Northland Counseling Center

Committed to Recovery

PHQ – 9

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PHQ - 9

"*" indicates required fields

MM slash DD slash YYYY
Name

Over the last 2 weeks, how often have you been bothered by any of the following problems? Please check the box next to the number that best describes how often you have been bothered by these problems.
Little interest or pleasure in doing things:*
Feeling down, depressed, or hopeless:*
Trouble falling or staying asleep, or sleeping too much:*
Feeling tired or having little energy:*
Poor appetite or overeating:*
Feeling bad about yourself — or that you are a failure or have let yourself or your family down:*
Trouble concentrating on things, such as reading the newspaper or watching television:*
Moving or speaking so slowly that other people could have noticed? Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual:*
Thoughts that you would be better off dead or of hurting yourself in some way:*
How difficult have these problems been for you?