Hypomania Symptom Checklist (HCL-32)

The HCL-32 is a screening tool for researchers trying to find people with bipolar disorder. This is one of the better “complete but simple” lists of manic-side symptoms. It’s a good “fine-tooth comb” when people want to inventory all possible hypomanic symptoms, usually in the context of asking “do I really have bipolar disorder?”

Remember, however, that this is not exactly the right question. As at the Harvard bipolar clinic, we should instead be asking “how bipolar are you?” In their Bipolarity Index,  hypomania or mania only account for up to 1/5th of the possible score.  The other 4/5th’s of the points possible come from other factors such as family history, age of onset of depression, course of the depressions since, and response to medications. (If that’s not familiar information, go back to the Diagnosis page…)

Thus you should not look at the HCL as a “yes or no” tool for detecting bipolar disorder. It’s simply a handy way to check what should be checked when looking for hypomania or mania — which is just one part of the story. Okay, with that reminder, here we go.

HCL-32

At different times in their life everyone experiences changes or swings in energy, activity and mood (“highs and lows” or “ups and downs”). The aim of this questionnaire is to assess the characteristics of the “high” periods.

1. First of all, how are you feeling today compared to your usual state?

• Much worse than usual
• Worse than usual
• A little worse than usual
• Neither better nor worse than usual
• A little better than usual
• Better than usual
• Much better than usual

2. Compared to other people, my level of activity energy and mood: (Not how you feel today, but how you are on average)

• is always rather stable and even
• is generally higher
• is generally lower
• repeatedly shows periods of ups and downs

3. Please try to remember a period when you were in a “high” state (while not using drugs or alcohol). In such a state:

1. I need less sleep
2. I feel more energetic and more active
3. I am more self-confident
4. I enjoy my work more
5. I am more sociable (make more phone calls, go out more)
6. I want to travel and/or do travel more
7. I tend to drive faster or take more risks when driving
8. I spend more money/too much money
9. I take more risks in my daily life (in my work and/or other activities)
10. I am physically more active (sport etc.)
11. I plan more activities or projects.
12. I have more ideas, I am more creative
13. I am less shy or inhibited
14. I wear more colourful and more extravagant clothes/make-up
15. I want to meet or actually do meet more people
16. I am more interested in sex, and/or have increased sexual desire
17. I am more flirtatious and/or am more sexually active
18. I talk more
19. I think faster
20. I make more jokes or puns when I am talking
21. I am more easily distracted
22. I engage in lots of new things
23. My thoughts jump from topic to topic
24. I do things more quickly and/or more easily
25. I am more impatient and/or get irritable more easily
26. I can be exhausting or irritating for others
27. I get into more quarrels
28. My mood is higher, more optimistic
29. I drink more coffee
30. I smoke more cigarettes
31. I drink more alcohol
32. I take more drugs (sedatives, anti-anxiety pills, stimulants)

In the official version of this tool, there are additional questions about how these “highs” affect your life (positively/negatively); other people’s reactions to them; how long they last; whether you’ve had one recently; and how much of the last year has been spent in such a state. Print the whole form here.

This test was originally published by noted Swiss epidemiologist Jules Angst and colleagues. It is used widely in Europe and has been translated into over 15 languages.

(updated 10/2020)