Burns Depression Checklist: A Depression Scale For Mental Health Care

Depression has a long list of symptoms that can be brought out by any number of things – loss and grief, significant life changes, and even genetics. Although the word “depressed” is often used interchangeably with the word “sad,” the two are clinically different, and the mechanisms of each are separate. Nevertheless, many people may realize that they are struggling with depression after showing symptoms like sadness, despair, low self-esteem, loss of motivation, sleep difficulties, loss of interest in previously loved activities, and increased levels of anxiety. If these symptoms have been occurring for longer than two weeks, it may be worth looking into them more deeply.

The presence of these symptoms can lead people to search for answers and information on depression. One common resource that comes up when searching for depressive symptoms is the Burns Depression Checklist. Utilizing this checklist may help you recognize your symptoms and find mental health treatment sooner. 

What is the Burns Depression Checklist?

The Burns Depression Checklist is a self-assessment questionnaire that lists common depression symptoms, such as sadness and loss of motivation, which are rated in severity. The total score indicates whether the individual may be experiencing mild, moderate, or severe depression.

Overview of the tool

The Burns Depression Checklist is a single-page assessment comprised of 25 questions and a 0-4 rubric, wherein test-takers score themselves on how they can relate to statements such as, “Feeling unhappy or blue.” Starting at 0 (“Not at all”) and going up to 4 (“Extremely”), people using the Burns checklist can rate their own symptoms and come up with a semi-reliable indicator of the presence or lack of depression symptoms.

Who can use it and why it matters

Uses for the checklist vary. It can be used in some clinical settings to provide clinicians with a reference point from which to begin a CBT session. It can also be utilized in a community setting to screen a population for symptoms of depression, anxiety, and other mental illnesses. Or certain individuals might use it as a means of detecting mental illness within themselves. Far from functioning as a treatment tool, the Burns Depression Checklist can be one of the first steps in seeking help in both personal and clinical settings.

How to use the Burns Depression Checklist

To use the Burns Depression Checklist, grab the checklist and a pen. This is not a timed assessment, nor should it be treated as an exam; there are no right or wrong answers.  When using the checklist for yourself, you may consider the following guidelines:

• Answer honestly. To get an accurate idea of whether you are experiencing depressive symptoms, it may help to answer as honestly as possible. If you are concerned about judgment from others, remember that you do not have to send the paper anywhere after you are done. You can tear the assessment up (if completing the assessment at home) or request that your assessment not be viewed (if you are in a clinical setting). Answering honestly is pivotal to the efficacy and accuracy of the assessment.
• Select your answers according to ongoing feelings, rather than acute ones. Feeling intense sadness after the loss of a beloved pet or loved one does not necessarily indicate the presence of depression. Feeling extreme anger after your trust has been betrayed is also a typical experience and does not necessarily suggest that something is amiss. Constant, unprompted irritability or feelings of despair may warrant further investigation, beginning with the Burns assessment.
• Pay attention to even low depression scores. Although it may be tempting to write off your symptoms if your numbers add up to “mild depression,” the presence of depression in any capacity can be reason enough to seek help.

Step-by-step guide

Using the Burns Checklist is a simple process. Your answers are only as public as you’d like them to be, and are often used only as a basic assessment, rather than a means of diagnosis. The purpose of the assessment is to shed light on how you are feeling, how strong your symptoms are, and possible avenues for treatment.

The 25 symptoms of the Burns Depression Checklist are divided into four sections (Thoughts and Feelings, Activities and Personal Relationships, Physical Symptoms, and Suicidal Urges). When using the assessment, you are asked to indicate how many times in the past week you have experienced each symptom and to rate its severity on a scale of 0 (Not At All) to 4 (Extremely). 

Interpreting scores and identifying severity

Once you complete the checklist, you determine your score by adding up each item. Then, interpret your score as follows: 

• 0 to 5: No depression
• 6 to 10: Normal but unhappy
• 11 to 25: Mild depression
• 26 to 50: Moderate depression
• 51 to 75: Severe depression
• 76 to 100: Extreme depression

Tracking changes over time

One of the benefits of the Burns Depression Checklist is that it can be used to track depression symptoms over time. By retaking the assessment every week and tracking your symptoms and severity, you can recognize whether your symptoms are improving or worsening, and whether it may be time to seek support.

Signs and symptoms of depression

Depression affects people in different ways, but there are common signs to look out for. Recognizing these symptoms is the first step toward getting help.

Emotional symptoms

Emotional symptoms of depression may include:

• Persistent sadness
• Hopelessness
• Irritability 
• Anxiety
• Frustration
• Restlessness

Physical symptoms

Depression can also have a number of physical symptoms, such as: 

• Sleep disruption
• Changes in appetite
• Unplanned weight changes
• Fatigue
• Changes in energy levels
• Physical aches and pains
• Headaches
• Digestive problems

Cognitive symptoms

Depression can also cause cognitive challenges, such as: 

• Difficulty concentrating
• Negative thought patterns
• Inability to focus
• Memory issues
• Negative thinking
• Reduced motivation

Behavioral impact

Behavioral impacts of depression may include:

• Social withdrawal
• Reduced interest in activities
• Functional impairment
• Loss of interest in hobbies
• Neglect of responsibilities at home, work, or school

Differences between depression and anxiety

Depression and anxiety are often comorbid. One recent study determined that 72% of people with anxiety in their lifetime also had a history of depression, and 48% of those with a history of depression had anxiety disorders. These conditions can have overlapping symptoms, and one can significantly impact the other.

Understanding overlapping symptoms

Some of the overlapping symptoms of depression and anxiety may include: 

• Digestive problems
• Changes in appetite
• Unexpected weight changes
• Difficulty sleeping
• Difficulty concentrating
• Irritability
• Restlessness

How anxiety can influence depression scores

Anxiety can have a significant effect on depression. Research suggests that, compared to those with depression who do not have anxiety, people who experience symptoms of both have poorer work performance, family relationships, friendships, and overall quality of life.

These effects can artificially inflate depression scores. For example, someone who is experiencing difficulty concentrating as a result of anxiety may misattribute it to depression.

When to seek professional care

If feelings of sadness, worry, or fear persist, are frequent, or are very intense, or if you feel that you cannot cope on your own, it can be important to seek professional help.

Recovery steps and treatment options

Recovering from depression, anxiety, or both is possible with the right support. Below, we look at possible treatment approaches that can help improve symptoms of these conditions and overall quality of life.

Therapy approaches

Various approaches to therapy can be effective at treating depression and anxiety, including cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), and more. When you work with a mental health professional, they will help determine which approach you may benefit from the most.

Lifestyle support

Research has shown that a variety of lifestyle changes can support mental health, including exercising, eating a nourishing diet, practicing mindfulness, getting adequate sleep, and maintaining social connections.

Medication considerations

In some cases, medication may be recommended as part of a treatment plan for depression and/or anxiety, typically antidepressant medications. In some cases, these medications may be used in combination with talk therapy.

Online therapy with BetterHelp

Online therapy can effectively address a plethora of mental disorders, including anxiety, depression, and substance use disorder. You can start your journey toward good mental health through BetterHelp, an online counseling platform. Depression can make it difficult for some people to get out of bed— this can be a common barrier for those wanting mental health care. Online therapy removes that obstacle by allowing you to receive care from the comfort of your home.

With BetterHelp, you can connect with a therapist via phone, videoconferencing, or live chat. You can also contact your therapist at any time through in-app messaging, and they’ll respond as soon as they can. This may be helpful if you’d like to discuss symptoms of depression or any other mental illnesses or concerns in between therapy sessions.

The effectiveness of online therapy for anxiety and depression

If you are experiencing symptoms of depression, do not hesitate to reach out for help, whether to a friend, a family member, or a licensed counselor. Local therapy offices, counseling centers, and online therapy practices are all resources that can potentially improve your quality of life. Cognitive behavioral therapy, in particular, is one of the most evidence-based psychological treatments for depression. In this study, online therapy was found to be just as effective as in-person therapy for those experiencing depression, anxiety, and emotional distress. Online depression therapy may also be a viable option for individuals facing other mental health challenges, such as substance use disorder, which some people experience in tandem with depression. Therapy may help individuals move forward on an alcohol- and drug-free path toward improved mental health.