About this worksheet
The tracker prescribers actually ask for. Fourteen daily rows across seven columns: mood on a -5 to +5 scale (negative depression, zero baseline, positive elevated/hypomanic), sleep hours, anxiety 0–10, irritability 0–10, medication adherence yes/no, notes. Below the grid: current regimen (what, how much, when), side effects noticed this cycle, questions for the prescriber. Two-week cycles align with typical prescriber-visit intervals and give enough data to see interaction between sleep loss and mood elevation, or between missed doses and drift. A footer note anchors rating consistency (rate at the same time each day, evening works best) and the mood scale (-5 severe depression, 0 baseline, +5 elevated/hypomanic).
When to use it
- Bipolar I and bipolar II treatment — the tracker is standard between prescriber visits.
- Mood-episode prediction — sleep loss on the tracker precedes episodes by days.
- Medication trials and titrations — side effects and mood change tracked in parallel.
- Prescriber-therapist coordination when the therapist is not the prescriber.
- Cyclothymic and mood-instability presentations under clarification.
How to use it
- 1
Same time daily
Evening usually works best. Rating variability by time-of-day contaminates the signal.
- 2
Track sleep next to mood, not separately
Sleep loss precedes hypomania and mania by 24–72 hours in bipolar. The adjacency is diagnostic.
- 3
Log medication as yes/no, not detailed
Detailed tracking increases perfectionism and abandonment. Yes/no is enough for adherence patterns.
- 4
Bring the sheet to the prescriber visit
The tracker is designed for prescriber use as much as therapist use. Photograph and share when the client sees the therapist first.
Frequently asked questions
Is this a mood chart in the NIMH format?+
It's simpler than the full NIMH Life Chart but derives from the same evidence base. Full NIMH charting adds daily notation of stressors and detailed medication columns; this version prioritizes daily completion.
Should this replace formal mood scales?+
No — it complements them. Formal scales (YMRS, BDI, MADRS) give validated snapshots; this tracker gives the between-visit pattern.
Is this worksheet free?+
Yes. Free printable PDF. Sign in to send as a secure client link.
Worksheet — Mood and Medication Tracker — provided by TherapistAssist for clinical use. Not a substitute for assessment or treatment.
