Syndicated from the Bipolar Blog

Whenever you have a change in medications or therapies, your moods will improve, worsen, or stay about the same. Documenting how you feel can be a valuable tool in helping you team up with your doctor and therapist to obtain the right combination of medications and therapy. Use the following form to record the most recent change in your treatment plan and in how you feel since the change. (Or download the form as a Word Document.)

Date of treatment modification: __________________

Description of medication change or change in therapy:

_________________________________________________

How do you feel since the treatment modification?

__ Greatly improved

__ Somewhat improved

__ About the same

__ Somewhat worse

__ Much worse

What improvements, if any, have you noticed?

_______________________________________________

Note any problems you experienced since the change:

__ Inability to concentrate or focus on tasks

__ Sadness/crying

__ Aches/pains

__ Sleeping too much

__ Sleeping too little or inability to sleep

__ Irritability or anger

__ Worried or anxious

__ Fatigue – lack of energy

__ Feeling overwhelmed at work or home

__ Thoughts of death or suicide

__ Increased use of alcohol or other substances

__ Increased risk taking

__ Other (describe): __________________________________

If you changed medications, did you experience any of the following common side effects?

__ Weight gain or loss: ( __________ lbs)

__ Confusion

__ Loss of memory

__ Constipation

__ Diarrhea

__ Dizziness

__ Nausea

__ Sexual difficulties

__ Shortness of breath

__ Dry mouth

__ Night sweats

__ Rash

__ Other (describe): ___________________________

Are you adhering to your treatment plan?

__ Yes

__ No

__ Sort of (explain): _____________________________________

Has anyone commented on your mood? If so, what did they say?

______________________________________________________

______________________________________________________

______________________________________________________

What changes would you need to experience to consider yourself “feeling good?”

______________________________________________________

______________________________________________________

______________________________________________________

Jot down any questions you have for your doctor or therapist:

Question 1: _____________________________________________

Answer: _______________________________________________

Question 2: _____________________________________________

Answer: _______________________________________________

Question 3: _____________________________________________

Answer: _______________________________________________

Tip: Make a copy of this form for your doctor, so he or she can keep a copy in your file for future reference. This can help you and your doctor avoid trying a new medication that you already tried and had problems with in the past. (Yes, your doctor should be keeping track of this, but sometimes if you have to change doctors details can get overlooked during the transition.)

Important: Always consult your doctor before you stop taking a prescribed medication. If a medication is producing undesirable side effects, your doctor can often recommend ways to reduce or eliminate those side effects without having to discontinue the medication. For more about dealing with undesirable side effects, check out our post, “Managing Bipolar Medication Side Effects.”

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