Questionnaire

Instructions: Please place a check beside the answer that suits you the best.

1. .To what sex do you Belong?

Male

Female

2. To what age group do you belong?

11-13

14-16

17-19

3. What type of family are you from?

Single

nuclear

extended

combined

Grand-family

4. Have you ever been depressed ?

never

Rarely

sometimes

often
5. What do you do when you feel depressed?

Smoke

drink alcohol

Withdraw (go into my shell)

overeat or under eat

Sleep

take it out on others

feel sorry for myself

cut myself

6. What do you think is the root cause of depression amongst adolescents ?

Peer pressure

Hormonal changes

conflict with boyfriend and girlfriend

Insecurities

family conflict

bullying

loss of love one

Social issues

Failure at school

feeling neglected
7. Does your Future seems hopeless?

Not at all

Somewhat

Just a little

Moderately

Vrey much

Qutit alot

8. Have you ever got abused?

Yes

No

8b. If yes How

Sexual

Verbal

Physical

Neglect

Other ________________________________

9. What is your relationship with your parents like?

Very close

Moderately close
 Some what close

Not close at all

10. What are some effects of depression on adolescents?.

Difficulty concentrating

chronic pain

fatigue

loss of interest in activities

loss of appetite

feeling of hopelessness

11. .Do you occasionally have thoughts of death or suicide' ?

often

Never

always

sometimes

12. What do you imply the school do to help student battling with depression?

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