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Start Depression Assessment
Step
1
of
10
10%
Feeling down, sad, or hopeless
Not At All
Several Days
More Than Half the days
Nearly Everyday
Trouble falling or staying asleep, or sleeping too much
Not At All
Several Days
More Than Half the days
Nearly Everyday
Feeling tired or having little energy
Not At All
Several Days
More Than Half the days
Nearly Everyday
Poor appetite or overeating
Not At All
Several Days
More Than Half the days
Nearly Everyday
Feeling bad about yourself – or that you are a failure or have let yourself or your family down
Not At All
Several Days
More Than Half the days
Nearly Everyday
Trouble concentrating on things, such as reading the newspaper or watching television
Not At All
Several Days
More Than Half the days
Nearly Everyday
Thoughts that you would be better off dead, or of hurting yourself.
Not At All
Several Days
More Than Half the days
Nearly Everyday
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.
Not At All
Several Days
More Than Half the days
Nearly Everyday
Do you have any known health conditions?
None
Diabetes
PCOS
Hypertension
Physical Pain(Back/ Neck / Knee)
Thyroid
Cholesterol
Heart Disease
Vitamin Deficiency
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