Mood Trends

Mood TrendsMood trends are useful to track in order to prevent a full blown episode of depression, hypomania or mania.

I think of them as equivalent to the idea of a falling or rising barometer.

Before satellites and modern weather forecasting, whether the barometer was rising or falling was the best predictor of the weather. If the barometer was rising it meant sunnier weather, and if it was falling it could be sign of a future storm.

Similarly, keeping track of certain markers of mood can help predict where your mood is headed and therefore what to watch for and how what kind of self care to focus on.

Let’s say you notice that you are waking up a bit earlier in the morning, and that you are feeling like tackling more projects, or are talking to friends more, or chatting more online, this could be a sign that your mood barometer is trending up. It doesn’t mean that you are hypomanic, but it does mean that you are more likely to head in that direction than to suddenly dip into depression.

Or maybe you find yourself having a harder time getting out of bed, feeling like putting decisions off to the future, feeling like you want more quiet time and more rest, it doesn’t mean you are depressed, just that you might be heading in that direction.

Trending Up or Trending Down

Take Advantage of the Trend

Certain things are easier to do when you are trending up or trending down.

When you are trending down –

  • It may be easier to have deeper conversations with good friends than to do a lot of socializing with many people.
  • Quiet and contemplative activities may make more sense. Reading may be easier or listening to more complex music.

When you’re trending up –

  • It may be a good time for generating new ideas and new approaches to problems.
  • Tackle decisions that don’t require too much contemplation or analysis.
  • Clean the house or organize things.

But Make Sure to Balance That with Opposite Action

To avoid going from a trend to a full-blown mood episode consciously balance your activities to include some that counter the trend.

When you’re trending down –

  • Focus on not sleeping in. You may want to restrict yourself to a little bit shorter sleep time and make sure to get plenty of bright light in the morning.
  • Make sure you’re getting enough exercise. 30 minutes a day of brisk walking is plenty.
  • Do reach out to those close friends who can help you keep a sense of perspective when your mind tends to focus on the negative too much.
  • Consciously avoid negative news sources.

When you are trending up –

  • Make sure you’re getting enough sleep. Set alarms on your devices so that you stop using them in time to get ready for sleep.
  • Be cautious about beginning lots of projects or committing to big new ideas.
  • Even a small dose of mindfulness meditation (5 minutes twice a day of can help moderate the trend to hypomania.

The Science Behind This

The STEP-BD research project, the largest longitudinal study of people with bipolar ever found that so-called sub-syndromal or residual mood symptoms were a major predictor of new episodes.

In particular, residual mood symptoms early in recovery appear to be a powerful predictor of recurrence, particularly for depression. Risk of depressive recurrence increases by 14% for every DSM-IV depressive symptom present at recovery… This is consistent with the work of Keller et al. that found that subsyndromal symptoms were associated with risk of recurrence…

Perlis RH, Ostacher MJ, Patel JK, Marangell LB, Zhang H, Wisniewski SR, Ketter TA, Miklowitz DJ, Otto MW, Gyulai L, Reilly-Harrington NA, Nierenberg AA, Sachs GS, Thase ME. Predictors of recurrence in bipolar disorder: primary outcomes from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Am J Psychiatry. 2006 Feb;163(2):217-24. PubMed PMID: 16449474.