Anxiety and depression checklist (K10)

For many of us, this is a particularly stressful time.  With so much going on, and so much yet to come, what worked before may not seem to be working this time around.  Our coping strategies and habits can be challenged when faced with so much change and uncertainty.  Are you stressed or are you in distress?  This quiz may help. If you are having a mental health emergency, please do not complete this survey.  Instead please call 911 or go to your nearest emergency room.

This simple questionnaire aims to measure whether you may have been affected by depression and anxiety during the past four weeks. The higher your score, the more likely you are to be experiencing depression and/or anxiety.

Your answers and results are completely confidential and we don’t store any of your information. After taking the test, you can print the results for your records or share with your PCP and/or your mental health treatment provider.

What happens next?

Your responses will help us provide you with a score

  • Based on this score, we’ll tell you whether you fall into the low, medium or high range.
  • We’ll help you take the next step, with information and contacts so you can seek support.
  • Please remember that this is not a diagnosis – that would require a more personalized assessment – but it can give you a better sense of how you’re feeling.

The following questions relate to how you’ve been feeling over the past four weeks. Please tick a box next to each question that best reflects your thoughts, feelings and behavior.

1.During the last 30 days, about how often did you feel tired out for no good reason?
2.During the last 30 days, about how often did you feel nervous?
3.During the last 30 days, about how often did you feel so nervous that nothing could calm you down?
4.During the last 30 days, about how often did you feel hopeless?
5.During the last 30 days, about how often did you feel restless or fidgety?
6.During the last 30 days, about how often did you feel so restless you could not sit still?
7.During the last 30 days, about how often did you feel depressed?
8.During the last 30 days, about how often did you feel that everything was an effort?
9.During the last 30 days, about how often did you feel so sad that nothing could cheer you up?
10.During the last 30 days, about how often did you feel worthless?

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