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Mood Disorder Questionaire
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1. Has there ever been a period of time when you were not your usual self and…
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…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?
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…you were so irritable that you shouted at people or started fights or arguments?
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…you felt much more self-confident than usual?
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…you got much less sleep than usual and found you didn’t really miss it?
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…you were much more talkative or spoke faster than usual?
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…thoughts raced through your head or you couldn’t slow your mind down?
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…you were so easily distracted by things around you that you had trouble concentrating or staying on track?
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…you had much more energy than usual?
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…you were much more active or did many more things than usual?
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…you were much more social or outgoing than usual, for example, you telephoned friends in the middle of the night?
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…you were much more interested in sex than usual?
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…you did things that were unusual for you or that other people might have thought were excessive, foolish, or risky?
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…spending money got you or your family in trouble?
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Please add up total number of YES responses for Question #1:
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2. If you checked YES to more than one of the above, have several of these ever happened during the same period of time?
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3. How much of a problem did any of these cause you —like being able to work; having family, money, or legal troubles; getting into arguments or fights?
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4. Have any of your blood relatives (ie, children, siblings, parents, grandparents, aunts, uncles) had manic-depressive illness or bipolar disorder?
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5. Has a health professional ever told you that you have manic-depressive illness or bipolar disorder?
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