Mood Check

This is a screening tool designed to help identify symptoms you might be experiencing. It does not consider all symptoms or the possible reasons why a person might be experiencing these symptoms. This tool is not designed to provide a diagnosis. Only a professional can make a diagnosis.

This questionnaire asks about both anxiety and depression symptoms. After answering the questions, you will get a separate score and feedback for your level of anxiety and depression symptoms.

Please read each statement and select a description that indicates how much the statement applied to you over the past week. There are no right or wrong answers. Do not spend too much time on any statement.

We will not share your answers or any information about you with anyone. Please see our privacy policy for more information.

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Female

Age

Over the past week...

	Did not apply to me at all	Applied to me to some degree, or some of the time	Applied to me a considerable degree, or a good part of time	Applied to me very much, or most of the time
I was aware of dryness of my mouth	Did not apply to me at all	Applied to me to some degree, or some of the time	Applied to me a considerable degree, or a good part of time	Applied to me very much, or most of the time
I couldn't seem to experience any positive feeling at all	Did not apply to me at all	Applied to me to some degree, or some of the time	Applied to me a considerable degree, or a good part of time	Applied to me very much, or most of the time
I experienced breathing difficulty (eg. excessively rapid breathing, breathlessness in the absence of physical exertion)	Did not apply to me at all	Applied to me to some degree, or some of the time	Applied to me a considerable degree, or a good part of time	Applied to me very much, or most of the time
I found it difficult to work up the initiative to do things	Did not apply to me at all	Applied to me to some degree, or some of the time	Applied to me a considerable degree, or a good part of time	Applied to me very much, or most of the time
I experienced trembling (eg. in the hands)	Did not apply to me at all	Applied to me to some degree, or some of the time	Applied to me a considerable degree, or a good part of time	Applied to me very much, or most of the time
I was worried about situations in which I might panic and make a fool of myself	Did not apply to me at all	Applied to me to some degree, or some of the time	Applied to me a considerable degree, or a good part of time	Applied to me very much, or most of the time
I felt that I had nothing to look forward to	Did not apply to me at all	Applied to me to some degree, or some of the time	Applied to me a considerable degree, or a good part of time	Applied to me very much, or most of the time

Lovibond, S.H. & Lovibond, P.F. (1995). Manual for the Depression Anxiety Stress Scales. (2nd. Ed.) Sydney: Psychology Foundation. ISBN 7334-1423-0.T

Mood Check

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