Low Serotonin - Anxiety, Negativity, Worry etc.
Select all that apply.
Afternoon or Evening Cravings such as sweets, starch, chocolate, alcohol, marijuana, ecstasy Prozac, Zoloft, Paxil, Lexapro, Celexa,, Cymbalta, Prestiq
Negativity, depression, worry, anxiety
Obsessive, racing thoughts, perfection, controlling
Low self-esteem, social anxiety, self-hate, or eating disorders
Irritability, rage, PMS, or migraines
Panic attacks/phobias (fear of heights, snakes, small spaces, social interactions, etc.
Winter blues, SAD - Seasonal Affective Disorder]
Fibromyalgia, TMJ, other chronic pain
Suicidal thoughts
Low Serotonin - Lack of Sleep
Select all that apply.
Night owl, racing thoughts, struggle going to sleep
Insomnia, disturbed sleep
Use something like Trazodone, Lunesta, Ambien, Sleeping Pills, CBD, ZZQuil, Valerian, Melatonin, Benadryl, to help you sleep
Low Catecholamines (Dopamine) Lack of Energy
Select all that apply.
Cravings for stimulation such as caffeine, sugar, chocolate, starches, drugs, alcohol, meth, cocaine
Depression, apathy
Lack of energy, drive, easily bored
Lack of focus, concentration, ADD or ADHD
Low GABA - Struggle to Chill out, Calm down, Panic
Select all that apply.
Crave for relaxation such as: sweets, starch, chocolate, marijuana, alcohol, tobacco, Xanax, Ativan, Klonopin, Neurontin
Stiff, tense, or painful muscles
Stressed/burned out, or feel overwhelmed
Unable to relax, loosen up, or get to sleep
Low Endorphins - Lack Happiness
Select all that apply.
Crave comfort, reward or numbing through food sweets, starch, chocolate, caffeine, tobacco, heroin, cocaine or alcohol. opiates, Lortab, Oxycodone, Vicodin
Excessive behaviors through excess exercise, gaming, internet, tv, porn, shopping, social media, gambling, out of control money spending
"Love" certain foods, behaviors, substances, etc.
Sensitive to emotional or physical pain
Self-harm, such as cutting, hair pull out, etc.
Cry, tear up easily, or overwhelming grief
Low Blood Sugar
Select all that apply.
Crave Sugar, Starch or Alcohol
Irritable, shaky, headache especially if too long between meals
Skip meals
Do you struggle with weight? No matter what you do it just doesn't feel like you can keep it off?
Yes
No
Full Name
Email Address
Phone Number
How did you hear about Shelly Jo Hypno Aminos?
Please select the one which best matches.
Energy Healing Event - Oregon
Energy Healing Retreat/Conference
Coffee and Tea with CarrieVee podcast
Feed Your Brain Change Your Life Book
Facebook Live
Podcast
HTLIVE
Googled it
Friend or Family
Other