Depression Self-Assessment

Burn’s Depression Assessment

Instructions: Add a check to indicate how much you have experienced each symptom during the past week, including today. Please answer all 25 items.
0 = Not At All
1 = Somewhat
2 = Moderately
3 = A Lot
4 = Extremely
Thoughts and Feelings:
1. Feeling sad or down in the dumps
2. Feeling unhappy or blue
3. Crying spells or tearfulness
4. Feeling discouraged
5. Feeling hopeless
6. Low self-esteem
7. Feeling worthless or inadequate
8. Guilt or shame
9. Criticizing yourself or blaming others
10. Difficulty making decisions
Activities and Personal Relationships:
11. Loss of interest in family, friends or colleagues
12. Loneliness
13. Spending less time with family or friends
14. Loss of motivation
15. Loss of interest in work or other activities
16. Avoiding work or other activities
17. Loss of pleasure or satisfaction in life

Physical Symptoms

18. Feeling tired
19. Difficulty sleeping or sleeping too much
20. Decreased or increased appetite
21. Loss of interest in sex
22. Worrying about your health

Suicidal Urges

23. Do you have any suicidal thoughts?
24. Would you like to end your life?
25. Do you have a plan for harming yourself?
Please Total Your Score on Items 1-25
Total Score:
No Depression = 0-5
Normal but unhappy = 6-10
Mild depression = 11-25
Moderate depression = 26-50
Severe depression = 51-75
Extreme depression = 76-100

Please Total Your Score on Items 1-25

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