Bay Area Medical Information
Mood Disorder Questionnaire (Bipolar Depression)

This questionnaire is a screening tool that can help in the diagnosis of bipolar depression

For every given situation in the left column respond with either a "yes"
or a "no" in the right columns.

Situation
Yes
No
1. 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?    
...you were so irritable that you shouted at people or started fights or arguments?    
...you felt much more self-confident than usual?    
...you got much less sleep than usual and found that you didn't really miss it?    
...you were more talkative or spoke much faster than usual?    
... thoughts raced through your head or you couldn't slow your mind down?    

...you were so easily distracted by things around you that you had trouble concentrating or staying on track?

   

...you had much more energy than usual?

   

...you were much more active or did many more things than usual?

   

...you were much more social or outgoing than usual, for example, you telephoned friends in the middle of the night?
 

   

...you were much more interested in sex than usual?

   

...you did things that were unusual for you or that other people might have thought were excessive, foolish, or risky?

   

...spending money that got you or your family in trouble?

   
2. If you checked Yes to more than one of the above, have several of these ever happened during the same period of time?    
3. Have you or any of your blood relatives (i.e children, siblings, parents, grandparents, aunts uncles) had mani-depressive illness or bipolar disorder?    
4. Has a health care professional ever told you that you have manic -depressive illness or bipolar disorder?    


Question
No Problem
Minor Problem
Moderate Problem
Serious Problem
5. How much of a problem has any of these ever caused you:        
problems with being able to work        
having family troubles        
money or legal troubles        
getting into arguments or fights        


Result:  Mood Disorder likely present if all 3 of the following criteria are met:

  • Question 1: 7 out of 13 responses are "yes" Question 2: "yes" response
  • Question 5: any "moderate" or "serious" response

    Note: This information should not be used as a substitute for the advice of an appropriately qualified and trained professional health care provider. It is for educational and informational purposes only and in no way should be considered as an offering of medical advice. Please check with a physician if you suspect you have a problem with a mood disorder.

Last updated January 2008


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