FREE DEPRESSION QUIZ

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Please enter a valid phone number.

4

1. Would you describe your overall feelings and thoughts as helpless, hopeless, with an impending sense of sadness or doom?* This field is required.

Yes

No

Uncertain

5

2. Has there been trauma to yourself or others in the past/recently, or any suffering experienced on any level?* This field is required.

Yes

No

Uncertain

6

3. Have you felt depressive symptoms for two or more weeks?* This field is required.

Yes

No

Uncertain

7

4. Is it hard to fall asleep because of racing thoughts, and once asleep is your sleep very disruptive?* This field is required.

Yes

No

Uncertain

8

5. Do you ever think life is not worth living?* This field is required.

Yes

No

Uncertain

9

6. Have you experienced suicidal thoughts of how you may end your life?* This field is required.

Yes

No

Uncertain

10

7. Are you unable to allow yourself to be in certain environments?* This field is required.

Yes

No

Uncertain

11

8. Do you always feel a level of anxiety that just doesn’t go away?* This field is required.

Yes

No

Uncertain

12

9. Do you participate in the use of drugs or alcohol to cope with the feelings on a regular basis, or binge on the weekends?* This field is required.

Yes

No

Uncertain

13

10. Does your family have a history of depression?* This field is required.

Yes

No

Uncertain

14

11. Do you see symptoms occur on a regular basis at certain points throughout the year, for example special holidays such as Christmas or seasonal times of the year such as winter?* This field is required.

Yes

No

Uncertain