The Adaptation Questionaire
The following signs and symptoms could indicate excess biochemical stress. Though many of these symptoms can be seen with a range of medical problems, the underlying issue often is maladaptation, the impact on your health of having elevated cortisol levels from long term stress.
Score 1 point for each symptom in the Early signs lists and
Score 2 points for each symptom in the Later signs or Long-term outcome list
Early physical signs and symptoms
Weight gain, esp. in abdomen................ _____
Headaches................................................. _____
Hypoglycemia, (low blood sugar)........... _____
Frequent colds and flu.............................. _____
Muscular pain and tenderness............... _____
Joint pain and tenderness....................... _____
Poor exercise tolerance........................... _____
Fatigue and tiredness ............................. _____
Heart palpitations ..................................... _____
Menstrual irregularity................................ _____
Back or neck pain...................................... _____
Abdominal discomfort.............................. _____
Alternating diarrhea/ constipation.......... _____
Total ......................................................... _____
Later Signs/Symptoms of Maladaptation
Allergies...................................................... _____
Sexual dysfunction.................................... _____
Loss of muscle mass.............................. _____
Depression................................................. _____
Obesity......................................................... _____
Glucose (sugar) intolerance, insulin
resistance................................................... _____
Poor wound healing.................................. _____
Increased blood pressure....................... _____
Apathy ......................................................... _____
Salt craving................................................. _____
Worsening premenstrual tension.......... _____
Generalized weakness and fatigue....... _____
Poor memory............................................. _____
Total ............................................................ _____ |
Early emotional and behavioral signs
Nervousness............................................... _____
Anxiety, agitation.......................................... _____
Poor sleep.................................................... _____
Noise sensitivity.......................................... _____
Worries and fears....................................... _____
Inability to concentrate .............................. _____
Alcohol craving or intolerance.................. _____
Dependence on caffeine/stimulants.. _____
Craving sweets and fats........................... _____
Lower sex drive........................................... _____
Total ............................................................ _____
Long-Term Outcomes of Maladaptation
Reduced resistance to infection............. _____
Greater susceptibility to cancer............... _____
Heart disease............................................. _____
Poor recovery from injury.......................... _____
Diabetes...................................................... _____
Arthritis......................................................... _____
Chronic depression and anxiety............. _____
Alzheimer’s disease and other
cognitive disorders................................... _____
Chronic fatigue syndrome....................... _____
Hypertension (high blood pressure).. _____
Increased cholesterol/triglycerides....... _____
Osteoporosis ............................................ _____
Total .............................................................. _____
Grand Total........................................... ________ |
After completing the questionnaire total the points and use the scoring guide below. If your score is elevated and you are ready to make the changes needed to reduce your stress hormone production and improve your adaptation IQ, contact us at 858-457-1314.
Scoring Guide
0-5 mild maladaptation
6-12 moderate maladaptation
above 12 significant maladaptation
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