Falling asleep:
I never take more than 30 minutes to fall asleep.
I take at least 30 minutes to fall asleep, less than half the time.
I take at least 30 minutes to fall asleep, more than half the time.
I take more than 60 minutes to fall asleep, more than half the time.
Sleeping during the night:
I do not wake up at night.
I have a restless, light sleep, waking up briefly a few times each night.
I wake up at least once a night, but I go back to sleep easily.
I wake up more than once a night and stay awake for 20 minutes or more, more than half the time.
Waking too early:
Most of the time, I wake up no more than 30 minutes before I need to get up.
More than half the time, I wake up more than 30 minutes before I need to get up.
I almost always wake up at least one hour or so before I need to, but I go back to sleep sooner or later.
I wake up at least one hour before I need to and can’t go back to sleep.
Sleeping too much:
I sleep no more than 7-8 hours/night, without napping during the day.
I sleep no more than 10 hours a day, including naps.
I sleep no more than 12 hours a day, including naps.
I sleep more than 12 hours a day, including naps.
Feeling sad:
I do not feel sad.
I feel sad, less than half the time.
I feel sad, more than half the time.
I feel sad, nearly all the time.
Less hungry:
There is no change in my usual appetite.
I eat slightly less often or less food than usual.
I eat much less than usual and only if I make myself.
I rarely eat within a 24-hour period, and only if I force myself, or when others make me eat.
More hungry:
There is no change from my usual appetite.
I feel a need to eat, more often than usual.
I regularly eat, more often and/or more food than usual.
I feel driven to overeat, both at mealtime and between meals.
Weight loss (within the past two weeks):
I have not had a change in my weight.
I feel as if I’ve had a slight weight loss.
I have lost two to four pounds.
I have lost five pounds or more.
Weight gain (within the past two weeks):
I have not had a change in my weight.
I feel as if I’ve had a slight weight gain.
I have gained two to four pounds.
I have gained five pounds or more.
Concentration/decision-making:
There is no change in my being able to concentrate or make decisions.
I sometimes cant make decisions or find that my attention wanders.
Most of the time, I struggle to focus my attention or make decisions.
I cant focus myself well enough to read or make even minor decisions.
View of myself:
I see myself as worthwhile and deserving as other people.
I blame myself for things more than usual.
I largely believe that I cause problems for others.
I think almost constantly about major and minor flaws in myself.
Thoughts of death or suicide:
I do not think of suicide or death.
I feel that life is empty or wonder if it’s worth living.
I think of suicide or death several times a week for several minutes.
I think of suicide or death several times a day in some detail, or I have made specific plans for suicide, or I have actually tried to take my life.
Call your doctor right away if you have thoughts of suicide.
Interest level:
There is no change from usual in how interested I am in other people or activities.
I notice that I am less interested in people or activities.
I find I have interest in only one or two of the activities I used to enjoy.
I have virtually no interest in the activities I used to enjoy.
Energy level:
There is no change in my usual level of energy.
I get tired more easily than usual.
I have to make a big effort to start or finish my usual daily activities (for example, shopping, homework, cooking, or going to work).
I really cant carry out most of my usual daily activities because I just don’t have the energy.
Feeling slowed down:
I think, speak, and move at my usual rate of speed.
I find that my thinking is slowed down or my voice sounds dull or flat.
It takes me several seconds to answer most questions and I’m sure my thinking is slowed.
I am often unable to answer questions without extreme effort.
Feeling restless:
I do not feel restless.
I often fidget, wring my hands, or need to shift how I am sitting.
I have impulses to move about and am quite restless.
At times, I cant stay seated and need to pace around.
Adapted from © 2000, A. John Rush, M.D., Quick Inventory of Depressive Symptomatology (Self Report) (QIDS-SR).