If you’re a high-achiever, it’s likely that the first signs of stress will show up in your body as a physical illness, rather than in your mind as an emotional disturbance. Many doctors aren’t sure how to go about assessing patients for stress and are afraid that they might cause offense if they suggest that the reasons for your symptoms are psychological. The eight questions mentioned below can be a good way for family doctors and other primary-care professionals to start subtly assessing stress and mood.
1. How are you? Most doctors are trained to ask, “What’s wrong?” or “What brings you here today?” which elicits a recitation of your physical complaints. A doctor who asks a more global question may get a response that indicates stress.
2. Has anything changed in your life since your last appointment? Simply by asking this question, doctors can learn about negative sources of stress, such as the death of a friend or a separation from a spouse. The can also learn about positive sources of stress such as moving to a new house or getting a promotion at work.
3. How is your family doing? Again, this is a question that encourages you to disclose any major stressors in the family.
4. Have you noticed yourself getting more angry or irritable than usual? This question addresses both anxiety and depression, since one symptom of depression, especially among men, is a tendency to get angry more quickly than normal.
5. How have you been sleeping lately? This is another question aimed at capturing depression. Typically, people who are experiencing a major depression either have a difficult time falling asleep or wake up much too early in the morning. Some depression patients, however, prefer to sleep as much as possible. This question about sleep covers both symptoms.
6. Is anyone in your life hurting you physically, emotionally, or sexually? Doctors are now trained to ask women these questions so that, if one of their patients is being battered by a family member, they can offer assistance. Since men can also be victims of abuse, it makes sense to ask them the same question.
7. Do a CAGE assessment. A CAGE assessment is a series of four yes or no questions to screen for substance abuse problems. Typically, the questions asked in a CAGE assessment are: 1) Have you ever felt you should cut back (C) on your drinking? 2) Have people ever annoyed you (A) by criticizing your drinking? 3) Have you ever felt guilty or ashamed (G) about your drinking? and 4) Have you ever had a drink first thing in the morning (E -eye-opener)?
8. Finally, it’s a good idea to ask the patient to rate his or her own anxiety level and mood. For instance, a doctor might say, “On a scale of 1 to 10, with one being almost zero stress, and ten being the most stress you can imagine, how would you rate your stress level on an average day?”
Asking any or all of these eight questions can help doctors pick up on physical disorders that may be rooted in stress, depression, or substance abuse. Picking up on these disorders early allows the doctor to make a referral so his or her patient can receive counseling and get back on the path to feeling healthy again.