“A mood diary is incredibly helpful, and I always encourage my patients to use them. . .The patients are, on a day-to-day basis, in tune with how they’re doing, and they can take care of themselves.” ~ Adele C. Viguera, MD,
Adele C. Viguera, MD, psychiatrist and associate director of the perinatal and reproductive psychiatry program at the Cleveland Clinic in Ohio, makes a point that psychiatrists have been making for decades with their bipolar patients–it’s crucial that you chart your moods. Barring those with superlative memories, patients can’t recall the ins and outs of their days when they see their psychiatrists once a month or every two months, and the vital data about triggers, cycling, and symptoms is lost.
When I started in this field we encouraged patients to chart their moods with good old pen and paper, checking off boxes and circling numbers.
Well, a better day has arrived. Not only do the mobile apps make access to the mood chart much simpler [even the most dutiful of patients in the 'old day's didn't carry their mood chart in their back pockets on dates, or along with their sunscreen and a novel to the beach]–they’re more sophisticated and hold more data as well.
And they actually send you texts or beep at you to remind you, absolving you of the need to even activate your memory cells.
Oh–and who could ignore the winning ability to share every mood dip, every trigger, every ‘5-star’ day with ‘your friends’ on Facebook or twitter?
We’ve come a long way, baby.
Let’s take a look at just how far–and try to find something that might suit each individual’s taste. For now, let’s tart with four.
I’m starting off pretty bare bones, I’ll confess, but I’m a fan of MoodTrak for a couple main reasons:
1. It allows for multiple entries. As anyone familiar with rapid cyclers, or those in a mixed state, knows, what looks like a ‘1-star-moment’ at 7:00 A.M. might be a full ‘5-star-moment’ at 12:00 P.M., only to plummet back to a ‘2-star’ by the evening. In fact, when I put out an ‘all-call’ for apps that allowed for multiple data entries, Lizzie from the blog Running Naked With Scissors was right on target with this recommendation.
It’s crucial to have those daily swings accounted for, and MoodTrak let’s you enter to your heart’s content–the more times you feel like graphing about your mood, the more complex your graph,, and that very complexity tells you something.
2. It doesn’t just remind you to enter by text. It actually allows you to respond using that self-same text message, which I find wonderful, as the app has the fatal flaw of not being downloadable for the iPhone [this is serious, I'll have you know, it was big of me to test it out by actually hauling myself over to my computer when prompted].
The whole manuever is pretty simple–there’s no bells and whistles, no symptom and trigger requests–no questions about your medicines.
It’s just this:
When you’re ready to make an entry, the app asks for a word about how you feel. This runs the gamut from ‘confused’ to ‘happy’ to ‘anxious’ to ‘pensive’–to more than one word answers, because who ever really follows the directions? So you’ll see samples like ‘trying hard to be positive,’ ‘so freaking tired,’ ‘worried, then excstatic [sic].’ You get the picture.
Step two is a comment–which you don’t even have to do, but I advise it, since ‘lousy’ isn’t usually that informative a month later without something to hang your hat on. People write anything from ‘too much caffeine,’ to ‘anxiety is getting worse’ to ‘hopefully today will get better.’
And step three is easiest of all–you have a choice of 5 stars; you click on 0-5 of them, and voila, you have a graph.
What I didn’t realize in trying this out online, is that apparently your tracking isn’t the slightest bit–how shall I say this?–private, unless you specifically opt for that each entry, which I didn’t even notice.
So . . .most people use aliases. I say ‘most’, since, clueless me, I had no idea that this was for public consumption so I bravely. . . used my daughter’s name.
It’s free online and for an Android, and automatically backs up online.
2. T2 Mood Tracker
The T2 Mood Tracker actually allows for more than just bipolar mood-graphing, really, as it has 6 pre-loaded scales: anxiety, stress, depression, brain injury, post-traumatic stress, general well-being. Under each of those is a sliding scale [no numbers, you just sort of estimate] with opposite descriptors of that mood state that allow you to choose where you fall between extremes.
For example, under anxiety you would slide yourself somewhere between worried and untroubled, sleepless and rested, unsafe and safe, and several more along those lines.
‘Depression’ seemed a bit obvious to me when the first descriptor pair was ‘depressed’ to ‘happy,’ but you’ve also got ‘hopeless’ to ‘hopeful’ and ‘distracted’ to ‘focused’ in with the others.
Additionally, let’s say that some of these scales don’t apply to you.
No problem at all. You turn off that scale, and replace it with one of your own [I knocked off PTSD and threw in 'Physical Wellbeing,' just for fun]. You can also replace the descriptors under the scales [I decided 'weird' and 'normal' were good pairs to use under my Physical Well-being scale. They tell the doctor a lot about. . . things].
At any point you can write a note.
The notes, however, don’t necessarily correlate with any symptom sliding you’re doing–they’re just kind of ‘out there.’
Additionally, there’s no mechanism for writing about medications, triggers, or quantities [you can be 'sleepy,' under 'Depression,' but you can't put in how many hours of sleep you had] or goals, particularly [you can be on the ‘lonely’ end of the ‘lonely-involved’ scale, but can’t write in a plan [although I suppose you could use your notes for this, and just figure out how to sort it all through later] to call a friend.
Although I find it less detail-oriented than some apps, a lot of people are really big fans, so it does pay to check it out [and a lot of people couldn't be bothered to enter all that detail from the other apps, anyway, so there's a point for its side].
Its graphing mechanism is completely unique, and that does balance some of my complaints. After you fill in all your sliding measures for each scale, say, for anxiety, the app then makes a composite point based on all your responses. So initially it looks more like a ‘dot-graph’ than a ‘line-graph,’ but you can see from day-to-day if your depression or anxiety is decreasing, and you can see if they’re on the higher or lower ends of the spectrum.
[From the screenshots, apparently if I stick with it I will one day be worth of a line graph, as the promotional materials display (lower left). Sticking with it, as you can see from some of the comments, is the name of the game in actually getting something out of this mood charting. None of these apps will work if you don't use them. Sorry to bear such bad news.]
However [I feel like I'm playing that old game of 'fortunately-unfortunately' here], I can’t find any way to download, e-mail or save the graph results, so they’re a bit limited when it comes to the ability to share [I don't mean with every friend you've ever had on Facebook; I mean with your physician].
Another plus: Apparently there’s a competition (not with wide name-recognition, but still) called The Apps for the Army (A4A) which. . . .well, you can figure out what it’s about.
The challenge began in March of 2011, asking developers to submit apps that would help “overcome mission-related challenges.”
So, this is a long way of saying that this one ‘took the gold,’ in a perhaps still little-known but still existent category, the “morale, welfare and recreation category.”
What more can I say after that unique praise?
Well, actually, one more thing. Natasha Tracy, a mental health writer whom I highly respect, writes about all aspects of bipolar disorder in her Bipolar Burble. She’s a big fan of the T2 Mood Tracker, and I consider that extremely high praise. See her tribute to it here.
This one will send you reminders as well, and is, bless the developers, available for iPhone (and Android).
Optimism, once yielding a big price tag but now free, has gotten a lot of positive press recently.
Heck, being the research fiend I am, when I saw they were running a study I myself began pimping subjects for them in a recent post, although when many people heard they had to use it every day for 6 months they thought they had other commitments.
Anyway. although I have certain concerns about Optimism’s applicability to–yet again–rapid cycling (it doesn’t allow for multiple points of data entry–if you’re ‘irritable’ at 10:00 A.M., just easy-going as the proverbial clam at 2:30 P.M., a total witch with your family at dinner time, much less cranky when you sit and read the paper in bed with your husband, and then off the ‘irritable’ chart when he brings up your mood disorder, there’s no way to account for that. You’ve just got a 1-10 slider scale, and I suppose you add up all your mood points and divide by the number of switches to get a number. It’s less than ideal.
Additionally, it asks you if you’ve taken your meds, and then asks if “meds [are] a problem,’ but there’s no point of input for what your meds actually are, when you take them, what your side effects are, and if, say, taking an anti-anxiety brings down your ‘Anxiety,’ where, again, there’s only one number you can put in, although it’s known that anxiety levels fluctuate much over the course of the day.
It does have a lot on its side, though.
It’s main screen leads you to screens for:
- Core Data*: This is really basic. It’s your mood (slider scale), how you coped [which again I find needs more detail to accurately assess your coping] and sleep quality, both slider scales of 10, and then sleep and exercise time amounts.
- Stay Well Strategies*: Include slider scales on adequate sleep, healthy meals, plenty of water, positive thinking, time outside–it’s extremely detailed, which may turn some people off, but may be helpful. Hard to know, especially since I don’t see it all being represented in the final graph.
- Triggers*: Lets you slide the scale on ‘lack of exercise,’ ‘stress at home,’ ‘hormonal,’ and a number of other useful indicators (I like that they have ‘poor diet,’ ‘ill-health,’ and ‘negative self-talk’ in there).
- Symptoms*: Here you slide around on sadness, feeling guilty, anxiety, difficulty with ADLs, even wanting to die, which I think is an important symptom to be measured, and which I haven’t seen other apps address head-on yet.
- Notes: Again I find this a little less than desirable. You’re welcome write as much as you want, but it all goes under one note for the day. Thus you might be commenting on that desire to die, and what ti feels like, and even make some notes about self-harm, and it all goes into the same place with what you write about your period, or how much water you drank.
- Charts and Reports: I’m a huge fan of charts and graphics, but this didn’t float my boat as much as some of the other graphic systems I’ve seen. It provides you with two graphs, one charting exercise, mood and coping, and the second sleep hours and sleep quality. I felt it left out a whole passel-full of information that I spent a lot of time inputting–and that seemed fully relevant. For example, graphing mood without graphing anxiety, or sadness, or desire to die feels pretty bare bones. But. . .better than nothing.
*You can customize each of these screens.. For example, I pulled out ‘too much alcohol’ under my Triggers screen [fortunately they didn't ask about too much chocolate or I'd have been in trouble--although I could have added it, now that I think of it. . . .], and actually shut down ‘Anger’ (I could always put it back, my family shouldn’t fear) under ‘Symptoms,’ simply because that’s not one of my major affective states. Perhaps it would be different if I had a mood disorder, but I thought Irritability covered me well enough.
You can work on it online, on an android, iPhone, or iPad, and can e-mail yourself the graphs.
Maybe its biggest selling point? It doesn’t keep offering that you share your fascinating mood information on Twitter or Facebook. Some dignity goes a long way in my book.
I was underwhelmed by iMoodJournal, which didn’t really seem equipped to handle bipolar mood tracking.
First off, its front is a little smiley emoticon. That pretty much put me over the edge right there.
But then you come to the mood-charting page, where you click on one of the mood states that they provide for your delectation. There’s no ability to combine moods (for example, one is ‘sad,’ one is ‘depressed,’ and one is ‘exhausted.’ Seems to me those all easily might go in one package–but not here), and some strike me as not taking the whole thing to seriously (for example, there’s a ‘so-so’ mood, followed, a step down, by ‘Meh.’ In all my long years I’ve never heard a bipolar person describe their mood as ‘meh.’ It will give you a little graph, which isn’t that informative, unless your mood is all over the place, in which case this mood journal would help–but so would any mood tracking device–or any husband or parent or doctor, or anyone who pays even the slightest attention.
Its most individual points weren’t speaking to me, but to be fair it had a unique approach. In a note, you could mark each emotion with a #hashtag (like on Twitter), so I guess under ‘meh,’ you could write, well, help me out here. . .#blah. There.
And this is pretty useful–you can then filter your mood records by #hashtags, and find, say, how many times in a month you wrote, say, #needcoffee.
Another one of their big sells was something I wanted no part in, but I could see might be fun for a younger–or much more attractive–set.
It wanted you to take a picture of yourself [something I try not to do on the best of days], both when you felt poorly and when you felt more positive. The app claims the “self-portrait photos [help you] realize how your mood affects your appearance.” I find they help me realize that I have bags under my eyes, and the skin under my chin–well, this is getting off the topic.
Of course another big sell–as with many of these apps, is that you can share this insightful information about your ‘meh’ mood because you #stayedoutallnightdrinking with a lovely shot of you at 6:00 A.M. the next morning–right with all your friends on Facebook!
All sarcasm aside, in a pinch it might do, but without reference to your medications, your triggers, your symptomatology, your sleep, etc., I don’t feel it’s equipped for the kind of mood charting that a cycling bipolar person might need.
It is cute, though, if you like beaming smily faces–and only $0.99 on the iPhone. I couldn’t find its equivalent for an Android phone. #Maybe #it #just #isn’t #ready #for #that #market #yet.
Although I estimate there are easily over 20 apps for bipolar disorder, I promise I won’t go through them all. But in next post I’ll bring you some more that might pique your interest, if so far nothing appeals. My teaser is that you should come back tomorrow for (I could not make this up) an app that blurts out random, silly sound bytes, either upbeat and cheerful if it’s in an ‘up’ phase–or depressed and negative, assumedly if the app’s at the bottom of his cycle. How could that fail to improve control of your illness, I ask you?
[I've got useful ones up my sleeve, too--don't be scared away. See you tomorrow.]
**Even for those without a mood disorder, doctors have been recommending mood tracking, particularly for those with a challenging physical illness (sample questions below). See the Wall Street Journal’s “Doctors Track Patients’ Mood, Social Life to Manage Illness.” Perhaps one of the mood disorder tracking apps would be helpful in cases like this, as well.
- The WhatsMyM3 App Screens for Mental Disorders (washingtonian.com)
- First Free Depression and Anxiety Health Screener Mobile App – Depressioncheck, Now Available for iPhone and iPod Touch (prweb.com)
- Got Mental Health Problems? There’s an App for That (geardiary.com)
- Subjects Wanted for Research on App for Mood Disorders (candidaabrahamson.wordpress.com)