The Burns Depression Checklist: Steps Toward Recovery

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 come to the realization that they may be 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. 

The Burns Depression Checklist: An overview

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.

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; you cannot answer incorrectly.  When using the checklist for yourself, please take care to follow these basic guidelines:

• Answer honestly. In order to get an accurate idea of whether you are experiencing depressive symptoms, you must 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.

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.

Other uses for the checklist

The checklist is not only a tool for self-assessment; it can also be used to assess others. In a clinical setting, it is usually still somewhat self-directed as a therapist might deliver the questions but leave the answering up to the patient. The checklist may also be used by a caregiver, family, or concerned partner in search of more information about depression and symptoms their loved one is showing. If depressive symptoms seem significant, they may then present the assessment to the individual they are concerned about. This is not a common use of the assessment, but it can be used as a way to start a conversation.

The checklist may also be brought to your first therapy appointment to demonstrate to a therapist exactly what it is you are experiencing. Although therapists are trained to ask questions and pay close attention to speech and mannerisms to detect mental illness and direct treatment, it can be helpful to have a baseline from which to work. Feel free to discuss the possibility of bringing and using the assessment when making your first appointment.

The assessment may also be used as a helpful reminder of recovery— or an indication that the current treatment needs to shift. If, for instance, the assessment was taken at the start of therapy, and is taken again two months later, with little change, that could suggest that current treatment avenues are not working and need to be updated. Conversely, if the answers have been positively impacted after several months of therapy, it can be encouraging for both therapist and patient to see that current treatment methods are working.

Steps toward recovery

Although a single assessment cannot cure an ailment, assessments of your mental health can be useful in determining whether there is a likelihood of mental illness present or whether more information is needed. This can be an important tool for many individuals to have at their fingertips, as it transfers the power of knowledge from being solely within the grasp of medical professionals and moves it into the hands of the public at large. Being able to plug in your symptoms and have them quickly evaluated can help you move forward with mental health treatment. You can also compare the results of your assessments each year to map out the long-term impacts of treatment.

Far from being a mental health treatment in and of itself, the Burns Checklist is designed to alert users to the possible onset of depression. This can help give users confidence in reaching out for help and provide mental health professionals with a basic framework from which to operate. It is important to understand that even if the Burns Checklist does not identify you as “at-risk” for having depression, this does not mean, with certainty, that you don’t have it.

Who is “Burns” on the Burns Depression Checklist?

The “Burns” in Burns Depression Checklist is David Burns, a psychiatrist who began practicing in 1976. Burns was known for popularizing the use of Cognitive Behavioral Therapy (CBT), a type of therapy that is usually delivered to individuals, couples, or families struggling with mental illness. While he was not the inventor of CBT, his consistent use of the practice garnered increased interest, and his 1980s book “Feeling Good: The New Mood Therapy” brought even greater acclaim and interest in the practice. From there, Burns continued to write books and practice in the mental health field as an MD. His work increased public health awareness of the mind and mood, including how important both are in shaping worldview, combating (or prolonging) mental illness, and improving quality of life.

David Burns earned numerous awards throughout his career, including the “Distinguished Contribution to Psychology through the Media Award,” honoring his efforts to bring psychological concepts and treatment methods for mental illness to the public through his books (2).

Why is his work significant?

The approach Dr. Burns took to working in psychiatry was somewhat new: he focused on drug-free mental illness treatment, honing in on mindset and creating improved mental health through changing thoughts and thought patterns. He is also known for his TEAM approach (Testing, Empathy, Agenda Setting, Methods), which is still used in many therapy offices to this day. While many of his contemporaries were working closely with patients to improve mental health and stress management techniques, Dr. Burns strove to create a system that made the process simpler, streamlined, and more effective, making drug-free treatment for mental illness more widely available to both practitioners and patients.

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 often makes it difficult 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 still receive care, even 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

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 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.