1. Falling Asleep:

• I never take longer than 30 minutes to fall asleep
• I take at least 30 minutes to fall asleep, less than half the time
• I take at least 30 minutes to fall asleep, more than half the time
• I take at least 60 minutes to fall asleep, more than half the time

2. Sleep During the Night:

• I do not wake up at night
• I have a restless, light sleep with a few brief awakenings each night
• I wake up at least once a night, but I go back to sleep easily
• I awaken more than once a night and stay awake for 20 minutes or more, more than half the time

3. Waking Up Too Early:

• Most of the time, I awaken no more than 30 minutes before I need to get up
• More than half the time, I awaken more than 30 minutes before I need to get up
• I almost always awaken at least one hour or so before I need to, but I go back to sleep eventually
• I awaken at least one hour before I need to, and can’t go back to sleep

4. Sleeping Too Much:

• I sleep no longer than 7-8 hours/night, without napping during the day
• I sleep no longer than 10 hours in a 24 hour period including naps
• I sleep no longer than 12 hours in a 24-hour period including naps
• I sleep longer than 12 hours in a 24-hour period including naps

5. Feeling Sad:

• I do not feel sad
• I feel sad less than half the time
• I feel sad more than half the time
• I feel sad nearly all the time

6. Decreased Appetite:

• My usual appetite has not decreased
• I eat somewhat less often or lesser amounts of food than usual
• I eat much less than usual and only with personal effort
• I rarely eat within a 24-hour period, and only with extreme personal effort or when others persuade me to eat

7. Increased Appetite:

• My usual appetite has not increased
• I feel a need to eat more frequently than usual
• I regularly eat more often and/or greater amounts of food than usual
• I feel driven to overeat both at mealtime and between meals

8. Decreased Weight (Within the Last Two Weeks):

• My weight has not decreased
• I feel as if I’ve had a slight weight loss
• I have lost 2 pounds or more
• I have lost 5 pounds or more

9. Increased Weight (Within the Last Two Weeks):

• My weight has not increased
• I feel as if I’ve had a slight weight gain
• I have gained 2 pounds or more
• I have gained 5 pounds or more

10. Concentration/Decision Making:

• There is no change in my usual capacity to concentrate or make decisions
• I occasionally feel indecisive or find that my attention wanders
• Most of the time, I struggle to focus my attention or to make decisions
• I cannot concentrate well enough to read or cannot make even minor decisions

11. View of Myself:

• I see myself as equally worthwhile and deserving as other people
• I am more self-blaming than usual
• I largely believe that I cause problems for others
• I think almost constantly about major and minor defects in myself

12. Thoughts of Death or Suicide:

• I do not think of suicide or death
• I feel that life is empty or wonder if it’s worth living
• I think of suicide or death several times a week for several minutes
• I think or suicide or death several times a day in some detail, or have actually tried to take my life

13. General Interest:

• There is no change from usual in how interested I am in other people or activities
• I notice that I am less interested in people or activities
• I find I have interest in only one or two of my formerly pursued activities
• I have virtually no interest in formerly pursued activities

14. Energy Level:

• There is no change in my usual level of energy
• I get tired more easily than usual
• I have to make a big effort to start or finish my usual daily activities (for example, shopping, homework, cooking or going to work)
• I really cannot carry out most of my usual daily activities because I just don’t have the energy

15. Feeling slowed down:

• I think, speak, and move at my usual rate of speed
• I find that my thinking is slowed down or my voice sounds dull or flat
• It takes me several seconds to respond to most questions and I’m sure my thinking is slowed
• I am often unable to respond to questions without extreme effort

16. Feeling Restless:

• I do not feel restless
• I’m often fidgety, wringing my hands, or need to shift how I am sitting
• I have impulses to move about and am quite restless
• At times, I am unable to stay seated and need to pace around