| The following self test has been developed to assist adults in determining if they may be experiencing symptoms related to Bipolar Disorder (Manic Depression). This is only a preliminary questionaire and should not be used to diagnose or treat any condition, disorder or disease. |
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| 1. Have you recently or at some point in the past experienced a period of time during which you didn’t feel like your usual self and you felt unusually hyper or “high” that friends, relatives, and acquaintances noticed that you didn’t seem like your usual self and/or you got into trouble because of your extreme hyper behavior? |
| Yes |
| No |
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| 2. Have you recently or at some point in the past experienced a period of time during which you didn’t feel like your usual self and you required much les sleep than you normally do, staying up very late and getting up early without missing the sleep or being tired the next day? |
| Yes |
| No |
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| 3. Have you recently or at some point in the past experienced a period of time during which you didn’t feel like your usual self and you were much more talkative than usual, spoke much faster than you normally do, and/or were much more animated while talking than usual? |
| Yes |
| No |
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| 4. Have you recently or at some point in the past experienced a period of time during which you didn’t feel like your usual self and you felt notably much more energetic than usual? |
| Yes |
| No |
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| 5. Have you recently or at some point in the past experienced a period of time during which you didn’t feel like your usual self and you felt unusually driven to accomplish many big goals, whether at school, work, or home? |
| Yes |
| No |
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| 6. Have you recently or at some point in the past experienced a period of time during which you didn’t feel like your usual self and you felt unusually driven to seek out pleasurable experiences without regard to your health or safety, such as risky sexual interactions? |
| Yes |
| No |
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| 7. Have you recently or at some point in the past experienced a period of time during which you didn’t feel like your usual self and you spent much more money than you could afford on items that you did not need without regard to your financial security, risking getting yourself or your family into financial trouble? |
| Yes |
| No |
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| 8. Have you recently or at some point in the past experienced a period of time during which you didn’t feel like your usual self and you felt that your thoughts were racing, jumping from one idea to the next quickly? |
| Yes |
| No |
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| 9. Have you recently or at some point in the past experienced a period of time during which you didn’t feel like your usual self and you were more easily agitated than usual, irritable, and picking fights with those around you over relatively insignificant occurrences? |
| Yes |
| No |
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| 10. Have you recently or at some point in the past experienced a period of time during which you didn’t feel like your usual self and it was extremely hard to concentrate, you were more easily distracted than usual, and your attention was too easily drawn to unimportant or irrelevant stimuli? |
| Yes |
| No |
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| 11. Have you recently or at some point in the past experienced a period of time during which you didn’t feel like your usual self and you were overly confident, overestimated your abilities, or felt much more confident than usual? |
| Yes |
| No |
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| 12. For questions 1 through 12 did you experience these effects while abusing alcohol or an illicit substance such as cocaine, marijuana, or methamphetamine? |
| Yes |
| No |
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| 13. Have you also experienced at a separate time, either recently or in the past, a Major Depressive Episode as defined by feeling slowed down, overly tired, or a noticeable loss in energy? |
| Yes |
| No |
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| 14. Have you also experienced at a separate time, either recently or in the past, a Major Depressive Episode as defined by overwhelming feelings of guilt or being down on yourself? |
| Yes |
| No |
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| 15. Have you experienced at a separate time, either recently or in the past, a Major Depressive Episode as defined by noticeable appetite changes such as unusually active appetite or little or no appetite? |
| Yes |
| No |
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| 16. Have you experienced at a separate time, either recently or in the past, a Major Depressive Episode as defined by feeling unusually sad all of the time, sometimes for no reason? |
| Yes |
| No |
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| 17. Have you also experienced at a separate time, either recently or in the past, a Major Depressive Episode as defined by complete loss of interest in activities you usually enjoy? |
| Yes |
| No |
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| 18. Have you experienced at a separate time, either recently or in the past, a Major Depressive Episode as defined by unusual difficulty making decisions or concentrating? |
| Yes |
| No |
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| 19. Have you experienced at a separate time, either recently or in the past, a Major Depressive Episode as defined by general feelings of hopelessness about your situation? |
| Yes |
| No |
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| 20. When experiencing an episode like the one mentioned in question 1, do you feel that it interferes with your ability to maintain your normal routine or function at usual capacity? |
| Yes |
| No |
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| 21. When experiencing a Major Depressive Episode like the one described in question 3, do you feel that it interferes with your ability to maintain your normal routine or function at usual capacity? |
| Yes |
| No |
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| 22. Have you experienced each of these states (a Manic Episode and a Major Depressive Episode) at least once? |
| Yes |
| No |
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