Mood Disorder Questionnaire

  • Remember ONLY your Healthcare Professional can diagnose this condition.
  • The following questionnaire can be used as a starting point to help you recognize the signs/symptoms of bipolar disorder but is not meant to be a substitute for a full medical evaluation.
  • This tool is available in numerous locations elsewhere on the internet and can be found in various formats but it should only be used to assist you in seeking suitable help.

Bipolar disorder is complex and an accurate, thorough diagnosis can only be made through a personal evaluation by your doctor. However, a positive screen here may suggest that you might benefit from seeking such an evaluation from your doctor.

Mood Disorder Questionnaire

Answer these 17 questions as acurately as you can, most are Yes/No answers, all are multiple choice… Results are anonymous however; they will be sent to your email for you to print and keep the results.

Mood Disorder Questionnaire

Progress:

Has there ever been a period of time when you were not your usual self and... you felt so good or so hyper that other people thought you were not your normal self or you were so hyper that you got into trouble?

Has there ever been a period of time when you were not your usual self and... you were so irritable that you shouted at people or started fights or arguments?

Has there ever been a period of time when you were not your usual self and... you felt much more self-confident than usual?

Has there ever been a period of time when you were not your usual self and... you got much less sleep than usual and found you didn't really miss it?

Has there ever been a period of time when you were not your usual self and... you were much more talkative or spoke much faster than usual?

Has there ever been a period of time when you were not your usual self and... thoughts raced through your head or you couldn't slow your mind down?

Has there ever been a period of time when you were not your usual self and... you were so easily distracted by things around you that you had trouble concentrating or staying on track?

Has there ever been a period of time when you were not your usual self and... you had much more energy than usual?

Has there ever been a period of time when you were not your usual self and... you were much more active or did many more things than usual?

Has there ever been a period of time when you were not your usual self and... you were much more social or outgoing than usual, for example, you telephoned friends in the middle of the night?

Has there ever been a period of time when you were not your usual self and... you were much more interested in sex than usual?

Has there ever been a period of time when you were not your usual self and... you did things that were unusual for you or that other people might have thought were excessive, foolish, or risky?

Has there ever been a period of time when you were not your usual self and... spending money got you or your family into trouble?

If you answered predominantly YES to more than one of the previous questions, have several of these issues ever happened during the same period of time?

How much of a problem did any of these cause you - like being unable to work; having family, money or legal troubles; getting into arguments or fights?

Have any of your blood relatives (children, siblings, parents, grandparents, aunts, uncles) had manic-depressive illness or bipolar disorder?

Has a healthcare professional ever told you that you have manic-depressive illness or bipolar disorder?

Thank you for taking the time to complete our questionnaire, we will email you our analysis of your answers and forward you to a page giving advice..

Regardless of the questionnaire results, if you or your family has concerns about your mental health, please contact your physician and/or other healthcare professional.

When completed, your responses may be printed off for further discussion with your doctor.