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Are you struggling with depression?
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1
/
5
How would you describe your overall mood?
A
Mostly positive and hopeful
B
Occasional low moments, but manageable
C
Frequently sad, empty, or irritable
D
Persistently hopeless, despairing, or numb
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2
/
5
How interested are you in activities you once enjoyed?
A
Fully engaged and enthusiastic about favorite activities
B
Less interested than before, but still participate occasionally
C
Rarely feel motivated to do activities you used to like
D
Completely lost interest in all activities—nothing brings joy
3
/
5
How would you rate your sleep quality?
A
Consistent, restful sleep (7-9 hours nightly)
B
Occasional insomnia or oversleeping (1-2 nights/week)
C
Frequent sleep disturbances (3-4 nights/week)
D
Severe sleep issues (5+ nights/week) or inability to sleep/stay awake
4
/
5
How would you describe your energy levels?
A
Energetic and able to handle daily tasks easily
B
Mild fatigue, but can complete necessary tasks
C
Significant tiredness that limits daily activities
D
Extreme exhaustion—unable to perform basic self-care or tasks
5
/
5
How do you feel about yourself or your self-worth?
A
Accepting of yourself; feel valuable
B
Occasional self-doubt or criticism
C
Frequently negative about yourself; feel inadequate
D
Intense self-hatred, guilt, or worthlessness
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