Most of the self-help books you suggest that you keep a mood chart. And it is a good idea to keep one for all the reasons I’ve listed on the previous page.
However, I wasn’t satisfied with any of the ones I found, particularly since they did not distinguish between feeling emotionally stable and being functional.
As I found out, it is possible to be quite manic and still be fully functional. Or mildly depressed and functional enough to hide the depression from others.
I have used the charts to show my family that when they thought I was normal (i.e. functional), I wasn’t emotionally stable. It came as quite a shock to them because they often couldn’t detect that anything wrong with me.
Here’s the easiest way to set up a mood chart.
Get a daily appointment book (diary), one that has one page per day for appointments. Don’t invest in anything fancy – a basic one will do. But make sure it has space for you to jot down about 10-15 lines of notes daily.
The size I use is 6 inches wide by 8 1/2 inches tall, which I think is a standard size.
The advantage of using a diary over printed charts is that (a) you don’t have to spend time printing and photocopying anything, (b) the pages are dated, and (c) all the pages are bound together – it’s harder to lose a diary than loose pages.
These issues are important because when you are depressed, doing anything more than picking up a diary is going to be difficult. And no matter how organised you are generally, when you are depressed you are going to put loose pages in any old place.
Do not think it is a waste of money to buy an annual diary in September because you won’t be using more than half of it. Charting your moods is valuable and a diary is a good investment.
Now that you have gotten the diary, it’s time to decide when to chart your moods.
Select two or three times for the day that you will chart your mood. I have generally used 7:00 am (shortly after I have awoken), noon (about lunch time), and 6:00 pm (not too close to bedtime).
You don’t need to use these exact times. The important thing is chart your moods at consistent times each day. Checking your moods more than once a day allows you to chart how your mood varies during the day – but if you find that three times a day is too much, you can check it twice a day.
Charting your moods at a consistent time each day allows you get a long term set of daily readings which aren’t affected by mood variations during the day.
You are going to forget to chart your mood at the selected times. That’s ok. We can usually remember how we were feeling earlier in the day, so if you suddenly realise at bedtime that you haven’t written anything down, all is not lost. Simply fill in the information based on how you remember the day being.
If you’ve forgotten a few days, you can also backfill the information. My experience is that you can pretty much remember today, yesterday, the day before yesterday, and the day before that. After that your memory gets pretty fuzzy.
If you don’t think you can accurately remember how you were feeling, don’t guess. It is better to leave the page blank than to fill it with incorrect information.
Now that you been prepped, what do you actually write in the diary.
Well, it’s pretty straightforward. Here’s an example of a daily entry.
Thur 18 Sep 06
E – 3
P – 3
M – 100 mg Tegretol
E – 4
P – 3
M – 150mg Depakote
Went to work. Was able to concentrate to get some stuff done. Still down, but pulling out of the cycle.
And you think “What the hell is E and P and M”
It’s pretty simple actually.
E is my emotional / stability / mood scale – it is a measure of how I am feeling.
P is my productivity / functionality scale – it measures how well I am getting things done, regardless of how I am feeling.
M is the medication I am taking – when I took it, what I took, how much of it.
The little note at the bottom is just a synopsis of how the day went. It’s isn’t a diary as such, more of a reminder so that two months from now I can understand what had been going on.
Now you see why I recommend an appointment book with at least 10-15 lines per day.
The details of the E and P scales that I use to measure mood and productivity are as follows:
The E Scale
EMOTIONAL / STABILITY / MOOD SCALE – how I feel
0 – True terrible depression. I stop thinking. Time to hide in the closet, or disappear. My life is a failure, I want out of my relationship, suicide starts looking good.
1 – Really low confidence. I don’t want to leave the house or talk with people, but I manage with great effort.
2 – Living through the day hurts. Everything appears insurmountable. I have low self confidence and it affects everything I do. It is nearly impossible to get anything done.
3 – I find it hard to think and I am sluggish. I don’t really want to try hard to do anything. Lower end of a very bad day for a normal person.
4 – A bad hair day.
5 – NORMAL. Feeling how I imagine a normal person would.
6 – Good day. Lot’s accomplished.
7 – Feeling great. A little too much accomplished, but not too much hyperactivity. Upper end of a great day for a normal person.
8 – Definitely hyperactive / manic. Still functional, but remaining in control requires control.
9 – Hyperactive and not too much control. I require most of my energy to control myself, not too much left over for being functional.
10 – True mania. So far I have never had a true manic episode.
The P Scale
PRODUCTIVITY / FUNCTIONALITY SCALE – how I act
0 – Productive / functionality below that of anything a normal person would do. Or you have just shut down and nothing is getting done.
1 – A really bad day for a normal person.
2 – Things below par.
3 – NORMAL. What you would expect from a normal person.
4 – Good to great day
5 – Much accomplished but too much to be normal.
I’d recommend that for easy reference you either handwrite the E and P scales in the diary, or print them out and stick them in the inner cover. I usually forget what the numbers are supposed to mean.
I’ve found out that minor changes in medication can make big changes in how I felt, so tracking my medication and dosages was useful. And embarrassing as it was, tracking when I didn’t take medication was useful. By the way, the M isn’t a scale, it’s just a shortcut for writing the word “medication.”
So I’ve been keeping a mood chart in the diary, now what?
Well, you now have data about how you have been feeling and how you have been acting.
The most useful scale is the E scale as it allows you to monitor the cycles of your moods. If your mood swings are regular, you can figure out how long your depression and manic periods are, use them to predict when you are likely to be depressed or functional, and make tentative plans accordingly.
The combination of E scale and medications allows you to see if the medications you are taking are working. If you start a new medication (or adjust dosage), you can see how your moods react to it over time. Determining if medication is working can get complicated (check “How Drugs Affect Us” for more info) and the mood chart is a valuable tool in finding out.
The diary can also be useful to show to your psych so that they can have an idea on how well (or not) you are doing, as well as offering them a reason why you want to change drugs or drug dosages.
The diary is also very useful for showing spouses, parents, etc. that you are not making this all up. If you can say to them “Remember last month when I was being superwoman, well, that’s because I was manic. And remember last week when I was moody and didn’t want to get out of bed, that’s because I was depressed. Here’s the data.”
I have been able to simply scan the diary and read the information on the E scale to see the changes in my moods. But I have a two week cycle and my moods change daily. It’s obvious from just looking at the numbers what the cycle is.
If you have a longer cycle, or if your moods aren’t as mercurial, you will probably have to chart them on graph paper. Alternatively, you can download and print out this Mood Chart (in Microsoft Excel format).
I’ve created my mood chart based on my needs. It should work for pretty much everyone, but here are some variations.
If you find that the productivity scale (1-5) is too narrow, you can expand it to 1-10. However, if you do expand it, make sure to describe what each of the numbers mean, the way I did above. If you don’t, you are going to forget what the difference between 3 and 4 or 7 and 8 is supposed to be.
If you suffer from anxiety, you can create an Anxiety Scale (an A scale) as well. It’s simple. List the numbers from 1-10, and write down what the numbers mean (10 can mean a full blown panic attack, 4 can be a normal no anxiety day). Define in words what each of the numbers mean and write it down, or you will forget what the the numbers are supposed to signify. Don’t forget to write a copy of the scale in the diary for easy reference.
And you can create any scale you want to, the same way as the Anxiety Scale is created.
The Fine Print
If you assume that I have years and years of meticulously kept mood charts, you’d be wrong.
Mood charts are very difficult to keep consistently. My experience is that a bout of depression is all that it takes to derail the record keeping. Mania doesn’t help either – you wonder why you need to bother if you are feeling good.
I have never been able to keep a mood chart for more than 4-6 weeks (3 weeks or less was normal). What I have are mood charts with missing periods in between. However, the records I did make were sufficient to allow me to chart my hypomanic / depressive cycles (and to allow me to realise that I had no periods of normality), and to determine if some of my meds were working.
Some suggestions on how to keep a more consistent mood chart:
Have something easy to write in. This is why I suggest an appointment book / diary rather than loose pages.
Make sure you keep the diary somewhere visible, such as the kitchen counter, where you put the house keys, where you keep the medications, near the bathroom sink. You should not have to look for it.
Keep a pen clipped to the diary. When you are depressed, looking for a pen is too much effort.
Make sure to have the E and P scales written or glued in the diary for easy reference.
Keep the mood chart simple. Notice that all I recommend is two numbers and medication info, and optionally a few lines of notes. Do not include an ongoing written diary as part of your mood chart. If you don’t feel like writing in your diary, you won’t fill out the mood chart either.
Ask someone to help you. If you are taking medication, you are supposed to have someone making sure that you do take it (you do have someone, don’t you?). When they are giving you your medication, ask them to make sure that the mood chart gets filled out as well.
And if the whole mood chart business slips for a few days or a week or two, just tell yourself that you are doing your best and don’t feel guilty about the empty entries. We have enough other stuff to stress out on.