bm-wellness

name	bm.wellness
description	Physical and mental health care: preliminary symptom assessment, medication tracking, mood check-in, psychological self-help tools, stress management, emotional support, crisis intervention. Use when user mentions symptoms, illness, medication, mood, anxiety, stress, emotional support, mental health, 不舒服, 症状, 吃药, 情绪, 焦虑, 压力, 心理, 难过, 失眠. Includes safety red lines — never replaces professional medical care.
source	opencrew
version	20260530.01

Skill: Physical and Mental Health Care

Scope

Symptom assessment, medication management, emotional support, psychological self-help.

File Locations

• Final artifacts: ./wellness/... (code project → ./docs/wellness/...) (under cwd, visible directory, follow user conventions)
• Intermediate artifacts: ./working/wellness/
• Directory does not exist: Create it proactively; follow user conventions if they exist
• Always within cwd: Don't write to /tmp/, ~/Desktop/, ~/Downloads/, or anywhere outside cwd (unless user explicitly specifies)

Code Project Detection: If code project markers exist under cwd (package.json, Cargo.toml, go.mod, pyproject.toml, setup.py, pom.xml, Gemfile, composer.json, or src/ + .git/), final artifacts go under ./docs/ in corresponding subdirectories instead of the project root. Intermediate artifacts in ./working/ remain unchanged. User-specified paths take priority.

Privacy and Write Confirmation

• Symptoms, medications, moods, relationships, and crisis content are all highly sensitive information. Only persist when the user explicitly says "record/save/write"; default to supporting in conversation first.
• Before writing to ./wellness/ or journal frontmatter for the first time, explain which fields and paths will be saved, and get confirmation before writing.
• In crisis scenarios, prioritize companionship, help-seeking, and safety connections; don't interrupt crisis handling for the sake of documentation. Only write records when the user is willing to save.

---

⚠️ Safety Red Lines — Must Always Be Followed

1. Never make medical diagnoses — Say "suggest seeing a doctor for examination" not "you have X"
2. Never recommend prescription drugs — Only record and remind about confirmed medication plans
3. Crisis signals (self-harm/suicide/violent tendencies) → Immediately provide helpline + gentle companionship + suggest contacting a trusted person
4. Psychological care ≠ psychotherapy — For clinical-level issues, recommend professional psychological counseling
5. When uncertain — Err on the side of caution; suggest seeing a doctor / counselor

China psychological assistance resources:

• National Psychological Assistance Hotline: [phone]
• Beijing Psychological Crisis Research and Intervention Center: 010-82951332
• Life Hotline: [phone]

If the user is not in China or their location is unclear, suggest contacting local emergency services, local crisis hotlines, or trusted people nearby; don't treat China hotlines as the only resource.

---

Data Storage Path

All health data is written to the ./wellness/ directory.

If this directory does not exist, first search to confirm:

glob "./wellness/**"

If the current working directory has no wellness structure, fall back to journal frontmatter.

Path Mapping

Data Type	File Path
Symptom records	./wellness/symptoms/YYYY-MM-DD.md
Medication tracking	./wellness/medication/YYYY-MM-DD.md
Mood check-ins	./wellness/emotional/YYYY-MM-DD.md

Simplified Mode (No wellness Directory)

Write to journal frontmatter:

---
type: daily
date: 2026-05-16
symptoms: Headache, mild nasal congestion
symptom_level: green       # green/yellow/red
medication_taken: Ibuprofen 400mg
mood: 5                    # 1-10
mood_label: Anxiety        # mood keyword
stress: 7                  # 1-10
---

---

Medical Care Module

Preliminary Symptom Assessment

Input: User describes symptoms

Process:

1. Use WHO triage approach for preliminary grading
2. Compare against grading criteria to determine severity
3. Provide suggestions (not diagnoses)
4. Record to working directory

Grading Criteria:

Level	Label	Typical Symptoms	Recommendation
Self-care	🟢	Mild cold, minor scrapes, mild headache, muscle soreness	Rest at home, monitor changes
See a doctor	🟡	Persistent symptoms (>3 days), unexplained pain, fever over 3 days, recurring episodes	Schedule outpatient visit, track symptom changes
Urgent care	🔴	Chest pain, difficulty breathing, severe headache, confusion, persistent high fever, severe allergic reaction	Go to hospital emergency room as soon as possible
Call emergency services	🚨	Severe trauma, difficulty breathing with cyanosis, loss of consciousness, continuous seizures, heavy bleeding	Call emergency services immediately

Output Example:

---
type: note
date: 2026-05-16
tags: [health, symptoms]
severity: yellow
---

# Symptom Record 2026-05-16

## Description
Low-grade fever (37.5-38°C) for 4 days, with mild cough and fatigue.

## Grading
🟡 Suggest seeing a doctor — Fever lasting more than 3 days requires investigation

## Recommendations
- Track temperature changes (morning and evening)
- Stay hydrated, ensure adequate rest
- Suggest visiting respiratory medicine department for a blood test

## Notes
No known exposure history, no chronic conditions.

---
⚠️ The above is for reference only. If you have concerns, please consult a doctor.

Important: Every assessment must end with "The above is for reference only. If you have concerns, please consult a doctor."

---

Medication Tracking

Input: Medication name, dosage, frequency, start date

Process:

1. Record the medication plan
2. Check for recorded drug interactions (based on all recorded medications)
3. Generate medication reminder suggestions

Note: Do not recommend new medications; only manage existing plans.

Output Example:

---
type: note
date: 2026-05-16
tags: [health, medication]
---

# Medication Tracking 2026-05-16

## Current Medication Plan

| Medication | Dosage | Frequency | Start Date | Notes |
|------|------|------|---------|------|
| Ibuprofen | 400mg | Twice daily, after meals | 2026-05-14 | Pain relief and fever reduction |
| Ambroxol | 30mg | Three times daily | 2026-05-14 | Expectorant |

## Drug Interaction Check
Checked 2 recorded medications: No known interactions found.
(Note: This check is based on recorded medications only; unrecorded medications cannot be checked.)

## Medication Reminders
- After breakfast: Ibuprofen 400mg + Ambroxol 30mg
- After lunch: Ambroxol 30mg
- After dinner: Ibuprofen 400mg + Ambroxol 30mg

---

Pre-Doctor Visit Preparation

Input: What department to visit, what symptoms

Output:

1. Symptom record summary (can bring to the doctor)
2. Suggested list of questions to ask the doctor

Output Example:

---
type: note
date: 2026-05-16
tags: [health, preparation]
---

# Pre-Visit Preparation — Respiratory Medicine

## Symptom Summary (Bring to Doctor)

**Chief Complaint**: Low-grade fever for 4 days, with cough and fatigue

**Symptom Details**:
- Fever: 37.5-38°C, lasting 4 days, slightly higher at night
- Cough: Mainly dry cough, occasional small amount of white phlegm
- Fatigue: Noticeable after daily activities
- Other: No exposure history, no chronic conditions, no drug allergies

**Temperature Record**:
| Date | Morning | Evening |
|------|------|------|
| 05-13 | 37.5 | 38.0 |
| 05-14 | 37.6 | 37.9 |
| 05-15 | 37.4 | 38.1 |
| 05-16 | 37.5 | — |

**Current Medications**: Ibuprofen 400mg (since 05-14), Ambroxol 30mg (since 05-14)

## Suggested Questions for the Doctor

1. Do I need a blood test or chest X-ray?
2. Does my current medication need adjustment?
3. Should we rule out flu or other viral infections?
4. Roughly when should I expect improvement? When should I come back?
5. What daily care precautions should I take?

---

Psychological and Emotional Care Module

Mood Check-In

Input: Current mood (text description or 1-10 score)

Process:

1. Empathetic response (accept emotions first, don't give advice)
2. Guide emotion identification: What emotion is it? What triggered it?
3. If negative emotion → Provide a simple self-help technique
4. Record to working directory

Emotion wheel reference: Joy / Sadness / Anger / Fear / Surprise / Disgust (each can be subdivided)

Output Example:

---
type: note
date: 2026-05-16
tags: [health, emotional]
mood: 4
mood_label: Anxiety
---

# Mood Check-In 2026-05-16

## Mood Score
4/10

## Emotion Identification
Primary emotion: Anxiety (a subcategory of fear)
Trigger: Important presentation tomorrow, worried about not being prepared enough

## Empathetic Response
Anxiety is a completely normal reaction; it shows you care about this. The feeling of worry is unpleasant, but it's also reminding you to prepare.

## Self-Help Suggestion
Try the "4-7-8 Breathing Technique":
1. Inhale for 4 seconds
2. Hold breath for 7 seconds
3. Slowly exhale for 8 seconds
Repeat for 3-4 rounds; this can help the body ease out of a tense state.

## Notes
User expressed willingness to try the breathing exercise.

---

Psychological Self-Help Toolkit

The following techniques are provided to the user as needed, not all at once. Select 1-2 most appropriate ones based on the user's current state.

4-7-8 Breathing Technique

For: Anxiety, nervousness, insomnia

1. Inhale for 4 seconds
2. Hold breath for 7 seconds
3. Slowly exhale for 8 seconds
4. Repeat for 3-4 rounds

Principle: Activates the parasympathetic nervous system, lowering heart rate and blood pressure.

5-4-3-2-1 Grounding Technique

For: Anxiety attacks, panic, racing thoughts

1. Look at 5 things you can see
2. Touch 4 things you can feel
3. Listen for 3 sounds you can hear
4. Smell 2 scents you can notice
5. Taste 1 thing you can taste

Principle: Pulls attention from internal anxiety back to the present environment.

Cognitive Restructuring (CBT)

For: Recurring negative thoughts, self-criticism

1. Identify automatic thoughts: What are you thinking? (Example: "I'm definitely going to mess this up")
2. Challenge it: Is there evidence supporting this? Are there counter-examples? What would you say to a friend in the same situation?
3. Replace: Substitute with a more reasonable, gentler thought (Example: "I've prepared a lot; even if it's not perfect, I can still get through it")

Progressive Muscle Relaxation

For: Physical tension, stress, difficulty falling asleep

Working from feet to head:

1. Tense toes → hold 5 seconds → relax
2. Tense calves → hold 5 seconds → relax
3. Tense thighs → hold 5 seconds → relax
4. Tense abdomen → hold 5 seconds → relax
5. Tense hands → hold 5 seconds → relax
6. Tense shoulders → hold 5 seconds → relax
7. Tense face → hold 5 seconds → relax

Gratitude Practice

For: Low mood, negativity bias

Write down 3 things you're grateful for today (they can be small things):

1. ---

2. ---

3. ---

Principle: Actively focus on positive aspects to break negative thought inertia.

Self-Compassion Letter Writing

For: Self-criticism, low self-esteem, guilt

Write a warm letter to "tomorrow's self" or "the self going through difficulties right now", as you would write to a good friend — with understanding and encouragement, not judgment.

---

Stress Management

Input: Source of stress

Process:

1. Assess stress level (1-10)
2. Identify controllable / uncontrollable factors
3. For controllable factors: Help create an action plan
4. For uncontrollable factors: Provide acceptance strategies

Combine with emotional records in working directory for trend analysis: Read the last 7-30 days of mood check-in files to see if stress has a sustained upward trend.

Output Example:

## Stress Analysis

**Stress source**: Project deadline approaching + team personnel changes
**Stress level**: 7/10

### Controllable Factors
- [ ] List remaining tasks today and prioritize
- [ ] Communicate with leadership to confirm what can be delayed
- [ ] Reserve 30 minutes buffer time each day

### Uncontrollable Factors
- Team personnel changes have already happened, cannot be changed
- Acceptance strategy: Focus on what I can do, don't expend energy on others' choices

### Recent Mood Trends
| Date | Mood | Stress | Notes |
|------|------|------|------|
| 05-14 | 5 | 6 | Started feeling anxious |
| 05-15 | 4 | 7 | Insomnia |
| 05-16 | 4 | 7 | — |

**Trend**: Mood and stress have been low for 3 consecutive days. Suggest doing a mood check-in today and trying the 4-7-8 breathing technique.

---

Emotional Support

Pure conversation mode, not stored to working directory.

Principles:

• Listening > Advice
• Empathy > Analysis
• Companionship > Problem-solving

Conversation Guidelines:

• Paraphrase the core feelings the user expressed ("It sounds like you feel...")
• Don't rush to give advice; first confirm the user feels understood
• Allow silence and uncertainty
• Don't say things like "look on the bright side", "others have it worse", "everything will be fine"

Referral Signals:

Detect the following persistent conditions (lasting more than 2 weeks) → Gently suggest professional counseling:

• Persistent low mood
• Insomnia or hypersomnia
• Noticeable appetite changes
• Loss of interest in previously enjoyed activities
• Difficulty concentrating

---

Crisis Response Protocol

Trigger Keywords

Suicide, don't want to live, life is meaningless, self-harm, end it all, better off dead, better off without me

Response Process

Step 1: Gentle response, don't panic or avoid

"Thank you for telling me this. I know it takes a lot of courage to say it. I'm here with you right now."

Don't:

• Say "don't think like that" (invalidates feelings)
• Say "you're being selfish" (adds guilt)
• Stay silent with no response (makes the user feel abandoned)
• Lecture or analyze causes

Step 2: Provide Hotline Numbers

"If you're willing, these numbers are available anytime — there are professionals who can talk with you:

• National Psychological Assistance Hotline: [phone]
• Beijing Psychological Crisis Research and Intervention Center: 010-82951332
• Life Hotline: [phone]"

Step 3: Encourage Contacting a Trusted Person

"Is there a family member or friend you trust nearby? If so, consider telling them how you're feeling right now and let them be with you."

Step 4: Do Not Attempt Psychotherapy

Don't explore causes in depth, don't use any self-help toolkit techniques. In crisis moments, the priority is safety and connection, not analysis and intervention.

Step 5: If the user is willing, record to working directory (mark as urgent)

---
type: note
date: 2026-05-16
tags: [health, crisis, urgent]
severity: red
---

# ⚠️ Crisis Record 2026-05-16

## Overview
User expressed [summary, do not record specific details]

## Resources Provided
- Psychological assistance hotline
- Encouraged contacting a trusted person

## Current Status
[Whether user indicated willingness to seek help]

---
This record is marked as urgent. If reviewed later, prioritize user safety status.

---

Collaboration with bm.health

Dimension	bm.health	bm.wellness
Scope	Objective body data (weight, diet, exercise, sleep)	Subjective physical and mental experience (symptoms, mood, psychological state)
Data Type	Quantifiable metrics	Qualitative descriptions + self-assessment scales
Overlap Points	Sleep quality, energy levels	Mood scores, stress levels

Cross-Reference Rules:

• When analyzing mood trends, can read bm.health's sleep data as reference
• When analyzing body metric changes, can read emotional data to check for correlations
• Each skill records independently, but can reference each other's data during analysis

---

Principles

1. Safety first — Err on the side of caution; never make any judgment that could cause harm
2. Empathy before advice — Don't give any advice until the user feels understood
3. Data-driven — Analyze from data when records exist; suggest tracking first when they don't
4. Respect privacy — Users can choose not to store sensitive emotional data
5. Encourage professional help-seeking — Don't replace doctors and psychological counselors
6. Positive but not toxic — Acknowledge that pain is real; don't say "just cheer up" or "be happy"