The Mood Disorder Questionnaire March 24, 2022 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? Yes No None ...you were so irritable that you shouted at people or started fights or arguments? Yes No None ...you felt much more self-confident than usual? Yes No None ...you got much less sleep than usual and found that you didn’t really miss it? Yes No None …you were more talkative or spoke much faster than usual? Yes No None ...thoughts raced through your head, or you couldn’t slow your mind down? Yes No None ...you were so easily distracted by things around you that you had trouble concentrating or staying on track? Yes No None ...you had more energy than usual? Yes No None ...you were much more active or did many more things than usual? Yes No None ...you were much more social or outgoing than usual? Yes No None ...you were much more interested in sex than usual? Yes No None ...you did things that were unusual for you or that other people might have thought were excessive, foolish or risky? Yes No None ...spend so much money that you go yourself or your family in trouble? Yes No None 2. If you checked YES to more than one of the above, have several of these occurrences happened during the same period of time? Yes No None 3. How much of a problem did any of these occurrences cause you? Did they make you unable to work, lead to family, financial or legal troubles, or cause you to get into arguments or fights? No problem Minor problem Moderate problem Serious problem None 4. Have any of your blood relatives (i.e., children, siblings, parents, grandparents, aunts or uncles) had manic-depressive illness or bipolar disorder? Yes No None 5. Has a health professional ever told you that you may have manic-depressive illness or bipolar disorder? Yes No None Your confidential assessment results will appear below. Please enter your information to proceed to your results. Email Address First Name Last Name Time's up Next
