The Bipolar Spectrum Diagnostic Scale (BSDS)

Developed by Ron Pies and modified by S. Nassir Ghaemi. Used by permission.

Instructions: Please read through the entire passage below before filling in any blanks.

Some individuals notice that their mood and/or energy levels shift drastically from time to time___. These individuals notice that, at times, their mood and/or energy level is very low, and at other times, very high___. During their “low” phases, these individuals often feel a lack of energy; a need to stay in bed or get extra sleep; and little or no motivation to do things they need to do___. They often put on weight during these periods___. During their low phases, these individuals often feel “blue”, sad all the time, or depressed___. Sometimes, during these low phases, they feel hopeless or even suicidal___. Their ability to function at work or socially is impaired___. Typically, these low phases last for a few weeks, but sometimes they last only a few days___. Individuals with this type of pattern may experience a period of “normal” mood in between mood swings, during which their mood and energy level feels “right” and their ability to function is not disturbed___. They may then notice a marked shift or “switch” in the way they feel___. Their energy increases above what is normal for them, and they often get many things done they would not ordinarily be able to do___. Sometimes, during these “high” periods, these individuals feel as if they have too much energy or feel “hyper”___. Some individuals, during these high periods, may feel irritable, “on edge”, or aggressive___. Some individuals, during these high periods, take on too many activities at once___. During these high periods, some individuals may spend money in ways that cause them trouble___. They may be more talkative, outgoing, or sexual during these periods___. Sometimes, their behavior during these high periods seems strange or annoying to others___. Sometimes, these individuals get into difficulty with co-workers or the police, during these high periods___. Sometimes they increase their alcohol or non-prescription drug use during these high periods___.


Now that you have read this passage, please check one of the following four boxes:

This story fits me very well, or almost perfectly
This story fits me fairly well
This story fits me to some degree, but not in most respects
This story doesn’t really describe me at all

Now please go back and put a check after each sentence that definitely describes you.


Scoring: each sentence checked is worth one point. Add six points for “fits me very well,” 4 points for “fits me fairly well,” and two points for ” fits me to some degree.”

Total Score Likelihood of Bipolar Disorder
0 – 6 Highly unlikely
7 – 12 Low probability
13 – 19 Moderate probability
20 – 25 High probability

The optimum threshold for positive diagnosis: a score of 13 or above. Using this criteria only about 20% of people with bipolar depression will be missed, and almost all of those identified as having a bipolar depression will have that form of depression.