Part I: For at least the past two weeks, have you experienced either of these symptoms to the point where they're starting to interfere with your life?

1. You've felt depressed or sad for most of the day, nearly every day?

Yes
No

2. You've lost interest in your regular activities or the things that you usually enjoy?

Yes
No

Part II: For these same two weeks or more have you:

1. Felt depressed or sad most of the time?

Yes
No

2. Lost interest in your regular activities, or things that you usually enjoy?

Yes
No

3. Lost or gained weight without trying to, or noticed a change in your appetite without a known cause?

Yes
No

4. Had trouble sleeping, or been oversleeping?

Yes
No

5. Been agitated or restless, or very slow or listless (so much that others may have noticed)?

Yes
No

6. Felt very tired or lethargic, (like you had no energy)?

Yes
No

7. Thought that you're worthless, or that things are hopeless, or felt guilty?

Yes
No

8. Been forgetful, or had trouble concentrating or making decisions?

Yes
No

9. Had thoughts of death (besides a fear of dying) or suicide?

Yes
No