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1. Have you been in a depressed mood for most of the day, nearly every day for at
least two weeks? Yes – No
2. Have you lost interest or pleasure in most of the activities during the
day, nearly every day for at least two weeks? Yes – No
3. Have you experienced a significant weight change (at least five pounds),
either a loss or gain, recently? Yes –No
4. Has your appetite changed (increased or decreased) for an extended period?
Yes – No
5. Have you suffered from lack of sleep or too much sleep, nearly every day for at
least two weeks? Yes – No
6. Have you felt tired or experienced a loss of energy during the day, nearly
every day for at least two weeks? Yes – No
7. Have you had guilty feelings or feelings of worthlessness nearly every day
for at least two weeks? Yes – No
8. Have you had difficulty thinking, concentrating, or making decisions nearly
every day? Yes – No
9. Have you had recurrent thoughts of death or recurring thoughts of suicide
without any specific plan? Yes – No
10. Did the depressed mood begin after someone close to you died or within
four weeks of giving birth? Yes – No
a) Did you circle yes for either question 1 or 2? _________
b) Did you circle yes four or more times in questions 3 through 9? ___________
c) Did you answer yes to question 9? ____________
d) Did you answer yes to question 10? ____________
If you answered yes to both (a) and (b), you may be suffering from an episode of major depression and should seek professional treatment.
If you answered yes to (c), seek professional help as soon as possible.
If you answered yes to (d), and your symptoms are disabling and have lasted for more than two months, seek professional help immediately. Don't delay.
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