psychTracker
Articles by Derek Wood, RN, BC, MS
Mood Charting
"Treating bipolar disorder without charting moods
is like treating diabetes without glucose monitoring"
David Sheehan, M.D.
June 1998 Issue of "Transference"
Mood charting is a very simple, but extremely effective tool in the treatment process for mood disorders. Those with mood disorders find that they are not sure what brought on a mood cycle, if a medication is helping a little or not at all, or even if it is helping some symptoms but not others. By taking a few minutes a day, mood charting can help both you, your therapist, your doctor, and your support system understand your illness better, and ensure a higher quality of care. And the longer you chart, the easier it becomes, the more it becomes a habit, the more reliable it becomes, and the more effective it becomes. The hard part is putting down the honest information, and not "fudging" it, it make it better or worse. We have a habit of trying to make things "more rosy" than they are. Also, the process of starting to retake control of our lives , regain confidence in our abilities, and begin even greater self-care can seem to be one that it enormous. In order to do this, we need an ordered, effective approach. "A Mood Journal" is one such method.
Mood charting as used in "A Mood Journal" is a method to provide you with a graphic representation of the outward physical and emotional behaviors your exhibit or experience as a result of your disorder. As you chart on a daily basis, you will transfer your individual day's information to a weekly summary sheet which will show you trends that are occurring. This allows you to systematically begin to see how your mood states alter the signs and symptoms of your illness, and how environmental factors affect them, when used in conjunction with daily journaling. As time passes, you will begin to be able to discern what subtle changes in your signs and symptoms may be indicating the onset of an emerging pattern from baseline, whether to be toward a depressive or manic state. You will begin to notice patterns emerging that are extremely difficult to notice without a systemic way to track your moods, and their effects. In other words, as time progresses, you move from looking at your mood charts in a retrospective basis to both a retrospective and prospective view.
By charting, you learn more about how the illness affects you specifically. We all can read books and references that generally describe the disease process, and I fully encourage this. However, until we specifically explore how it emerges in ourselves, and how it manifests within us, we cannot truly grasp its significance, nor can we fully participate in self-care, as we do not know just what we need to focus on. We need to learn that as we begin to get irritable, it indicates we are sliding toward depression. This doesn't mean that one day of irritability means we have to run to the doctor. It means that we look at our charting and when we begin to see a pattern of irritability getting worse, it is a possible indicator that we are sliding into a depression. And, we know that there are 3 or 4 other symptoms that go along with this irritability, and we will look to those as well, so that we can gain a holistic view, and catch the change in mood early on, so that we can proactively work to reverse it. As well, we can see that it is just a "one day thing" of irritability that we don't have to worry about. We also can begin to see that in our journaling that whenever "I did XXX today", you suddenly have a high number of symptoms that are negative, you are able to begin to see how environmental factors are influencing your moods and symptoms. This allows you to begin living a "mood healthy" life, in which you can change your lifestyle, habits, and interactions if you wish to avoid those situations that you find can cause you to head down negative mood pathways.
Other than providing you with this information, what else are mood charts good for? Quite a large number of uses, actually. If you wish, you can share them with your support system to help them get that "personal understanding" of your illness. This allows them to understand you more. And it helps them to know your personal symptoms so that they can be on the lookout for them as well. My wife knows mine almost better than I do, and catches them at the drop of a hat. If you show them journaling along with the chartijg, it can help them to understand what types of situations are "mood unhealthy" for you. Suprisingly, when my wife and I discussed WHY I didn't do Christmas shopping (that the crowds absolutely drove me to the brink of homicide and threw me all out of whack - I am an ultra-rapid cycler), she understood and already had figured that out. The mood chart can be used very effectively with your psychiatrist. If you see them once every two months, or even every month, and they ask how you are doing, many people answer "up and down." Or "alright.". We simply can't remember exactly how we have been doing over a long time span. It blurs together. We can instead show them our mood charting and these can graphically see exactly how we have been doing since we last saw them, and this can assist them greatly in regulating our medications if necessary. When we go see our therapists, we can also show them our chart, along with any journaling we have done, and these two together can be a wonderful starting point for any session.
With children and teenagers, charting is often done by the parents at first, with the child participating, in a talk format. This allows them to verbalize their feelings, and see how they correlate to the charting. As time passes, they are then able to begin charting on their own, and to express their own feelings and symptoms. Thus, the same benefits are derived for the pediatric population as for the adult population, with the added benefit that the children are being taught appropriate skills and ways to express their emotions and feelings.
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