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Mood Charting
"My medications work for a while and then they just stop working..."
"I have tried everything and nothing works..."
"I have been in treatment forever but I just never seem to get better..."
In our experience these very common concerns are often symptoms of an everyday
problem in psychiatric treatment of mood disorders: it is very hard in a traditional
practice for doctors or patients to really know when a medication is working,
when it isn't, and, especially, when it worked for some things but didn't
for other aspects of an illness.
Mood charting is the most powerful way to improve the quality of the treatment
you receive. But it is also something that is surprisingly hard for some people
to do.
What is involved is putting a check box in a chart, keeping track of the
medications that you take, and rating yourself on a few important dimensions.
The many patients in our clinic who do mood charting say that it takes about
2 minutes per day.
So why is it so hard? Partly the problem is logistic (where do you put
a mood chart to remind you to fill it out -- can you really stick it on the
refrigerator?), but another important dimension is the training many of us
received as children that when you are feeling bad you should do whatever
you can to avoid being aware of those bad feelings. Unfortunately, this training,
which probably made things more pleasant at home, didn't do anything to help
you figure out what to do in order to feel better.
An Introduction to Mood Monitoring
What is monitoring and mood monitoring?
Monitoring is way of becoming
aware of what is happening in a certain circumstances. For example, a parent
may monitor how much milk the child is drinking, a person who is dieting may
monitor what they are eating or a person exercising may monitor how much
they exercise a day. All these people have the goal of understanding or
becoming more aware of what is happening in these situations. The parent,
through his/her monitoring, may realize that, in fact, her child drinks only
half a bottle of milk every other time. The person who is dieting may
realize that they don’t really eat a lot but, they tend to eat more
fattening foods and the person exercising may realize that he/she tends to
exercise longer if they do it in the morning. Mood monitoring, similarly, is
a way of becoming more aware of mood and mood changes.
Why should I monitor my mood?
Some people may already
be monitoring their mood and may not be aware of it. These people know
exactly when their mood changes and can predict what will happen. Others are
not as in tune with their mood and changes in mood. Mood monitoring is a
learning process which helps people get better in tune with their mood.
Some people have reported that their mood is
either too low or too high and that they don’t have any “in-between” moods.
Others have said that they can have days of ups and days of downs and some
have said that they can feel both high and low in the same day. The goal of
mood monitoring is to understand if mood changes, how mood changes, when it
changes and is there anything happening before it changes.
How do I monitor my mood?
Identify extremes of
mood, and when you are okay.
Understand that there may be a progression in mood.
Graph or monitor your mood.
Identifying extremes of mood and when you
are okay:
An initial step in mood
monitoring is identifying aspects of mood when you have been feeling very
energized, very low and when you are feeling okay. Think about times when
you have felt extreme energized and very low, sad or depressed. Now you can
complete the table using the guidelines provided. Use these aspects of mood
as guidelines only. There may be other aspects of your mood that are not
listed here. The key is to put down how you feel.
Most people have a difficult time to identify
what they are like when they are okay or on an even keel or experiencing
stable mood. Often a question that arises is “Is there an okay me?” This can
be a hard question to answer especially if mood swings are a major part of
your life. Here are some ways of coming up with what you are like when you
are okay.
- You could ask your significant other,
family members or friends.
- Think about your hobbies and
interests
- Describe your personality
- Your likes and dislikes
It is important to remember that no has a
flat mood. Joyful events tend to put us in a more buoyant mood and sad
experiences make us sad. The goal of identifying the stable aspects of your
mood will help you understand if the mood you are experiencing is in the
normal range or not.
The different stages or phases of your
mood.
The next step to awareness of
mood includes understanding the concept about how mood progresses from an
early to a middle to a later stage. Some people feel that they don’t have
early stages, they just get depressed or energized while others feel that
there may be milder forms of some of the aspects of their mood. It is not
easy to identify these milder forms of mood. One way of recognizing these
phases is to look at your mood at an early, middle and late stage. You could
ask yourself some questions about your mood and behavior (How do I behave?
What is my thinking like? How do I feel?).
Firstly, look at the table
you completed on your mood when you were feeling extremes of mood.[ “My mood
and other aspects of it” ]
Then ask yourself: What was I
like just before this? It is a good idea to ask family members or close
friends to tell you about what they have noticed about your mood.
For example, if you have
identified not wanting to see anyone when you are feeling very down, then
just before that you may have noticed that you tend to not answer the phone
and at an earlier stage, you may have noticed you start screening your calls
on the answering machine.
Therefore, the table would
look like:
Stages of my depressed mood
Early stage
Screening calls on answering machine |
Middle stage
Don't want to answer the phone |
Late stage
Don't want to see anyone
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Similarly, when you are more energized,
you may have notice that in a later stage, you tend to not sleep for 3
straight days, before that, maybe you were going to bed a few hours later
and getting up earlier and before that, maybe you were just having trouble
going to sleep.
Therefore, the table would look like:
Stages of my energized mood
Early stage
Having trouble sleeping |
Middle stage
Sleeping few hours later and getting up
earlier |
Late stage
No sleep for 3-4 days
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The main reason to understand if there are early changes in mood is help us
take action before the mood progresses into the next stage. It is like
driving a car down a hill. If you put the brakes on when the gradient is
low, it is easier to slow down the car than if you put the brakes on further
down the hill.
In order to deal with some of the logistic problems we have come up with a
way of creating a secure online mood charting process. For more information
click here.
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www.arttoday.com
Page Updated
04/03/08
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