A symptom monitoring record can be a very useful tool on your path towards relief from chronic fatigue. Not only will this help you better understand your own experience, it will also be useful to share with your doctor and other healthcare providers. They’ll usually want at least two weeks of symptom monitoring data if possible. Below, we describe the different aspects of symptom monitoring. Your action plan for this week will be to record your own personal information on the forms provided. 

Activity Diary

The first part of self-monitoring for chronic fatigue is activity monitoring. In order for you to gain an accurate understanding of how you spend each day, it is important that you keep a diary of your activity levels. For the first week or so, the aim is simply to record what you do, without making any changes. This will form your baseline or starting point and you can refer to this throughout the course to track your progress. 

How to use the activity diary:

• Record the day and date at the top of the page.
• Write down what you are doing at the allocated times in your activity diary. As you’ll see, the activity diary breaks time down into hourly blocks.
• Describe what you are doing in detail. For example, it should be clear what the activity is, the amount of time you spent on it, and the effort it required. 
• Write something for each hour of the day, even if it seems trivial. Even things like resting or lying in bed count as activities, so make sure you include them. 
• Record the activities as you do them throughout the day, rather than waiting until the end of the day to fill out the entire form. This takes the pressure off you, as completing the form in one go may feel overwhelming and you’re likely to have forgotten some of the details. 

After a week or so of doing this, you may start to see some patterns emerging. For example, you may notice that you’re more active at the start of the week, but tend to crash later on. Or, you may notice that you do more in the mornings and tend to rest all afternoon. Your levels of fatigue may mirror these patterns. All of this information is helpful in forming a picture of your current situation. It can also give you ideas for how you might change your activity patterns and work towards your goals. 

Symptom Diary

The second part of self-monitoring for chronic fatigue is symptom monitoring. This allows you to record your symptoms across the course of the week. Monitoring your symptoms can help you gain a better understanding of how they change over time and the circumstances that impact them in a positive or negative way. As with activity monitoring, symptom monitoring in the first few weeks gives you a baseline to help you track your progress over time.

How to use the symptom diary:

• You’ll need two or three different coloured pens for this activity.   
• Record the day and date at the top of the page.
• Identify two or three symptoms that you want to track over the course of the week. These should be your most debilitating and distressing symptoms. For example, you may choose to track fatigue and muscle pain. Or, you may choose to track fatigue, headaches and problems with concentration. Once you have chosen your symptoms, assign a colour to each one and keep this consistent throughout the week. 
• Each day, rate the severity of each symptom from 0 (not present) to 10 (extremely severe) at three different time points. A score of 0 is best and a score of 10 is worst. The three time points represent morning (am), midday, and afternoon/evening (pm). Each symptom should be recorded in the colour you assigned to it previously.
• At the end of each day, note down the main activities you did or events that occurred that day, your mood/physical sensations, thoughts and worries and the number of hours of sleep you got the night before.
• Once you have your data, you can draw a line between the rating points for each symptom. This will create a chart to help you visualise how your symptoms have fluctuated in severity over the week. 

The symptom diary compliments your activity diary and allows you to see patterns in your symptoms over time. It also allows you to link your symptoms to other things, like your sleep patterns and activity levels. This information can be valuable when trying to identify target areas for treatment. For example, you may identify that your symptoms are worse after napping during the day. As such, you could set a goal to achieve a more regular sleep routine and limit daytime naps. 

You’ll need to look at your activity diary and symptom diary next to each other and combine data across the two. For example, using your symptom diary, you can identify when your fatigue is better or worse. You can then look at your activity diary and see what types of activities you were doing before, during and after the period your symptoms were at their worst. This can give you information about what triggers your symptoms, how you cope with them, and whether this makes them better or worse.