Mood and medicine log
A one-week sheet for mood, sleep, energy, activity, medicines, and side effects, with space for questions. Fill it in each day and bring it to your next appointment.Download PDFThe PDF can be filled in on a computer or printed and written by hand.
Printable weekly log
Weekly mood and medicine log
- Name
- Week starting
- Filled in by
Scroll the table sideways to see all 7 days. The PDF and the printed sheet fit the whole week on one page.
| Each day | Mon | Tue | Wed | Thu | Fri | Sat | Sun |
|---|---|---|---|---|---|---|---|
| Mood0 = worst, 10 = best | / 10 | / 10 | / 10 | / 10 | / 10 | / 10 | / 10 |
| SleepHours last night | hrs | hrs | hrs | hrs | hrs | hrs | hrs |
| EnergyLow, medium, or high | |||||||
| Activity or exerciseWhat, and for how long | |||||||
| Medicines takenName, dose, time | |||||||
| Missed or late doseWhich one, and why | YesNo | YesNo | YesNo | YesNo | YesNo | YesNo | YesNo |
| Side effectsWhat, and how bad | |||||||
| Notable eventsStress, changes, good moments | |||||||
| Thoughts of death or self-harmYes or no. If yes, call or text 988 | YesNo | YesNo | YesNo | YesNo | YesNo | YesNo | YesNo |
If you have thoughts of death or of hurting yourself on any day, do not wait for your appointment. Call or text 988 or chat at 988lifeline.org to reach the 988 Suicide & Crisis Lifeline, free and confidential, 24/7. In a life-threatening situation, call 911.
My medicines
Include over-the-counter medicines, herbal remedies, vitamins, and supplements.
| Medicine | Dose | When I take it | What it is for | Started |
|---|---|---|---|---|
Questions for my next appointment
Write them down as they come up during the week.
- 1.
- 2.
- 3.
- 4.
- 5.
- 6.
- 7.
Why keep a log
Tips for tracking and bringing notes
Notes make the visit easier
A provider may ask when your symptoms began, how long they have lasted, how often they happen, and whether they keep you from your usual activities. It may help to take some notes about your symptoms before the visit.
Be specific
Describe all your symptoms, when they started, how severe they are, and how often they happen. Share any major stress or recent life changes too.
National Institute of Mental Health · Tips for talking with a health care provider
List every medicine
Tell your provider about all the medicines you take, including over-the-counter drugs, herbal remedies, vitamins, and supplements.
National Institute of Mental Health · Tips for talking with a health care provider
Watch sleep and appetite, not only mood
Antidepressants usually take 4 to 8 weeks to work, and sleep, appetite, and concentration often improve before mood lifts. Writing these down can show early change.
Write down questions as they come up
Make a list of what you want to discuss and any questions or concerns, so you remember them during the appointment.
National Institute of Mental Health · Tips for talking with a health care provider
Do not wait to report some changes
Call your provider right away about new or worsening symptoms, unusual changes in mood, or acting differently. Never change a dose or stop an antidepressant on your own.
Bring someone if you like
A family member or friend can come for support, help take notes, and help remember what the provider said.
National Institute of Mental Health · Tips for talking with a health care provider
Crisis wording follows the National Institute of Mental Health depression page.
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