Why Keeping a Regular Schedule is Important for People With Bipolar Disorder

Keeping to a regular schedule is good for anybody’s health and well-being but it is especially important for people with bipolar disorder. BD is characterized by periods of depression and periods of abnormally elevated mood that can last from days to weeks each. If the elevated mood is severe or associated with psychosis, it is called mania. Sticking to a consistent routine can help decrease the risk of experiencing these periods of mania and depression. 

People with bipolar disorder are more vulnerable to disruptions in their circadian rhythms, which are biological processes that operate on a roughly 24-hour cycle and serve a crucial role in maintaining health. Circadian rhythms include the cycle of sleeping and waking and the cycle of regulating body temperature. 

The circadian system is governed by a region of the brain known as the suprachiasmatic nucleus, with assistance from peripherals located in body tissues. These internal clocks synchronize biological circadian rhythms with external cues in the environment, such as light, meal times, and daily routines.

Such external cues are also referred to as “social zeitgeber,” explained Alexandra Gold Ph.D. in Psychology Today. “According to the social zeitgeber theory, developed by Dr. Ehlers, Frank, and Kupfer, life events that disrupt social zeitgebers can lead to irregularity in circadian rhythms, which can in turn contribute to ongoing, broader desynchronization between circadian rhythms and social zeitgebers, ultimately leading to a mood episode.”

The social zeitgeber theory suggests that “life events disturb social zeitgebers (“time givers”), which, in turn, disturb biological rhythms, resulting in affective symptomatology in vulnerable individuals,” wrote Boland, Stange, et al. in their 2016 study “Affective Disruption from Social Rhythm and Behavioral Approach System (BAS) Sensitivities.” 

“The occurrence of life events, or the stress associated with their occurrence, disrupts daily social rhythms (such as bedtimes, mealtimes, and the beginning and ending of work), which are theorized to entrain internal circadian rhythms,” wrote the authors “In turn, the disruption of the circadian rhythms is thought to lead to depressive or manic episodes.”

Keeping a regular schedule works to minimize those disruptions. So, what should a healthy schedule look like? “Ideally, this looks like having regular times for some of the major events that create the framework for your day,” wrote Dr. Gold. “This would include regular times that you go to sleep and wake up, regular times that you eat your meals, and regular times that you go to work.”

She recommended three steps for putting schedule regularity into practice: 

1. Aim for consistency in daily activities. Try to keep the same sleeping and waking times, meal times, and work times on a daily basis. 
2. Use a calendar to help you keep track of times for consistent daily events outlined in step 1. A calendar can also be a helpful tool for scheduling new events that might not fall into your regular routines.
3. Notice how your schedule is impacting your mood.

Recovery from serious mental illness requires that people experiencing disorders such as BD retain a sense of empowerment—a belief in their ability to take charge of their lives and manage the complex demands and consequences of the illness. This includes understanding and adopting a healthy regular schedule. 

Colorado Recovery opened as an independent treatment center in Boulder in 2006 to create a non-hospital treatment center for people with serious mental illness that employed the most effective diagnostic and treatment methods and focused on respectful, compassionate, and optimistic care.

Our treatment facility provides the services needed to address schizophrenia, bipolar disorder, and other serious mental illnesses which are specific to each individual. About half of our clients are under 35 years of age and we expect good outcomes regardless of the duration of the disorder. Clients of any age will feel comfortable in our program. Call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.