Please read each statement carefully. If the statement is true about how you felt over the last week, circle the number of that statement. If the statement is not true about you over the last week, then just read it and go on to the next statement.

• I felt sad, or down, or unhappy, or like crying.

• I was angry.

• I felt guilty.

• I felt like no one loved me.

• I didn't like myself.

• I felt like life was harder on me than on other people.

• I had aches and pains.

• I worried about my health.

• I was tired.

• I had trouble concentrating.

• I couldn't sit still.

• I felt like I was moving in slow motion.

• I wanted to be by myself.

• Nothing seemed fun.

• I had trouble sleeping.

• I slept longer than usual.

• I didn't feel like eating.

• I ate more than usual.

• I tried to hurt myself.

• I thought about hurting myself.