This tool is designed for
you to check for yourself whether you (or a team mate, friend or loved one etc.) may be experiencing a
depressive illness. Please complete the following assessment to determine if this might be likely. Feel free to
contact us via e-mail or telephone; ‘Kick Off’ do not keep any record of your identity or the
For a period of two (2) or more weeks have you:
‘down’, ‘miserable’ or ‘sad’
most of the time?
lost interest or pleasure in most of your usual activities?
In answering ‘YES’ to either of these questions, complete the section
Not interested in going
out, or have stopped going out except
Using Alcohol &/or
drugs &/or sedatives to cope.
Withdrawing from family
& friends. Tending to isolate yourself at home,
after training or
Not getting things
completed at home. Not concentrating on the game or
interested in the
Unable to concentrate,
Thinking you are a
‘failure’, ‘worthless’; blaming yourself,
even when you’re not to
“Life isn’t worth
living”; “nothing ever good happens”
miserable, flat or ‘depressed’.
not need to be constantly, though most of the time.Yes No
Feelings of ‘no
‘It’s all too much for
you”, everything, even the simplest thing. Yes
Feeling miserable or
guilt. Yes No
Finding it difficult to
make a decision.
Sick & ‘run down’
much of the time, with headaches &
Appetite & weight
changes; either poor and weight loss,
or increased appetite
& weight gain.
Poor sleep – waking
early, difficulty getting to sleep
or frequently waking
during the night.Yes No
answering ‘yes’ to 4 or more of these, you may very well have a depressive illness.
(optional) - *only if you would like a response.