1. Little interest or pleasure in doing things Not at allSeveral daysMore than half the daysNearly every day 2. Feeling down, depressed, or hopeless Not at allSeveral daysMore than half the daysNearly every day 3. Trouble falling or staying asleep, or sleeping too much Not at allSeveral daysMore than half the daysNearly every day 4. Feeling tired or having little energy Not at allSeveral daysMore than half the daysNearly every day 5. Poor appetite or overeating Not at allSeveral daysMore than half the daysNearly every day 6. Feeling bad about yourself - or that you are a failure or have let yourself or your family down Not at allSeveral daysMore than half the daysNearly every day 7. Trouble concentrating on things, such as reading the newspaper or watching television Not at allSeveral daysMore than half the daysNearly every day 8. Moving or speaking so slowly that other people could have noticed Not at allSeveral daysMore than half the daysNearly every day 9. Thoughts that you would be better off dead, or of hurting yourself Not at allSeveral daysMore than half the daysNearly every day 10. If you checked off any problems, how difficult have these problems made it for you at work, home, or with other people? Not at allSeveral daysMore than half the daysNearly every day
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Sex -None-MaleFemale Race/Ethnicity - None -White (non-Hispanic)Hispanic or LatinoBlack or African American (non-Hispanic)Native American or American IndianAsian or Pacific IslanderMore than one of the aboveOther Age - None -11-1718-2425-3435-4445-5455-6465+ Household Income - None -Less than $20,000$20,000 - $39,999$40,000 - $59,999$60,000 - $79,999$80,000 - $99,999$100,000 - $149,999$150,000+ Zip/Postal Code State - None -Other/Outside of U.S.AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Are you currently, or have you ever been, diagnosed with a mental health condition by a professional? -None-YesNo Which of the following populations describe you? Veteran or active duty militaryCaregiver of someone living with emotional or physical illnessLGBTQStudentNew or expecting mother Do you have any of the following general health conditions? Heart diseaseDiabetesAlzheimer's or other dementiasCancerArthritis or other chronic painCOPD or other lung conditionsOther If 'Other' please specify (for general health conditions) How can Answers Thru Counseling help you? A phone number to get immediate support or guidanceAdditional information about mental healthReferrals to local ATC affiliates or other organizations that can helpWorksheets or coping skills to use at homeAn online or mobile program or app that can help you track or manage your symptomsOther If 'Other' please specify (for how ATC can help you) What next steps do you plan to take after screening? - None -Discuss the results with a family member, a friend or a professionalFind additional information onlineFind treatmentMonitor my health by taking screens regularlyNone at this time Enter your email Would you like us to Contact You?
- None -YesNo