
I have bad dreams
I feel agitated
I stop caring about things that are important to me
I try to find ways to make myself feel better, whether they are good for me or not
I don’t have mental or emotional stress signs
Select one
I withdraw
I try to surround myself with other people
I feel sad
I feel angry
I feel anxious
I become forgetful
I become easily annoyed or aggravated
I have trouble concentrating
I feel helpless
I feel worthless
I doubt myself
I have bad dreams
I feel agitated
I stop caring about things that are important to me
I try to find ways to make myself feel better, whether they are good for me or not
I don’t have mental or emotional stress signs
Select one
I withdraw
I try to surround myself with other people
I feel sad
I feel angry
I feel anxious
I become forgetful
I become easily annoyed or aggravated
I have trouble concentrating
I feel helpless
I feel worthless
I doubt myself
I have bad dreams
I feel agitated
I stop caring about things that are important to me
I try to find ways to make myself feel better, whether they are good for me or not
I don’t have mental or emotional stress signs
Choose up to three
Sometimes a good friend, time with family, or being alone for a while can help ease stressful situations and feelings.
What kind of company do you usually like to keep when you want to de-stress?
*
Choose one.
Myself
My pet(s)
Parents
Sibling(s)
Other family members
Significant other
A friend
A group of friends
Teammates
Surrounded by strangers in a public place
It’s important and totally possible to train your body and your mind to cope with stress, even when things are tough.
What is one thing you can do that will almost always help you relax?
Breathing exercises
Clean
Cook or bake something
Dance
Do a puzzle
Do yoga
Draw
Eat a snack
Go for a run
Have a conversation with someone
Listen to music
Make music
Mediate
Nap
Organize something
Pet an animal
Play a game
Read
Take a walk
Take a warm shower or bath
Workout
Being clear about what matters most to you—your priorities—will help you achieve balance, which in turn can help reduce stress.
What are your top three priorities in life at this point in time?
*
Fill in the blanks and list your top priority first.
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Learn about stress and its triggers.
Get some perspective on things that matter.
Try meditation.
Learn easy ways to chill.
Achieve balance in your life.
Exercise your imagination with guided imagery.