| Over the last 2 weeks, how often have you been bothered by any of the following problems? | Not at all | Several Days | More than half the days | Nearly every day |
| 1. Little interest or pleasure in doing things | 0 | 1 | 3 | 3 |
| 2. Feeling down, depressed, or hopeless | 0 | 1 | 3 | 3 |
| 3. Trouble falling or staying asleep, or sleeping too much | 0 | 1 | 3 | 3 |
| 4. Feeling tired or having little energy | 0 | 1 | 3 | 3 |
| 5. Poor appetite or overeating | 0 | 1 | 3 | 3 |
| 6. Feeling bad about yourself — or that you are a failure or have let yourself or your family down | 0 | 1 | 3 | 3 |
| 7. Trouble concentrating on things, such as reading the newspaper or watching television | 0 | 1 | 3 | 3 |
| 8. 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 | 0 | 1 | 3 | 3 |
| 9. Thoughts that you would be better off dead or of hurting yourself in some way | 0 | 1 | 2 | 3 |