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Over the last 2 weeks, how often have you been bothered by feeling down, depressed, or hopeless?

Over the last 2 weeks, how often have you been bothered by trouble falling or staying asleep, or sleeping too much?

Over the last 2 weeks, how often have you been bothered by feeling tired or having little energy?

Over the last 2 weeks, how often have you been bothered by poor appetite or overeating?

Over the last 2 weeks, how often have you been bothered by feeling bad about yourself, or that you are a failure or have let yourself or your family down?

Over the last 2 weeks, how often have you been bothered by trouble concentrating on things, such as reading the newspaper or watching television?

Over the last 2 weeks, how often have you been bothered by 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?

Over the last 2 weeks, how often have you been bothered by thoughts that you would be better off dead, or of hurting yourself in some way?

If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?