Depression is a common mental illness in the U.S. caused by a combination of genetic, biological, environmental, and psychological factors. To help measure the severity of a person’s depression symptoms, the Beck Depression Inventory is widely used by clinicians and individuals. It is a 21 item self report for adolescents and adults created by Aaron Beck, a psychiatrist renowned as the “father of cognitive therapy.” While this questionnaire is not used to diagnose a person with depression, it can be a useful instrument in helping a person determine if, and to what degree, they need to seek help for their symptoms. 

History of The Beck Depression Inventory

First introduced in 1961, the Beck Depression Inventory is one of the most popular questionnaires for evaluating a person’s depression severity and has been revised several times since its initial development. The tool was intended to track clinical observations of symptoms and attitudes among depressed adolescents and adults and has since evolved to be used widely as a self-reporting instrument both in and outside of a clinical setting. 

The Beck Depression Inventory has high levels of reliability and validity across cultures and has undergone two major revisions — one in 1978, known as the BDI-IA, and another in 1996, known as the BDI-II. Revised in accordance with the diagnostic criteria of the DSM-V, the manual used to diagnose mental health disorders, the BDI-II continues to be the version most commonly used today. Multiple studies over the years have found this tool has a high accuracy rate in helping identify, and ultimately lead to the treatment of, depression.

Signs and Symptoms of Depression 

To better appreciate how and when the Beck Depression Inventory should be applied, it is important to learn about the signs and symptoms of clinical depression — the very severity of which the tool was created to measure. While it is perfectly normal to have periods of sadness and unhappiness, there are serious disorders that cause a person to experience persistent feelings of unhappiness, self-dislike, and loss of interest, impacting how you think, feel, and act, and if left untreated, can have a major impact on your overall quality of life. 

Outside of the occasional bad day or few weeks, there are specific ways to determine if you are experiencing depression.The 21 item self report Beck Depression Inventory evaluates key symptoms of depression including mood, pessimism, and irritability to gauge how intense a person’s symptoms are, and it can also be used to detect initial depressive thinking. Further, each of the symptoms in the Beck Depression Inventory intentionally fit the diagnostic criteria of the DSM-V. 

Below you’ll find some of the most common signs of depression according to the Beck Depression Inventory:

  • Self-dislike. You may believe you are worthless, experience self-hate, and have a negative outlook on life, as well as persistent feelings of sadness and emptiness. 
  • Agitation. These feelings may cause you to have angry outbursts, feel irritable, and experience frustration over situations big and small. 
  • Loss of interest in hobbies you once enjoyed. Depression has a way of sapping the pleasure out of everything that brings you enjoyment. If you are withdrawing from normal activities that you used to look forward to, this may be a sign of depression.
  • Changes in sleep. Disturbances in sleep patterns, such as insomnia or sleeping too much is a common sign of depression.
  • Changes in appetite. Weight and appetite fluctuate for people with depression and can vary depending on the individual. You may be unintentionally losing or gaining weight or notice changes in your eating habits.
  • Loss of energy. Slowed thinking, speaking, or body movements can occur with depression and result in problems concentrating, making decisions, and remembering.
  • Unexplained physical problems. You may experience back pain or headaches without other known causes. Additionally, depression and stress can have a negative impact on your immune system. 
  • Thoughts of death or self harm. Depression is sometimes connected to feelings of self harm and suicide. If you, or someone you know, is considering suicide, please get immediate help from a crisis or suicide prevention hotline. Call the National Suicide Prevention Lifeline at 800-273-8255 or 911 immediately.

It is important to note that not everyone who is depressed will experience each symptom, and the severity and frequency of these symptoms can vary depending on the individual and their particular experience. Some individuals experience just a few of these symptoms, while others experience many of them. 

Taking The Beck Depression Inventory 

The Beck Depression Inventory can be self-scored and administered from a person’s home or in a clinical setting. In the 21-item, multiple choice questionnaire, a person is asked to rate 21 symptoms and attitudes of depression on a scale of zero to three to best reflect their level of intensity. Each of the symptoms in the Beck Depression Inventory fit the diagnostic criteria of the DSM-V, and the total time it should take a person to complete the questionnaire is five to 10 minutes. 

An example of a question and rating scale can be found below:

  • 0. I do not feel sad
  • 1. I feel sad
  • 2. I am sad all the time, and I can’t snap out of it
  • 3. I am so sad and unhappy that I can’t stand it

Scoring The Beck Depression Inventory 

Once a person completes the short questionnaire, the scoring is straightforward and simple. You will need to add up the score reported for each of the 21 questions ranging from zero to three. The results of the tool are determined by the sum of the ratings, creating a score that ranges anywhere from 0 to 63. In general, answering with the first answer of the multiple choice (zero) indicates that you do not have any problems with the symptom, while the last choice (three) indicates a major issue with a particular symptom. 

The various scoring ranges correspond to the following guidance:

  • Score of 1-10: These ups and downs are considered normal
  • Score of 11-16: Mild mood disturbance
  • Score of 17-20: Borderline clinical depression
  • Score of 21-30: Moderate depression
  • Score of 31-40: Severe depression
  • Score of 40+ Extreme depression

Getting Help for Depression

While the Beck Depression Inventory, or more specifically the BDI-II, is widely used to indicate the severity of a person’s depression, it does not serve as a diagnostic tool or a source of treatment for depression. 

Fortunately, if you are experiencing symptoms of depression, help is available. Depression may make you feel hopeless, but even in severe cases, depression is treatable with medication, psychotherapy, or a combination of the two. It is important to note that treatment doesn’t mean you need to take medication for the rest of your life, rather, therapy and lifestyle modifications can also play a critical role in managing symptoms of depression.

Depression is a very common mental illness in the U.S., and across the globe, with tell-tale signs and symptoms that will help an individual receive an accurate diagnosis from a trained medical professional or a licensed online therapist. While the causes and risk factors can make some people more susceptible to depression than others, no one is immune to experiencing depression. Completing the Beck Depression Inventory is just the start of making long-term, positive change.