Quick Answer
The PHQ-9 and bipolar screening work together. The PHQ-9 measures depression severity over the past two weeks, but it doesn't ask about highs, so it can't distinguish unipolar from bipolar depression. Adding the MDQ and questions about past energy, sleep and family history helps catch bipolar disorder before treatment is chosen.
Understanding PHQ-9 and Bipolar Screening
The PHQ-9 is a nine-question form that asks how often you’ve been bothered by depression symptoms over the past two weeks, such as low mood, loss of interest, sleep and appetite changes, fatigue, poor concentration, feelings of worthlessness and thoughts of death. Scores range from 0 to 27, with higher numbers meaning more severe depression. It’s quick, widely used and useful for tracking change. What it doesn’t do is ask about the other side of bipolar disorder: periods of unusually high energy, confidence, activity or little need for sleep. Someone with bipolar depression and someone with unipolar depression can have identical PHQ-9 scores. This guide is part of the New York bipolar depression hub.
That gap matters because treatment differs. Bipolar depression often calls for mood stabilizers or one of the medications approved specifically for bipolar depression, while antidepressants taken alone can sometimes trigger mania or rapid cycling. For this reason, many clinicians follow a positive depression screen with bipolar questions before choosing treatment. The Mood Disorder Questionnaire is one common option; the University of Washington’s summary describes a positive MDQ as yes to 7 or more of 13 items, several in the same period, and a moderate or serious problem. Our guide on MDQ scoring explains it in detail.
For New Yorkers screened for depression at a busy primary care visit, one extra set of questions can change the whole treatment plan. The NYC Health Department‘s 2024 report estimated that about 3% of adult New Yorkers have been diagnosed with bipolar disorder by a health professional. Secure video visits from anywhere in New York can make it easier to start bipolar care and keep regular follow-ups without extra travel.
What the PHQ-9 measures, adding bipolar questions, and tracking bipolar depression are the three ideas this guide covers.
Tracking bipolar depression
Once bipolar disorder is diagnosed, the PHQ-9 still has value. Repeating it every few weeks shows whether depression is lifting with treatment. It’s often paired with a mood chart that tracks highs, sleep and energy, since a dropping PHQ-9 score combined with very little sleep and racing thoughts could signal a switch toward hypomania rather than recovery. Using both gives a more complete picture than either alone.
Primary care and screening
Many people first take a PHQ-9 at a primary care visit. If depression is found, adding a bipolar screen before starting an antidepressant can prevent problems later. If you’ve already started an antidepressant and noticed agitation, very little sleep, racing thoughts or a sudden unusual high, tell your doctor promptly. That information is important and may mean a psychiatric evaluation is the next step.
PHQ-9 and Bipolar Screening at a glance
| Feature | PHQ-9 | Bipolar screening (e.g., MDQ) |
|---|---|---|
| Asks about | Depression symptoms, past 2 weeks | Lifetime highs and energy changes |
| Detects bipolar? | No | Flags possible bipolar |
| Use | Severity and tracking | Screening before diagnosis |
| Next step | Treatment decisions | Full clinical interview |
Questions beyond the form
A bipolarity follow-up goes beyond a questionnaire. Clinicians ask whether depression began early in life, whether episodes are frequent or start and stop abruptly, whether antidepressants caused agitation, insomnia or a sudden lift, whether there have been stretches of unusual energy or spending, whether depression includes heavy sleep and slowed movement, and whether close relatives have bipolar disorder. None of these proves bipolar disorder, but together they shift the odds and guide how carefully treatment is chosen and monitored.
Mixed features
Some people have depression with a few hypomanic symptoms mixed in, like racing thoughts, restlessness, irritability or more talkativeness, at the same time as low mood. This is called depression with mixed features. It can feel especially uncomfortable and may raise the risk of impulsive behavior. A PHQ-9 alone won’t capture it. Asking about these symptoms during depression helps identify mixed states, which can affect medication choices. Our guides on MDQ scoring and mood charting for bipolar depression cover related topics.
Depression and bipolar screening for New York patients
The PHQ-9 and bipolar screening can both be completed online before a secure video visit. Visits run by secure video anywhere in New York, while you’re physically in the state. The practice is in-network with Aetna and Cigna; confirm your New York plan with the office, and see self-pay fees on the Good Faith Estimate page.
Talking about past highs
People often don’t think of past highs as symptoms, especially if they felt productive or happy. It helps to think back to times when you needed much less sleep, started many projects, spent more, talked faster or felt unusually confident. Writing these down before a visit, and asking someone close what they remember, makes the follow-up more accurate.
When to seek help
Seek an evaluation if depression is moderate or severe, keeps returning, began early in life or hasn’t improved with antidepressants, or if you’ve had periods of unusual energy or little sleep. Thoughts of suicide or self-harm need immediate help through 988. Bipolar depression is treatable, and screening helps match care to the right condition.
Key Takeaways
- The PHQ-9 measures depression severity, not bipolar disorder.
- It doesn't ask about manic or hypomanic periods.
- Bipolar screening adds questions about past highs and family history.
- PHQ-9 scores are still useful for tracking bipolar depression over time.
The Bottom Line
PHQ-9 and Bipolar Screening is common and treatable, and careful care can make daily life feel more manageable.
Frequently Asked Questions
Can the PHQ-9 detect bipolar disorder?
No, the PHQ-9 measures depression severity over the past two weeks. It doesn't ask about manic or hypomanic periods. Someone with bipolar depression can have the same score as someone with unipolar depression. Bipolar screening adds questions about past highs. A clinical interview confirms the diagnosis.
Why screen for bipolar disorder before treating depression?
Bipolar depression is treated differently from unipolar depression. Antidepressants taken alone can sometimes trigger mania or rapid cycling in people with bipolar disorder. Medications approved for bipolar depression may fit better. Screening helps choose treatment safely. It can prevent problems later. An evaluation can clarify what's happening and which options fit.
What questions are part of a bipolarity follow-up?
Clinicians ask about early onset of depression, frequent or abrupt episodes and how antidepressants affected you. They ask about stretches of unusual energy or spending and family history of bipolar disorder. Heavy sleep and slowed movement during depression are noted too. None of these proves bipolar disorder alone. Together they guide treatment choices.
What is depression with mixed features?
Depression with mixed features includes some hypomanic symptoms, like racing thoughts, restlessness or irritability, alongside low mood. It can feel especially uncomfortable. It may raise the risk of impulsive behavior. A PHQ-9 alone won't capture it. Asking about these symptoms helps identify it. An evaluation can clarify what's happening and which options fit.
Is the PHQ-9 useful once bipolar disorder is diagnosed?
Yes, repeating the PHQ-9 every few weeks shows whether depression is lifting. It's often paired with a mood chart tracking highs, sleep and energy. A falling score with very little sleep could signal a switch toward hypomania. Using both gives a fuller picture. Your clinician will review them together.
Can I complete the PHQ-9 and bipolar screening before a video visit in New York?
Yes, both can be completed online before a secure video evaluation anywhere in New York. Your clinician reviews the results with you. You need to be physically in New York during the visit. A full interview follows the screening. Bring notes about any past periods of unusual energy.
Where to go from here
- Right now, if you're not safe
- Call or text 988, or call 911.
- If you'd like an evaluation
- See how scheduling and telehealth work on the new patient page.
- If you want to keep reading
- Return to our library of New York bipolar guides for more guides. For more help preparing and finding care, see NIMH’s tips for talking with your health care provider and FindTreatment.gov.
How We Reviewed This Page
Written by Steven Lockhart of Health Marketing Group and clinically reviewed by Gabriella I. Farkas, MD PhD, a board-certified psychiatrist. Clinical information comes from the sources listed below, and the page is reviewed every 180 days or when guidance changes.
What’s new: September 29, 2026. Page published.
References
- University of Washington Psychiatry. The Mood Disorder Questionnaire (MDQ) overview and scoring. https://pcl.psychiatry.uw.edu/wp-content/uploads/2021/12/MDQ.pdf
- National Institute of Mental Health. Bipolar Disorder statistics. https://www.nimh.nih.gov/health/statistics/bipolar-disorder
- NYC Health Department. The State of Mental Health of New Yorkers (2024). https://www.nyc.gov/assets/doh/downloads/pdf/mh/state-of-mental-health-new-yorkers.pdf
- 988 Suicide & Crisis Lifeline. https://988lifeline.org/
- Tips for talking with your health care provider. https://www.nimh.nih.gov/health/publications/tips-for-talking-with-your-health-care-provider
- FindTreatment.gov. https://findtreatment.gov/