Bipolar Survey

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Bipolar Survey

This survey is used to understand whether an individual is showing symptoms of bipolar disorder.

Question 1*

Please select your gender

Male

Female

Question 2*

Please select your age

Under 18

18-24

25-34

35-44

45-54

55-64

Above 64

Question 3*

Please select the most appropriate answer

Never

Rarely

Sometimes

Often

Very Often

At times I am much more talkative than usual

Never

Rarely

Sometimes

Often

Very Often

At times I am much more active than usual

Never

Rarely

Sometimes

Often

Very Often

I get into a mood where I feel jumpy and irritated

Never

Rarely

Sometimes

Often

Very Often

There are times when I have felt happy and sad at the same time

Never

Rarely

Sometimes

Often

Very Often

My self-confidence ranges from great to self-doubt to overconfidence all at the same time

Never

Rarely

Sometimes

Often

Very Often

In recent times there has been great variation in the quality and standard of my work

Never

Rarely

Sometimes

Often

Very Often

For no specific reasons I get angry and hostile

Never

Rarely

Sometimes

Often

Very Often

At times I am mentally dull and other times I am quick and sharp

Never

Rarely

Sometimes

Often

Very Often

I constantly keep forgetting names, words, places, locations etc.

Never

Rarely

Sometimes

Often

Very Often

At times I am greatly interested in being around people and other times I want to be left alone

Never

Rarely

Sometimes

Often

Very Often

Question 4*

Over the last 3 weeks, how often have you been bothered by the following:

Not at all

Several days

More than half the days

Nearly everyday

No interest or pleasure in doing things

Not at all

Several days

More than half the days

Nearly everyday

Trouble falling asleep, staying asleep or sleeping way too much

Not at all

Several days

More than half the days

Nearly everyday

Feeling tired or having very little energy

Not at all

Several days

More than half the days

Nearly everyday

Eating too less or eating way too much

Not at all

Several days

More than half the days

Nearly everyday

Trouble concentrating on things, such as reading, watching television etc.

Not at all

Several days

More than half the days

Nearly everyday

Thoughts of hurting yourself or harming yourself in any way

Not at all

Several days

More than half the days

Nearly everyday

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