REFRAME Depression Assessment [form] Name[text,r_name,30] Email [text,r_email,30] In reference to feeling DEPRESSION ... WHOM OR WHAT IS the Object of your attention? [list,Your main focus] [option,My focus is on me my sense of self ,On ME my sense of self] [option,on other person or persons directly involved,On OTHER person or persons directly involved] [option,on third parties,On third parties not directly involved but influencing] [option,My focus is on LIFE in general ,Mostly focused on LIFE in general and how I view it] [option,My focus is on God or the divine ,Mostly focused on GOD or the Divine] [/list] WHEN I am facing loss (with implications for the future, for example possessions, job, loved one etc.) [list,I am facing loss (with implications for the future, for example possessions, job, loved one etc.)][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] I am feeling failure [list,I am feeling failure][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] I have a negative evaluation of my SELF [list,I have a negative evaluation of my SELF][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] OTHER DEPRESSIVE SITUATIONS? [textarea,Other situations,3,70] I FEEL DEPRESSION [list,My General assessment of the Depression Impact is] [option,0,Choose level of DEPRESSION IMPACT] [option,1 The absence of any distress,1 The absence of any distress. Feeling calm and totally relaxed] [option,2 Neutral feeling or just OK,2 Neutral feeling or just OK, not as relaxed as could be] [option,3 Increased discomfort,3 Increased discomfort, unpleasant, but in control] [option,4 Noticeable discomfort or distress,4 Noticeable discomfort or distress, perhaps agitation, but tolerable] [option,5 Discomfort is very uncomfortable,5 Discomfort is very uncomfortable, but I can stand it.] [option,6 Discomfort worsens and affects my life,6 Discomfort worsens and affects my life] [option,7 Discomfort is severe emotional pain interferes,7 Discomfort is severe and emotional pain interferes with my life.] [option,8 Discomfort increases in thoughts constantly,8 Discomfort increases and it is in my thoughts constantly] [option,9 Nearly intolerable,9 Discomfort is nearly intolerable] [option,10 discomfort extreme worst imaginable,10 Discomfort is extreme and the worst imaginable. I feel panicky and overwhelmed.] [/list] HOW I RESPOND IS I withdraw from reinforcements [list,I withdraw from reinforcements][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] I withdraw into myself [list,I withdraw into myself][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] I create an environment consistent with my feelings [list,I create an environment consistent with my feelings][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] I do not intentionally relax myself [list,I do not intentionally relax myself][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] I do not exercise or get involved in aerobic activity [list,I do not exercise or get involved in aerobic activity][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] I attempt to terminate feelings of depression in these self-destructive ways suicide attempts [list,suicide attempts][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] inflicting pain [list,inflicting pain][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] damaging property [list,damaging property][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] OTHER DEPRESSIVE RESPONSES? [textarea,Other kinds of behaviour,3,70] BECAUSE I only see negative aspects of the loss of failure [list,I only see negative aspects of the loss of failure][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] I think of other losses and failures that I have experienced [list,I think of other losses and failures that I have experienced][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] I think I am unable to help myself (a sense of helplessness) [list,I think I am unable to help myself (a sense of helplessness)][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] I only see pain and blackness in the future (a sense of hopelessness) [list,I only see pain and blackness in the future (a sense of hopelessness) ][option,choose,Choose the frequency of occurence,selected][option,0,0 Not at all][option,1,1 Sometimes][option,2,2 Frequently][option,3,3 Most of the time][/list] OTHER DEPRESSIVE THOUGHTS? [textarea,Other kinds of thoughts I have,3,70] IF any of the following statements are similar to your because-thoughts with this issue, please check them in the box beside. [checkbox,I must do well or very well]I MUST do well or very well! [checkbox, I am a BAD or WORTHLESS PERSON when I act weakly, or stupidly]I am a BAD or WORTHLESS PERSON when I act weakly, or stupidly. [checkbox,I MUST be approved, acknowledged or accepted by people I find important to me]I MUST be approved, acknowledged or accepted by people I find important to me. [checkbox,People MUST treat me fairly and give me what I NEED]People MUST treat me fairly and give me what I NEED. [checkbox,People MUST live up to my expectations or it is TERRIBLE ... awful]People MUST live up to my expectations or it is TERRIBLE (awful...) [checkbox,I CAN'T STAND really bad things or very difficult people]I CAN'T STAND really bad things or very difficult people! [checkbox,MUST have few major hassles or troubles]My work (task, job...) MUST have few major hassles or troubles. [checkbox,It's AWFUL or HORRIBLE when major (important...) things don't go my way]It's AWFUL or HORRIBLE when major (important...) things don't go my way [checkbox,I CAN'T STAND IT when work (tasks, situation...) is really unfair]I CAN'T STAND IT when work (tasks, situation...) is really unfair. [checkbox,I NEED a good deal of gratification (satisfaction...) and HAVE to feel miserable (upset, disturbed) when I don't get it.]I NEED a good deal of gratification (satisfaction...) and HAVE to feel miserable (upset, disturbed) when I don't get it. [checkbox,I must not suffer more discomfort than I feel I can bear]I MUST NOT experience more discomfort physically or emotionally than I feel I can bear Please share with me anything else you feel I need to know to understand you and your experience of Anger? Comments Box [textarea,comments,3,70,Write in here...] [checkbox,send copy] SEND ME A COPY PLEASE [submit,SEND this Entry][reset,Start Over again] [/form]