BSTTW Depression Questionnaire

Over the past two weeks have you had persistent thoughts of death, dying, or suicide?

	NO
	YES

Over the past two weeks have you had a plan to end your life?

	NO
	YES

Over the past two weeks have you felt like it's not worth living?

	NO
	YES

Over the past two weeks have you been unable to go to work or keep up with responsibilities that are part of your daily life because you felt bad and do not know why?

	NO
	YES

Over the past two weeks are activities that you have always found pleasurable, no longer enjoyable?

	NO
	YES

Over the past two weeks you feel tired all the time?

	NO
	YES

Over the past two weeks do you feel like eating all the time, especially sweets, or has your appetite decreased significantly?

	NO
	YES

Over the past two weeks are you having a hard time concentrating?

	NO
	YES

Over the past two weeks do tasks that use to seem simple now seem very difficult?

	NO
	YES

10.

Over the past two weeks are you avoiding friends and crowds?

	NO
	YES

11.

Over the past two weeks are you having a very hard time getting over a loss or trauma in your life?

	NO
	YES

12.

Over the past two weeks, how often have you been feeling low in energy or slowed down?

	NO
	YES

13.

Over the past two weeks, how often have you been blaming yourself for things?

	NO
	YES

14.

Over the past two weeks, how often have you had poor appetite?

	NO
	YES

15.

Over the past two weeks, how often have you had difficulty falling asleep or staying asleep?

	NO
	YES

16.

Over the past two weeks have you slept more than usual or had insomnia?

	NO
	YES

17.

Over the past two weeks are you having a hard time remembering simple things like appointments and people's names?

	NO
	YES

18.

Over the past two weeks, how often have you been feeling hopeless about the future?

	NO
	YES

19.

Over the past two weeks, how often have you been feeling blue?

	NO
	YES

20.

Over the past two weeks have you felt ashamed?

	NO
	YES

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