Even the Seinfeld chain of Xs doesn't work

July 29, 2010 8:06 AM

Sustained Motivation: I've searched but come up empty. Please hope me. The general answer to mood-related questions, both here and from therapy, is "keep track of your mood". I can't do that. I lose interest after a few days because "I"m fine now, that was a lot of huffle about nothing."

I've been seeing a therapist for over a year now. I also have a psychiatrist I have seen at times. We've been through diagnoses of and meds for:

- generalized anxiety
- ADHD
- depression
- bipolar II

The meds have included: Adderall (XR and regular), Lexapro, Prozac, Xanax, every sleep aid you can name including the superspecial ones that need to be approved by the insurance company speaking with my psychiatrist, Vyanase, Staterra.

I've been on Yaz which is supposed to help with mood swings from PMS.

The problem is that ALL of these drugs either work for a very short time (a few weeks, or in the case of the Yaz, a few months) and then stop working OR make me feel like a zombie.

The sleeping aids did nothing. They would knock me out for a little, but then I'd wake up after a few hours.

The Adderall was great for about the first 4 weeks than slowly stopped working at all. Doctor increased dosage to maximum and then beyond: it was like I was taking nothing.

The problem:

I definitely have mood swings. But I can't keep track of my moods. I am trying to work through Feeling Good and keeping a notebook just for that, I carry it around with me. I did great with it for like a month. But then I'll start to feel better or something and think "Man, what a load of bull. i'm better now, i'm not gonna let that happen again."

The only time I have ever felt "normal" as in, even-keeled, generally good disposition, not emotionally strained, slept well, ate well, FELT well was the month or so when the Adderall was working. I only felt the "high" that some people talk about for the first few days. After that, I felt the way I've always wanted to feel. It felt like I had a RANGE of emotions, not just worried, anxious, nervous, and fatigued.

My psychiatrist is mystified. He's pretty sure that I have ADHD but he can't figure out why the meds don't work. We've even tried stopping all meds for several months and then trying Adderall again, thinking I needed a break. Nope...it was if I was taking a placebo.

And here I am again...yesterday and today I WOKE UP in a bad mood. Yesterday I woke up early on my own, after only 6 hours of sleep, tried to exercise and just got very irritated but did it anyways. This morning, I had eight hours of sleep and still felt very irritated.

I'm sleeping better than I used to, definitely. But this mood thing is not really improving.

I know that I need to keep track of my moods and my therapist and psychiatrist have given me mood charts and encouragement. But I lose them or give up. The whole "sense of accomplishment" just doesn't do it for me...I don't care about a chain of Xs. At first I do, but then I don't anymore.

I think that my moods are invalid or not genuine. Or that I am "wrong" for feeling the way I do and not giving them a true account of what is really wrong with me.

But in order for me to properly diagnosed as ADHD, depressed, anxious, or just plain lazy and unmotivated, I NEED to be able to do this mood tracking thing. My problem is that I will just start telling stories - I will try to RATIONALIZE why I feel sad/mad/happy/tired rather than just SAY that I am. I feel guilty for feeling.

I've talked about this my therapist and we're working on it, but this is interfering with my life. It makes me unhappy and makes me make poor decisions and I can never tell if I'm being honest with myself or not. Honestly, a lot of the CBT and Feeling Good techniques don't work for me. I think I'm just lying to myself.

I'm only saying all this backstory because well, it's what I do. I wish I had two-hour long therapy sessions because I spend so much time rationalizing and explaining. My therapist is good, tho and I'm better than I was a year ago.

While I would like to know why meds don't work for me (anti anxiety meds make me feel like hell. i get angry or zombie-like), AskMe cannot do a study on me.

What I would like is some actual specific things I can do to try to keep track of my mood for more than a few days. I would like to hear from people who have actually had to do this. If you have never had to do this or find this sort of stuff comes naturally, while I appreciate your input, you probably can't help me.

I'm just at wit's end and obviously in a low swing. I know I am self-defeatist, but I need help figuring out if this is in my brain or just in my head. I NEED to be able to do this moodt tracking and I keep failing. I keep trying and trying isn't good enough. I feel like I need a silent observer to follow me around like a wild animal in the forest, noting my actions. Even if I try to write down "feeling stressed right now" I'll come up with all sorts of reasons about how I'm not really stressed right now, I'm tired or PMSing or something.

Also, I've never been able to keep track of my period. And I've had it for 17 years now. So it's not just moods. (see why they think I have ADHD?)

I'm just going to stop now because otherwise I'll keep rambling and there's no therapist to stop me and get me to focus.

Throwaway: [e-mail]

posted by anonymous to health & fitness (12 comments total)

Do you have an accomplice? Someone you can email each day with whatever it is you need to say, who will text you when you forget and buy you cookies when you do a whole week straight? I find external motivation very helpful; I hate disappointing or upsetting others even when I would have rather skipped doing (whatever) if left on my own. I also like incorporating record keeping into a routine - I keep up with my car gas record because I have to fill in all the info before I can put on my seat belt and thus turn on the car. 67 entries and counting, woot.

Also, I see no reason why you can't put as much rationalization in as you like - the important part is capturing the data, not fulfilling the dream of having a clean chart.

For periods I like dots on a big wall calendar. If I slack off for a few days, the blank boxes mock me and I usually remember far enough back that it stays accurate.
posted by SMPA at 9:04 AM on July 29

A quick idea that crossed my mind is using stickers like this instead of using an actual word, because maybe it will have less of an impact than saying 'i feel depressed.'

Something else that crossed my mind was when you said in order to be properly diagnosed you have to do this. Maybe that is why you are having trouble and it's a fear of that so you are self-sabotaging?
posted by heatherly at 9:05 AM on July 29 [1 favorite]

I'm a numbers geek. If I was ranking on a scale of 1-10 (on 2-3 variables?), inputting them into Excel, and making charts from the data, that would help me!
posted by salvia at 9:14 AM on July 29

Twitter. I'm serious. Once you get in the habit of making notes about everything you do (going for lunch with Jane today to the new Korean restaurant!), your moods will show up in patterns. There are a billion Twitter apps, so it's easy to access and you don't have to worry about where you saved that Excel sheet/put that notebook. Tweetake lets you download your archive. You can make a protected account if you don't want to share it.

I don't tweet to track my moods, but I bet if you paid attention to my feed, you'd get a pretty good feel for them even though you don't know me.
posted by desjardins at 10:48 AM on July 29

Moodscope.com is free and easy to use for tracking your moods. It gives you a series of cards each day based on different feelings (e. g. nervous, excited, hostile) and you rate how much you feel that way. Then it analyses your mood for you. I find it extremely helpful--when I remember to do it.
posted by Put the kettle on at 10:53 AM on July 29

Do you have somebody who could call you, each day, and ask: "mood?", and you could give a number from 1-3? It would literally be easier for you to answer the question then to try and get out of it.

And, yes, you could also say "and I have my period", if you do. Because there's a darn good chance your moods are related to your cycle, and that you eve "give up" with the tracking at the same time every month !
posted by wyzewoman at 11:16 AM on July 29

My problem is that I will just start telling stories - I will try to RATIONALIZE why I feel sad/mad/happy/tired rather than just SAY that I am. I feel guilty for feeling.

It's possible that something like Acceptance and Commitment Therapy would work better for you than CBT. It's based on the same behavioral principles as CBT, but instead of arguing with your thoughts, you're trained to notice them, accept that you're having them, and then take the actions you want to take (based on what you value in life) rather what your negative thoughts are pushing you to do.

For example, when you have the thought, "Man, what a load of bull. i'm better now, i'm not gonna let that happen again," could you say to yourself, "Okay, I'm having the thought that tracking my moods is a load of bull and I don't need to. That's my thought. But I know that tracking my moods is a good idea for my life in general, so right now I'm going to keep doing it"? If you think this approach is interesting, it might be worth talking to your therapist about it.
posted by synchronia at 11:36 AM on July 29 [1 favorite]

Mood 24/7 is really easy -- they send you a text message every day and you text back with your mood in the form of a number from 1-10. You can add a descriptive note, but you don't have to. If you have to record you mood in the form of a number, then it doesn't matter what description you give it -- you don't have to distinguish between feeling stressed, feeling tired, or whatever. Just 1-10.
posted by yarly at 11:44 AM on July 29 [2 favorites]

Is there any chance that your moods are affected by the weather? Some people, including myself are strongly affected. I was talking with someone yesterday about this, we both used to live in very grey upstate NY, and both agreed that even here in the south we feel down on cloudy days.
posted by mareli at 11:48 AM on July 29

Sometimes it can come down to trusting yourself. Knowing that the past self who wanted to track the moods is the same self who doesn't want to track it, and that future self really wants to look back and see all those weeks and months of tracked behaviors. So 2 out of 3 of your selves agree that mood tracking is good, and don't you trust yourself?

Also, find your best way to keep track. Maybe photocopy a jillion mood chart blanks and keep them in a binder, so you never lose them and you won't have to make new ones for ages.

You can set aside a couple fun project hours and revamp a mood chart to your own purposes. Sure, you can pick a spot on the mood scale, but maybe also use the same worksheet to keep a meal log, or check off which activities you did that day. Then, the worksheet will help you keep track of more than just mood; it will serve as a quick and easy diary of fun stuff you did.

If you always check your e-mail in the evenings, maybe make one of these lovely fancy google doc trackers and then click some buttons before you head off to bed.
posted by redsparkler at 12:09 PM on July 29 [2 favorites]

IANAD, IANYD, and I don't really know anything about your situation -- but have you thought that you might be focusing on the wrong diagnosis? I've met a lot of people who have bipolar disorder who have been misdiagnosed at first as having ADD or ADHD because a lot of the symptoms of bipolar disorder mimic ADD/ADHD. In those cases (and in my own), the ADD/ADHD meds made them (me) feel better for a while and then wore off; it took a real mood stabilizer (bolstered by an antipsychotic) for me to actually feel better. (And it had to be calibrated for my weight -- if I gained more than ten pounds, the meds stopped working.) Same for many other people I know. It might be worth getting a second opinion about meds and diagnosis from another psychiatrist.

About your actual question: I'm seconding desjardins -- Twitter is great for mood-tracking. You can do it on the internet or from your phone. Just make sure that you lock it so no one else can see what you're doing (also, locked Twitters don't get/won't be archived by the Library of Congress). You don't even have to write in complete sentences -- just a word or two that describes what you're feeling, and maybe a number to describe the intensity of the feelings.
posted by shamash at 12:39 PM on July 29

What shamash said about mood stabilizers. If you're bipolar you'll know pretty quickly and none of the other meds will do anything for you (except maybe make you feel worse).

Another option for mood tracking is one of those services that transcribes your voice mail and emails it to you. Set up a Google voice number and call it whenever.
posted by fshgrl at 3:07 PM on July 29