This test is confidential and no data will be saved. This test
is solely for your reference and should not be used in place of medical advise.
Question 1: Have you been feeling down, depressed, or hopeless?
Question 2: Have you had little interest or pleasure in doing things?
Question 3: Have you had trouble falling or staying asleep, or sleeping too much?
Question 4: Have you felt tired or had little energy?
Question 5: Have you had poor appetite or overeating?
Question 6: Have you felt bad about yourself — or that you are a failure or have let yourself or your
family down?
Question 7: Have you had trouble concentrating on things, such as reading the newspaper or watching
television?
Question 8: Have you been moving or speaking so slowly that other people could have noticed? Or the
opposite — being so fidgety or restless that you have been moving around a lot more than usual?
Question 9: Have you had thoughts that you would be better off dead or of hurting yourself in some way?
Question 10: Have you had any unexplained physical pain (e.g., headaches, back pain)?
Question 11: Have you felt more irritable or angry than usual?
Question 12: Have you felt that you have no one to turn to or that others do not understand you?
Question 13: Have you felt anxious or worried more than usual?
Question 14: Have you felt guilty about things you have done or things you should have done?
Question 15: Have you felt that you are not as good as other people?
Question 16: Have you had difficulty making decisions?
Question 17: Have you felt that life is not worth living?
Question 18: Have you had difficulty trusting others?
Question 19: Have you felt like you have to push yourself to do even the simplest tasks?
Question 20: Have you felt that you are a burden to others?