Mood Monitoring for Bipolar
Bipolar is an unpredictable illness that affects our insight and alters our judgement. We can spiral into lows or shoot into highs with normal periods in between. However, it is different for everyone. No two people experience bipolar the same.
Mood monitoring can really help us become aware of our mood pattern and is an essential tool in educating the medical professionals supporting us. It helps us to predict our mood pattern, which enables strategies to be put into place to limit the risk of relapse. We can also assess what triggers our mood changes and determine what we can do to manage these, helping us to live better lives.
Mood monitoring provides invaluable information over time that can maximize the potential of managing bipolar through crisis to recovery.
Monitoring With Journals
I have always monitored my moods, initially without even realizing it. I started writing a daily diary back in 2008, after recognizing something was wrong. I scribbled down my thoughts and how I felt, following no structure whatsoever. Every time I saw a doctor I took the diaries with me and at times, when I was unable to consciously speak my thoughts, I recited the few sentences that I felt would portray the severity of my feelings.
Any information we formulate for medical professionals is positive. There are many structured ways to do this but at the same time, simple diary notes can inform a psychiatrist or doctor of behaviour to be concerned about. If you write that you can’t cope anymore and you don’t want to live this will of course indicate depression and concern for suicidal thoughts. On the other hand if you write about big ideas with a clear annoyance for lack of understanding, you could be displaying manic symptoms. Any information is good.
I was an inpatient in a psychiatric unit in April this year and even in a crisis state, I somehow reminded myself to write a few notes every night about how I felt. I knew my illness and I knew I needed to help myself. I wrote about my vivid dreams, irritability, self-harming and my desperation for everything to be over. I noted issues with nurses or other medical professionals and triggers from people not understanding my symptoms.
The night before my weekly psychiatric appointment I sat down, forced myself to read my diary notes and scribbled down in only a few sentences what my main problems were. From that point on I was able to advocate for myself. I still requested my community psychiatric nurse and members of my family to be present but I took control. I told myself I was the expert of my body and what I thought and felt couldn’t be shared better by anyone else. It was quite liberating.
Thankfully I had a wonderful psychiatrist who would start the appointment with, "Go ahead Fliss," and then simply listen. At the end he would respond to each problem with a solution and as a result my medication might be tweaked, my sleep concerns addressed, nursing practice and strategies to manage triggers discussed.
It is worth remembering that we often talk about how we feel at that moment. Bipolar is renowned for being changeable and it is difficult to retain insight. I had a friend who I suspected of having a mood disorder after his continual talk of depression with bursts of energy where he felt life was so good and he could write essays in half the amount of time. His doctor put him on anti-depressants but he reported side effects and clouded thinking. He complained that his doctor wasn’t helping him.
I asked him one day what his doctor said about his highs and he looked at me confused? He had only reported his depression. He had lost insight in his high moments, most likely wanting them to continue so he didn’t have a true representation of his mood cycle. This could have been avoided through mood monitoring but we need to accept there is a problem first, which can be the difficult part.