Using this calendar to track your mood and anxiety

This calendar helps you monitor your mood and anxiety on a daily basis. It can help you and your health care professional review your symptoms and treatment.

At the end of each day, take a few moments to think about your day, what you experienced, how you felt, how you acted, etc. Then follow these steps for recording the information.

1.Medications/Herbal supplements

List all the medications and supplements you take in the spaces provided, including the daily dosages and number of pills that should be taken each day. At the end of each day, write the exact number of tablets or capsules of each medication that you actually took in the appropriate day’s space.

2.Hours of sleep

Estimate the number of hours of sleep you had the previous night.

3.Rate the severity of your mood episodes

Record how much your mood has affected your ability to function at home, work, or school by putting an✘ in the appropriate space.

4.Mixed states

If you have symptoms of mania and depression at the same time (a mixed state) put a check mark (✔) in the appropriate day’s space.

5.Alcohol or drug use

Put a check mark in the appropriate day’s space if you drank or used drugs.

6.Rate the severity of your anxiety symptoms

Record how much your anxiety, worry or panic has affected your ability to function at home, work or school by putting an ✗ in the appropriate space.

7.Record other symptoms and life events

List physical or mental symptoms (such as loss of appetite, pain, paranoia or

thoughts of suicide) or life events (such as job loss or family crisis). Rate how

much each symptom or event interferes with your life on the day(s) it affects you.

0. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

No interference with life                  Most interference with life



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