No sadness (Worsening symptoms) Looks dispirited but does brighten up without difficulty (Worsening symptoms) Appears sad and unhappy most of the time (Worsening symptoms) Looks miserable all the time. Extremely despondent

Occasional sadness in keeping with the circumstances (Worsening symptoms) Sad or low but brightens up without difficulty (Worsening symptoms) Pervasive feelings of sadness or gloominess. The mood is still influenced by external circumstances (Worsening symptoms) Continuous or unvarying sadness, misery or despondency

Placid. Only fleeting inner tension (Worsening symptoms) Occasional feelings of edginess and ill-defined discomfort (Worsening symptoms) Continuous feelings of inner tension or intermittent panic which the patient can only master with some difficulty (Worsening symptoms) Unrelenting dread or anguish. Overwhelming panic

Sleeps as usual (Worsening symptoms) Slight difficulty dropping off to sleep or slightly reduced, light or fitful sleep (Worsening symptoms) Sleep reduced or broken by at least two hours (Worsening symptoms) Less than two or three hours sleep

Normal or increased appetite (Worsening symptoms) Slightly reduced appetite (Worsening symptoms) No appetite. Food is tasteless (Worsening symptoms) Needs persuasion to eat

No difficulties in concentrating (Worsening symptoms) Occasional difficulties in collecting one's thoughts (Worsening symptoms) Difficulties in concentrating and sustaining thought which reduces ability to read or hold a conversation (Worsening symptoms) Unable to read or converse without great difficulty

Hardly any difficulty in getting started or no sluggishness (Worsening symptoms) Difficulties in starting activities (Worsening symptoms) Difficulties in starting simple routine activities, which are carried out with effort (Worsening symptoms) Complete lassitude. Unable to do anything without help

Normal interest in the surroundings and in other people (Worsening symptoms) Reduced ability to enjoy usual interests (Worsening symptoms) Loss of interest in the surroundings. Loss of feelings for friends and acquaintances (Worsening symptoms) The experience of being emotionally paralyzed, inability to feel anger, grief or pleasure and a complete or even painful failure to feel for close relatives and friends

No pessimistic thoughts (Worsening symptoms) Fluctuating ideas of failure, self-reproach or self-depreciation (Worsening symptoms) Persistent self-accusations, or definite but still rational ideas of guilt or sin. Increasingly pessimistic about the future (Worsening symptoms) Delusions of ruin, remorse or unredeemable sin. Self-accusations which are absurd and unshakable

Enjoys life or takes it as it comes (Worsening symptoms) Weary of life. Only fleeting suicidal thoughts (Worsening symptoms) Probably better off dead. Suicidal thoughts are common, and suicide is considered as a possible solution, but without specific plans or intention (Worsening symptoms) Explicit plans for suicide when there is an opportunity. Active preparations for suicide