Depression Skills: Self Monitoring

This is a Cognitive Behavioural Therapy (CBT) activity that might be useful for people to do as a self help activity.

It’s usually used as part of depression treatment but is potentially useful for anyone who wants to better understand their moods.

The activity involves doing ratings once an hour (which can be inconvenient but will take about 30 seconds to do the basic version). If you forget or get busy for a few hours you can catch up the last few hours’ ratings but your ratings will be more accurate if you do them in real time rather than from memory.

The basic premise is that activities that give you a sense of pleasure and/or mastery/accomplishment are important for positive mood. I’ll explain the instructions for doing the ratings and then what to look for in analyzing your ratings.

I recommend trying the activity for two weeks.

Instructions

Once an hour, write down

1. What you’re doing currently doing (just a word or two e.g. watching the news).

And 3 numbers:

2. How much pleasure you’re feeling doing the activity. (10 = as much pleasure as you can imagine ever experiencing while doing anything, 0 = no pleasure)

3. How much of a sense of mastery/accomplishment you’re feeling doing the activity (10 = as much of a sense of mastery/accomplishment as you can ever imagine experiencing while doing anything, 0 = no sense of mastery/accomplishment).

4. Your current mood on a scale of 0 to 10 (10 = as good as you can imagine ever feeling, 0 = as bad as you can imagine ever feeling)

The above is the basic procedure. Here are a couple of additions to make the data you get more useful.

5. If during the last hour, you had thoughts related to

a) anxiety (e.g. concerns about some aspect of the future),
b) shame (“there’s something wrong with me,” personal failure or defectiveness etc.)
c) anger, or
d) sadness/loneliness/disappointment

then also make a note of what thoughts you were having.

6. An optional rating that’s well worth doing is to also rate “degree of challenge” each hour (10 = extremely challenging, 0 = not at all challenging). Why I think this is a good inclusion is explained below.

What to look for in your ratings

1. This activity is about getting an accurate picture of how doing different activities makes you feel. What are your high points? Look for what your high points of mood/pleasure/mastery were each day and also across the week. If you learn that doing a particular activity was a high point of your day/week, would you enjoy doing it more often?

2. Understand your lows. The data you get from this activity will help you understand what triggers slumps in your mood. You might need to look back over the last day or two of ratings to find the factors that contributed to the slump. Subtle factors can contribute to triggering mood slumps and this activity will help you pick up on those, so that when they occur in the future you can manage them in ways that lessen the impact on your mood (e.g., by doing extra self care when they occur).

3. How much of your time is spent doing activities that are BOTH low pleasure and low mastery? What percentage? Would you feel better if you made changes?

4. Do you have a mixture of low/moderate/high challenge activities that provide a sense of mastery/accomplishment. Recognize that sense of mastery/accomplishment comes from both low and high challenge activities. For example, recycling might be low challenge but high sense of accomplishment.

5. What’s the balance like in your days? If you have stretches of time (e.g. whole mornings/afternoons/evenings) in which you’re only doing sense of accomplishment activities, only doing pleasure activities, or only doing activities that provide neither of these things, then could you get more balance?

For example, you might notice you have low mood in an afternoon and looking back on your ratings see your low afternoon mood comes after doing 5 hours straight of activities that gave you little pleasure.

Balance of degree of challenge is also important.

6. Sometimes hard data can give you the impetus to ditch activities you do (out of habit, psychological obligation, or compulsively) that are no longer pleasurable or no longer provide some sense of accomplishment.

7. Although its not what this activity sets out to do, monitoring your activities will probably change how you spend your time because you’ll be paying more attention to it.