Daily Mood Rating Form

Please rate your mood at different times during the day, that is, how good or bad you felt, using the 10-point scaleshown below. If you felt good, put a high number on the chart below. If you felt “so-so,” mark a 5. And if you feltlow or depressed, mark a lower number.

1 2 3 4 5 6 7 8 9 10

verydepressed

“so-so” veryhappy

Time of day Mood score Reasons why I felt this way:

Larry W. Thompson, Leah Dick-Siskin, David W. Coon, David V. Powers, Dolores Gallagher-ThompsonTreating Late-Life Depression.© 2010 by Oxford University Press

Oxford Clinical Psychology | Oxford University Press