Mood Patterns Self-Reflection

Over the past month, how would you describe your mood most of the time?

Choose one:

• Very low
• Somewhat low
• Neither low nor high
• Somewhat high
• Very high or elated

Which of these have you noticed during the past month? Select all that apply.

Choose any that apply:

• Sadness without a clear cause
• Feeling restless
• Losing interest in activities I usually enjoy
• A change in appetite
• None of these

How would you rate your usual energy level at each of these times of day?

• Morning
• Afternoon
• Evening

For each row: choose one:

• Very low
• Low
• Moderate
• High
• Very high

How often do you have serious trouble getting enough sleep?

Choose one from a list:

• Never
• About once a month
• About once a week
• Several times a week
• Almost every day

How often do you sleep far longer than usual?

Choose one from a list:

• Never
• About once a month
• About once a week
• Several times a week
• Almost every day

Have changes in your mood got in the way of any of these? Select all that apply.

Choose any that apply:

• Work or study
• Relationships
• Hobbies and interests
• Physical health
• None of these

Can you give an example of an activity or interaction that your mood affected? (optional)

Condition: Shown when at least one area was affected

Open answer

Have you ever asked a professional for help with your mood?

Choose one:

• Yes
• No

Which kinds of treatment or support have you used? Select all that apply.

Condition: Only for those who sought professional help

Choose any that apply:

• Talking therapy
• Medication
• Support groups
• Complementary therapies