1. Do you feel guilty but are unsure as to why?
A. Yes, I feel constantly guilty
B. No, I have no feelings of guilt
C. Occasionally I will feel guilty
2. Do you enjoy spending time with friends and family?
A. Yes, I see them as often as I can
B. No, I don’t feel like being around loved ones
C. I will spend time with them periodically
3. Do you have a hard time getting motivated?
A. I am very lethargic
B. I am very motivated to get things done
C. My motivation varies
4. Do you have scary thoughts about hurting yourself or your child?
A. I have thought about them
B. I have not had those thoughts
C. I have them sometimes, but they are dismissed easily
5. Do you look forward to the future and make future plans?
A. Yes, I have a lot of hope for the future
B. No, I focus purely on the present
C. I make a few future plans
6. Do you feel like you are bonding with your baby?
A. Unfortunately, I am not bonding well with my child
B. Yes, I feel very close to my baby
C. I feel close, but at times, I don’t feel connected
7. Are you excited about your new family?
A. No, I just want to be alone
B. From time to time, I am excited
C. Yes, I can’t wait to see what happens in the future
8. Do you enjoy spending time with your baby?
A. Yes, I really enjoy being around my new child
B. No, I have very little interest
C. I have to step away and take breaks
9. Do you feel down and hopeless and that you have little interest in things?
A. Extremely down and hopeless
B. I feel happy and have interest in things
10. Do you have the energy to complete household tasks?
A. Half of the time
B. Not really
C. Yes, I have a lot of energy