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Mental Health Self-Assessment Questionnaire

Instructions: Answer each question based on how you have felt over the past two weeks. Choose the response that best describes your experience:

Never (0 points)
Sometimes (1 point)
Often (2 points)
Always (3 points)

Anxiety Disorder

Do you frequently feel excessive worry or fear that is difficult to control?"

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you experience restlessness or feeling on edge?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you have difficulty concentrating due to anxious thoughts?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you experience physical symptoms like rapid heartbeat, sweating, or shaking without a clear cause?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you avoid situations or places due to fear or anxiety?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Depression

Have you felt down, hopeless, or uninterested in things you usually enjoy?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you struggle with low energy or fatigue most days?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Have you noticed changes in your appetite or weight (increase or decrease)?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you have trouble sleeping or sleep too much?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you experience frequent thoughts of worthlessness, guilt, or self-blame?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

ADHD (Attention-Deficit/Hyperactivity Disorder)

Do you often struggle to stay focused on tasks or conversations?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you frequently forget important tasks or appointments?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you have difficulty staying still or feel the need to move constantly?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you act impulsively, such as interrupting others or making decisions without thinking?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you find it hard to complete projects, even when they interest you?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Bipolar Disorder

Have you experienced periods of extreme highs (elevated mood, racing thoughts, excessive energy)?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you experience periods of extreme lows, similar to depression?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Have you engaged in risky or impulsive behaviors during high-energy periods?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do your mood swings cause problems in relationships or work?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you have trouble sleeping due to racing thoughts or excessive energy?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

PTSD & Trauma

Do you have distressing flashbacks or nightmares about a past traumatic event?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you feel constantly on edge, easily startled, or hypervigilant?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you avoid people, places, or situations that remind you of past trauma?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you experience emotional numbness or difficulty feeling positive emotions?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you have trouble trusting others due to past experiences?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Scoring Guide:

0-5: Symptoms may not indicate a significant concern.
6-10: Mild symptoms—consider monitoring and self-care strategies.
11-15: Moderate symptoms—seeking professional guidance is recommended.
16+: Severe symptoms—strongly consider reaching out to a mental health professional.

Next Steps: If your score suggests moderate to severe symptoms, consider booking a consultation with a licensed therapist. JB Counseling Services, LLC welcomes new clients and provides tailored support for anxiety, depression, ADHD, bipolar disorder, and trauma-related concerns.

This quiz is not a diagnostic tool. It is intended for informational purposes only.

Mental Health Self-Assessment Questionnaire

Instructions: Answer each question based on how you have felt over the past two weeks. Choose the response that best describes your experience:

Never (0 points)
Sometimes (1 point)
Often (2 points)
Always (3 points)

Anxiety Disorder

Do you frequently feel excessive worry or fear that is difficult to control?"

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you experience restlessness or feeling on edge?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you have difficulty concentrating due to anxious thoughts?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you experience physical symptoms like rapid heartbeat, sweating, or shaking without a clear cause?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you avoid situations or places due to fear or anxiety?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Depression

Have you felt down, hopeless, or uninterested in things you usually enjoy?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you struggle with low energy or fatigue most days?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Have you noticed changes in your appetite or weight (increase or decrease)?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you have trouble sleeping or sleep too much?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you experience frequent thoughts of worthlessness, guilt, or self-blame?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

ADHD (Attention-Deficit/Hyperactivity Disorder)

Do you often struggle to stay focused on tasks or conversations?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you frequently forget important tasks or appointments?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you have difficulty staying still or feel the need to move constantly?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you act impulsively, such as interrupting others or making decisions without thinking?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you find it hard to complete projects, even when they interest you?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Bipolar Disorder

Have you experienced periods of extreme highs (elevated mood, racing thoughts, excessive energy)?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you experience periods of extreme lows, similar to depression?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Have you engaged in risky or impulsive behaviors during high-energy periods?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do your mood swings cause problems in relationships or work?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you have trouble sleeping due to racing thoughts or excessive energy?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

PTSD & Trauma

Do you have distressing flashbacks or nightmares about a past traumatic event?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you feel constantly on edge, easily startled, or hypervigilant?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you avoid people, places, or situations that remind you of past trauma?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you experience emotional numbness or difficulty feeling positive emotions?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Do you have trouble trusting others due to past experiences?

Never (0 points)

Sometimes (1 point)

Often (2 points)

Always (3 points)

Scoring Guide:

0-5: Symptoms may not indicate a significant concern.
6-10: Mild symptoms—consider monitoring and self-care strategies.
11-15: Moderate symptoms—seeking professional guidance is recommended.
16+: Severe symptoms—strongly consider reaching out to a mental health professional.

This quiz is not a diagnostic tool. It is intended for informational purposes only.