Scribd
Upload
66 views

Ood Tracking: © 2004 Depression and Bipolar Support Alliance

Uploaded by

Fisca Aza
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
66 views

Ood Tracking: © 2004 Depression and Bipolar Support Alliance

Uploaded by

Fisca Aza
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 4

M OOD TRACKING

Tracking your activities such as eating, sleeping and relaxing can help
you see how much of an impact these things have on your moods. The
charts on the next pages can help you see patterns. Take a few minutes
each evening to fill them out. Make copies or draw your own, so you can
use them every month. Share them with your health care provider(s).

12 © 2004 Depression and Bipolar Support Alliance


M EDICATION M O N T H / Y E A R _________________________________________

List the names of all medications prescribed to you by your doctor(s), not At the end of each day, write down how many pills you actually took.
just those for mood disorders. Write your dosage and the number of pills If you take your medication in the morning and evening, it might be helpful
prescribed per day. to use two lines, one for AM and one for PM.
DOSE PER PILLS PER DAY PILLS PER DAY TAKEN
MEDICATION NAME PILL (MG) PRESCRIBED 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Medication 10 3 3 3 3 3 3 3 3 3 3 3 3 2 3 3 3 3 3 3 3 3 3 3 4 3 2 3 3 3 3 3 3
L IFESTYLE M O N T H / Y E A R _________________________________________

Record your hours of nighttime sleep, number of meals and number of Check the spaces next to the things that affected you that day, such as
snacks. relaxation time or physical illness. Add some of your own if you want to.

DAY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Hours of nighttime sleep 7


Number of meals 3
Number of snacks 1
√ IF YES

Physical activity? √
Relaxation time?
Went to support group? √
Spent time talking with (or
writing to) a supportive person?
Medication side effects?
Physical illness?
Major life event?
Menstrual period?
Drank alcohol or used drugs?
M OOD LEVEL M O N T H / Y E A R _________________________________________

Fill in the box that best describes your mood for the day. If your mood Look for patterns.
changes during the day, fill in the boxes for the highest and lowest moods. See how your daily moods relate to your lifestyle and your treament.
Connect them by drawing a line or filling in the boxes between them.
DAY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

EXTREMELY MANIC
VERY MANIC
SOMEWHAT MANIC
MILDLY MANIC OR HYPOMANIC
STABLE
MILDLY DEPRESSED
SOMEWHAT DEPRESSED
VERY DEPRESSED
EXTREMELY DEPRESSED

Mixed state (manic √


and depressive symptoms)
(√ if yes)

You might also like