Ben Weinstein, MD, says journaling can be a tool to cultivate self-awareness and challenge what psychiatry calls “lack of insight." Lack of insight is a characteristic of bipolar disorder, especially in elevated moods. It means the individual with the illness doesn’t always recognize how behavior is changing as a mood shift starts or even during a mood episode—even when the differences are quite obvious to others. "The parts
of the brain that help with insight and understanding don’t always function as well during mood episodes. A person may not notice the changes in patterns of behavior or moods in advance, but these patterns can help us learn to predict when things are going bad,” says Weinstein.
“Everyone is allowed to have a bad day, a bad mood, or a bad night’s sleep, but when patterns emerge or you see a trend, it’s time to call your doctor so you don’t have a major episode,” he adds.
Ideally, your journal can help alert you and your treatment team that something is going on—especially if you keep track of easy to quantify behaviors like sleep and activity levels, along with attitude and outlook.
If you normally sleep seven hours, and for the past days it’s been four or five and you are not tired, it could suggest an impending manic episode,” Weinstein says.
Some people with bipolar disorder report a great uptick in mood and euphoria before a full-blown episode, but this may already be headed to a point where insight is not as good. If you track sleep and mood, you can say, “Wait a second, this may not end well for me.”
Ultimately, journaling puts you in the driver’s seat because it allows you to notice patterns and “take ownership of your treatment,” Weinstein says.
Yvette P. 50, of Glendora, CA states, “when I am depressed, my entries can be dark and filled with negative self-talk and self-pity.” Her handwriting gets messier when she is feeling low, another sign that depression is brewing. She wakes up and journals, this practice sets the tone for her day, she says. “If I notice that I am feeling “blah” I try to do positive self-talk to counter the negatives, and review my gratitude list. It helps me realize that my problems are minute in comparison to many. As she looks back on her journaling, she can see how far she has come.
Bp, Fall, 2019, Denise Mann, MS