This questionnaire aims to help you reflect on your mental health and identify potential signs of depression and is only a guide. Answer the following questions honestly, considering how you’ve felt over the past two weeks.
Section 1: Emotional Well-being
- How often have you felt sad, empty, or hopeless?
- ( ) Not at all
- ( ) Several days
- ( ) More than half the days
- ( ) Nearly every day
- Have you lost interest or pleasure in activities you once enjoyed?
- ( ) Not at all
- ( ) Several days
- ( ) More than half the days
- ( ) Nearly every day
- How frequently do you feel anxious or overwhelmed?
- ( ) Not at all
- ( ) Several days
- ( ) More than half the days
- ( ) Nearly every day
- Do you often find yourself feeling irritable or frustrated?
- ( ) Not at all
- ( ) Several days
- ( ) More than half the days
- ( ) Nearly every day
Section 2: Physical Well-being
- Have you experienced changes in your appetite or weight?
- ( ) No changes
- ( ) Slight changes
- ( ) Moderate changes
- ( ) Severe changes
- How often do you feel fatigued or have low energy, even after rest?
- ( ) Not at all
- ( ) Several days
- ( ) More than half the days
- ( ) Nearly every day
- Are you having trouble sleeping (insomnia) or sleeping too much?
- ( ) No issues
- ( ) Occasional issues
- ( ) Frequent issues
- ( ) Severe issues
Section 3: Cognitive Functioning
- How often do you have difficulty concentrating, making decisions, or remembering things?
- ( ) Not at all
- ( ) Several days
- ( ) More than half the days
- ( ) Nearly every day
- Have you had thoughts of self-harm or suicide?
- ( ) Never
- ( ) Rarely
- ( ) Sometimes
- ( ) Often
Section 4: Social Interaction
- How often do you withdraw from friends, family, or social activities?
- ( ) Not at all
- ( ) Several days
- ( ) More than half the days
- ( ) Nearly every day
- Do you feel isolated or disconnected from those around you?
- ( ) Not at all
- ( ) Several days
- ( ) More than half the days
- ( ) Nearly every day
Section 5: Reflection and Action
- Have you noticed a decline in your work or academic performance?
- ( ) No decline
- ( ) Slight decline
- ( ) Moderate decline
- ( ) Severe decline
- Do you often feel that you can’t cope with daily life?
- ( ) Not at all
- ( ) Sometimes
- ( ) Often
- ( ) Always
- Are you aware of any family history of depression or mental health issues?
- ( ) No
- ( ) Yes, but not severe
- ( ) Yes, moderate
- ( ) Yes, severe
Scoring and Considerations:
- If you answered “More than half the days” or “Nearly every day” to several questions, particularly those related to emotional well-being, cognitive functioning, and thoughts of self-harm, it may be time to seek help.
- Consider reaching out to a mental health professional, a trusted friend, or a family member to discuss your feelings and experiences.
- Remember that seeking help is a sign of strength, and you don’t have to navigate this alone.
Conclusion: Your mental health is important. Please use this questionnaire as a starting point to evaluate your feelings and consider the next steps. This questionnaire does NOT provide a diagnosis.