If you have schizophrenia, you should know that taking your medication as prescribed is very important. But it’s not always easy to know whether your current plan, which includes any medications you’re using and mental and behavioral strategies, is working well. It might also be hard to tell if something you’re experiencing is a medication side effect or a disease symptom. Or you might have trouble remembering to take your medication. Self-monitoring can help.
Self-monitoring refers to tracking your own health by keeping a record of your daily activities, your mood, and/or any other things that might tell you that you’re at risk for a psychotic episode. Some people with schizophrenia benefit from tracking changes in sleep patterns. Others might need to focus on whether they’re getting enough exercise, keeping up with basic hygiene, remembering to pay bills on time, or having good social interactions with others.
You should work with a mental health care provider who can help you identify what’s most important for you to monitor on a daily or weekly basis.
The overall goal of self-monitoring is to catch any changes in your habits, mood, or behavior that may show that your condition is worsening. That way, you can take action before your symptoms get worse. Don't change any of your medication doses unless your mental health provider tells you to do so. Always check in with them to discuss the next steps. You might just need to go over some coping techniques or learn new ways to ease stress.
How to Self-Monitor Your Schizophrenia
Many experts who treat schizophrenia believe that self-monitoring is useful, but there isn’t any standard way to do it. Ask your provider if they have a preferred method, such as a worksheet or app. It’s perfectly OK to make up your own tracker, but it’s a good idea to first discuss what you should be tracking. These will be different for everyone with schizophrenia but might include:
- Taking your medication regularly
- Possible medication side effects
- Daily hygiene practices
- Handling regular responsibilities/activities (showing up for work, tidying your home, etc.)
- Sleep habits (especially any changes)
- Social habits
- Feeling stressed, anxious, or agitated
- Trouble concentrating or speaking clearly
- Seeing things that aren’t there
- Hearing voices
- Paranoid thoughts
If you’re most concerned about remembering to take your medication, ask your pharmacy about “compliance packaging,” which is also called adherence packaging. This is when the pharmacist (or company that ships drugs to your local pharmacy) packages your medication in blister packs or pouches that are organized by the dose, day of the week, and even time of day, making it easy to tell if you’ve missed a dose.
When it comes to tracking moods and behaviors, start by asking your doctor or therapist if there’s a specific tracking worksheet they’d like you to use. If not, a blank journal might do, or you could create your own daily tracker with a list of the things you want to monitor, along with space to rate them and/or enter notes.
The easiest way to self-monitor might be to use a smartphone app designed for this purpose. Some worth considering include:
Health Storylines. Co-created by the Schizophrenia & Psychosis Action Alliance, this app is designed to help you easily monitor symptoms, moods, and daily routines, as well as remember your medication and doctor’s appointments. Download it at the Apple App Store or Google Play Store, or get the web-based version at healthstorylines.com.
eMoods Bipolar Mood Tracker. Although it has “bipolar” in the name, this app is also useful for people with schizophrenia. It is designed to help you chart your symptoms, sleep habits, and moods. If you want, you can use it to email a PDF report to your doctor for review at the end of each month. This app is among those included in a database maintained by the Division of Digital Psychiatry at Beth Israel Deaconess Medical Center. Check out MindApps.org to learn about others. Download the eMoods Bipolar Mood Tracker at the Apple App Store or Google Play Store.
FOCUS. It’s not directly available to the public, but a number of clinicians in the Seattle area are using the research-backed FOCUS app with their patients. You can also get it through some licensed community mental health services in states other than Washington. This app, which was developed by researchers at the University of Washington, prompts you to enter information about mood, sleep, voices, and other symptoms. It also provides customized, on-the-spot interventions. Learn more at mh4mh.org/focus.
However you choose to self-monitor, don’t go it totally alone. Sometimes, people with schizophrenia have trouble noticing changes in their own behavior, so it’s also wise to ask a trusted family member or friend to alert you to any changes they notice. Discuss how you would like to be told about them. You should also plan to alert your health care provider to any changes that seem significant, whether you’ve formally tracked them or not.
