For each question, select the answer that best describes how you have felt and how things have been going for you during the past month.

1. How have you been feeling in general?
   Select... In excellent spirits In very good spirits In good spirits mostly I've been up and down in spirits a lot In low spirits mostly In very low spirits
   
   
2. Have you been bothered by nervousness or your "nerves"?
   Select... Extremely so--to the point where I could not work or take care of things Very much so Quite a bit Some--enough to bother me A little Not at all
   
   
3. Have you been in firm control of your behavior, thoughts, emotions, or feelings?
   Select... Yes, definitely so Yes, for the most part Generally so Not too well No, and I am somewhat disturbed No, and I am very disturbed
   
   
4. Have you felt so sad, discouraged, hopeless, or had so many problems that you wondered if anything was worthwhile?
   Select... Extremely so--to the point I have just about given up Very much so Quite a bit Some--enough to bother me A little bit Not at all
   
   
5. Have you been under or felt you were under any strain, stress, or pressure?
   Select... Yes--almost more than I could bear Yes--quite a bit of pressure Yes--some, more than usual Yes--some, but about usual Yes--a little Not at all
   
   
6. How happy, satisfied, or pleased have you been with your personal life?
   Select... Extremely happy--couldn't have been more satisfied or pleased Very happy Fairly happy Satisfied--pleased Somewhat dissatisfied Very dissatisfied
   
   
7. Have you had reason to wonder if you were losing your mind or losing control over the way you act, talk, think, feel, or of your memory?
   Select... Not at all Only a little Some, but not enough to be concerned Some, and I've been a little concerned Some, and I am quite concerned Much, and I'm very concerned
   
   
8. Have you been anxious, worried, or upset?
   Select... Extremely so--to the point of being sick, or almost sick Very much so Quite a bit Some--enough to bother me A little bit Not at all
   
   
9. Have you been waking up fresh and rested?
   Select... Every day Most every day Fairly often Less than half the time Rarely None of the time
   
   
10. Have you been bothered by any illness, bodily disorder, pain, or fears about your health?
    Select... All the time Most of the time A good bit of the time Some of the time A little of the time None of the time
    
    
11. Has your daily life been full of things that are interesting to you?
    Select... All the time Most of the time A good bit of the time Some of the time A little of the time None of the time
    
    
12. Have you felt downhearted and blue?
    Select... All the time Most of the time A good bit of the time Some of the time A little of the time None of the time
    
    
13. Have you been feeling emotionally stable and sure of yourself?
    Select... All the time Most of the time A good bit of the time Some of the time A little of the time None of the time
    
    
14. Have you felt tired, worn out, used-up, or exhausted?
    Select... All the time Most of the time A good bit of the time Some of the time A little of the time None of the time
    
    
15. Click the button that seems closest to how you have felt generally during the past month.

    How concerned or worried about your health have you been?

    Not concerned at all	10	8	6	4	2	0	Very concerned

    
    
    
16. How relaxed or tense have you been?

    Very relaxed	10	8	6	4	2	0	Very tense

    
    
    
17. How much energy, pep, and vitality have you felt?

    No energy at all, listless	0	2	4	6	8	10	Very energetic, dynamic

    
    
    
18. How depressed or cheerful have you been?

    Very depressed	0	2	4	6	8	10	Very cheerful

    
    
    

Your Score:

Scoring

Add up all the points for the answers you have chosen, and find your score below.

81-110	Positive well-being
76-80	Low positive
71-75	Marginal
56-70	Stress problem
41-55	Distress
26-40	Serious
0-25	Severe

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