About Stress...

and what you can do about it--

Stress could be said to be the result of a person's attempt to adapt to a difficult or unpleasant situation. Stress is not the situation itself, so much as how we respond to that situation.

Excessive stress can affect both your mental and physical health.

Normal stress causes a number of body responses in order to help you to cope. Your heart beats faster, your blood pressure rises, your adrenalin level rises, and your perspiration increases. Breathing becomes rapid or shallow. The liver releases stored sugar into the blood to meet the increased energy needs for survival.

The pupils dilate to let in more light. All senses are heightened. Concentration narrows to the source of threat. Muscles tense for movement. Blood flow to the digestive organs is greatly constricted. Blood flow increases to the brain and major muscles. Blood is constricted to the extremities and the hands and feet become cold. You are ready for a fight-or-flight response.  

However, in the modern world, we don't generally cope by using physical responses, so these body states have nowhere to go, so to speak. If we are continually in this physical state, our health begins to suffer.

Some stress is actually enjoyed by many people. Consequently, they may engage in competitive sports, or bet on a game, in order to experience the resulting stress. Stress resulting from negative life events can affect people differently, depending on how they respond to those events.

Part of the art of life is learning to respond to it in a way that minimizes the degree of stress it places on us. Some common techniques for dealing with stress include exercise, meditation, yoga, and self-hypnosis.

An enjoyable hobby is also a way of relieving stress, such that you are better able to cope when you return to your problem-solving activity. Take time off. Go on a vacation.


This test, created by Dr. George S. Everly Jr., of the University of Md. tells you how well you are coping with the stress in your life.

Do you feel that you have a supportive family around you? (add 10)

Do you actively pursue a hobby? (add 10)

Do you belong to some social or activity group that meets at least once a month? ( add 10)

Are you within 16 pounds of your ideal weight? (add 15)

Do you practice some form of deep relaxation at least three times a week? Deep relaxation exercises include meditation, imagery and yoga. (add 15)

Do you exercise 30 minutes or longer during the course of an average week? (add 15)

Do you eat nutritionally balanced and wholesome meals regularly during an average week? (add 5)

Do you do something you really enjoy, just for you, during the course of an average week? (add 5)

Do you practice time-management techniques in your daily life? (add 10)

Do you have some place in your home where you can go an relax and/or be by yourself? (add 10)

Do you take any form of medication or chemical substance to help you sleep? (subtract 5)

How many days in the week do you bring work home? (Subtract 10 for each day)

80+ You should be able to handle it.

60-75 Generally adequate

60- Consider changing your lifestyle.


Assign a number from 0 to 5 to the following, indicating the degree of change you have noticed over the last 6 months, with 0 meaning No, 5 meaning Very, to indicate the degre of change you perceive.

1. Do you tire more easily? Feel fatigued rather than energetic?

2. Are people annoying you by telling you that you don't look so good lately?

3. Are you working harder and accomplishing less?

4. Are you increasingly cynical and disenchanted?

5. Are you often invaded by a sadness you can't explain?

6. Are you forgetting? (Appointments, deadlines, personal possessions.)

7. Are you increasingly irritable? More short-tempered? More disappointed in the people around you?

8. Are you seeing close friends and family members less frequently?

9. Are you too busy to do even routine things like make phone calls or read reports or send out your Christmas cards?

10. Are you suffering from physical complaints? (aches, pains, headaches, a lingering cold)

11. Do you feel disoriented when the activity of the day comes to a halt?

12. Is joy elusive?

13. Are you unable to laugh at a joke about yourself?

14. Do you have very little to say to people?

Total possible points: 70. 0-25, you're doing fine. 26-35, there are things you should be watching. 36-50, you're a candidate for burnout. 51-65, you're burning out. Over 65, you're in a dangerous place, threatening to your physical and mental well-being.


1. Exercise...If you feel tired, exercise will revive you. Get out and run, walk, or work out in a gym.

2. Leave your work at the workplace.

3. Develop a hobby that takes your mind off the tensions of the school day.

4. Get plenty of sleep. Go to bed to sleep. (See the page on sleep if you have problems.)

5. Don't feel guilty because you haven't lived up to your ideal of the perfect (...) (whatever you do for a living.)

6. Keep a daily diary of wacky things that happen.

7. Don't worry. That has never undone a wrong or prevented a problem.

8. Learn to say no.

9. Be good to yourself. Take yourself out and treat yourself.

10. Always have something to look forward to.

11. Do something in your spare time that you have always dreamed of doing.

12. Keep learning. Read. Learn to do something different.

13. Travel.

14. Don't schedule all your leisure hours.

15. Take a leave of absence, do something completely different.

16. Set realistic and flexible goals for yourself.

STRESS: "That confusion created when the mind overrides the body's overwhelming desire to choke the living daylights out of some jerk who desperately deserves it." --anon.

The following test was developed by psychologists Lyle Miller and Alma Dell Smith at the Boston University Medical Center.

Select from: almost always (1), usually (2), about half the time (3), seldom (4), and never (5)

1. I eat at least one hot, balanced meal a day.

2. I get 7 to 8 hours of sleep at least 4 nights a week.

3. I give and receive affection regularly.

4. I have at least one relative, within 50 miles, on whom I can rely.

5. I exercise to the point of perspiration at least twice a week.

6. I smoke less than half a pack of cigarettes a day.

7. I take fewer than five alcoholic drinks a week.

8. I am the appropriate weight for my height.

9. I have an income adequate to meet basic expenses.

10. I get strength from my religious beliefs.

11. I regularly attend club or social activities.

12. I have a network of friends and acquaintances.

13. I have one or more friends to confide in about personal matters.

14. I am in good health (including eyesight, hearing and teeth.)

15. I am able to speak openly about my feelings when angry or worried.

16. I have regular conversations with the people I live with about domestic problems.

17. I do something for fun at least once a week.

18. I am able to organize my time effectively.

19. I drink fewer than three cups of coffee (or tea or cola) a day.

20. I take quiet time for myself during the day.

Subtract 20 from your total, and you have your score. The maximum possible is 80. 60 would be highly stressed. 40 would be about average, and 20 would mean you are doing better than most. If you score zero, the world would like to know your secret.


* Start off the day with breakfast, and allow yourself time to really enjoy it. Breakfast can help you avoid a mid-day "energy slump," and might allow your appetite to be less voracious at lunch, too.

* Get up early to allow yourself time. (Read the paper, go for a jog.) The simplest trick to getting up early, is to go to bed on time to do that.

* Get your clothes ready the night before. This could even include tying your tie the night before, putting things in your pockets before you go to bed, and even shaving before bedtime.

* Plan crockpot meals, to cut down on actual preparation at meal time.

* Avoid drinking coffee or soft drinks all day; drink water or fruit juice instead. If you think you "don't like water," try drinking various brands of bottled water. Try putting a little lemon juice in cold water. Or add lemon juice and a sweetener like Stevia. Excess sugar is bad for the health.

* Organize your work by setting priorities. Accept that you can't do everything in a day.

* For one week, write down everything you actually do, no matter how trivial. Then analyze what you have written. Is there actually time to do everything on your "to do" list? Are there things you could change, that would increase your available time?

* Write things down, don't overburden your memory.

* Don't try to be perfect at all times, or to do three or four things at once.

* Reduce the noise level, if possible. Rugs or draperies can help.

* Speak up about petty annoyances while respecting the other's feelings.

* Develop co-worker support networks.

* Don't take your job with you on breaks. Take time for yourself.

* Occasionally go to lunch with a co-worker or friend.

* Monitor your work/recreation balance. Are changes needed?

* Consider changing your job or having your job responsibilities changed to better meet your interests and skills.

* Be assertive, learn how to express differences or say "no" constructively. A course in assertiveness training may be helpful. A book called "When I Say No I Feel Guilty" is helpful, too.

* Begin a healthier lifestyle-- get plenty of sleep, eat balanced meals, and exercise regularly.

* Hold informal meetings with employees to discuss their job concerns and long-term goals.

* Do what you can to help employees achieve their long-term goals.

* Use non-destructive, non put-down humor to keep daily challenges in perspective. Find ways to laugh at yourself without devaluing yourself.

* Take up a hobby that helps take your mind off work. Encourage employees to do the same.

* Limit your intake of alcohol. One flavorful "near beer" is O'Doul's, which tastes a lot like the real thing. O'Doul's Amber is even more so, and can be found at bigger stores.

The following is called the STRESS CHECK UP:

1. What are my goals in life? How realistic are they? How clear are they? How clear do I want them to be?

2. Is my use of time and energy helping me to reach those goals?

3. Do I have a proper sense of responsibility or do I try to do too much and fail to acknowledge my limitations?

4. How do I react to disappointments and losses?

5. How am I coping with stress and anxiety?

6. What is the consistency and quality of my personal relationships? Are my contacts with others superficial, meager, or unrewarding?

7. From whom do I receive and to whom do I give emotional support? Do I avoid getting support from others for fear of appearing weak?

8. What is the role of love in my life? How much time do I give to listening to and caring to for others?


A professor of mine once suggested I keep notes on what I do with a day's time. I said I already do, showing him my to-do list scratched on the back of my notebook.

He said, "Not what you plan to do, but what you actually do." After that I began writing down when I eat, when I sleep, when I watch TV or anything else. I was surprised at what I found.

I discovered I spent a couple of hours a day walking to the cafeteria and back, so I bought a bicycle. I spent several hours a week walking to a pay telephone, so I installed a telephone. I decided not to watch less TV, but that was a conscious, deliberate decision. With my bicycle I also got to class more quickly, and so could leave the house later. Most of my activities I kept the same, but I had a couple more hours a day than I had had before.

However, I discovered I was writing into my to-do list far more than I could do in a day, and then feeling bad about not getting most of it done. It appeared I could do maybe 3 things in a day outside my routine, so I set my goals a little lower, and decided not to feel so bad if I did not get everything done in a day I might have liked to.

In this way I got a little bit more done, and at the same time lowered my stress level.

Gene Douglas


Give yourself the number of points indicated after the question. Notice that even good things can be stressful. Also note that things that happen to you do not determine your level of stress. How you handle them determines how much stress they will cause for you.

If you score 300, you are likely to have a serious illness within the next year. If you score 200, your stress level is average. If your score is not over 100, you are doing very well, indeed.

1. death of a spouse (100)

2. divorce (73)

3. marital separation (65)

4. jail term (65)

5. death of close family member (63)

6. personal injury or illness (63)

7. marriage (50)

8. fired at work (47)

9. marital reconciliation (45)

10. retirement (45)

11. change in health of family member (44)

12. pregnancy (40)

13. sex difficulties (39)

14. gain of a new family member (39)

15. business readjustment (39)

16. change in financial status (38)

17. death of a close friend (37)

18. change to a different line of work (36)

19. change in number of arguments with spouse (35)

20. mortgage over 60,000 (31)

21. forcloseure of mortgage or loan (30)

22. change in responsibilities (29)

23. son or daughter leaves home (29)

24. trouble with in-laws (29)

25. outstanding personal achievement (28)

26. spouse begins or stops work (26)

27. begin or end school (26)

28. change in living conditions (25)

29. revision of personal habits (24)

30. trouble with work environment (23)

31. change in work hours or conditions (20)

32. Change in residence (21)

33. change in schools (20)

34. change in life style (19)

35. change in church activity (19)

36. change in social activities (18)

37. mortgage or loan less than $60,000 (17)

38. change in sleeping habits (16)

39. change in number of family get-togethers (15)

40. change in eating habits (16)

41. vacation (13)

42. Christmas (12)

43. minor law violations (11)

44. difficulty with supervisor on the job (20)

45. Feeling unable to learn a new task (15)

46. disagreement with friends frequently (10)

47. inability to get adequate sleep on a regular basis (15)

48. loss of close personal friends (20)

49. unwilling to discuss issues. (20)

50. frequent use of alcohol to calm self (35)


The Stanley-Oliver fine mess stress scale

These stressful events will probably not cause you to contract a major mental illness; but if enough of them happen in one day, you may:

a. Fall down and scrape the knees out of your new pants.

b. Back your car into a guard rail.

c. Start to cry during your presentation to the board

d. Lose control of your vocabulary.

If any seven of the following happen to you before 8 a.m., go directly home, get into bed, and administer large doses of murder mysteries, hot soup and daytime TV.

1. Unexplainable rent decrease

2. Monday

3. Ending housecleaning

4. Change in hemlines

5. Change in label-and-tie widths

6. Change in hairline

7. Change in pollen count

8. Beginning housecleaning

9. Trouble with cockroaches

10. Getting a parking ticket

11. Death of an African violet

12. Inability to grow bean sprouts

13. No place to park

14. Power failure

15. Disagreement with a dog

16. Inability to eat bean sprouts

17. Inability to like yogurt

18. Running out of gas

19. Locking keys in car

20. Loss of hubcaps

21. Loss of a shoe

22. Change in laundromat prices

23. Change to a different line of reasoning

24. Forgetting your lunch

25. Writer's cramp

26. Pets leaving home

27. Rent increase

28. Identity crisis

29. Gum on your shoe

30. Children's birthday party

31. Discovery of large patch of grey hair

32. Previously undetected toilet paper on your shoe

33. Gum in your hair

34. Loss of sense of humor

35. Accidentally turning a fire hydrant on a friend

36. Loss of battery and wheels

37. Fall of arches

38. Thawing of freezer contents due to power failure

39. Fall into mud puddle

40. Inability to locate draft of annual report

41. Failure to sell anything in a garage sale

42. Spilling coffee on the boss

43. Loss of someone to flirt with

44. Inability to locate bad smell in refrigerator

45. Failure to order beer for today's TGIF

46. Being towed

47. Writer's block

48. Watching your Volkswagen burn

49. Angst

50. Inability to define "angst."

10 Ways To Control Stress

1. Set realistic goals and priorities: Identify those things you must do first.

2. Organize your time in accordance with those priorities.

3. Learn to say "No" when asked to do something stressful, if it is honestly your preference not to do it. (See page on assertion)

4. Recognize that some stress is unavoidable -- it's part of life.

5. Make a list of stressful situations in your life.

6. Divide the list into things you can't avoid or control, and things you can hope to influence.

7. Use your time and talents effectively to address those stressful situations you can change.

8. Don't waste your energies in a frustrating attempt to conquer what you can't control.

9. Don't be afraid to ask questions, solicit suggestions, and share your problems with certain trusted others.

10. Do allow yourself time out -- to enjoy personal interests or just to smell the roses.

How You Can Tell When It's Going To Be A Rotten Day

* You wake up with your face down on the pavement.

* You put your bra on backward, and it fits better.

* You call Suicide Prevention, and they put you on hold.

* You see a "60 Minutes" news team waiting for you in your office.

* Your birthday cake collapses from the weight of the candles.

* You want to put on the clothes you wore home from the party, and there aren't any.

* You turn on the news, and they're showing emergency routes out of the city.

* Your twin sister forgot your birthday.

* You wake up and discover your waterbed broke, and then realize that you don't have a waterbed.

* Your car horn goes off accidentally, and remains stuck as you follow a group of Hell's Angels on the freeway.

* Your wife wakes up feeling amorous and you have a headache.

*Your boss tells you not to bother to take off your coat.

* The bird singing outside your window is a vulture.

* You wake up and your braces are locked together.

* You walk to work, and find your dress is stuck in the back of your pantyhose.

* You call your answering service and they tell you it's none of your business.

* Your blind date turns out to be your ex-wife.

* Your income tax check bounces.

* You put both contact lenses in the same eye.

* Your pet rock snaps at you.

* Your wife says, "Good morning, Bill," and your name is George.


Do you have little or no control over your job, how it's defined, and/or how you're supposed to perform it?

Are you often overworked (e.g. could you do a better job if you had more time?)

Is it harder to make decisions at work?

Has the quality of your work deteriorated (e.g. do you make excuses to cover up poor work?)

Are you unable to keep up with new equipment or methods that your job requires?

Has your company recently reorganized, merged with, or been taken over by another company, which you feel significantly threatens your job?

Do you feel that management and/or your co-workers are openly or covertly biased against a category you occupy? (i.e. older workers, females, your department)

Is it harder for you to go to work (e.g. do you sometimes go to work late or take days off because you don't feel up to it?)

Do you find yourself losing your temper at work over things you know to be trivial?

Have you suddenly become accident-prone?

Are you drinking more during or after work?

Are you experiencing physical symptoms that occur only, or are more pronounced, at work?

3 or more "yes" answers: Some degree of stress.

5 or more "yes" answers: Enough stress to threaten your career.


On a scale of 1 to 4, rate how strongly you identify with the following statements, 0 meaning not true at all, 1 meaning hardly true, 2 meaning somewhat true, 3 meaning very true, and 4 meaning completely true.

1. I am angered by others' undesirable behavior.

2. I feel trapped by circumstances, demands and obligations.

3. I have a need to do "more" and "better."

4. I put off doing things I feel I ought to do.

5. I experience insecurity and anxiety about my future.

6. I have a need for more love and caring.

7. I have a need for recognition and respect.

8. I have a need to meet others' requests and expectations.

9. I resent unfair situations and events.

10. I do not get the recognition and credit I feel I deserve.

11. I have a need for attention and approval.

12. I find responsibility difficult to handle.

13. I need the confirmation and agreement of others.

14. I find my life unfulfilling and meaningless.

15. I feel inadequate, inferior, unworthy and guilty.

16. I am impatient and easily frustrated.

17. I have a need to prove my worth.

18. I find it to make decisions and stick to them.

19. I am harsh and demanding with myself.

20. I have a need to control situations and events.

21. I blame myself for mistakes, defeats and failures.

22. I experience anxiety when undertaking new endeavors.

23. I worry about my work and my loved ones.

24. I have a need to win - to be the "best"

25. I fear others will discover my faults and inadequacies.

100 is the maximum possible.

26-74 is average.

75 indicates a high level of stress in your life.

0-25 indicates that your stress level is low.


1. Learn to plan - disorganization breeds stress. Having too many projects at the same time often leads to confusion, forgetfulness, and pressure.

2. Recognize and accept limits. We can never be perfect, so we may develop a sense of failure and inadequacy no matter how well we perform. Set achievable goals. Measure progress in small steps.

3. Have fun - you occasionally need to escape from the pressures of life.

4. Be a positive person. Avoid criticizing others. Learn to praise the things you like in others.

5. Learn to be tolerant and forgiving. Intolerance leads to frustration and anger.

6. Avoid unnecessary competition.

7. Get regular physical exercise.

8. Meditate three 10 minute periods a day. Learn self-hypnosis.

9. Improve relationships, communication and discipline with kids.

10. Work on yourself, decide on realistic personal goals. Consider weight loss, schooling, job improvement, hobbies, new friends, vocational assessment. Don't let life just happen to you, by being a reactor.

11. Limit your intake of coffee and cigarettes.

12. Discuss your feelings with the person you are having problems with.

13. Consult a doctor if your feelings of stress are constantly interfering with your everyday life. Your health and peace of mind come before everything else.

14. Book trips so that you have some spare time in your schedule.

15. Eat lightly when travelling, so you digestive tract doesn't face a challenge.

16. Keep up your physical fitness program while on your trip.

17. Be prepared for surprises: broken down phones, lost luggage, etc.

18. Understand your values. Take the priorities test further down on this page.


Breakfast: 1/2 grapefruit, 1 slice whole wheat toast, 8 oz skim milk

Lunch: 4 oz lean broiled chicken breast, 1 cup steamed zuccchini, 1 Oreo cookie, Herb tea

Mid-afternoon snack: Rest of the package of Oreos. 1 quart of Rocky Road ice cream, 1 jar hot fudge.

Dinner: 1 loaf garlic bread, large pepperoni pizza, pitcher of beer, 3 Milky Way candy bars

Bedtime snack: 1 frozen cheesecake, eaten directly from freezer.


1. If no one sees you eat it - it has no calories.

2. If you drink a diet soda with a candy bar, they cancel each other out.

3. When eating with someone else, calories don't count if you both eat the same amount. If you eat less than the other person, you can have a free snack later, of double the amount you underate.

4. Food used for medicinal purposes NEVER counts, such as hot chocolate, brandy, toast, and Sara Lee cheese cake.

5. If you fatten up everyone around you, then you look thinner.

6. Movie related foods don't count, because they are simply a part of the entire entertainment experience and are not a part of one's personal fuel.

7. Cookie pieces (crumbkies) contain NO calories. The process of breakage causes caloric leakage.

8. Food eaten in several small servings has fewer calories than food eaten in a single large serving.

9. It is possible to exceed your planned caloric intake today, by counting the excess against tomorrow's planned intake. Accumulating a "calorie debt" beyond a year, however, may create problems.


Rank the following in the order of their importance to you:

Having a happy, meaningful marriage or primary love relationship.

Investing in spiritual growth or your relationship with a supreme being.

Maintaining good physical health by proper diet, exercise, physical fitness

Investing time and energy into parenting happy, well-adjusted kids.

Spending time in recreation, fun, relaxation. Having a good time.

Building meaningful friendships, having a good support system.

Becoming famous, gaining recognition and status.

Investing in your own self-worth, personal growth, self-actualization.

Becoming independent, self-sufficient, having your own identity.

Finding adventure and excitement in your life.

Emotionally gaining internal peace, comfort, and security.

Gaining financial security, a successful job or career.

Serving others, making the world a better place for others.

Now, make a list of how you are spending your time, with each of the above items. Rank them according to the number of your waking hours (16 hours a day, 8 waking hours on work days).

How well does the way you spend your time match with what you value?


Rate yourself using a scale of 1 to 4. 1 means always true, and 4 means never true for you.

1. I love a challenge. The more demanding, the better.

2. I speak rapidly

3. I get right to the point. I dislike having to explain details to someone.

4. I hate deadlines. They put me under pressure.

5. Anything worth doing is worth doing well.

6. Other people would describe me as impatient.

7. My hands fidget constantly when I am listening.

8. I know what I want, and I go for it.

9. I walk fast, with a sense of purpose.

10. I "blow up" frequently.

11. Questionnaires like this one annoy me.

12. I have to be nearly dying to stay in bed.

13. I get angry when I can't fix something.

14. I have trouble sleeping.

15. I like to get things done right away so they aren't hanging over my head.

16. I am always in a hurry.

17. I drive fast, and often pass other cars. I get tense if I am stuck in traffic.

18. when I am given several tasks at once, I get uptight.

19. I usually do more than one thing at a time (talk on the phone and read the mail, watch TV and read the paper, etc.)

20. My desk is cluttered.

21. I am a "packrat." The more things I have, the better.

22. I like to keep busy.

23. I get annoyed with people who beat around the bush or won't get to the point.

24. I use my days off to do work around the huse, like weeding or washing the car. After all, somebody has to do it!

25. I feel I will never get caught up.

If you choose mostly 1's and 2's, consider using some techniques for coping with stress that will help lessen the effects of stress on your health. Read "Type A Behavior and Your Heart."


(Relates to the book, "Type A Personality and Your Heart.")

Rate yourself regarding the following elements. The left column is type B. The right column is type A. So you would be very A, somewhat A, somewhat B or very B.

1. Doesn't mind leaving things temporarily unfinished ...... Must get things finished once started.

2. Calm and unhurried about appointments ..... Never late for appointments.

3. Not competitive...... Highly competitive.

4. Listens well, lets others finish speaking ..... Anticipates others in conversations (nods, interrupts, finishes others' sentences).

5. Never in a hurry, even when pressured ...... Always in a hurry.

6. Able to wait calmly. ............................... Agitated over waiting.

7. Easygoing .............................................. Always going at full speed.

8. Take things one at a time. ...................... Does more than one thing at a time. Anticipates next move.

9. Slow and deliberate in speech. .......................Vigorous and forceful in speech and gesture.

10. Concerned with satisfying self, not others. ... Wants recognition from others.

11. Slow in doing things. .................................... Fast in actions (eating, walking, etc.)

12. Easygoing. .................................................. Hard driving.

13. Expresses feelings openly. ............................ Holds feelings in.

14. Has large number of interests. ...................... Few interests outside of work.

15. Satisfied with job. ........................................ Ambitious, perfectionistic.

16. Never sets own deadlines. ............................ Often sets deadlines.

17. Feels limited responsibility. .......................... Always feels responsible.

18. Does not judge in terms of numbers. ............. Judges performance by numbers (how many, etc.)

19. Casual about work (works overtime at home). ..... Takes work very seriously (stays late at office, pushes to finish before closing, etc.)

20. Not very precise. ......................................... Very precise and detailed.

One last note: Support groups can go far to alleviate stress.

* Sometimes this can be your family-- do you spend quality time, actually interacting with your family in a pleasurable way?

* Does too much of your family time consist of work, separate entertainment, or quarreling? Do you eat meals together? Do you watch TV as you eat? Do you work different shifts?

* Do you have a group at church or a social club that eats lunch together at least once a week?

* If drinking is a problem, AA can provide a very helpful support group.

Finding your ACE Score (Adverse Childhood Events)

While you were growing up, during your first 18 years of life:

1. Did a parent or other adult in the household often or very often...

Swear at you, insult you, put you down, or humiliate you?


Act in a way that made you afraid that you might be physically hurt?

Yes                                                                                                                                             No If yes enter 1_____

2. Did a parent or other adult in the household often or very often...

Push, grab, slap, or throw something at you?


Ever hit you so hard that you had marks or were injured?

                                                                                                                                                    Yes No If yes enter 1_____

3. Did an adult or person at least 5 years older than you ever...

Touch or fondle you or have you touch their body in a sexual way?


Attempt or actually have oral, anal, or vaginal intercourse with you?       If yes enter 1_____

4. Did you often or very often feel that...

No one in your family loved you or thought you were important or special?


Your family didn’t look out for each other, feel close to each other, or support each other?

                                                                                                                                                     Yes No If yes enter 1_____

5. Did you very often feel that...

You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?


Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

                                                                                                                                                      Yes No If yes enter 1_____

6. Were your parents ever separated or divorced?

                                                                                                                                                      Yes No If yes enter 1_____

7. Was your mother or stepmother...

Often or very often pushed, grabbed, slapped, or had something thrown at her?


Sometimes, often, or very often kicked, bitten, hit with a fist,or hit with something hard?


Ever repeatedly hit at least a few minutes or threatened with a gun or knife?

                                                                                                                                                       Yes No If yes enter 1_____

8. Did you live with anyone who was a problem drinker or alcoholic or

who used street drugs?

                                                                                                                                                       Yes No If yes enter 1_____

9. Was a household member depressed or mentally ill, or did a household member attempt suicide?

                                                                                                                                                       Yes No If yes enter 1_____

10. Did a household member go to prison?

                                                                                                                                                       Yes No If yes enter 1_____

Now add up your “Yes” answers: _____ This is your ACE score. If your score was 4 or higher:

You will be 242% more likely to smoke,

222% more likely to be obese, 298% more likely to contract an STD,

443% more likely to become addicted to illicit drugs,

555% more likely to develop alcoholism,

157% more likley to develop cancer,

285% more likely to develop heart disease, and

1220% more likely to attempt suicide.


1. The past is gone. It can never be changed.

2. The present moment is all that ever exists.

3. Our history does not automatically determine our life. We can change our outcomes.

4. If we know that a regrettable past has an influence over our present, we have the power to change that.

5. Stress is not what happens to us -- it is how we react to what happens to us. We can alter that reaction, if we are conscious of it.

Safe Coping Skills

Ask for help--Reach out to someone safe.

Inspire yourself. Carry something positive (e.g. poem) or negative (e.g. photo of friend who overdosed.)

Leave a bad scene--When things go too wrong to tolerate, get out.

Persist--Never, never, never, never, never, never, never give up.

Honesty--Secrets and lying are at the core of PTSD and substance abuse; honesty heals those.

Cry Let yourself cry; it will not last forever.

Choose self-respect. Choose whatever will make you like yourself tomorrow.

Take good care of your body. Healthy eating, exercise, safe sex.

List your options In any situation, you have choices.

Create meaning Remind yourself what you are living for: Your children, love, truth, justice? God?

Do the best you can with what you have. Make the most of available opportunities.

Set a boundary. Say "no" to protect yourself.

Compassion--Listen to yourself with respect and care.

When in doubt, do what's hardest. The most difficult path may be the right one.

Talk yourself through it. Self talk helps in difficult times.

Imagine Create a mental picture that helps you to feel different. (e.g. remember a safe or comfortable place.)

Notice the choice point. In slow motion, notice the exact moment when you chose a substance, or bad habit, or a choice you knew would be harmful to yourself.

Pace yourself. If overwhelmed, go slower, if stagnant, go faster.

Stay safe. Do whatever you must to put your safety above all.

Seek understanding, not blame. Listen to your behavior. Blaming prevents growth.

If one way doesn't work, try another. As if in a maze, turn a corner and try a new path.

Link PTSD and substance abuse. Recognize substances as a poor attempt to self medicate.

Alone is better than a bad relationship. If living or dining alone are safe for now, that's O.K.

Create a new story. You are the author of your life. Be the hero who overcomes adversity.

Avoid avoidable suffering. Prevent bad situations in advice.

Ask others. Ask others if your belief or hunch is accurate.

Discovery. Find out whether your assumption is true, rather than "staying in your head."

Get organized. You'll feel in control with "to do lists" and a clean house.

Watch for danger signs. Face a problem before it becomes huge. Notice red flags.

Healing above all. Focus on what matters.

Try something, anything. A good plan today is better than a perfect one tomorrow.

Attend treatment AA, self help, therapy, medications, groups -- anything that keeps you going.

Create a buffer. Put something between yourself and danger. (e.g. time, distance, a person.)

Say what you really think. You'll feel closer to others (but only do this with safe people.)

Listen to your needs. No more neglect--really hear what you need.

Move toward your opposite. For example, if you are too dependent, try being more independent.

Replay the scene. Review a negative event. What can you do differently next time?

Notice the cost. What is the price of substance abuse (or other bad habits) in your life?

Structure your day. A productive schedule keeps you on track and connected to the world.

Set an action plan. Be specific, set a deadline, and let others know about it.

Protect yourself. Put up a shield against destructive people, bad environment and influences.

Soothing talk Talk to yourself gently, as if to a friend or a small child.

Think of the consequences of bad choices. Really see the impact for tomorrow, next week or next year.

Trust the process. Just keep moving forward. The only way out is through.