• You feel sad, scared, or empty for weeks or months at a time.
• You feel down-hearted, blue and sad.
• You feel that you can’t help yourself get better.
• You feel hopeless or guilty.
• Morning is when you feel the best.
• You can’t keep your mind on anything for a long time.
• You have trouble making decisions.
• You feel more nervous, jumpy, or short-tempered than usual.
• Your eating habits change.
• You gain or lose weight without meaning to.
• You have trouble sleeping through the night.
• You sleep too much.
• You wake up early and can’t go back to sleep.
• You don’t seem to have any energy.
• You get tired with no reason.
• You have crying spells or feel like it.
• You feel sluggish or tired all the time.
• You are more irritable than usual.
• You are not interested in things you usually like to do.
• You have lost interest in sex.
• You feel useful and needed.
• Your life is pretty full.
• You have thoughts of killing yourself or you have tried to kill yourself.
• You feel others would be better off if you were dead.

Personal History

1. Do you have any allergies to medications, foods, preservatives, or dyes?
2. Do you consume alcoholic beverages?
3. Do you take any other medications, over the counter or prescription?
4. Do you have kidney or liver disease?
5. Are you pregnant or plan to become pregnant?
6. Do you have, or have you had, an eating disorder such as bulimia or anorexia nervosa?
7. Do you have a history of head injury, convulsions or seizures?