Ingrid Oliansky, Licensed Marriage and Family Therapist
MFC# 48975
Call for an appointment (818) 927-3855
Anxiety Inventory Page 3
Name:
Date:
Skipping, racing or pounding of the heart (palpitations)
Pain, pressure or tightness in the chest
Tingling or numbness of toes and fingers
Butterflies or discomfort in the stomach
Constipation or diarrhea
Restlessness or jumpiness
Tight, tense muscles
Sweating not brought on by heat
A lump in the throat
Trembling or shaky
Rubbery or "jelly" legs
Feeling dizzy, lightheaded or off balance
Choking or smothering sensations or difficulty breathing
Headaches or pains in the neck or back
Hot flashes or cold chills
Feeling tired, weak, or easily exhausted
