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180 9 St NE #100, Calgary, AB T2E 0P4, Canada
(403) 294 1077
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180 9 St NE #100, Calgary, AB T2E 0P4, Canada
info@alpinedentalcare.ca

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About
- About Us
- Meet Our Team
- CDCP Plan
- Blog
- Gallery
New Patients
- New Patient Forms
Patient Resources
- Videos
Services
Referral
Contact

About
- About Us
- Meet Our Team
- CDCP Plan
- Blog
- Gallery
New Patients
- New Patient Forms
Patient Resources
- Videos
Services
Referral
Contact

Beck’s Depression Inventory

Patient's Legal Name:(Required)

First Last

Date of Birth:(Required)

Month

Day

Year

1

I do not feel sad

I feel sad

I am sad all the time and I can't snap out of it

I am so sad and unhappy that I can't stand it

2

I am not particularly discouraged about the future

I feel discouraged about the future

I feel I have nothing to look forward to

I feel the future is hopeless and that things cannot improve

3

I do not feel like a failure

I feel I have failed more than the average person

As I look back on my life, all I can see is a lot of failures

I feel I am a complete failure as a person

4

I get as much satisfaction out of things as I used to

I don't enjoy things the way I used to

I don't get real satisfaction out of anything anymore

I am dissatisfied or bored with everything

5

I don't feel particularly guilty

I feel guilty a good part of the time

I feel quite guilty most of the time

I feel guilty all of the time

6

I don't feel I am being punished

I feel I may be punished

I expect to be punished

I feel I am being punished

7

I don't feel disappointed in myself

I am disappointed in myself

I am disgusted with myself

I hate myself

8

I don't feel I am any worse than anybody else

I am critical of myself for my weaknesses or mistakes

I blame myself all the time for my faults

I blame myself for everything bad that happens

9

I don't have any thoughts of killing myself

I have thoughts of killing myself, but I would not carry them out

I would like to kill myself

I would kill myself if I had the chance

10

I don't cry any more than usual

I cry more now than I used to

I cry all the time now

I used to be able to cry, but now I can't cry even though I want to

11

I am no more irritated by things than I ever was

I am slightly more irritated now than usual

I am quite annoyed or irritated a good deal of the time

I feel irritated all the time

12

I have not lost interest in other people

I am less interested in other people than I used to be

I have lost most of my interest in other people

I have lost all of my interest in other people

13

I make decisions about as well as I ever could

I put off making decisions more than I used to

I have greater difficulty in making decisions more than I used to

I can't make decisions at all anymore

14

I don't feel that I look any worse than I used to

I am worried that I am looking old or unattractive

I feel there are permanent changes in my appearance that make me look unattractive

I believe that I look ugly

15

I can work about as well as before

It takes an extra effort to get started at doing something

I have to push myself very hard to do anything

I can’t do any work at all

16

I can sleep as well as usual

I don't sleep as well as I used to

I wake up 1-2 hours earlier than usual and find it hard to get back to sleep

I wake up several hours earlier than I used to and cannot get back to sleep

17

I don't get more tired than usual

I get tired more easily than I used to

I get tired from doing almost anything

I am too tired to do anything

18

My appetite is no worse than usual

My appetite is not as good as it used to be

My appetite is much worse now

I have no appetite at all anymore

19

I haven't lost much weight, if any, lately

I have lost more than five pounds

I have lost more than ten pounds

I have lost more than fifteen pounds

20

I am no more worried about my health than usual

I am worried about physical problems like aches, pains, upset stomach, or constipation

I am very worried about physical problems and it's hard to think of much else

I am so worried about my physical problems that I cannot think of anything else

21

I have not noticed any recent change in my interest in sex

I am less interested in sex than I used to be

I have almost no interest in sex

I have lost interest in sex completely

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(403) 294-1077
info@alpinedentalcare.ca
180 9 St NE #100, Calgary, AB T2E 0P4, Canada

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