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Questionnaire for Depressive Disease

Given below are 25 questions.

Please read them carefully and answer in Yes or No, whichever is most appropriate to you. Be truthful to yourself (this is confidential)

Questions

1.

Does you heart, beats faster than usual?

Yes / No

2.

Do you have frequent body aches?

Yes / No

3.

Have you become more irritable lately?

Yes / No

4.

Do you have frequent headaches?

Yes / No

5.

Are you suffering from loss of self-confidence, of late?

Yes / No

6.

Is there a loss of appetite?

Yes / No

7.

Have you lost concentration in work and/or other activities?

Yes / No

8.

Do you sweat a lot even without physical activities?

Yes / No

9.

Have you lost interest in activities and/or hobbies, which you earlier enjoyed?

Yes / No

10.

Do you feel downhearted, depressed, blue or sad?

Yes / No

11.

Are you losing weight?

Yes / No

12.

Is there a loss of sleep?

Yes / No

13.

Do you get bad and negative thoughts?

Yes / No

14.

Do you happen to forget things easily?

Yes / No

15.

Do you get tired easily for no reason?

Yes / No

16.

Do you have trouble with constipation?

Yes / No

17.

Do you get bad and horrifying dreams which trouble you during working hours?

Yes / No

18.

Do you wake up early in the morning without reason?

Yes / No

19.

Is your sexual interest/desire reduced?

Yes / No

20.

Do you feel like crying frequently?

Yes / No

21.

Do you become restless and cannot keep still?

Yes / No

22.

Do you think too much and spend most of your time worrying about the past and/or future?

Yes / No

23.

Do you find it hard to take decisions?

Yes / No

24.

Do you consume alcohol, or any other substance to suppress your nervousness/tension?

Yes / No

25.

Do you feel that others would be better off if you were dead?

Yes / No

If 7 or more questions are answered YES, then you probably are suffering from Depressive Disease. It is advisable to consult your Family Doctor or a Psychiatrist.


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