Windrose - Depression assestment form

1

Little Interest or please in doing things?* This field is required.

Not At All

Several days

More than half the days

Nearly every day

2

Feeling down, depressed, or hopeless?* This field is required.

Not At All

Several days

More than half the days

Nearly every day

3

Trouble falling or staying asleep, or sleeping too much?* This field is required.

Not At All

Several days

More than half the days

Nearly every day

4

Feeling tired or having little energy?* This field is required.

Not At All

Several days

More than half the days

Nearly every day

5

Poor appetite or overeating?* This field is required.

Not At All

Several days

More than half the days

Nearly every day

6

Feeling bad about yourself - or that you are a failure or have let yourself or your family down?* This field is required.

Not At All

Several days

More than half the days

Nearly every day

7

Trouble concentrating on things, such as reading the newspaper or watching television?* This field is required.

Not At All

Several days

More than half the days

Nearly every day

8

Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual?* This field is required.

Not At All

Several days

More than half the days

Nearly every day

9

Thoughts that you would be better off dead, or hurting yourself?* This field is required.

Not At All

Several days

More than half the days

Nearly every day

10

Total Score

11

Depression Severity