Here are a few questions to help determine the level of sadness. Please complete this print-it-out, and bring it in with you on your first appointment.
Depression Screening Test
Circle the appropriate descriptor below the question.
1. I do things slowly.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
2. My future seems hopeless.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
3. It is hard for me to concentrate on reading.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
4. The pleasure and joy have gone out of my life.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
5. I have difficulty making decisions.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
6. I have lost interest in aspects of life that used to be important to me.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
7. I feel sad, blue, and unhappy.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
8. I am agitated and keep moving around.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
9. I feel fatigued.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
10. It takes great effort for me to do simple things.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
11. I feel that I am a guilty person who deserves to be punished.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
12. I feel like a failure.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
13. I feel lifeless — dead than alive.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
14. My sleep has been disturbed — too little, too much, or broken sleep.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
15. I spend time thinking about HOW I might kill myself.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
16. I feel trapped or caught.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
17. I feel depressed even when good things happen to me.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much
18. Without trying to diet, I have lost, or gained weight.
Not at all
Just a little
Somewhat
Moderately
Quite a lot
Very much