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Thin Myelin Sheathing Test
A
thin myelin sheathing
is a common denominator of many people who suffer from:
OCD
Bi-polarity
Trichotillomania
Bell's Palsy
Shingles
Parkinson's disease
MS (Multiple Sclerosis)
Anorexia
Bulimia
Body Dysmorphia
Self Injury or Self Cutting
Panic Attacks
Social Phobia
Tourette's
ADD
...and other neurological disorders.
Why should I complete this survey?
Completing this survey will help you to determine your myelin sheathings level of health. Your answers will also help us to gather statistics to prove to the medical community that OCD and similar conditions are biologically based, which causes psychological symptoms, rather than just being purely psychological.
All information that you provide will be kept in strict confidence.
If you would like to receive the results of this survey,
enter your first name and email address.
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Part 1 of 1
Do you have symptoms of OCD?
Yes
No
Have you been diagnosed with OCD?
Yes
No
Which medications do you take?
Have you been diagnosed with any of the following conditions? OCD , Bi-polarity, Trichotillomania, Bells Palsy, Shingles, Parkinson's disease.
Have you been diagnosed with any of the following conditions? MS (Multiple Sclerosis), Anorexia, Bulimia, Body Dysmorphia, Self Injury or Self Cutting, Panic Attacks, Social Phobia, Anxiety, ADD, Tourette's ...and other neurological disorders. If so please list all you have been diagnosed with.
What prompted you to take this analysis?
It has been brought to my attention that some people thought they would be contacted by me, Dr. Mary Reed (Gates), when they filled out this form. If you want me to contact you to help set up a protocol please enter your name and email address here. Only those who put their name and email address here will be contacted personally.
What year were you born?
1
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Never
2
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Seldom
3
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Often
4
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Always
1
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4
Do noise, people or commotion get on your nerves? Many people control it. I do not mean do you react to it negatively, but does it bother you?
Do you avoid large groups of people or noisy places?
Do you have a hard time concentrating when things are going on around you?
Do you tend to turn things off or down when someone talks to you?
Do you have a hard time getting to sleep?
Do you have invasive thoughts at night?
Do you play the radio, TV, fan, or air conditioner to help you sleep better or to help you fall asleep?
Does sudden noises startle you?
Do you have a hard time shutting your mind off at night to go to sleep?
Less than 6 days a week, do you dream vividly and remember the dream for about 20 minutes after you awaken?
Do you catch yourself double checking things?
Do you have rituals that you need to do to feel you did something right?
Do you ever think you see someone or something out of the corner of your eye, but when you turn your head, nothing is there?
Do you ever hear voices that are not there?
Do you ever hear music or sounds that are not there?
Do you ever feel that someone is next to you, but no one is there?
Do you have to say your prayers over and over again because you fear you did not say them right?
Do you forget where you are or what direction a place is that you have gone to often?
Do you ever forget common words?
Do you ever do something that is routine and suddenly wonder if you did it wrong?
Do you ever forget common everyday information? For example, which side of a road barrier you should drive on.
Do you ever worry that you have caused injury to someone, even if you did not see anyone, and have to check to make sure you did not?
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Never
2
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Seldom
3
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Often
4
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Always
1
2
3
4