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Mood Chart for Bipolar Disorder
http://yourtotalhealth.ivillage.com
A mood chart is a monthly diary that tracks your illness, treatment and other factors to help youbetter manage bipolar disorder. Charting your moods may reveal a pattern behind the highs andlows of bipolar disorder, such as a change in medication, dosage or some other factor that mightotherwise have gone unnoticed.
Over time, a mood chart may serve as an early warning radar to help predict when depressive or manic phases may begin. Stressful occurrences or a change in sleep patterns that precede thestart of the depressive cycle can be identified, and steps taken to help you.
Filling out your chart takes only a few minutes each day, and it can go a long way to help youand your doctor manage bipolar disorder.
The accompanying mood chart, sample chart and instructions are provided courtesy ofMassachusetts General Hospital (MGH) and Dr. Gary Sachs, director of MGH’s Bipolar Clinic andResearch Program. iVillage Total Health thanks Dr. Sachs and MGH for making this chart availableto our users.
You can learn all about bipolar disorder, its symptoms, treatments and the latest research by vis-iting our Depression & Bipolar Center <http://totalhealth.ivillage.com/depression-bipolar>.
This information is intended for your general knowledge only and is not a substitute for professional medical care. This chartshould be used only under the supervision and direction of your physician. Please consult your physician with any questions orconcerns you may have about your condition.
mood_chart 11/15/07 12:02 PM Page 1
Instructions forMood Charting
http://yourtotalhealth.ivillage.com
General Instructions: Please fill out yourname and date of birth on each mood chartpage. Each page is meant to chart one month ata time. Begin on the appropriate day of themonth and continue charting until the end of themonth. For example, if you begin the chart onMay 15th, continue charting until the end of Mayand begin June on a separate page. However, ifyou begin your chart at the end of the month, forexample May 27th, write in those last days of themonth in the blank spaces before the first of themonth of June and continue charting until theend of the next month, in this case June.
Treatments: For each day, record the totalnumber of tablets of each medication that youhave taken. Draw a line through the box to indi-cate if the medication was not taken that day. Ifyou are taking a medication PRN (as needed)indicate this next to the name of the medicationand enter the dosage of the prescription. In thecase of PRN medication, mark the amount oftablets taken that day in the appropriate blocks.
Major Life Events: In this column note any sig-nificant event that happened on that day. Includeany event that you feel contributed to your moodstate on that day or may have precipitated afuture episode. Include suicide attempts, hospi-talization, and psychotic symptoms.
Menses: For women, indicate days on whichyou had your period by circling the dates.
Mood Ratings: There are three categories ofmood ratings: Depressed, Elevated, or WNL(within normal limits). For each day, mark an "X"in the block that appropriately describes yourmood at its best and worst for that day (you willtherefore possibly have two marks for each day).If symptoms of both mood elevation and depres-sion are present in any given day indicate theseverity of each. Also, indicate the presence ofany psychotic symptoms (hallucinations, delu-sions) on any day by marking an "X" in that col-umn.
Drug Level: If you are taking Lithium, Tegretol(Carbamazepine), or Depakote(Valproate) andhave had a blood level done, mark the level onthe day that your blood was drawn and use thechart to indicate the level. For Lithium, make thelevel with an "L", for Tegretol use a "T", and forDepakote use a "D".
Weight: Record your weight and the day onwhich you weighed yourself. You should weighyourself on the same day each month (e.g., the5th of each month).
This information is intended for your general knowledge only and is not a substitute for professional medical care. This chartshould be used only under the supervision and direction of your physician. Please consult your physician with any questions orconcerns you may have about your condition.
©Gary Sachs, M.D.
mood_chart 11/15/07 12:02 PM Page 2
Nam
e __
____
____
____
____
____
____
____
_MOOD
Rat
e w
ith 2
mar
ks e
ach
day
to in
dica
te b
est a
nd w
orst
Moo
d C
hart
Depressed
WNL
Elevated
TR
EA
TM
EN
TS
(Ent
er n
umbe
r of
tabl
ets
take
n ea
ch d
ay)
Mon
th/Y
ear
____
____
__
0 =
non
e1
= m
ild2
= m
oder
ate
3 =
seve
reSe
vere
Mod
.M
ildM
ildM
od.
Seve
re
___ mg
Antipsychotic___mg
___ mg
Antidepressant___ mg
Anticonvustant___ mg
Benzodiazepine___ mg
Lithium___ mg
Verbal Therapy
Dai
ly N
otes
Irritability
Anxiety
Hours Slept Last Night
Significant ImpairmentNOT ABLE TO WORK
Significant ImpairmentABLE TO WORK
Without SignificantImpairment
MO
OD
NO
TD
EFI
NIT
EL
YE
LE
VA
TE
D O
RD
EPR
ESS
ED
.
NO
SY
MPT
OM
S
Cir
cle
date
to in
dica
teM
ense
s
Without SignificantImpairment
Significant ImpairmentABLE TO WORK
Significant ImpairmentNOT ABLE TO WORK
Psychotic SymptomsStrange Ideas, Hallucinations
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 31W
eigh
t
© G
.S. S
achs
, M.D
. 199
3
http://yourtotalhealth.ivillage.com
mood_chart 11/15/07 12:02 PM Page 3
Nam
e __
____
____
____
____
____
____
____
_MOOD
Rat
e w
ith 2
mar
ks e
ach
day
to in
dica
te b
est a
nd w
orst
Moo
d C
hart
Depressed
WNL
Elevated
TR
EA
TM
EN
TS
(Ent
er n
umbe
r of
tabl
ets
take
n ea
ch d
ay)
Mon
th/Y
ear
____
____
__
0 =
non
e1
= m
ild2
= m
oder
ate
3 =
seve
reSe
vere
Mod
.M
ildM
ildM
od.
Seve
re
___ mg
Antipsychotic___mg
___ mg
Antidepressant___ mg
Anticonvustant___ mg
Benzodiazepine___ mg
Lithium___ mg
Verbal Therapy
Dai
ly N
otes
Irritability
Anxiety
Hours Slept Last Night
Significant ImpairmentNOT ABLE TO WORK
Significant ImpairmentABLE TO WORK
Without SignificantImpairment
MO
OD
NO
TD
EFI
NIT
EL
YE
LE
VA
TE
D O
RD
EPR
ESS
ED
.
NO
SY
MPT
OM
S
Cir
cle
date
to in
dica
teM
ense
s
Without SignificantImpairment
Significant ImpairmentABLE TO WORK
Significant ImpairmentNOT ABLE TO WORK
Psychotic SymptomsStrange Ideas, Hallucinations
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 31W
eigh
t
© G
.S. S
achs
, M.D
. 199
3
12/0
8
4 4 4 4 4 4 4 4 4 2 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4
2 2 2 2 2 2 2 2 2 2 2 2 2 0 2 1 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2
1 1 1 0 1 1 1 2 3 2 3 1 1 1 0 0 0 2 2 2 1 1 1 1 2 2 3 1 0 0 1
1 1 1 2 3 2 3 1 1 1 0 0 0 2 2 2 1 1 1 0 2 1 1 1 2 3 2 3 1 1 1
8 8 8 9 9 7 8 9 9 8 7 8 8 8 8 9 9 6 7 7 8 7 9 8 8 8 9 7 9 9 8
Co
ld/A
ches
/Pai
n
Vaca
tio
n
End
of
Vaca
tio
n
X X X X
250
450
Depakote
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mood_chart 11/15/07 12:02 PM Page 4