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Please answer each question to the best of your ability.

Please note, all fields are required.

Has there ever been a period of time when you were not your usual self and…

1. You felt so good or hyper that other people thought you were not your normal self or were so hyper that you got into trouble?

Yes No None

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

Yes No None

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

Yes No None

4. You were much more talkative or spoke much faster than usual?

Yes No None

5. Thoughts raced through your head or you couldn’t slow your mind down?

Yes No None

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

Yes No None

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

Yes No None

8. You were much more interested in sex than usual?

Yes No None

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

Yes No None

10. Spending money got you or your family into trouble?

Yes No None

Time’s up

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CRISIS SUPPORT
We are NOT an emergency mental health treatment clinic. If you are experiencing a mental health emergency you can call 9-8-8, and talk with someone now. Also, see our Crisis Resources page.