Mood Charting Overview
“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
Screening calls on answering machine
Don’t want to answer the phone
Don’t want to see anyone
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
Having trouble sleeping
Sleeping few hours later and getting up earlier
No sleep for 3-4 days
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.
- An example of a mood chart (Tip: Before printing, select File?Page Setup and change the orientation from Portrait to Landscape).
- The complete manual on life charting developed at the National Institute for Mental Health
- Doing a Life Chart as part of a consultation.
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