We all know the feeling. That sense of being stretched thin, when fatigue settles deep in your bones, or a wave of anxiety washes over you for no apparent reason. It is easy to dismiss these feelings as just a bad day or a stressful week. But what if that feeling lingers, coloring your days and nights until it becomes a constant, draining hum in the background of your life? Sometimes, this persistent state of tension, irritability, and exhaustion is more than just passing stress; it is a signal that we need to listen more closely to ourselves.

This is where we touch on the concept of neurosis—a state where internal conflicts and prolonged stress begin to actively interfere with our ability to live fully. It's not a diagnosis to be feared, but rather a description of a struggle. To help people get a clearer picture of their own inner world without complex procedures, German psychiatrists Karl Heck and Hans Hess developed a straightforward method in the 1960s. Think of their test as a mirror; it does not label you, but it reflects your current emotional state, helping you see if it might be time to seek a little support.

Psychology has long recognized the profound link between chronic stress and what were once termed neurotic states. It is estimated that a significant portion of the population experiences these challenges at some point in their lives, often stemming from pressures at work, strains in relationships, or deep-seated internal conflicts. Recognizing the early signs is a powerful act of self-care. If you have encountered other self-assessment tools, like the Zung Self-Rating Depression Scale, this one can offer another layer of insight, contributing to a more complete understanding of your emotional well-being.

The Test: A Moment of Honest Reflection

Find a quiet moment for yourself. The following 40 questions are a chance to check in with how you've been feeling over the last week or two. Grab a piece of paper or open a note on your phone. For each question, simply write "yes" if you agree or "no" if you do not. The key is to be honest and answer from the heart, without overthinking.

1. I feel internal tension.
2. I'm so absorbed in my thoughts that I cannot sleep.
3. I'm easily hurt.
4. It's hard for me to talk to strangers.
5. I often feel indifferent or tired for no reason.
6. It seems like people are looking at me critically.
7. Thoughts that I cannot get rid of haunt me.
8. I'm quite nervous.
9. It seems like no one understands me.
10. I get irritated easily.
11. If people were not against me, things would go better for me.
12. I dwell on troubles for too long.
13. The thought of possible failure worries me.
14. I've had strange or unusual experiences.
15. My mood changes without reason—one moment joy, the next sadness.
16. I daydream or fantasize more than I should.
17. My mood changes easily.
18. I try to hide my shyness.
19. I wish I could be as happy as others seem to be.
20. Sometimes I tremble or feel chills.
21. My mood often depends on trivial matters.
22. I feel fear even when there is no real threat.
23. Criticism or a reprimand hurts me a great deal.
24. I become so restless that I cannot sit still.
25. I worry about trivial things.
26. I often feel dissatisfied.
27. It is hard for me to concentrate on a task or my work.
28. I do things that I later regret.
29. Overall, I am happy.
30. I am not very confident in myself.
31. Sometimes I feel worthless.
32. I often feel unwell for no clear reason.
33. I dwell on myself a lot.
34. I feel less valuable than others.
35. Sometimes my whole body aches for no reason.
36. I have oppressive moods.
37. I feel like something is wrong with my nerves.
38. It's hard for me to start a conversation with new people.
39. The hardest struggle I have is with myself.
40. Sometimes my difficulties seem insurmountable.

Understanding Your Score

Now, let’s look at your answers. Give yourself 1 point for every "yes" answer, except for question 29, where a "no" answer earns 1 point. Add them all up to get your total score.

0–24 points: This range suggests that while you experience the normal ups and downs of life, a neurotic state is unlikely. Your emotional state appears to be generally stable. However, if specific things are still bothering you, it is always worthwhile to pay attention to your feelings and practice self-care.

Over 24 points: If your score is in this range, it might be a signal from your mind and body that the burden of stress has become too heavy. This is not a verdict or a diagnosis. It is simply an indication that there is a high likelihood of a neurotic state. Consider this a gentle nudge to reach out and speak with a psychologist or doctor. Addressing these feelings early can prevent them from becoming more overwhelming.

A First Step, Not a Final Word

The Heck-Hess test has stood the test of time for a reason: it offers a simple, private way to take the first step in understanding yourself better. Heck and Hess designed it so that anyone could have a tool for self-awareness.

Remember, psychological states like neurosis are often very treatable. The path to feeling better can involve conversations with a specialist, adjustments to your lifestyle, or other forms of support. If your score was high, see it not as a reason for alarm, but as an opportunity for empowerment. You have noticed something is off, and that awareness is the most crucial step of all.

References

• Sapolsky, R. M. (2004). Why Zebras Don't Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping. St. Martin's Griffin. This widely respected book provides a clear and accessible explanation of how chronic stress affects the body and mind. It supports the article's premise that prolonged stress is a key factor in the development of anxiety and other psychological difficulties, detailing the biological mechanisms that connect our external pressures to our internal sense of well-being.
• Groth-Marnat, G. (2009). Handbook of Psychological Assessment (5th ed.). John Wiley & Sons. This text is a standard reference in the field of psychological testing. For the purposes of this article, chapters on clinical interviewing and self-report inventories explain the principles behind questionnaires like the Heck-Hess scale. It clarifies their role as screening tools rather than diagnostic instruments, reinforcing the message that such tests are a starting point for further exploration with a professional.
• Eysenck, H. J. (1967). The Biological Basis of Personality. Transaction Publishers. This foundational work by a prominent psychologist explores the personality dimension of Neuroticism-Stability. Eysenck’s theory posits that individuals high in neuroticism are predisposed to react more strongly to stress. This provides a deeper, academic context for understanding why some people may be more susceptible to developing the symptoms measured by the Heck-Hess test, linking them to underlying personality traits.