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Bipolar Treatment Strategies Reviewed By Fort Collins, CO Psychiatrist

By harrisjensen - Posted on 26 March 2010

Chart Your Mood And Help Yourself And Your Doctor!

Bipolar Monthly Symptom Chart Makes It Easier!

by Harris Jensen, MD

Editor, Good Day Journal


The really hard thing about bipolar mood swings is there is sometimes no rhyme or reason to the vicious up and down swings of mood that can terrorize a person.

One day they are feeling OK, the next hour here come racing thoughts that lead to agitation, and minutes to hours later a severe mood shift can follow: a person can suddenly feel angry for little cause, sad or hopeless for little reason, and then it can go away only to recur hours to days or weeks later.

The really hard part is keeping up with all this when depression symptoms (feeling sad or empty, sleeping more, tired in the day, low energy, low motivation, ruminating thoughts, feeling hopeless and helpless) are mixed with manic symptoms (feelling up or euphoric or like I don't have to pay attention to consequences of my actions, sleeping less than usual such as 3 hours per night, not tired in the day, with increased goal directed activity, racing thoughts, which lead in turn to restlessness, poor attention--which can look like attention deficit disorder--and poor impulse control, spending sprees, etc.).

I mean, who said in a mood swings, you can only have manic symptoms at one time, and at another time you can only have depression symptoms?

One survey found 40% of mood swings are really a mix.

The problem is too, how do you keep track of that?  When the mood is up or down, a symptom of mania or depression is poor concentration.  So when you most need to keep track of those symptoms of the mood swings, you are least able to do so.

And this is critical. 

People with bipolar are taking medictiton to control these symptoms.  The only way to tell if the medication is working is by looking at the response in the symptoms.

Most mood charts that try to track symptoms actually get to looking very messy with dots for three or more symptoms occurring each day and lines connecting the dots...which look like zig zags and it is hard to make sense of it all, a chaos reflecting the chaos in a person's mind with severe mood swings of bipolar.

So in the Bipolar Monthly Symptom Chart I simply listed all the symptoms of mania and depression in common sense terms, and each day each symptom is given a number.  No dots.  No lines.  Just the facts, neat and tidy on the chart.

The downside is it takes three pages of the chart to cover two weeks, but it is worth it if one's mood swings are severe, and you need to keep track of three or more symptoms to get your symptoms right.

In looking at this chart after it is used, and usually people just use it for a month or two until the medications are adjusted and controlling the mood swings well, it is very instructive for the daughter.  Symptoms may fluctuate independant of one another.  It's not like all the depression symptoms get better at one time or all the manic symptoms get better at one time.

There is an individual response by each symptom, depending on the impact of medication...and other interventions.

This chart clearly shows the patient that some symptoms of their bipolar represent stress not from a "chemical imbalance" directly, but the stress is coming from other  problems:

skipping a meal

irregular sleep times

substance abuse

skipping a medication

arguments in the home

negative or pessimistic thinking

unhealthy attachments

unhealthy or irrational expectations

thinking errors

isolating from friends and/or family

the lack of exercise

taking set backs personally


So this chart provides great feedback to patients, in helping them see very specifically, that some of their symptoms represent the results of their relationships, thinking, daily routine, exercise, and other activities.

Nobody ever proved that all symptoms of bipolar come only from a "chemical imbalance" that only a medication can control.  That kind of "tiny minded" thinking is quite in vogue now days, the idea that our mood is just the result of chemical reactions that only a medication can help.

This chart is great for people who don't want to be tied to the idea that a pill will fix everything in their mood.  Most people want to know--really experience first hand and learn for themselves--that they can control their mood with their actions and with medication.  This chart is a great way to help make that kind of wholistic approach work!



Bipolar Monthly Symptom Chart By Harris Jensen, MD.pdf75.66 KB