Take this mood disorder questionnaire—and discuss it with your doctor

Recognizing bipolar disorder isn’t easy, especially in its depressive phase, which can mimic other kinds of depression. Some people may not remember a single instance of elevated mood; others may not see their “high” episodes as a problem. For your healthcare provider, though, such information is a clue that could affect your diagnosis and the way you’re treated.

This questionnaire can’t tell you if you have bipolar depression—or any other disorder. It can help you have a productive talk with your healthcare provider about all of your symptoms. (Caregivers can find a questionnaire just for them here.) Simply answer a few questions and share your responses at your next appointment. To receive your responses for that discussion, just follow the instructions below.

Please note: We do not collect or save your personal information. The answers you enter can be printed by clicking the button at the end or by emailing them to yourself. For your security, these answers will not be saved.

This instrument is designed for screening purposes only and is not to be used as a diagnostic tool. Always consult with your healthcare provider.

Sharing your questionnaire responses with your healthcare provider is a great opportunity for an in-depth discussion of your symptoms. While you’re having that conversation, here are some questions you may want to ask:

  • Could my symptoms be bipolar depression instead of another kind of depression?
  • What are the differences between bipolar depression and other kinds of depression?
  • Is bipolar depression treated differently from other kinds of depression? If so, how?
  • What are the three FDA-approved treatment options for bipolar depression?
  • What things can I do, in addition to medicine, to manage my depressive symptoms?
These discussion points—along with space to jot down your own questions—will appear in your customized “responses” page.

THE MOOD DISORDER QUESTIONNAIRE

Answer each of the following questions to the best of your ability, then talk with your healthcare provider.

1Has 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 you didn’t really miss it?

... you were much 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 got you or your family into trouble?

2If you checked YES to more than one of the above, have several of these ever happened during the same period of time?

3How 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?

THE MOOD DISORDER QUESTIONNAIRE
©2000 by Robert M.A. Hirschfeld, MD. Reprinted with permission.

If you have serious thoughts about suicide, call your healthcare provider right away or go to the hospital emergency room. You can also call the National Suicide Prevention Lifeline 24 hours a day at 1‑800‑273‑8255.