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.



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.

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.

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

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:
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:
www.heretohelp.bc.ca
When people with health conditions have depression, it’s usually what is known as mild depression. Mild depression is best handled by:
A small number of people with health conditions suffer from major depression. This is more serious. Major depression is best handled by:
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:
The most useful skills for dealing with irritability and anger are:

Isolation
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.
The most useful skill for dealing with isolation is:
Relationship Building |