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Acknowledging how you feel is the first step toward feeling better. Answer honestly — this is a safe space.
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Question 1
Feel down, depressed, or hopeless
0
Not at all
1
Several days
2
More than half the days
3
Nearly every day
Question 2
Trouble Falling asleep or sleeping too much
0
Not at all
1
Several days
2
More than half the days
3
Nearly every day
Question 3
Feeling tired or having little energy
0
Not at all
1
Several days
2
More than half the days
3
Nearly every day
Question 4
Poor appetite or little eating
0
Not at all
1
Several days
2
More than half the days
3
Nearly every day
Question 5
Feel bad about yourself
0
Not at all
1
Several days
2
More than half the days
3
Nearly every day
Question 6
Have trouble concentrating
0
Not at all
1
Several days
2
More than half the days
3
Nearly every day
Question 7
People notice I am slower than usual
0
Not at all
1
Several days
2
More than half the days
3
Nearly every day
Question 8
Thoughts that you would be better off dead, or of hurting yourself
0
Not at all
1
Several days
2
More than half the days
3
Nearly every day
If you checked any problems above, how difficult have these
made it to work, manage home life, or get along with others?