KEEP A MOOD DIARY

Keeping a Mood Diary is a very helpful tool for managing your bipolar disorder. It not only helps you track your symptoms on a daily basis, but over time it will help you to see how your mood patterns emerge. 

• It may help you identify the onset of a new mood cycle, and guide you in taking preventative actions.
• Further, a mood diary will make speaking with your doctors easier, because when they ask you how you’ve been doing, your can pull out your mood diary and show them the actual record of how you’ve been doing mentally and physically, over the last few weeks or months.  
• Lastly, a mood diary will help you stay focused on day-to-day coping strategies, as well as long-term life goals. Keeping a mood diary helps you maintain control over your bipolar symptoms, while reminding you that you have life to live outside of your bipolar disorder.

Here are some things you might include in your Mood Diary.

Mood Chart: Create a scale of your daily mood from 1 to 10 with 5-6 being normal, 1 being very severely depressed, and 10 being severely elevated. Next to the numerical value for that day, write some words that describe how you’re feeling that day. Examples include: energized, annoyed, important, full of ideas, talkative, impulsive, spending, sleepy, sleepless, guilty, drained, apathetic, indecisive, inadequate, hopeless, suicidal.

Anxiety Chart: Chart you level of anxiety and/or irritability. Use a scale of 1 to 4 with 1 being not very anxious/irritable, and 4 being severely anxious and irritable.

Events Chart: Make notes of important events in your life. Include joyful events like a birthday celebration, and stressful events like getting reprimanded at work. Also make a note of how your mood that day had a positive or negative impact on that event.

Coping Chart: If you’re experiencing mood symptoms, either depression or elevation, chart something that has helped you cope with these symptoms in the past. Examples include: contacting your doctor or family/friends, identifying the triggers, avoiding drugs and alcohol, maintaining your normal activities, maintaining good sleep habits, identifying any changes in medications that may be impacting your mood.

Sleep Chart: Chart the time you went to sleep, the time you woke, and rate the quality of your sleep on a scale from 1 to 10, with 1 being very poor sleep with frequent awakening, and 10 being very deep sleep with difficulty awakening.

Medication Chart: Keep a record of your current meds and their dosages and whether you took them, forgot to take them, or chose not to take them.

Body Chart: Rate how you feel physically on a scale of 1 to 3, with 1 being feeling bad, 2 being feeling ok, and 3 being feeling good physically. Also write a word that describes how you feel that day. Examples include: sick, sleepy, sore, strung-out, stable, strong, sexy. Record your weight every day, and for women, chart your period.

Goals Chart: Every month set a goal, or continue to pursue an existing goal. Each day write down anything you did that moved your closer, or further away from achieving that goal.

Notes: Be sure to leave a little space at the bottom just for notes that you’d like to remember about that day.

The Doctor's Perspective

I think as a physician one of the scariest things is watching your patient not do well. Whether it be because they are not taking their medications or that they are just having another manic or depressive episode, it's very difficult to stand and watch helplessly.

While medications can help, sometimes the illness is just too strong and takes time to get under control. In my own experiences when seeing a patient de-compensate, I automatically feel that I'm not doing something I should be. 

In these instances I find it particularly helpful to speak with patients families about what we can do to help get the patient well. I also find that getting input from colleagues has helped.

Ultimately, I've found that asking for help is never a bad thing. One of the prior blogs mentioned the importance of utilizing patient family and friends as a resource for education which I absolutely second!

Support Networks

Dear Reader,

While all of us need them, for patients with bipolar disorder, support networks can be an essential part of the maintenance of this illness. People with bipolar disorder, when either in manic or depressed states, can often lose touch with reality and lack insight into how they are functioning. An aware and reactive support network can be essential during these times.

Who’s in a support network?

Support networks can be as big or as small as one chooses. Often they can include parents, siblings, close friends and even co-workers. Whomever is in your support network, these are people that you feel comfortable sharing the various facets of your illness with. These are people that often have known you for years and can offer acceptance and support if you become ill. Often patients will tell me who the key people in their support networks are. They will also give these people permission to notify me, as their doctor, if they notice any of the more dangerous symptoms of bipolar disorder appearing, such as risky or dangerous impulsive behavior or intense thoughts of self harm in the patient. Oftentimes, when these symptoms start to appear, the person living with bipolar disorder may not be as attune to them as a friend or family member who is able to see symptoms from a more objective perspective.

How to build a support network?

It’s important for people who are diagnosed with bipolar disorder to engage the family members and friends whom they trust from the beginning of a diagnosis. These are the people who love and care about you. These should be people who are there for you in both your joyous moments, and times of illness or despair.

In what ways can people in support networks be helpful?

When a person with bipolar disorder becomes sick, it sometimes may be difficult to listen to advice from multiple new sources. Sometimes these new sources may be doctors, whom the person suffering may or may not know very well. Friends and family in your support network can often act as a liaison between you and your doctors. The people who know you well are often the first to notice when your mood is not as it normally is and are often able to share these thoughts with you. When this information is coming from trusted sources, it is often easier to understand and interpret at a time where in may be difficult to process what is happening to you. Often the people in your support network can help you make the initial steps to contact your healthcare provider when symptoms arise, and this may allow you to treat symptoms before they escalate and in some cases may require more intensive treatments. Anything that can be done to lessen the amount of manic or depressive episodes, will be of benefit to the person suffering from bipolar disorder in the years after a diagnosis is made.