I can hear you now: Sticking to a routine is one of the most difficult things ever with bipolar disorder. Why do I have to do it?
I’ll tell you why: because your brain thrives on structure, and following a daily routine can help prevent and treat bipolar mood episodes, according to Ellen Frank, PhD, professor of psychiatry and psychology and director of the Depression and Manic Depression Prevention Program at the University of Pittsburgh School of Medicine.
In a study of interpersonal and social rhythm therapy (IPRST) and its effectiveness of managing mood episodes, Frank found that patients with bipolar disorder who followed a routine survived much longer without an episode than those who didn’t follow a rhythm, and that IPSRT was extremely effective at preventing mania and depression.
My therapist told me years ago that consistency would be the best gift I could give my children, and I despaired. How could I, being an inconsistent person based on my mental illness and habits developed in a chaotic childhood, provide them with a life with reliable “rocks,” or big activities that we did daily?
Finding–and sticking to–a pattern has been one of the most difficult things I’ve ever done. And as we’ve added to our family, I have changed the pattern. But I’ve noticed a stark difference in my own happiness and the happiness of my children when I create order in my life rather than submit myself and my family to chaos.
The importance of creating a daily routine–and following it!–can’t be stressed enough. But how do you create–and more importantly, stick to–a routine?
Read on for some tips and tricks based on my own personal experience.
Tip #1: Start Small
When I’m manic, I tend to want to organize my life. When I’m in this state, I suffer from the compulsion to make to-do lists and plan out my schedule and the schedules of my family.
So my first tip is probably obvious: don’t start planning your routine when manic. My next tip is probably less so: start small.
What I mean by that is don’t add a bunch of items to your to-do list all at once and expect to follow them daily. You’re setting yourself up for failure that way.
Start with the “rocks,” or big activities: meals, sleep, and work hours. Which leads into tip two.
Tip #2: Fix Your Sleep Hygiene
I could go on and on about how crucial sleep is for stabilizing your mental health. (In fact, I have, here and here.) Sleep hygiene is one of the easiest and most effective ways you can get yourself on an even keel and reduce the severity of mood episodes, even and especially preventing them.
Sleep is a rock in your day, so try to schedule sleep times. Schedule wake times. And try to stick to those. If you have sleep problems, talk to your doctor. You need enough sleep.
How much is enough depends on each individual person. Some adults need 7-8 hours, others need more. But if you’re not getting enough sleep, that’s a fast track to mania.
I go to sleep between 9-10pm every night. Approximately twenty minutes before bed, I shut off my phone and take a shower or bath, depending on my mood and how much time I have. I wind down at night by lying in bed by either praying or planning out my next fanfiction.
Waking up used to be much more difficult for me, but now that I’ve lowered the dose of one of my meds, I’ve been finding myself waking up with much more energy. But I still roll over and go back to sleep after turning off my alarm.
I’m telling you this tip–fix your sleep hygiene–but I’m also telling myself. I need to start waking up at 7am consistently like I used to and address the likely lingering slight depression.
Starting tomorrow, I will be waking up with my alarm at 7am and forcing myself out of bed rather than shutting it off and sleeping in. Wish me luck!
Tip #2: Schedule Meal Times
In addition to sleep, one of the quickest ways we can stabilize our moods is to keep our blood sugar levels stable. Being an Highly Sensitive Person (HSP), I know I myself am extremely susceptible to being hangry.
If you can, try to stick to regular meal times. Eating 3-4 small meals a day will help you keep an even mood, but not only that, it’ll help you lose weight or maintain a healthy one.
My meal routine is simple. I take my meds right before breakfast at 9:15am, eat a breakfast of a single egg and a glass of milk with sugar-free salted caramel syrup, and then take my daughter to the park until 12pm, at which point I eat lunch (usually last night’s leftovers). I eat a small snack at 3:30pm. Dinner, which I usually start making at 4:30opm, is between 5:30-6pm, depending on the recipe. I also drink about 144oz of water throughout the day.
This schedule works very well for me and my family, and helps keep me sane. Try scheduling your meals for regular times. You won’t regret it.
Tip #3: Schedule Your Work Hours
For most of us, work takes up most of our day. If you can schedule your own hours, do so. Whether you work in an office, attend school, or work from home, you need to set a start and end time.
According to Dr. Frank’s research, having a set work schedule will help you feel better. If you can, tap your colleagues, teachers, and family to help you meet your obligations with enough time for you to complete the day’s work at a set end time.
I’m a writer and a stay-at-home parent attending online psychology classes for my graduate degree, so my work day starts at 8am, when I wake up and make my daughter breakfast.
After that, we go to the park until 12pm, when we return home to eat lunch. Someone else watched my daughter from 1-4pm, during which I study. Then I make dinner at 4:30pm, eat at 5:30pm, and have time for relaxation with the rest of the family after the dinner dishes are done at 6:30pm.
At 8pm, the bedtime routine begins, including a bath for my daughter. She’s in bed by 9pm, and then I take my own shower and go to bed shortly afterwards on most nights.
My schedule is not very intense, and it leaves room for flexibility. But if you’re a homemaker, it’s especially important for you to schedule a set end to your workday. Without a specific time to stop and relax, you can easily work yourself to the bone.
Which leads to the next tip.
Tip #4: Schedule Time for Self-care
All work and no play makes Johnny a dull boy, or so it’s said. If you don’t schedule time for relaxation, you will burn out with stress, which is a known trigger for bipolar mood episodes.
As I said in the last tip, I have penciled in time to relax with my family from 6:30pm to 8pm. I also have a “night off” from the bedtime routine on Mondays, which I usually spend writing short stories or cross-stitching, hobbies I enjoy that chill me out.
Make time each day to do something you enjoy. Self-care is incredibly important in fighting mood episodes, especially depression.
There’s any number of things you can do for self-care. You could take a walk, indulge in a cup of tea or coffee, or do something creative, like painting or writing.
For a list of 100 Doable Ideas for Self-care When You’re Suffering from Depression, click here.
Tip #5: Forgive Yourself
If something throws you off your routine–and something always will eventually–don’t panic. Try to be flexible enough to roll with the punches.
Accept what has happened and then follow your routine as best as you’re able. Forgive yourself if you can’t quite make it one day. There’s always tomorrow.
When something interrupts my routine, I get crabby. That’s what I mean about feeling an impact to my happiness when my routine is altered, especially without my permission. But even with my permission, I struggle to remain happy with the change.
For example, Monday nights are my night off, and Tuesday is the night my husband shops. This Monday, the suggestion was made that he hit the store that night rather than Tuesday and give me a night off on Thursday, a change I agreed to because it would be better for my husband.
By the end of the night, while doing the unexpected bedtime routine with my daughter, I was cranky. She got on my nerves more than I care to admit.
But I bathed her and put her to bed, tucking her in and singing “Rock-A-Bye Baby” twice, as is her routine. Then, exhausted, I went directly to bed.
I made sure to give myself grace for being annoyed and reminded myself that this change was temporary and I agreed to it.
Sometimes routines don’t work out, and that’s okay. As long as you forgive yourself and get right back into it as soon as you can, you’ll be alright.
Make adjustments as needed, like getting a hotel room if you’re not going to get home on time to sleep. A hotel room costs less than a hospitalization if your mood destabilizes.
If you suffer from bipolar disorder, routines are crucial to your success in treating your mental illness. They prevent and treat mood episodes, keeping you stable and happy.
Think of following one for not only yourself, but also your family and those around you.
To follow a routine, start small, fix your sleep hygiene, set meal times, schedule a start and end times to the work day using your colleagues, and forgive yourself if the routine doesn’t go as planned.
You can follow a routine. You can be consistent, despite your mental illness making that difficult. Schedule your rocks and stick to those commitments. You will benefit from doing so.
I wish you well in your journey.