Bipolar & Mood Spectrum Assessments — Free Clinical Bipolar Screening
MDQ bipolar screener, HAM-D and PHQ-9 depression severity, MADRS medication response — clinically validated, instant results, free in the Mindtalk app.
What this hub covers
Bipolar spectrum and depression severity assessment. The tests in this hub are used together — MDQ screens for bipolar; PHQ-9 / HAM-D / MADRS measure depression severity; the pattern across them shapes treatment planning.
- MDQ — Mood Disorder Questionnaire — the standard bipolar spectrum screener. 13 lifetime yes/no items + co-occurrence + impairment. Positive screen requires all three.
- PHQ-9 — Patient Health Questionnaire — global standard depression screener. 9 items, 2-3 minutes, self-report.
- HAM-D — Hamilton Depression Rating Scale — 17-item clinician-administered depression severity standard since 1960.
- MADRS — Montgomery-Åsberg Depression Rating Scale — 10-item clinician-administered scale designed to detect medication response. Preferred when tracking treatment.
How to use them together
At intake or first evaluation: MDQ + PHQ-9. The MDQ asks about lifetime highs; the PHQ-9 measures current depression severity. Together they give the psychiatrist a bipolar-spectrum picture on Day 1.
During treatment: PHQ-9 weekly for self-tracking. MADRS at each clinician visit for medication-response tracking (MADRS detects response 1-2 weeks earlier than PHQ-9). HAM-D at 4-6 week intervals if the somatic symptom cluster is a specific clinical target.
If depression is recurrent or antidepressants haven't worked: re-take MDQ. The average delay to bipolar diagnosis is 8-10 years, and one negative MDQ years ago does not mean bipolar was correctly ruled out. Recurrent depression that hasn't responded to standard treatment is one of the strongest indicators of undetected bipolar spectrum.
When bipolar screening is most important
- You have had periods when others thought you were not your usual self — more energetic, more talkative, less sleep, more social, more risk-taking, or more irritable — even if those periods felt good at the time.
- Depression is recurrent — three or more distinct episodes across your adult life.
- Antidepressants haven't worked or have caused "buzzy" energy, agitation, insomnia, or mixed features.
- Family history includes bipolar disorder or completed suicide. Both substantially raise pre-test probability.
- First depression episode was in the teens or early 20s. Earlier-onset depression has a higher rate of bipolar spectrum than later-onset.
When to see a specialist
- Any positive MDQ screen.
- PHQ-9 or HAM-D moderate (≥14) or severe (≥19) — particularly if antidepressant treatment is being considered.
- Any positive Item 3 on HAM-D or Item 9 on PHQ-9 (suicide screen) — same-day clinical contact regardless of total score.
- Recurrent depression that has not responded to two or more adequate antidepressant trials.
- Mixed features — depression with agitation, racing thoughts, or "buzzy" energy — with or without a positive MDQ.
Mindtalk's psychiatrists with bipolar spectrum experience assess across Bangalore, Hyderabad, Mysore, and online for anywhere in India. Bring the MDQ + depression severity results to the consult.
Treatments backed by evidence
Bipolar depression: Mood stabilisers first (lithium, lamotrigine, quetiapine) — not antidepressant monotherapy. Combination with structured psychotherapy (interpersonal social rhythm therapy, family-focused therapy, or CBT for bipolar) improves outcomes substantially over medication alone. Sleep-wake regulation is a core intervention.
Unipolar depression: CBT + SSRI/SNRI is first-line for moderate-severe. Behavioural activation for milder cases.
Mixed features or bipolar spectrum: Careful psychiatric management. Antidepressant monotherapy is avoided; combination approach (mood stabiliser + antidepressant, or atypical antipsychotic + antidepressant) with close monitoring.
For structured 90-day recovery aligned to depression severity, the Emotional Reset programme suits sub-clinical to moderate PHQ-9 profiles.
Related reading
- MDQ detailed page
- PHQ-9 detailed page
- HAM-D detailed page
- MADRS detailed page
- Depression hub
- ITQ trauma screener — trauma often mimics bipolar depression
- Mindtalk's psychiatrists with bipolar spectrum experience across India
Frequently Asked Questions
- Why is bipolar so under-diagnosed?
- Three reasons. First, the person seeks help during depression (not during mania or hypomania, which usually feel good), and clinicians do not always ask systematically about past highs. Second, Bipolar II hypomania is often experienced as productivity or a "good phase," not illness — so it is under-reported. Third, family history is often not asked about in enough detail. Result: average time from first bipolar episode to correct diagnosis is 8-10 years globally. This is why bipolar screening (MDQ) is now recommended at every depression evaluation per NIMHANS and Indian Psychiatric Society guidelines.
- What does a positive MDQ mean?
- A positive MDQ screen (7+ Yes items in Section 1, AND several symptoms co-occurred, AND moderate/serious impairment) means your response pattern is consistent with bipolar spectrum at a level warranting clinical evaluation. It is not a diagnosis. MDQ has 73% sensitivity for Bipolar I but only 39% for Bipolar II, so a negative screen does NOT rule out bipolar — particularly the softer Bipolar II presentation. Formal diagnosis requires clinical interview, family history, and illness-course mapping.
- Can antidepressants make bipolar worse?
- Yes — this is one of the most important reasons to screen. Antidepressant monotherapy (SSRI or SNRI alone, without a mood stabiliser) in unrecognised bipolar depression can trigger switch to mania, mixed features, or rapid cycling. If you have a positive MDQ or a strong family history of bipolar and are being started on antidepressants, discuss with your prescriber before starting; treatment planning changes meaningfully.
- Which depression scale should I take alongside MDQ?
- Take at least one depression severity measure. [PHQ-9](/assessments/phq-9) is the fastest self-report standard. [HAM-D](/assessments/ham-d) is the clinician-administered historical gold standard. [MADRS](/assessments/madrs) is the clinician-administered scale preferred for medication response tracking — particularly useful in bipolar depression where medication response is the primary outcome. Rule of thumb: PHQ-9 for weekly self-monitoring; MADRS for clinician review during treatment.
- What about trauma and mood episodes?
- Trauma-related mood dysregulation and PTSD can mimic bipolar depression — mood swings, irritability, sleep disturbance, anger episodes, and emotional numbing all overlap. If you have any significant trauma history, take the [ITQ](/assessments/itq) alongside the MDQ. Treatment for trauma-driven mood dysregulation (EMDR, TF-CBT) is very different from treatment for bipolar depression (mood stabilisers, structured psychoeducation).
Need a clinician's read on your results?
A high score is a signal, not a diagnosis. Mindtalk's psychiatrists and clinical psychologists can interpret your results and recommend next steps — same-day appointments available.