depression quiz

Full Name: Email Address:

Over the last 2 weeks, how often have you noticed you or your loved one bothered by the following problems?

1. Little interest or pleasure in doing things.

yesno

2. Feeling down, depressed or hopeless.

yesno

3. Trouble falling or staying asleep, or sleeping too much.

yesno

4. Feeling tired or having little energy.

yesno

5. Poor appetite or overeating.

yesno

6. Feeling bad about yourself/themselves - or that you/they are a failure or have let yourself/themselves or your/their family down.

yesno

7. Trouble concentrating things, such as reading the newspaper or watching television.

yesno

8. Moving or speaking so slowly that other people could have noticed.

yesno

9. Thoughts you/they would be better off dead, or of hurting yourself/themselves.

yesno

10. If your loved one has experienced any of the above, has it effected work, home or their relationships with other people?

yesno

If you answered yes to 3 or more it is an indication your loved one needs help. Call Alchemy Consulting and we can help you find the right resources for your family.