Dysthymia assessment

Dysthymia (Persistent Depressive Disorder) Assessment | Double Board Certified Counseling Services

Double Board Certified Counseling Services

Dysthymia (Persistent Depressive Disorder) — Patient Assessment

Name Date

Please answer each question based on how you have felt over the past 2 years.

1. How often have you felt depressed or low most of the day, more days than not?

2. Do you often experience poor appetite or overeating?

3. Do you have trouble sleeping (insomnia) or sleep too much (hypersomnia)?

4. Have you experienced low energy or fatigue most of the time?

5. Do you often feel low self-esteem or poor self-worth?

6. Have you experienced difficulty concentrating or making decisions?

7. Have you felt hopeless about the future?

Describe how your symptoms have affected your daily life, relationships, or work/school performance:

What strategies, supports, or treatments have helped you cope with low mood in the past?