1. Do you feel motivated or passionate about things you care about?
A. Very
B. I still care about them, but not sure how to do anything now
C. What things
D. I feel like I have really lost interest, but I wish I hadn’t
2. Do you have trouble getting out of bed in the morning?
A. Every day, I just cannot convince myself to move
B. No, I get out pretty quickly.
C. Only recently
D. Sometimes
3. Do you feel your life has meaning?
A. Yes, and I think I know what it is
B. Not really
C. Eh…does anyone’s
D. Umm…I guess sort of…not sure what…
4. Did something happen recently that makes you especially sad?
A. Yes, I know exactly why I feel this way
B. Yeah, I have some ideas
C. No, I just feel awful
D. Not at all
5. Do you often have periods of time where you feel you don’t know what to do with yourself?
A. Yeah, A fair amount
B. No this is a first
C. Never
D. Define periods of time? Like a day?
6. Do you have the energy to do things you like to do?
A. Absolutely
B. Not at all
C. If I work myself up to it, I can make it happen
D. Of late, no!
7. Do you feel hopeless?
A. Very
B. Definitely feeling that a bit
C. Hopeless is too strong a word, but I’m not hopeful
D. Not at all
8. What’s your sleep schedule like?
A. It’s completely out of whack
B. Just how it usually is
C. Well, normal for me, but most people would probably think I was either a vampire or a bear
D. Recently it’s been a bit hard to get to sleep but not totally wild.
9. What about your eating?
A. I eat really healthily
B. I skip meals all the time
C. I’m eating a lot of comfort foods
D. I guess it’s been not the best recently
10. Have you had thoughts about self-harm?
A. Yes, quite a bit
B. No
C. I’ve considered it recently
D. No, I love my life