1. When you ask your friends and family about her, what do they say?
A. They say they have recently noticed behavioral changes in her
B. They say there may be an underlying cause for her behavior
C. They love her
D. They are not sure what the problem with her is
2. If you do not call her one day, how does she react?
A. She texts me a few times
B. She switches off her phone and does not speak to anyone
C. She calls herself to check in on me
D. She calls obsessively, might even show up to my location
3. What happens when she is extremely upset with you?
A. She gets really sad over the smallest of things
B. She shuts down and does not talk to me at all
C. She is very understanding and tries to talk it out
D. She gets very angry, to the point where she throws things and yells
4. How does she react if you post a picture with a close friend on your social media?
A. She doesn’t say much
B. She doesn’t care
C. She likes it and comments on it
D. She gets very upset about it
5. How does she react when you say you are going out with your gang?
A. She anyway likes to stay home these days
B. She does not want to hang out with them
C. She makes plans with her own friends or stays home for some me-time
D. She gets very upset about me leaving her behind
6. Has your wife ever been diagnosed with or received treatment for a mental illness?
A. I am not sure
B. Yes
C. No
D. Not that she has told me, but I think she should
7. Do you feel like you both have your own independence in your relationship?
A. Yes
B. Sometimes
C. Most of the time, I do
D. No, I think that is one of the issues
8. Does she often accuse you of doing things you are not doing, talking to people you aren’t talking to, or other outlandish accusations that she is convinced you are hiding from her?
A. No, never
B. Sometimes
C. Rarely
D. Yes, she does this frequently
9. How old is your wife?
A. 36+
B. 31-35
C. 26-30
D. 25 or under
10. Is this behavior something new, or has she always been this way?
A. This is something new
B. It comes and goes
C. I am not sure
D. No, she has been this way, but it has started getting to me more over time
11. Does anyone else close to her in her life (family, friends, etc.) ever comment about her temperament or have the same concerns you do?
A. Only recently, a family member said something
B. Sporadically
C. No, not that I can recall
D. Yes, both friends and family
12. If you have a sudden change of plans, is she understanding about it or not?
A. She used to always be, but recently she gets upset
B. It depends on her mood
C. Yes, most of the time, she is understanding
D. No, she rarely understands
13. Does she ever just show up at places where you are without being invited and just “check in” because she was “in the neighborhood” or “thinking about you”?
A. Not that I can remember
B. Rarely
C. No, but she does text a lot sometimes when we aren’t together
D. Yes, that has happened a few times or more
14. Do you ever feel like she will drop anything to hang out with you or rearrange her whole life to make herself available?
A. No, she hasn’t ever done that unless it was important to me
B. Rarely
C. I don’t think so
D. Yes, she has done that
15. Has she been experiencing unusual fatigue, hot flashes, weight gain, mood swings, chills, sleep issues, irregular periods, or other physical symptoms that have evolved recently?
A. Yes, definitely
B. Not so much physical; it’s more of the moods and behaviors I’ve noticed
C. No, not that I have noticed
D. I don't know
