Bipolar Disorder Questionnaire

1

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?

YESNO

2

You were so irritable that you shouted at people or started fights or arguments?

YESNO

3

You felt much more self-confident than usual?

YESNO

4

You got much less sleep than usual and found you didn't really miss it?

YESNO

5

You were much more talkative or spoke faster than usual?

YESNO

6

Your thoughts raced through your head or you couldn't slow your mind down?

YESNO

7

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

YESNO

8

You had much more energy than usual?

YESNO

9

You were much more active or did many more things than usual?

YESNO

10

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

YESNO

11

You were much more interested in sex than usual?

YESNO

12

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

YESNO

13

Spending money got you or your family in trouble?

YESNO

14

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

YESNO

15

Name* This field is required.

First Name

Last Name

16

Phone Number

Please enter a valid phone number.

17

Email

example@example.com

18

Score Indicative of Bipolar Disorder Yes to > 7 in question 1 AND Yes to question 2