Do you often find it difficult to sustain your attention on tasks or activities, even when they are enjoyable or important?
Yes
No
Do you frequently act impulsively, making decisions or blurting out responses without fully considering the consequences?
Yes
No
Do you often feel restless or find it challenging to sit still for extended periods, such as during meetings, classes, or while working?
Yes
No
Do you struggle with organization and time management, often misplacing items, underestimating time, or having difficulty completing tasks on time?
Yes
No
Have these difficulties with attention, impulsivity, or hyperactivity significantly impacted your daily life, relationships, or academic/work performance?
Yes
No
Do you frequently struggle to maintain focus on tasks or activities that require sustained attention, such as reading, studying, or working on projects?
Yes
No
Do you often find it challenging to stay organized, misplacing items, forgetting appointments, or failing to complete tasks because of disorganization?
Yes
No
Do you tend to procrastinate on tasks, delaying them until the last minute or avoiding them altogether due to difficulty initiating or sustaining effort?
Yes
No
Do you frequently have trouble following through on instructions, often making careless mistakes or overlooking details?
Yes
No
Have these difficulties with attention, organization, and task completion significantly affected your daily life, relationships, or academic/work performance?
Yes
No
Over the past few weeks, have you experienced persistent feelings of sadness, emptiness, or hopelessness?
Yes
No
Have you lost interest in activities or hobbies that you used to enjoy?
Yes
No
Have you experienced significant changes in your appetite or weight recently, either significant weight loss or gain without trying?
Yes
No
Have you been experiencing disruptions in your sleep patterns, such as trouble falling asleep, staying asleep, or sleeping too much?
Yes
No
Do you frequently experience feelings of worthlessness, guilt, or self-blame?
Yes
No
Do you often find yourself worrying excessively about various aspects of your life, such as work, relationships, health, or finances?
Yes
No
Have you experienced physical symptoms of anxiety, such as rapid heartbeat, sweating, trembling, shortness of breath, or stomach discomfort, without a clear cause?
Yes
No
Do you frequently avoid situations or activities that trigger feelings of anxiety or panic, even if they are necessary or important?
Yes
No
Do you find it challenging to relax or unwind, even when you're not in a stressful situation?
Yes
No
Have these symptoms of anxiety significantly interfered with your daily life, relationships, work, or school performance?
Yes
No
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