Falling asleep:
Never take longer than 30 minutes to fall alseep
Take at least 30 minutes to fall asleep, less than half the time
Take at least 30 minutes to fall asleep, more than half the time
Take more than 60 minutes to fall asleep, more than half the time
Waking up at night:
Do not wake up at night
Restless, light sleep with few awakenings.
Wake up at least once a night, but go back to sleep easily
Awaken more than once a night and stay awake for 20 minutes or more, more than half the time
Getting up in the morning:
Less than half the time, awaken no more than 30 minutes before necessary
More than half the time, awaken more than 30 minutes need be
Awaken at least one hour before need be, more than half the time.
Awaken at least two hours before need be, more than half the time.
How long do you sleep:
Sleep no longer than 7-8 hours/night, without naps.
Sleep no longer than 10 hours in a 24 hour period (include naps).
Sleep no longer than 12 hours in a 24 hour period (include naps).
Sleep longer than 12 hours in a 24 hour period (include naps).
Mood (Sad):
Do not feel sad.
Feel sad less than half the time.
Feel sad more than half the time.
Feel intensely sad virtually all the time.
Appetite (Decreased):
No change from usual appetite.
Eat somewhat less often and/or lesser amounts than usual.
Eat much less than usual and only with personal effort.
Eat rarely within a 24-hour period, and only with extreme personal effort or with persuasion by others.
Appetite (Increased):
No change from usual appetite.
More frequently feel a need to eat than usual.
Regularly eat more often and/or greater amounts than usual.
Feel driven to overeat at and between meals.
Weight (Decrease) Within The Last Two
Weeks:
Have experienced no weight change.
Feel as if some slight weight loss occurred.
Have lost 2 pounds or more.
Have lost 5 pounds or more.
Weight (Increase) Within the Last Two
Weeks:
Have experienced no weight change.
Feel as if some slight weight gain has occurred.
Have gained 2 pounds or more.
Have gained 5 pounds or more.
Concentration/Decision Making:
No change in usual capacity to concentrate and decide.
Occasionally feel indecisive or notes that attention often wanders.
Most of the time struggle to focus attention or make decisions.
Cannot concentrate well enough to read or cannot make even minor decisions.
Outlook (Self):
See myself as equally worthwhile and deserving as others.
Am more self-blaming than usual.
Largely believe that I cause problems for others.
Ruminate over major and minor defects in myself.
Do you think about suicide:
Do not think of suicide or death.
Feel life is empty or is not worth living.
Think of suicide/death several times a week for several minutes.
Think of suicide/death several times a day in depth, or have made specific plans, or attempted suicide.
Involvement:
No change from usual level of interest in other people and activities.
Notice a reduction in former interests/activities.
Find only one or two former interests remain.
Have virtually no interest in formerly pursued activities.
Energy level:
No change in usual level of energy.
Tire more easily than usual.
Make significant personal effort to initiate or maintain usual daily activities.
Unable to carry out most of usual daily activities due to lack of energy.
Thinking and speaking:
Normal speed of thinking, gesturing, and speaking.
I note slowed thinking, and voice modulation is reduced.
Take several seconds to respond to most questions with slowed thinking.
Am largely unresponsive to most questions without strong encouragement.
Restlessness:
No increased speed or disorganization in thinking or gesturing.
Fidget, wring hands and shift positions often.
I have impulse to move about and display motor restlessness.
Unable to stay seated. Pace about with or without permission.
