Daily Self Check
This is a little form I put together to monitor my emotional state (because I don’t always tell myself how I’m feeling). This morning, it’s too early to tell. But yesterday, for instance, I was about a -6, “Depressed,” but not “Dangerously” so.
Aside from simply monitoring myself, I also need to acknowledge that the effort to create and support a positive mental and emotional state is my responsibility. To that end, I can try to improve my score by making sure I take the positive actions outlined in the self check, such as talking to my loved ones, doing my schoolwork, do simple self-care stuff (like brush my teeth). That’s the idea, anyway.
Click here for Extended Daily Self-Checks, beginning March 1, 2011
LEADING INDICATORS
Did I …
(Yes = -2; No = 0)
cut myself?
think about suicide or wish I were dead?
(an extra -1 for having a plan, -1 for pursuing or having the means)
think morbidly about death and/or dying?
(Yes = -1; No = 0)
drift or avoid things?
(Yes = +1; No = -1)
leave the house?
take care of myself?
take care of my responsibilities?
eat & sleep well?
go to a meeting?
(-12 to +5)
MAJORS AND GENERALS
How is my …
(Very Good = +2 to Very Bad = -2)
Mood?
Physical state?
Cognition?
Energy?
(-8 to +8)
RELATIONSHIPS
How is …
(Good = +1; Bad or I don’t know = -1 or -2, depending)
school?
work?
ex-Wives #1 & 2?
Daughter?
Mom & Dad?
(-10 to +5)
-30 to +18
*Happy/Probably Hypomanic: +17 to +18* *
Doing Very Well: +13 to +16
Doing Fairly Well: +7 to +12
Functional: +2 to +6
Minimally Functional: -1 to +1
Depressed: -14 to -2
Dangerously Depressed: -30 to -15
* Hypomania and mixed states are a little too complex for this checklist to accurately detect. Therefore, if I score a 15, 16, or 17, I may be hypomanic or I may just be happy and/or very centered.
A Binge is defined as a single incidence of eating that (A) fulfills a need to cope with emotional states or to relieve boredom, and/or is simply done out of habit, AND fulfills two or three of the following criteria:
- involves excessive amounts of food high in fat, salt, and sugar
- involves the ingestion of more than three servings within a single half-hour period
- continues past the point of fullness
A Mini Binge is defined as a single incidence of eating that fulfills criterium (A) but fulfills only one of the above criteria.



This is amazing, I would like to have something like this for myself.
thank you. you can take this one. i’m not using it.
pretty proactive here. liking that.
thank you. i’m very good at planning to be proactive. most times. just not at implementing what i’ve planned.