What is a mood diary? Why does my therapist want me to keep a log of mood and activities? What kind of self-monitoring to you recommend for depressive patients?
One of the most important cognitive-behavioural techniques is self-monitoring. It helps the therapist (and the client) to get a more objective view of the complaints and to examine possible causes and changes of symptoms in the course of the day or week. More.
Usually a depressed patient will feel low and depressed all day, thinking there are no changes or it might become even worse in the course of the day. However self-monitoring of mood might help to get a different view. One of my clients described it this way:
"Somehow, the act of recording moods gave me a sense of control. I used the mood diary to track my reactions to pharmaceutical drugs and side effects and to record daily thoughts and feelings."
He used an analog scale starting with
- 0 = desperate, feeling extremely low to
- 10 = feeling great, no signs of depression
We started with a diary of mood and activities, to get a better understanding of his symptoms during the day:
Here are some notes of the first days of self-monitoring:
- 06:00 1 wake up, ruminating in bed
- 07:00 2 going to the bathroom
- 07:30 2 cup of coffee, low appetite
- 08:00 0 try to read a book, can't concentrate
- 09:00 2 back to bed, feeling low, worrying about the future
- 10:00 3 listening to some birds outside
- 11:00 4 decided to get up, have a walk with the dog
- 12:00 3 lunch, still no appetite
- 13:00 2 need a nap, cannot do my normal work
- 14:00 5 playing cards with my grandson
- 15:00 2 he left, feel lonely and desperate
- 16:00 0 extremely depressed, lay down in bed
- 17:00 0 cannot fall asleep.
- 18:00 2 read the newspaper (sports)
- 19:00 2 dinner with my family
- 20:00 3 watching TV
- There was a change of symptoms during the day! This is typical for depressive disorders, with a low mood in the beginning of the day. Usually there is a slight improvement during the days or in the afternoon.
- He noticed an influence of activites like walking the dog or playing cards with his grandson. This helped him to overcome worrying and to activate himself. So he deciced to schedule a regular walk to the park at least 4 times a week. Another of his ideas was to start gardening again. This was a hobby he had stopped at the onset of depression. These activities helped to give a better structure in the course of the day.