PCHC Positive Coping with Health Conditions
Stress Symptom TestImage

Below is a quick test to help you decide whether you have stress symptoms. In the test below, circle the number most like your feelings over the last two weeks.

Stress Symptom Test

Source: Young Q.-R., Ignaszewski A., Fofonoff D., Kaan A. (2007). Brief Screen to Identify the Five Most Common Forms of Psychosocial Distress in Cardiac Patients: Validation of the Screening Tool for Psychological Distress. Journal of Cardiovascular Nursing 22: 525-534.


If you scored 4 or more on any of these questions, then you are showing stress symptoms.

If you scored 4 or more on Question 2, then you might be dealing with low or depressed mood.

If you scored 4 or more on Question 3, then you might be dealing with worry, tension or anxiety.

If you scored 4 or more on Question 4, then you might be dealing with anger or irritability.

If you scored 4 or more on Question 5, then you might be dealing with isolation.


Now, we’re going to explain more about each of these stress symptoms and how they affect your health.

Sometimes worry and tension become so severe that a person develops an Anxiety Disorder (for example, Panic Disorder). A physician or psychologist can tell you whether you are suffering from an Anxiety Disorder. The most effective treatment for most Anxiety Disorders is a psychological treatment called Cognitive Behavioural Therapy (CBT), but these disorders may also be treated with anti-anxiety medications. The skills in this book should still be useful along with other treatments.

Worry and Tension

It’s not surprising that someone with a health condition might become worried or tense. After all, health conditions cause serious physical problems and may limit your ability to do your job or everyday chores. When you worry about problems caused by your health condition, you’re trying to figure out solutions.

But sometimes the worry and tension go too far. Worrying about health problems can become a new problem! If you experience one or more of the following, then worry and tension might be problems for you:

  • You are worrying much of the time – even when you’re trying to do enjoyable activities;
  • You feel nervous much of the time or you sometimes feel panicky;
  • You have a sense of foreboding, like you’re always expecting a disaster;
  • You feel muscle tension, restlessness, headache or nausea that aren’t caused by your health condition or medications (it can be difficult to figure this out – talk with your physician).

Excessive worry and tension don’t help you solve problems. Even though excessive worry feels like an attempt to solve problems, it’s usually not effective. There are three reasons why excessive worry is not good problem solving:

  1. Worry usually just goes in circles, and doesn’t get you closer to finding solutions.
  2. Worry often happens when you’re trying to do something else, like watch a movie with family or friends. It stops you from enjoying the moment.
  3. If you feel very tense, you won’t be very good at thinking clearly about problems. Tension makes it hard to concentrate.

The most useful skills for dealing with worry and tension are:


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Managing Worry

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Solving Problems

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Low Mood

Low Mood

If you have a health condition, you might become sad and discouraged. Perhaps you are thinking about activities you’re no longer able to do – and your mood drops. Perhaps you have reduced activities in order to avoid pain – but reduced activity makes your mood worse. Low mood is common in people with health conditions. It usually comes and goes, but it still might get in the way of your self-care. The skills in this book are useful for improving low mood.

The most useful skills for dealing with low mood are:

Activating Your Life

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Solving Problems

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Managing Depressive Thinking

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For some people, low mood doesn’t go away. Instead, it just keeps getting worse. These people have less interest in their own life as well as problems like feeling worthless or guilty. They might be suffering from depression. You can learn more about depression by going to this Web site:

When people with health conditions have depression, it’s usually what is known as mild depression. Mild depression is best handled by:

  • Keeping busy;
  • Talking to family and trusted friends;
  • Reading self-care materials, like this workbook; and
  • Talking to a physician, psychologist or counselor.

A small number of people with health conditions suffer from major depression. This is more serious. Major depression is best handled by:

  • Checking with a physician or psychologist to help figure out what’s been going on;
  • Getting treatment with antidepressant medication; or
  • Getting an equally effective treatment known as Cognitive Behavioural Therapy (CBT). CBT is a talk therapy that teaches new skills for thinking and acting more effectively.

In this workbook, we will be teaching skills for dealing with low mood or mild depression. These skills won’t be as effective when you’re dealing with major depression, but they will still be useful along with other treatments.


Irritability and Anger

It’s understandable that you might become more irritable, or even angry, when you’re dealing with a health condition. Illness often causes pain and physical symptoms that make it hard to stay calm. Physical limitations can be frustrating. As a result, you might have a short fuse when there’s conflict with a friend or family member. Or, you might find yourself carrying around resentment and frustration – like carrying a big weight on your back.

Being Irritable or Angry Can Cause Problems:

  • If you lose your temper, you might upset friends or family members, and that can harm your relationships. Maintaining relationships is very important when you have a health condition – if others pull back from you and are less willing to give you support, it’s harder to deal with your health problem. It also feels lonelier.
  • Anger causes changes in your body, such as muscle tension, nausea or increased heart rate. These changes might be bad for your health condition: someone with colitis might find that being angry triggers symptoms like cramping or gut pain; someone with chronic migraine might find that anger triggers a severe headache; etc. If you are often angry, you might be triggering the physical symptoms of your health condition – not a good idea.
  • For most people, being irritable or angry just doesn’t feel very good. Remember, you suffer enough just by having a health condition – adding more bad feelings because of anger isn’t fair.

The most useful skills for dealing with irritability and anger are:

Managing Anger

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When you are under stress from your health condition, you might have difficulty keeping a sense of connection to family, friends or others. This can happen in a few ways.

  • Maybe you’ve been withdrawing from others because of low mood or anxiety – you feel so discouraged and worried that it’s hard to be with other people. Or, maybe you think others don’t want to be around you. If you avoid social contact because of low mood or discouragement, you may find yourself cut off from others. This kind of isolation has been shown to worsen mood, which can lead to a vicious cycle:
    Low mood and discouragement -- avoiding social activity-- lower mood -- less social activity. And so on!
  • Maybe you aren’t reaching out to people because you’ve always been independent, and you find it hard to depend on others. But if you don’t reach out to others, they may not realize that you need their support.
  • Maybe you have less social support for other reasons. For example, you might have lost supportive people because of death or divorce. But no matter how it comes about, isolation is a problem and can be helped by using the skills in this book.

The most useful skill for dealing with isolation is:

Relationship Building

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