Depression Indicators

1. Over the past two weeks, how often have you had little interest or pleasure in doing things?

Not at all Several days More than half the days Nearly every day

2. Over the past two weeks, how often have you felt down, depressed, or hopeless?

Not at all Several days More than half the days Nearly every day

3. Over the past two weeks, how often have you experienced trouble sleeping or sleeping too much?

Not at all Several days More than half the days Nearly every day

Anxiety Indicators

4. Over the past two weeks, how often have you felt nervous, anxious, or on edge?

Not at all Several days More than half the days Nearly every day

5. How often have you found it difficult to control your worrying?

Not at all Sometimes Often Very frequently

6. How often have you experienced physical symptoms like restlessness or rapid heartbeat when worried?

Rarely Sometimes Often Very frequently

Stress and Contributing Factors

7. Over the past month, how often have you felt overwhelmed by your responsibilities?

Rarely Sometimes Often Very frequently

8. In your own words, can you describe any recent events or ongoing issues that might be affecting your mood or stress levels?