../burn-depression-checklist

Burn's depression checklist

Published: 2026-07-05

Tool Mental Health

David D. Burns, M.D.'s 25 question checklist from the book Feeling Good about Cognitive Behavioral Therapy. Dr Burns recommends filling out the form every week to track your mental health over time.

Your form data is neither sent anywhere nor collected by me in any form. Privacy guaranteed :). I built this as there was no such form online.

Burn's Depression Checklist

Instructions: Select the number that indicates how much you have experienced each symptom during the past week, including today. Please answer all 25 items.

0 = Not At All 1 = Somewhat 2 = Moderately 3 = A Lot 4 = Extremely

Thoughts and Feelings

1. Feeling sad or down in the dumps

2. Feeling unhappy or blue

3. Crying spells or tearfulness

4. Feeling discouraged

5. Feeling hopeless

6. Low self-esteem

7. Feeling worthless or inadequate

8. Guilt or shame

9. Criticizing yourself or blaming others

10. Difficulty making decisions

Activities and Personal Relationships

11. Loss of interest in family, friends or colleagues

12. Loneliness

13. Spending less time with family or friends

14. Loss of motivation

15. Loss of interest in work or other activities

16. Avoiding work or other activities

17. Loss of pleasure or satisfaction in life

Physical Symptoms

18. Feeling tired

19. Difficulty sleeping or sleeping too much

20. Decreased or increased appetite

21. Loss of interest in sex

22. Worrying about your health

Suicidal Urges

23. Do you have any suicidal thoughts?

24. Would you like to end your life?