Burns Depression Checklist | claritycounseling

Discouragement: Does the future look bleak or hopeless?

Not at All (0 Days per Week)

Somewhat (1-2 Days per Week)

Moderately (3-4 Days per Week)

A Lot (5-7 Days per Week)

Low Self-Esteem: Do you feel worthless or think of yourself as a loser?

Not at All (0 Days per Week)

Somewhat (1-2 Days per Week)

Moderately (3-4 Days per Week)

A Lot (5-7 Days per Week)

Inferiority: Do you feel inadequate or inferior to others?

Not at All (0 Days per Week)

Somewhat (1-2 Days per Week)

Moderately (3-4 Days per Week)

A Lot (5-7 Days per Week)

Guilt: Do you get self-critical and blame yourself?

Not at All (0 Days per Week)

Somewhat (1-2 Days per Week)

Moderately (3-4 Days per Week)

A Lot (5-7 Days per Week)

Indecisiveness: Is it hard to make decisions?

Not at All (0 Days per Week)

Somewhat (1-2 Days per Week)

Moderately (3-4 Days per Week)

A Lot (5-7 Days per Week)

Irritability and Frustration: Have you been feeling angry or resentful?

Not at All (0 Days per Week)

Somewhat (1-2 Days per Week)

Moderately (3-4 Days per Week)

A Lot (5-7 Days per Week)

Loss of Motivation: Do you feel overwhelmed and have to push yourself hard to do things?

Not at All (0 Days per Week)

Somewhat (1-2 Days per Week)

Moderately (3-4 Days per Week)

A Lot (5-7 Days per Week)

Poor Self-Image: Do you think you're looking old or unattractive

Not at All (0 Days per Week)

Somewhat (1-2 Days per Week)

Moderately (3-4 Days per Week)

A Lot (5-7 Days per Week)

Appetite Changes: Have you lost your appetite? Or, do you over eat compulsively?

Not at All (0 Days per Week)

Somewhat (1-2 Days per Week)

Moderately (3-4 Days per Week)

A Lot (5-7 Days per Week)

Sleep Changes: Is it hard to get a good night's sleep? Or, are you tired and sleeping too much?

Not at All (0 Days per Week)

Somewhat (1-2 Days per Week)

Moderately (3-4 Days per Week)

A Lot (5-7 Days per Week)

Loss of Libido: Have you lost your interest in sex?

Not at All (0 Days per Week)

Somewhat (1-2 Days per Week)

Moderately (3-4 Days per Week)

A Lot (5-7 Days per Week)

Hypochondriasis: Do you worry a lot about your health?

Not at All (0 Days per Week)

Somewhat (1-2 Days per Week)

Moderately (3-4 Days per Week)

A Lot (5-7 Days per Week)

Suicidal Impulses: Do you think life is not worth living or think you'd be better off dead?

Not at All (0 Days per Week)

Somewhat (1-2 Days per Week)

Moderately (3-4 Days per Week)

A Lot (5-7 Days per Week)

Michele Ashdown, LCSW, ch

Burns' Depression Checklist*

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