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Self Assessment: Anxiety and Sadness
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Question 1 of 11
1. How often have you been feeling nervous, anxious or on edge in the past two weeks?
Not at all
Several days
More than half the days
Nearly everyday
Question 2 of 11
2. How often have you not been able to stop or control worrying in the past two weeks?
Not at all
Several days
More than half the days
Nearly everyday
Question 3 of 11
3.
How often have you shown little interest or pleasure in doing things in the past two weeks?
Not at all
Several days
More than half the days
Nearly everyday
Question 4 of 11
4. How often have you been feeling down, depressed, hopeless or irritable in the past two weeks?
Not at all
Several days
More than half the days
Nearly everyday
Question 5 of 11
5. How often have you had trouble falling or staying asleep, or sleeping too much?
Not at all
Several days
More than half the days
Nearly everyday
Question 6 of 11
6. How often have you been feeling tired or having little energy in the past two weeks?
Not at all
Several days
More than half the days
Nearly everyday
Question 7 of 11
7. How often have you had a poor appetite, weight loss or overeating?
Not at all
Several days
More than half the days
Nearly everyday
Question 8 of 11
8. How often have you been feeling bad about yourself, or that you are a failure, or have let yourself and your family down in the past two weeks?
Not at all
Several days
More than half the days
Nearly everyday
Question 9 of 11
9. How often have you been having trouble concentrating on things, such as school work, reading or watching television in the past two weeks?
Not at all
Several days
More than half the days
Nearly everyday
Question 10 of 11
10. How often have you been 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 in the past two weeks?
Not at all
Several days
More than half the days
Nearly everyday
Question 11 of 11
11. How often have you had thoughts that you would be better off dead, or of hurting yourself in some way in the past two weeks?
Not at all
Several days
More than half the days
Nearly everyday
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John Doe
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