Bipolar Disorder: Building A Routine

bipolar disorder routineSetting and sticking to a daily routine helps people with bipolar disorder maintain stability.[1] Unexpected stressors can lead to manic or depressive episodes; therefore, the more people with bipolar disorder plan, the more stable they can remain.1

In fact, a therapy dedicated to helping individuals with bipolar disorder identify and maintain daily routines exists.1 It was founded by Ellen Frank and colleagues at the Western Psychiatric Institute & Clinic at the University of Pittsburgh, and it is called Interpersonal and Social Rhythm Therapy (IPSRT).1 Predicated on the belief that people with bipolar disorder have a disruption in sleep and circadian rhythms that produce their symptoms, this therapy helps patients to maintain a healthier schedule that works to avoid such disruptions.1

Sheri Van Dijk, MSW, a psychotherapist who specializes in bipolar disorder, said, “Sleep routines are especially important for people with bipolar disorder because sleep deprivation is one of the biggest triggers for manic episodes.”1

However, creating and maintaining a routine is not always easy; therefore, working with a specialized therapist can help.1

As sleep plays such a key role in maintaining stability with bipolar disorder, it is important to have an end-of-the-day routine.1 According to Van Dijk, “Going to sleep and waking up at approximately the same time is extremely important in developing a routine, since this will, in part, determine what your day is going to look like. Engaging in the same or similar activities at the end of the day will signal your brain that the day is coming to an end and it’s almost time for bed.”1

Sleeping in a comfortable bed at a comfortable temperature is important.1 There should be no light, as this will trick your brain into believe it is daytime, and no noise.1 A television in the bedroom is a bad idea, as well.1 The bedroom is for sleeping and intimate activities only.1

If your mind will still not shut off, writing a list of your worries helps to take it off your mind.1 If it is written down, you do not have to worry about remembering it.1 Also, focusing on your breathing—not necessarily changing it—will pull your mind back into a relaxed mode, which is needed to fall asleep.1

Not only is sleep structure important, but daily structure is, as well. It is important to have goals to meet, places to be, and things to do.1 Too much unstructured time can lead to ruminating and engaging in unproductive activities, making a person feel more depressed.1 Work naturally provides a structure; however, for those unable to work, filling the day with other activities is important.1 Volunteer work, structured therapy groups, regular outings, exercise classes, and other scheduled activities.1

Medicine is an important part of the daily routine of a person with bipolar disorder.1 Using a pillbox to organize what you need to take is helpful.1 Also, an alarm can be used as a reminder.1 However, it is also important to track your moods, sleeping habits, and medication compliance—especially when you are newly diagnosed.1 There are several apps on smartphones and the computer that can be used.1 Also, doctors have mood charts they can provide.1

While creating and maintaining a routine takes effort, it is a worthwhile and important part of effectively managing bipolar disorder.1

[1] Tartakovsky, M. (2014). Building a Routine When You Have Bipolar Disorder. Psych Central. Retrieved on January 24, 2014, from http://psychcentral.com/lib/building-a-routine-when-you-have-bipolar-disorder/00018573

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