Print this page out and complete the analysis below. Then call Connected Pathways LLC for assistance with the analysis results. We will also be happy to assist you with a program that fits your needs.
SEROTONIN DEFICIENCY QUESTIONNAIRE
On a piece of paper, note the number at the left if you answer “yes” to any of the following questions, then total your points.
3 Is alcohol your drug of choice?
2 If you have used marijunana, does it have a relaxing effect ?
5 Have you ever taken prescription antidepressants, Such as Prozac, Paxil or Zoloft?
5 Have you ever gotten relief from your symptoms by taking 5-HTP or the amino acid, tryptophan?
2 Does eating high-sugar foods or processed carbohydrates relax you or relieve your anxiety, or both?
2 Do you often have the sense that you are “out of sync” or not attuned to what is going on around you?
2 Do you have a history of anxious depression – that is, feeling nervous or irritable when you are “down”?
3 Do you have a regular pattern of unexplained rages or a history of explosive or assaultive behavior?
2 Do you have a history of sleep problems, especially waking up early and not being able to get back to sleep?
2 Is there a history of depression in your family?
3 Do you often experience symptoms of gastrointestional distress, including gas, bloating, loose stools or
constipation?
11-14 points means you are probably serotonin deficient. 15 points or more means you are very probably serotonin deficient.
CATECHOLAMINE DEFICIENCY QUESTIONNAIRE
(Dopamine and Norepinephrine)
On a piece of paper, note the number at the left if you answer “yes” to any of the following questions, then total your points.
5 Is either cocaine or amphetamines your drug of choice?
1 2 3 Do yo smoke cigarettes or use nicotine in another form, such as smokeless tobacco?
1 pak a day or less - 1 point, 2 paks a day- 2 points, 3 or more – 3 points
2 Does marijuana excite you or have a “speedy” effect on you?
2 Is there a history of mania in your family?
2 Is there a history of depression in your family?
3 Do you often experience tiredness, loss of energy, or an inability to feel pleasure?
3 Are you a thrill seeker or risk taker?
5 Do you respond positively to antidepressant drugs?
5 Do you respond positively to prescription Drugs such as Ritalin, Cylert, Adderall, or Amphetamines?
11-14 points means you are probably catecholamine deficient (Dopamine). 15 points or more means you are very probably catecholamine deficient(Dopamine).
GABA DEFICIENCY QUESTIONNAIRE
On a piece of paper, note the number at the left if you answer “yes” to any of the following questions, then total your points.
2 Are sedatives or “downers” your drug of choice?
2 Is alcohol your drug of choice?
4 Does alcohol relax you, or help you sleep?
5 Have you obtained relief from symptoms of anxiety by taking prescription drugs?
5 Do you often have symptoms such as headache, irritability or dizziness when you go four or more hours without food?
3 Do you have a history of panic attacks or sever anxiety?
2 Do you have a tendency to be thin or under weight?
2 Do you have problems sleeping, especially falling asleep?
2 Do you have sugar cravings?
2 Is there a history of anxiety or panic disorder in your family?
11-14 points means you are probably GABA deficient. 15 or more points means you are very probably GABA deficient.
ENDORPHIN DEFICIENCY QUESTIONNAIRE
On a piece of paper, note the number at the left if you answer “yes” to any of the following questions, then total your points.
5 Are heroin, Darvon, codeine, methadone, or other opiates your drugs of choice?
3 Have you ever had difficulty stopping the use of pain killing drugs such as codeine, Darvon, methadone or other opiates?
2 Do you use drugs or alcohol to carve out a respite or “time out” from a very busy, active life?
3 Are you troubled by chronic pain, such as back pain or headache?
2 Do you have difficulty enjoying pleasurable experiences much of the time (and not just when you are feeling down)?
3 Do you have a low pain tolerance?
8-11 points means you are probably Endorphin deficient. 12 points or more means your are very probably Endorphin deficient.
