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WEST COAST ANXIETY CLINIC
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Wca
Our story
About
Meet our Team
FAQ
Services
Treatment at WCA
What we treat
Low cost therapy
Evidence-Based Treatment for Anxiety
Wca Institute
Graduate Training
Post-graduate Training
Learn
Why am i anxious?
Reading Recommendations
Mailing List
Blog
Appointments
(206) 973-3791
Depression, Anxiety
& Stress Test
DASS21 response form
1
Questionnaire
2
Personal Details
1. I found it hard to wind down
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
2. I was aware of dryness of my mouth
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
3. I couldn't seem to experience any positive feeling at all
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
4. I experienced breathing difficulty (eg, excessively rapid breathing, breathlessness in the absence of physical exertion)
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
5. I found it difficult to work up the initiative to do things
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
6. I tended to over-react to situations
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
7. I experienced trembling (eg, in the hands)
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
8. I felt that I was using a lot of nervous energy
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
9. I was worried about situations in which I might panic and make a fool of myself
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
10. I felt that I had nothing to look forward to
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
11. I found myself getting agitated
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
12. I found it difficult to relax
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
13. I felt down-hearted and blue
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
14. I was intolerant of anything that kept me from getting on with what I was doing
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
15. I felt I was close to panic
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
16. I was unable to become enthusiastic about anything
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
17. I felt I wasn't worth much as a person
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
18. I felt that I was rather touchy
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
19. I was aware of the action of my heart in the absence of physical exertion (eg, sense of heart rate increase, heart missing a beat)
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
20. I felt scared without any good reason
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
21. I felt that life was meaningless
(Required)
Did not apply to me at all
Applied to me to some degree, or some of the time
Applied to me to a considerable degree, or a good part of time
Applied to me very much, or most of the time
Hidden
Stress Score
Hidden
Stress Level
Hidden
Anxiety Score
Hidden
Anxiety Level
Hidden
Depression Score
Hidden
Depression Level
Please enter your email for details about what your scores mean
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