One of the challenging things about bipolar moods is the constant process of shifting priorities and directions that is involved in “moodsurfing”.
A young man we’ve been working with for a couple of years has a very seasonal pattern to his moods. Most of the time, the focus of our work is trying to help him emerge from a constant low level depression, but there are a couple of times a year when he cycles into mania.
The challenge is recognizing when this is happening, because treatments and ideas that make a lot of sense during a period when he’s immersed in this chronic depression all of a sudden make no sense at all when he is cycling into an energized state.
We had been talking with him for a while about the idea of trying a medication that helps you be more alert during the day (Nuvigil) – as a way of helping him come out of that chronic depression.
He finally decided to start the medication at the same time (as it happens) as his mood began to cycle out of depression on its own.
The result was that he quickly shifted into a pretty severe mania.
I believe that trying the Nuvigil would probably have worked had we done it at an earlier point in his seasonal mood cycle, when he was in a more pure depression.
Mood charting allows us to see these seasonal patterns and better connect treatment recommendations with not only a person’s current mood but also where there mood is likely to be heading.