Monday, June 23, 2008

Mood Charts (Part 1)

Hi! I'm back from three days off. I didn't do anything I'd intended to, but I had a lovely mini-vacation nonetheless. And I strongly believe that taking time off when you need it--if you're able to--is an important wellness activity.

Today's post is about mood charts. While a number of you have written to say that you've never been able to keep the mood charts that your doctors have recommended to you, I can understand the feeling. When I first started keeping mood charts, it was something that I decided to do on my own; it wasn't something that my doctor had suggested.

What I developed was based on the Day-Timer model, a time management system I have used for many years. What I did was to adapt their system to the information I wanted to chart.

The Day-Timer system has its own headings. I used some of theirs and some of mine. In the upper left was the To Be Done Today (Action List). I used it as My Daily Record, in which I'd note what I'd accomplished or how I spent my time. So, in this case, I wrote that it was an awful day. For much of the day, I worked on my book, The Mommy and Daddy Guide to Kindergarten. At 3:00, I picked up my son from school, and I noted he didn't do his homework. I wrote that we went to the mall for dinner, and when I came home, I had a terrible wave of despair. (I later figured out it was caused by the Geodon, which was a terrible drug for me.)

Beneath this, on the bottom left, is where I listed Medications I was taking. On this page, I'd written the following: 15+ 5 mg Geodon. At 7:00 p.m., I took 1.25 mg. Zyprexa, 3 mg. Ativan (which, I usually took as a sleeping pill but might have taken earlier because I was feeling so bad, and 2 mg. more at 9:00. At the time I had no idea that taking this much Ativan was harmful because my doctor prescribed it. Now, I'm stunned that he prescribed such a high dosage, and I'm sure it had a major effect on why I was so depressed.)

In the next column, Appointments and Scheduled Events, I usually noted my "To Do" list, or what meetings I had scheduled. Some days I'd list what I'd eaten, or what I'd done for exercise. On this day, I noted that I visited with my neighbor from 4:00-4:30 and wrote what we'd talked about. On the bottom on this column, I usually wrote a Mood Summary and I'd write about how I felt and how the medication was affecting me.

On this particular day, which was genuinely terrible, I didn't write a mood summary because I discussed it on the following page (which I'll show you tomorrow). But if I had written one, it might read like this, "Hypomanic in terms of physical activity. Clearly I need this amount of Zyprexa and Geodon. (It turned out that both of these drugs were awful for me.) My question is about sleep at night. I wonder if I should take the Zyprexa earlier in the day so that I don't have so much difficulty sleeping at night. (And I'd note questions like this to discuss with my doctor.)


Bradley said...

I'm not sure if you noticed but I also keep a mood chart, though I haven't posted it on my blog recently. It wasn't suggested by my pdoc, but I've found it very helpful when I go to her office to give her an updated. Before that I'd sit on the couch and say "uh, I think I did fine." Now, I really know.

Jazz said...

What a great way to do it...I kind of do that in my journal...a summary of how things are going and how I feel. The problem with that is there is so much of it--I got through a notebook in about six weeks--that digging out the relevant data is nigh on impossible. I think the day-timer idea is great.

Bipolar Wellness Writer said...

Dear Bradley,
I did notice your "mood chart," which is an icon that shows how you're doing. The difference between that and what I used to do is significant however, because you end up with "measure" that quantifies your day.

When my mood changed during the day--which it frequently did given the amount of medication I was taking--it was important for me to note it. The reason was because then I could tell if a medication I took at a particular time of the day--was making a difference in how I felt.

But, and I truly agree with this, if you don't chart your moods on a daily basis, you forget the bad days and the good ones.


Bipolar Wellness Writer said...

Dear Jazz,
The reason Day-Timer was great for me is that it was the system I'd used at work for much of my career. And, at the time, I was a freelance writer so I was used to quantifying my time so I could bill clients.

The transition from doing this for work and for wellness was a natural one. After all these years, it's still the system I use, although I no longer need to chart my moods.


Gianna said...

I don't chart moods so much as my mood is relatively consistent...but I have started charting energy and what meds I'm taking and what meds I'm tapering from. Oh, and also how many hours I've slept.

It's been helpful. I use a notepad that has squares and make a chart out of it by hand.

I really wanted to do something with Excel, but when I tried I'd forgotten everything I learned about using it years ago.

Bipolar Wellness Writer said...

Meds and energy is good too. I like the physical act of writing, which is why I use a paper Day-Timer rather than the computer edition.


Gianna said...

oh...I like writing too...I just wanted the nice neat chart printed out on the computer...

Just like the day--planner---it's pre-printed and nice and neat...

right now my whole chart is hand drawn.

but yeah, I write out the information and use sentences just like your day planner.

Bipolar Wellness Writer said...

Dear Gianna,
I love the idea of a hand-drawn mood chart. Yes, I can understand how you would like one that's nice and neat as well.


Mary said...

What a good idea of a mood chart, thats something I could really use, because I find it hard to say hoe I feel, I think I'm going to try it ....thanks...Mary

Bipolar Wellness Writer said...

You're welcome Mary!


P.J. said...

Mood charting, eh??? I'd heard those words floating around but I've never fone anything about it. I mark down when I change meds, but since I've been on the current combo I've been feeling really well and haven't documented anything. I do know tat when I forget to take my afternoon dose, four days in a row, that I start feeling a little low. And, menstration always plays a factor. Then there's a few days that are a little higher than usual. Hmmm, it's sounding more and more like a good idea - maybe it'll help me be more diligent taking my meds, and see how life events and bodily cycles fit into it all!! It may help keep me organized, too!! (Which I desperately need!!)omjasfzz

Bipolar Wellness Writer said...

Dear PJ,
If you asked, "What is the most important tool you've used in order to understand your illness, I'd say, "Mood charts."

Good mood charts not only help you organize yourself, and keep track of your medication, but they enable you to see patterns that enable you to change the course of this illness.