I remember the first time a client described their moods as a rollercoaster—one week feeling invincible, like they could conquer the world, and the next crashing into a pit where getting out of bed seemed an insurmountable task. That is when I started to lean more on tools like the Mood Disorder Questionnaire (MDQ), to help untangle those complex experiences. As a psychologist who has spent years listening to such stories, I appreciate how this test cuts through the fog without overwhelming anyone. It was developed by a team led by Dr. Robert Hirschfeld, a psychiatrist who recognized the need for a straightforward method to help screen for bipolar I disorder—the type defined by high-energy manic episodes lasting over a week, which alternate with profound depressive lows. I will share the test here, explain what it uncovers, and reflect on its significance, letting the pieces fall as they may. This is all laid out plainly, so whether you're reading from a textbook or just scrolling late at night, it should be clear.

Understanding Bipolar I and the MDQ

Bipolar I disorder isn't just the mood swings everyone experiences; it is a serious mental health condition marked by at least one full manic phase. This phase involves abnormally elevated energy, racing thoughts, and often risky choices that feel brilliant in the moment. These periods are typically followed by depressive spells that drain the color and joy from life. Dr. Hirschfeld and his group developed the MDQ in 2000 specifically to screen for this condition, focusing on hypomanic or manic symptoms from a person's past, since those highs often get overlooked or even romanticized. The test takes about three minutes to complete and has 15 items: 13 yes/no questions about symptoms, plus two crucial follow-up questions on whether these symptoms occurred together and caused problems in daily life. It is critical to understand that the MDQ is not a diagnosis—far from it—but it is a validated screening tool that flags possibilities, with results that can be categorized as "unlikely," "low probability," "likely," "probable bipolar," or "strongly indicative," based on the number of questions answered affirmatively.

The Mood Disorder Questionnaire (MDQ)

If you are reflecting on your own patterns, here is the test. Answer based on any time in your life when you felt unusually upbeat or "wired" for several days at a time. For the first 13 questions, simply answer yes or no. If you have several "yes" answers, proceed to the final two questions. Answer as honestly as possible—this is a tool for self-reflection, not a graded exam.

1. Feeling so good or hyper that other people thought you were not your normal self or were so hyper you got into trouble?
2. Feeling so irritable that you shouted at people or started fights or arguments?
3. Feeling much more self-confident than usual?
4. Getting much less sleep than usual and finding you didn’t really miss it?
5. Being much more talkative or speaking faster than usual?
6. Having thoughts race through your head or being unable to slow your mind down?
7. Being so easily distracted by things around you that you had trouble concentrating or staying on track?
8. Having much more energy than usual?
9. Being much more active or doing many more things than usual?
10. Being much more social or outgoing than usual, for example, telephoning friends in the middle of the night?
11. Being much more interested in sex than usual?
12. Doing things that were unusual for you or that other people might have thought were excessive, foolish, or risky?
13. Spending money that got you or your family into trouble?

If you answered "yes" to several of the above, please answer the next two questions:

• 14. Did several of these things happen during the same period of time?
• 15. How much of a problem did any of these things cause you—like being unable to work; having family, money, or legal troubles; or getting into arguments or fights? Please select one: No Problem, Minor Problem, Moderate Problem, or Serious Problem.

Scoring and Interpretation

Interpreting the score is straightforward. A positive screen, which indicates a high likelihood that a bipolar disorder may be present, is determined by three criteria:

1. You answered yes to at least seven of the 13 questions in the first section.
2. You answered yes to question 14 (indicating the symptoms occurred together).
3. You answered "Moderate Problem" or "Serious Problem" to question 15 (indicating functional impairment).

A positive screen points toward "probable bipolar" or stronger, especially if the individual has a history of major depressive episodes. Fewer "yes" answers might land you in the "unlikely" or "low probability" categories, but even then, if the experiences resonate, it is worth exploring further with a professional. In my sessions, I've seen these scores open doors to crucial conversations. One woman in her thirties, for instance, tallied high on the energy and talkativeness items, which led us to explore how those "productive" bursts almost always ended in severe burnout. The goal was not about applying a label; it was about naming the cycle so she could begin to manage it.

Why the MDQ Matters in a Clinical Context

What draws me back to the MDQ is its foundation in real patient needs. Dr. Hirschfeld's team built it from the established DSM diagnostic criteria but designed it to be patient-friendly. It has been validated across numerous studies, showing it correctly identifies about 70% of individuals with bipolar disorder (sensitivity) while having a low rate of false positives (high specificity). It is especially useful for Bipolar I, where mania is prominent, but it also serves as a valuable nudge for clinicians to check for the full bipolar spectrum. I often think about how many people are misdiagnosed with unipolar depression and prescribed antidepressants, which can sometimes trigger a manic episode in someone with an underlying bipolar condition. This test helps bridge that diagnostic gap, at least as a starting point. Furthermore, its cultural reach is significant; it has been translated into dozens of languages, making it accessible far beyond specialized clinics. I have personally recommended it to individuals in support groups, who then feel empowered to bring the results to their doctors.

Limitations and Important Next Steps

Of course, no screening tool is perfect. Memory can blur the edges of past experiences; what felt like a "high" might overlap with periods of intense stress or substance use. That is why I always pair the MDQ with a comprehensive conversation. It is essential to ask about family history, since bipolar disorders often have a genetic component, and to track current moods over several weeks to get a clearer picture. If your answers on the MDQ suggest a "likely" probability or higher, consider starting a daily log of your energy levels, sleep patterns, and moods. Most importantly, reach out for a professional consultation. Early intervention strategies, such as establishing a consistent sleep routine, therapy (like Cognitive Behavioral Therapy or psychoeducation), and appropriate medication can shift the ride from chaotic to navigable. In my experience, clients who screen positive often feel a profound sense of relief just from knowing that their experience is not "all in their head"—it is a recognizable pattern with established tools to address it.

Tools like the MDQ remind me why I do this work: to demystify the brain's complex twists without erecting walls of jargon. If a question here sparked a moment of recognition, sitting with that feeling is a quiet form of strength. The MDQ is just one lens, not the whole view, but it can illuminate enough of the path to help you take the next, crucial step.

Reference

• Hirschfeld, R. M., Williams, J. B., Spitzer, R. L., Calabrese, J. R., Flynn, L., Keck, P. E., Jr., ... Zajecka, J. (2000). Development and validation of a screening instrument for bipolar spectrum disorder: The Mood Disorder Questionnaire. American Journal of Psychiatry, 157(11), 1873–1875.