1. Feeling sad or down in the dumps :

Not At All

Somewhat

Moderately

A Lot

Extremely

2. Feeling unhappy or blue:

Not At All

Somewhat

Moderately

A Lot

Extremely

3. Crying spells or tearfulness :

Not At All

Somewhat

Moderately

A Lot

Extremely

4. Feeling discouraged :

Not At All

Somewhat

Moderately

A Lot

Extremely

5. Feeling hopeless :

Not At All

Somewhat

Moderately

A Lot

Extremely

6. Low self-esteem :

Not At All

Somewhat

Moderately

A Lot

Extremely

7. Feeling worthless or inadequate :

Not At All

Somewhat

Moderately

A Lot

Extremely

8. Guilt or shame :

Not At All

Somewhat

Moderately

A Lot

Extremely

9. Criticizing yourself or blaming yourself :

Not At All

Somewhat

Moderately

A Lot

Extremely

10. Difficulty making decisions :

Not At All

Somewhat

Moderately

A Lot

Extremely

11. Loss of interest in family, friends or colleagues :

Not At All

Somewhat

Moderately

A Lot

Extremely

12. Loneliness :

Not At All

Somewhat

Moderately

A Lot

Extremely

13. Spending less time with family or friends :

Not At All

Somewhat

Moderately

A Lot

Extremely

14. Loss of motivation :

Not At All

Somewhat

Moderately

A Lot

Extremely

15. Loss of interest in work or other activities :

Not At All

Somewhat

Moderately

A Lot

Extremely

16. Avoiding work or other activities :

Not At All

Somewhat

Moderately

A Lot

Extremely

17. Loss of pleasure or satisfaction in life :

Not At All

Somewhat

Moderately

A Lot

Extremely

18. Feeling tired :

Not At All

Somewhat

Moderately

A Lot

Extremely

19. Difficulty sleeping or sleeping too much :

Not At All

Somewhat

Moderately

A Lot

Extremely

20. Decreased or increased appetite :

Not At All

Somewhat

Moderately

A Lot

Extremely

21. Loss of interest in sex :

Not At All

Somewhat

Moderately

A Lot

Extremely

22. Worrying about your health :

Not At All

Somewhat

Moderately

A Lot

Extremely

23. Do you have any suicidal thoughts? :

Not At All

Somewhat

Moderately

A Lot

Extremely

24. Would you like to end your life? :

Not At All

Somewhat

Moderately

A Lot

Extremely

25. Do you have a plan for harming yourself? :

Not At All

Somewhat

Moderately

A Lot

Extremely

Name:

Phone No :

Beck Depression Test

1. Feeling sad or down in the dumps :

2. Feeling unhappy or blue:

3. Crying spells or tearfulness :

4. Feeling discouraged :

5. Feeling hopeless :

6. Low self-esteem :

7. Feeling worthless or inadequate :

8. Guilt or shame :

9. Criticizing yourself or blaming yourself :

10. Difficulty making decisions :

11. Loss of interest in family, friends or colleagues :

12. Loneliness :

13. Spending less time with family or friends :

14. Loss of motivation :

15. Loss of interest in work or other activities :

16. Avoiding work or other activities :

17. Loss of pleasure or satisfaction in life :

18. Feeling tired :

19. Difficulty sleeping or sleeping too much :

20. Decreased or increased appetite :

21. Loss of interest in sex :

22. Worrying about your health :

23. Do you have any suicidal thoughts? :

24. Would you like to end your life? :

25. Do you have a plan for harming yourself? :