Bipolar Disorder -- Record Keeping

Bipolar Disorder -- Record Keeping
Bipolar disorder is characterized by mood swings from very high (mania) to very low (depression). Medication is an important part of mood stabilization, but research has shown that behavioral techniques are equally important.

In this article I discuss record keeping. It is helpful to document behavioral factors that relate to mood stabilization, including nutrition, exercise, medication, sleep, assigned therapeutic activities, and social contact. Recording your mood is also crucial. You should track your mood at least once a day but preferably three times during the day. Records like this keep you focused on self-help behaviors and maintain awareness and insight.

One way to log these factors is by using the Daily Achievement Record* shown below. Space is provided to record your mood three times a day, to determine if it varies according to time of day. If it does, you can schedule important decisions and activities accordingly.

Maintaining regular sleep patterns is essential for preventing mood episodes, since lack of sleep is a common trigger for mania. It also can be a symptom of mania or of depression, and oversleeping is a symptom of depression. Therefore, the Daily Achievement Record lets you document bedtime, wake time, naps, and quality of sleep.

Mood swings can be triggered by physical illness as well. It is important to maintain good health and fitness; one way is to eat nutritious food and exercise regularly. The Daily Achievement Record tracks nutrition and exercise, as well as caffeine such as soda, coffee, or tea. Research indicates that for some bipolar individuals, excessive intake of caffeine may lead to mania.

Finally, you can keep track of therapeutic activities and social contacts in the “Notes” section. When you receive assignments from a therapist or psychiatrist, log them here. Since social contact can be difficult if you are bipolar, especially during depressed episodes, keep track of that as well. Isolation can be deadly when one is severely depressed!

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An alternative method of keeping records is by journaling. In the morning, write down the following:

Physical – How are you feeling physically today? How many hours did you sleep? Do you feel rested? Do you have any aches and pains or other symptoms?
Mental – What are your emotions this morning? Be sure to use “feeling” words such as “scared” or “content.” You may want to rate your mood on a scale of 0 – 10, -3 to +3, or another scale that appeals to you.
Goals – List 2 or 3 specific goals for that day. Make sure they are something you can measure – for example, “Say affirmations 3 times” instead of “Feel good about myself.”

In the evening, ask yourself these questions and record your answers:

High – What was the best thing that you did or that happened today? It doesn’t have to be great, just the high point for that day.
Low – What was the worst thing that you did or that happened today? It doesn’t have to be terrible, just the lowest point of the day.
Goals – Did you meet your goals? Be sure to give credit for trying!
Gratitude – What do you feel grateful for today? Try to name at least 2 things.

Finally, once a month or so review your records, however you choose to keep them. If your mood is unstable, look them over more often. Your documents will prove invaluable to you and to your doctor, helping you to recognize the onset of an episode so that you can prevent or reduce the consequences. Good luck!

*To access the Daily Achievement Record, click the thumbnail, then right-click and select "Save As" to save the form to your computer!

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