Are You Depressed? -

Please answer the following questions as accurately as possible.

None of your information will be saved and no one else will have access to your answers.

1) During the past two weeks have you felt sad or down in the dumps?

2) During the past 2 weeks have you felt unhappy and blue?

3) During the past 2 weeks have you had crying spells or periods of tearfulness?

4) During the past 2 weeks have you felt discouraged?

5) During the past 2 weeks have you felt hopeless?

6) During the past 2 weeks have you had low self esteem?

7) During the past 2 weeks have you felt worthless or inadequate?

8) During the past 2 weeks have you felt guilt or shame?

9) During the past 2 weeks have you criticized or blamed yourself?

10) During the past 2 weeks have you had difficulty making decisions?

11) During the past 2 weeks have you lost interest in family, friends or colleagues?

12) During the past 2 weeks have you felt loneliness?

13) During the past 2 weeks have you spent less time with family or friends?

14) During the past 2 weeks have you felt a loss of motivation?

15) During the past 2 weeks have you lost interest in work or other activities?

16) During the past 2 weeks have you avoided work or other activities?

17) During the past 2 weeks have you felt a loss of pleasure or satisfaction in life?

18) During the past 2 weeks have you felt tired?

19) During the past 2 weeks have you had difficulty sleeping or been sleeping too much?

20)During the past 2 weeks have you experienced decreased or increased appetite?

21) During the past 2 weeks have you lost interest in sex?

22) During the past 2 weeks have you been more worried about your health?

Suicidal Urges**

23) Do you have suicidal thoughts?

24) Would you like to end your life?

25) Do you have a plan for harming yourself?

**Anyone experiencing suicidal thoughts should contact 911 immediately or consult a trained mental health professional!