Symptom journal

Record what happened, where, and how it affected you. You can use your own words without knowing the cause.

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Record an experience

Date

Situation

WorkHomeSocialFinancesStudyRelationshipsHealthErrands

What happened?

Losing focusLosing track of timeActing quicklyForgetting somethingStrong emotionsDifficulty startingFeeling overwhelmedRestlessnessGetting absorbedDifficulty organizing

Your note (optional) Impact on your daySmall impactSome disruptionMajor disruption What did you try? Did it help? (optional)

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