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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


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)


How is my …

(Very Good = +2 to Very Bad = -2)


Physical state?



(-8 to +8)


How is …

(Good = +1; Bad or I don’t know = -1 or -2, depending)



ex-Wives #1 & 2?


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.

4 Comments leave one →
  1. January 20, 2011 7:04 pm 7:04 pm

    This is amazing, I would like to have something like this for myself.

  2. January 20, 2011 10:27 pm 10:27 pm

    pretty proactive here. liking that.

    • January 23, 2011 4:41 pm 4:41 pm

      thank you. i’m very good at planning to be proactive. most times. just not at implementing what i’ve planned.

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