Check all items below that describe how you have been feeling recently.

During the past two weeks have you often (nearly every day) been bothered by . . .

Yes  No  

   1. Feeling down, depressed or hopeless?
   2. A loss of pleasure or interest in activities you once enjoyed doing?
   3. An unintentional, marked change in your weight or appetite (loss of
                  appetite or overeating)?
   4. Sleep disturbance, either too much or too little?
   5. Feeling restless and irritable or lethargic?
   6. A lack of energy or fatigue?
   7. Feeling worthless or excessively guilty?
   8. Difficulty concentrating or thinking?
   9. Recurrent thoughts of death or suicide?

10. Have your feelings in the past month caused you significant distress, or impaired your ability to function socially or at work (or school)?
     Yes
     No

Scoring Your Results^1-3

Symptom Score    Number of symptoms marked out of the possible 9 listed.

If you marked five or more items in questions 1-9 above, and you marked “Yes” on question #10, you  are likely suffering from depression. See your doctor for further evaluation and  personal guidance.

If you marked more than one but fewer than five, items on questions 1-9 above and you marked “Yes” on question #10, you may be experiencing minor depression. See your doctor for further evaluation and personal guidance.

If you marked only one or less on questions 1-9 above or marked "No" on question #10 indicating you have not been distressed or impaired in your ability to function,  you are likely not experiencing depression. If you have further questions, see your doctor for more specific evaluation and personal guidance.

References
1. MA Whooley, GE Simon, Managing Depression in Medical Outpatients, New England Journal of Medicine 2000; 343(26):1942-50
2. U.S. Preventive Services Task Force, Annals of Internal Medicine, May 21, 2002
3. JAMA Patient Page, Depression, JAMA 2000;284(12):1606