Do you feel like you shouldn't have been born to this world?
Yes
No
Are you sad and lonely most of the time?
Yes
No
Do you feel sad and lonely right now?
Yes
No
Do you always feel empty? (Not hungry, I mean your feelings.)
Yes
No
Do you ever had any angry outbursts?
Yes
No
Do you ever feel loss of interests?
Yes
No
Do you ever find it hard to sleep or sleep to much?
Yes
No
Do you ever had a bad headache?
Yes
No
Do you ever feel anxious about something?
Yes
No
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