Dialectical Behavioral Therapy (DBT) Diary Card

Fill it out once a day. Tap a day to open it, answer each item for that day, and add an insight. Everything saves automatically in this browser on this device as you go — you can close the page and come back and your entries will still be here. On a phone, use your browser's Add to Home Screen so it's easy to return to; on a computer, bookmark the page.

Day 1 is the day you start. The dates fill in automatically from your start date and stay fixed, so each row is a real calendar day — just fill in the matching day as you go.

Keep going as long as you like. The card starts as a 2-week set. When you reach the end, tap ＋ Generate another 2 weeks and it adds the next 14 days in order (Day 15, 16 … 28, and so on), so you can keep one continuous record across sessions. Your exported PDF lists every day you've filled in, so your therapist can see the whole span at once.

When you're ready, send it in. Tap Export to PDF to download a PDF and email it to your therapist. To wipe everything and start over, tap Clear all.

Unhelpful Behaviors — for Self-Harm, Suicidal Ideation, and Addiction Use: rate the strength of the urge from 0–10 (0 = no urge at all, 10 = a very strong urge), or tap NA if it doesn't apply to you. Then mark Yes/No for whether you acted on it that day (or NA).

Physical Care —

• Bed time / Wake time: when you got into bed and when you woke up.
• Sleepiness / fatigue level (0–10): how tired and sleepy you felt overall (0 = none, 10 = a high level of fatigue and sleepiness).
• Healthy sleep habits (Y/N): did you keep a consistent, healthy sleep routine.

Medical & Nutritional Support — Meds (Y/N): did you take your medication as prescribed. Breakfast / Lunch / Dinner (Y/N): did you eat that meal.

Distress & Functioning (0–10) — rate each from 0 to 10:

• Overall distress during the day: your overall distress across the day. 0 = deeply grounded, calm, present; 10 = extremely distressed, total burnout, panic attack, crisis.
• Daily functioning: how much your unhelpful behaviors affected your daily life. 0 = no impact; 10 = maximum negative effect on your day.
• Physical pain intensity: your worst pain level that day. 0 = no pain; 10 = emergency-room-level pain.
• Overall daily physical pain level: your pain across the whole day, overall. 0 = no pain all day; 10 = severe pain throughout the day.
• Emotional regulation difficulty: how hard it was to manage your emotions. 0 = completely effortless; 10 = total overwhelm / unregulated.

Medical & Nutrition — mark Meds taken? (Y/N), then for each meal (breakfast, lunch, dinner) whether you ate it (Y/N) and, if so, whether it included protein, healthy carbs, healthy fats, and fiber (Y/N each).

Relationships — rate overall relational distress (how much distress your relationships caused today, 0–10), aloneness (how alone you felt even around people), and fear of being rejected, left, or seen as "too much" (0–10); then mark whether you had a rupture (snapped, blew up, pushed someone away, or shut down) and whether you asked anyone for help (Y/N).

Key emotion you're tracking — at the top of the page, name one emotion you tend to struggle with (for example shame or guilt). Then each day, rate how intense that emotion was from 0–10, so you and your therapist can watch it over the week.

Insight gained today — what you learned or understood: a trigger you noticed, something that felt difficult, a deeper meaning, or a positive experience.

Your exported PDF includes your insights, a full trends table of every category, and a Pattern observations section that automatically looks for simple day-to-day connections in your own entries (for example, whether urges line up with later bedtimes or higher distress). Those are patterns to explore with your clinician — not conclusions or a diagnosis.