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HIPPAA Statement

Bipolar Assessment


Bipolar consists of two very real states of being. One is a state that is best described as "mania", while the other state is described as "depression". As you answer the questions below, ask yourself if you have ever experienced any of the following conditions:
Name:
EMail:


1: Expansive or elated mood
Yes
No

2: Irritable mood
Yes
No

3: Inflated self-esteem or grandiosity
Yes
No

4: Decreased need for sleep
Yes
No

5: Excessive need to talk
Yes
No

6: Flight of ideas or racing thoughts
Yes
No

7: Easily distracted
Yes
No

8: Increase in goal-directed activity
Yes
No

9: Excessive involvement in pleasurable activities that may result in painful consequences
Yes
No

10: Impulsive
Yes
No

11: Overwhelming need to spend money
Yes
No

12: Periods of sadness, loneliness and hopelessness
Yes
No

13: Loss of interest or pleasure in activities that you once found meaningful
Yes
No

14: Change in weight or appetite
Yes
No

15: Feeling of guilt or worthlessness
Yes
No

16: Trouble concentrating or remembering things
Yes
No

17: Indecisive
Yes
No

18: Fatigue or loss of energy
Yes
No

19: Thoughts of death or suicide
Yes
No

20: Need to isolate
Yes
No