Herbert Zirima's Site
summarize
Summary
summarize
Summary
close
shopping_cart
Cart
close
Depression Screening Tool
Start
Depression Screening Tool
This form is meant to screen your depression level. Fill it as honestly as possible. For each symptom, tick the most accurate its presence in the last two weeks.
Feeling Sad
*
settings
Indicate how you felt like this in the past 2 weeks
Not at all
Some of the days
More than half of the days
Almost everyday
Feeling drained emotionally
*
settings
Not at all
Some of the days
More than half of the days
Almost everyday
Do you feel overwhelmed and have to push yourself hard to do things?
*
settings
Not at all
Some of the days
More than half of the days
Almost everyday
Eating habits have changed, either eating too much or too little.
*
settings
Not at all
Some of the days
More than half of the days
Almost everyday
Sleep patterns have changed, either sleeping too much or very little.
*
settings
Not at all
Some of the days
More than half of the days
Almost everyday
Do you have thoughts that life is not worth living or that you might be better off dead?
*
settings
Not at all
Some of the days
More than half of the days
Almost everyday
Feeling unsettled and fidgeting pointlessly
*
settings
Not at all
Some of the days
More than half of the days
Almost everyday
Not being able to do anything meaningful due to lack of motivation.
*
settings
Not at all
Some of the days
More than half of the days
Almost everyday
Feeling tired without doing anything
*
settings
Not at all
Some of the days
More than half of the days
Almost everyday
Feeling hopeless and finding life to be meaningless.
*
settings
Not at all
Some of the days
More than half of the days
Almost everyday
Blaming yourself for everything that is going wrong around you.
*
settings
Not at all
Some of the days
More than half of the days
Almost everyday
Not able to follow conversations and the mind keeps wandering away.
*
settings
Not at all
Some of the days
More than half of the days
Almost everyday
No longer interested in activities that you used to find exciting
*
settings
Not at all
Some of the days
More than half of the days
Almost everyday
Submit
Depression Screening Tool
Click Submit to finish.
arrow_back
Back
Submit
Page
1
of 1
