Stress and Anxiety

Anxiety Screening Tool

Understanding your stress and anxiety level is the first step to coping with it.

Eustress vs. Distress

Some stress in life is normal. Occasionally, it can be quite intense. Recall the feeling before writing an exam or speaking in public. The unique sensation is due to adrenaline from the sympathetic nervous system and its potent effects on many organs simultaneously. It makes your heart pound, your skin sweat, it increases your alertness, and decreases your reaction times. To feel anxious in this way is normal in some circumstances and is a healthy response to stressful situations. We call this "eustress" or "good stress." With practice, we can train ourselves to embrace it and see it as a sign that we're doing something important and have an opportunity to excel.

However, sometimes stress can be prolonged due to an underlying cause that is persistent or due to an inability to gain sufficient distance from the trigger. If the symptoms of stress persist, they can affect our wellbeing and in some cases, our ability to function normally. In such cases, this is "distress," or extreme anxiety, and it typically represents a medical condition.

Uncontrolled anxiety can present in many ways. Poor sleep, inability to relax, and irritability are often the first symptoms. Some individuals have somatic (body) symptoms such as palpitations, chest pain, shortness of breath, or tingling sensations. It can also affect perception, sometimes resulting in a sensation that things aren't real (known as derealization). These symptoms can be alarming and occasionally result in patients presenting to the emergency department.

If any of these symptoms are familiar or if you feel that something is off with your ability to relax, read on. Try to be objective and consider any symptoms you have that seem new or bothersome. If you feel that your symptoms are affecting your quality of life, consider using a screening tool such as the GAD-7 to get an objective (albeit simplified) measure of your anxiety.

GAD-7 Anxiety Screening Tool

Generalised Anxiety Disorder Assessment (GAD-7)

Over the past two weeks, how often have you been bothered by the following problems?

at all (+0)
days (+1)
More than
one half of
the days (+2)
every day (+3)
Feeling nervous, anxious, or on edge
Not being able to stop or control worrying
Worrying too much about different things
Having trouble relaxing
Being so restless that it is hard to sit still
Becoming easily annoyed or irritable
Feeling afraid, as if something awful might happen
Total GAD-7 score =
Score Interpretation
0-4 Minimal anxiety
5-9 Mild anxiety
10-14 Moderate anxiety
15-21 Severe anxiety
Results should always be discussed with a physician

If you have any concerning symptoms or questions, book an appointment with Dr. Kwinter or call us at (+1 345) 623-1000.

Family Medicine and Urgent Care

Full Scope Family Medicine with Care for All Ages in the Cayman Islands

Dr. David Kwinter, MD, CCFP(EM)


Dr. Kwinter has extensive experience working in a rural general practice, which included his own family medicine clinic and a regional single-physician emergency department. He provides comprehensive medical care for all people, ages, and presentations.

Dr. Kwinter's services include:

Dr. Kwinter invites you to make an appointment to meet him in his clinic and to see how he can help ensure you achieve your health goals.

Clinical Chief of Primary Care and Concierge Medicine.

Call our clinic (623-1000) or Text/WhatsApp Dr. Kwinter (324-2424) or Request more info