Quantifying the Changeable Self: The Role of Self-Tracking in Coming to Terms With and Managing Bipolar Disorder

There has been a recent increase in the development of digital self-tracking tools for managing mental illness. Most of these tools originate from clinical practice and are, as a result, largely clinician oriented. As a consequence, little is known about the self-tracking practices and needs of individuals living with mental illness. This understanding is important to guide the design of future tools to enable people to play a greater role in managing their health. In this article, we present a qualitative study focusing on the self-tracking practices of 10 people with bipolar disorder. We seek to understand the role self-tracking has played as they have come to grips with their diagnosis and attempted to self-manage their health. A central motivation for these participants is to identify risky patterns that may be harbingers of mood episodes, as well as positive trends that support recovery. What emerges is a fragmented picture of self-tracking, with no clear delineation between clinician-initiated and self-initiated practices, as well as considerable challenges participants face in making observations of themselves when their sense of self and emotional state is in flux, uncertain, and unreliable. Informed by these observations, we discuss the merits of a new form of self-tracking that combines manual and automated methods, addresses both clinician and individual needs, helps engage people with bipolar disorder in treatment, and seeks to overcome the significant challenges they face in self-monitoring.