Track Your Mood

Use the checklist below to help you gauge your emotional well-being. Consistent poor moods can indicate a larger problem in the context of your mental health. By tracking these moods over time (one bad day is not enough!), you may become more aware of the possibility of having an underlying problem. Most mood disorders are treatable; if you feel that you have a mental or emotional disorder you should speak with your health care provider. Taking your checklists to your physician may also help him or her make a diagnosis if you have a medical condition.


On a scale of one to ten, how do you feel in general? Please circle a number below:

1 2 3 4 5 6 7 8 9 10

1 = sad, fatigued, anxious, tense, irritable, withdrawn
10 = happy, well-rested, relaxed, energized, involved in life

Rank how accurate the words below describe your feelings on a scale of one to three.

1 = not at all accurate
2 = moderately accurate
3 = strongly accurate


_ Sad, crying, generally upset

_ Eating too much or eating too little

_ Sleeping too much or sleeping too little

_ Irritable

_ Angry

_ Worried

_ Anxious

_ Impulsive

_ Apathetic or Pessimistic

_ Frantic, racing thoughts

_ Lethargic

_ Aching

_ Worthless

_ Hopeless

_ Overwhelmed

_ Guilty

_ Finding difficulty concentrating or making decisions

_ Desiring isolation

_ Reckless

_ Thinking of death or contemplating suicide

_ Using alcohol or hazardous drugs

_ Other: ___________________________________________________________

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