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Neurotransmitter Survey

Neurotransmitter Survey

Please check each of the sentences below that applies to you:

Part l

  • Your life seems incomplete
  • You feel shy with all but your closest friends
  • You have feelings of insecurity
  • You often feel unequal to others
  • When things go right, you feel undeserving
  • You feel something is missing in your life
  • You occasionally feel a low self-worth or self-esteem
  • You feel inadequate as a person
  • You frequently feel fearful when there is nothing to fear

Part ll

  • You often feel anxious for no reason
  • You sometimes feel “free-floating” anxiety
  • You frequently feel “edgy” and it’s difficult to relax
  • You often feel a “knot” in your stomach
  • Falling asleep is sometimes difficult
  • It’s hard to turn your mind off when you want to relax
  • You occasionally experience feelings of panic for no reason
  • You often use alcohol or other sedatives to calm down


Part lll

  • You lack pleasure in your life
  • You feel there are no real rewards in life
  • You have unexplained lack of concern for others, even loved ones
  • You experience decreased parental feelings
  • Life seems less “colorful” or “flavorful”
  • Things that used to be “fun” just aren’t any longer
  • You have become a less spiritual or socially concerned person


Part lV

  • You suffer from a lack of energy
  • You often find it difficult to “get going”
  • You suffer from decreased drive
  • You often start projects and then don’t finish them
  • You frequently feel a need to sleep or “hibernate”
  • You feel depressed a good deal of the time
  • You occasionally feel paranoid
  • Your survival seems threatened
  • You are bored a great deal of the time


Part V

  • It’s hard for you to go to sleep
  • You can’t stay asleep
  • You often find yourself irritable
  • Your emotions often lack rationality
  • You occasionally experience unexplained tears
  • Noise bothers you more than it used to; it seems louder than normal
  • You flare up at others more easily than you used to; you experience unprovoked anger
  • You feel depressed much of the time
  • You find you are more susceptible to pain
  • You prefer to be left alone

Please click here to download the Neurotransmitter Survey

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