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OOD TRACKING - dbsalliance.org

MOOD TRACKINGT racking your activities such as eating, sleeping and relaxing can helpyou see how much of an impact these things have on your moods. Thecharts on the next pages can help you see patterns. Take a few minuteseach evening to fill them out. Make copies or draw your own, so you canuse them every month. Share them with your health care provider(s).12 2004 Depression and Bipolar Support AllianceMEDICATION MONTH/YEAR_____DOSE PER PILLS PER DAY PILLS PER DAY TAKENMEDICATION NAMEPILL (MG)PRESCRIBED12345678910111213141516171 819202122232425262728293031 Medication103333333333332333333333343233 3333 List the names of all medications prescribed to you by your doctor(s), notjust those for mood disorders.

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.

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Transcription of OOD TRACKING - dbsalliance.org

1 MOOD TRACKINGT racking your activities such as eating, sleeping and relaxing can helpyou see how much of an impact these things have on your moods. Thecharts on the next pages can help you see patterns. Take a few minuteseach evening to fill them out. Make copies or draw your own, so you canuse them every month. Share them with your health care provider(s).12 2004 Depression and Bipolar Support AllianceMEDICATION MONTH/YEAR_____DOSE PER PILLS PER DAY PILLS PER DAY TAKENMEDICATION NAMEPILL (MG)PRESCRIBED12345678910111213141516171 819202122232425262728293031 Medication103333333333332333333333343233 3333 List the names of all medications prescribed to you by your doctor(s), notjust those for mood disorders.

2 Write your dosage and the number of pillsprescribed per day. At the end of each day, write down how many pills you actually took. If you take your medication in the morning and evening, it might be helpfulto use two lines, one for AM and one for MONTH/YEAR_____DAY1234567891011121314151 6171819202122232425262728293031 Hours of nighttime sleep7 Number of meals3 Number of snacks1 IF YESP hysical activity? Relaxation time? Went to support group? Spent time talking with (or writing to) a supportive person?

3 Medication side effects?Physical illness?Major life event?Menstrual period?Drank alcohol or used drugs?Record your hours of nighttime sleep, number of meals and number ofsnacks. Check the spaces next to the things that affected you that day, such asrelaxation time or physical illness. Add some of your own if you want LEVELMONTH/YEAR_____DAY12345678910111213 141516171819202122232425262728293031 EXTREMELY MANICVERY MANICSOMEWHAT MANICMILDLY MANIC OR HYPOMANICSTABLEMILDLY DEPRESSEDSOMEWHAT DEPRESSEDVERY DEPRESSEDEXTREMELY DEPRESSED Mixed state (manic and depressive symptoms)( if yes)Fill in the box that best describes your mood for the day.

4 If your moodchanges during the day, fill in the boxes for the highest and lowest them by drawing a line or filling in the boxes between them. Look for patterns. See how your daily moods relate to your lifestyle and your treament.


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