What Is a Bipolar Routine?
I have talked many times about how important a routine is in bipolar disorder (Limitations and Rules that Keep Us Safe). There are many reasons for this, but one of the main ones is because bipolar disorder is considered a circadian rhythm disorder by many medical professionals. Your circadian rhythm is critical to your functioning as a human as it tells your body when to sleep and when to be awake (among other things) and trying to go against it is like swimming upstream. Assuming bipolar disorder is, indeed, a circadian rhythm disorder, we should do everything we can to work to regulate our circadian rhythms in a healthy manner. Keeping a strict bipolar routine is one major way of doing that.
What is a Routine?
A routine, obviously, it just a set of things you do in a given order at a given time repeatedly. Each person’s routine is unique. There are certain components that I think every bipolar routine should contain, but there are many that vary from person to person.
My Bipolar Routine
I’m not suggesting my routine is the best or that you should copy it, but at the request of a reader, I’m sharing it just to give you an idea of what a bipolar routine might look like.
- 7:40 AM – Wake up and get out of bed (do not hit the snooze button)
- 7:45 AM – Morning ablutions, take medication and say good morning to the cats
- 7:50 AM – Make breakfast (I eat the same, quick-to-produce breakfast every day) and decorate coffee
- 8:00 AM – Eat breakfast while watching TV
- 8:30 AM – Start work
- 9:30 AM – Feed cats and give insulin (to my cat)
- 12:00 PM – Take medication
- 1:30 PM – Take break and afternoon nap
- 7:00 PM – Take medication
- 8:20 PM – Put on blue-light-blocking glasses
- 9:30 PM – Take medication, clean the kitchen, set up coffee maker, give the cat his insulin, clean the cat box, brush teeth (and the like)
- 10:30 PM – Go to bed
The really critical parts are:
- The same wake-up and bedtime every day
- An evening routine before bed
Aren’t Routines Boring?
Well, yes, I suppose so. But routines do two things:
- They make you higher-functioning
- They work to stabilize mood
They make you higher-functioning because you know that every single day you are going to accomplish certain goals as they are consistently scheduled (like, for example, that my kitchen is always clean when I go to bed). They work to stabilize mood (especially the sleep schedule) as shown in therapies like social rhythm therapy.
And because doing things (side effect free) every day both makes me feel more well and function more successfully, routines are absolutely worth having and worth sticking to. These are the gains you need to focus on in order to maintain the motivation to stick to a routine.
Yes, I realize that having a set routine means inflexibility. Yes, I realize that people bristle against that. Yes, I realize that routines take work. Yes, I realize people like to think they can “do whatever they want.”
But if you want to be well, it’s unlikely that medications alone are going to do it for you. You’re going to have to maintain certain lifestyle choices in order to support the gains the medications make. That’s just part of the work involved in getting better.
Tracy, N. (2013, January 15). What Is a Bipolar Routine?, HealthyPlace. Retrieved on 2020, September 29 from https://www.healthyplace.com/blogs/breakingbipolar/2013/01/what-bipolar-routine
Author: Natasha Tracy
I have a routine controlled by technology. Alarms that get me up, when to shower, take meds, leave for work, breaks and lunches at work etc. I found that works for me. I have a set work schedule since I'm a manager. My quirkiness (bipolar and ADD) has let me flourish in the world of retail. My doctor agrees that because I work a job that requires lots of energy I am able to take a stimulant for my ADD and low dose mood stabilizer and increase when I know I'm gonna have a bad time. I have times of the year that trigger episodes like clockwork. So my schedule includes increasing my meds to prevent episodes
Please make sure your doc is ordering blood tests; specifically thyroid levels. I know lithium can wreak havoc with those hormones, and having had thyroid problems in the past, I know that the pain-to-the-touch (from the shower) that you seem to be experiencing can be a symptom.
I sincerely hope you feel better than this soon.
And thank you all for this thread -- I've been feeling very isolated in my experience lately, and you've lightened my heart considerably.
Thank you so much for sharing your routine! I am very well aware through a billion articles suggesting a daily routine, but have yet to find one that gave any examples of one. It may seem obvious, but as many of you know, when you are overwhelmed by your mental illness even the simplest thing can become difficult. This is a great jumping off point for me (we also have pets), and I can now edit to suit my own stuff. THANK YOU!!!! LIFESAVER!!!!! (many caps, apologies, but omg I'm so grateful)
I'm sure this is right but I was invalided out of my "high-functioning" job 10 years ago so lost my routine. I go to bed around 3AM and get up between 11AM and 2PM... I do have regular, scheduled activities (singing lessons, choir, church) but during the holidays I'm lost and lonely. August is the worst so I'm taking part in an opera productions for 12 days... I no longer enjoy travel as it's too disruptive. Thanks, Natasha! I'll take inspiration from your timetable/schedule and will use it to write the memoir I've started.
NB: The form has the wrong email address. I can't correct it online!
I had the same sleep/wake cycle problem. Sometimes med changes will do that. I had to give my body a little time to adjust. Some meds were just too sedating and some not enough. Sometimes the dose was too high or too low. Sometimes it wasn't the right combination of meds. When I took my meds sometimes made a difference. I experimented a little on my own but ultimately I had to work with my psychiatrist to find the right balance. It's your life, don't settle for less than what is optimal for you and then fight like hell to get back on track the best you can. It's so important to having a fuller life. I know it can be very hard to do but don't give up til you find what works for you. Remember you have to speak up for yourself and be your own advocate. I know it can be very frustrating and discouraging at times but try to be patient.
I am bipolar, diagnosed in 2004, but i think it started in my teens........since ive been in the program i am in now, it has helped me tremendously, partial hospital for 6-8 weeks, then group therapy, such as anxiety, self esteem, symptom management, etc..i started out with making myself a routine to follow, strictly...worked very well with keeping me focused.....then the hypomania made an appearance for a few weeks, med changes, n then i try to get back on track. i would go to bed at 8-9 n get up at 7:00am for group..i found it almost impossible to do....if anyone has suggestions please let me know, as now i go to bed at 8:30-9 pm sleep till 12-1am and im up watching tv, or computer, reading till 4 sometimes 5 am...sleeping till 12 the next day.......i takes my meds religiously am-pm, 90% of the time...i forget......all i wanna do is sleep...very hard to take care of myself, shower mayb once a week, water hurts my skin......does anyone else experience any of these symptoms?????
Having daily routine and structure in my life is an absolute must, especially if I want my days to be productive. I guess that's why I tend to be more productive at work than at home. When I lived at home with my partents my days were much more structured as my mom made sure of it. I was made to get up at a certain hour every morning and went to bed by a certain hour every night. My bed was always made before breakfast, dishes were always done after each meal. Lunch was always prepared the day before. Dinner was at the same time every evening. Grocery shopping was done every Saturday. Laundry done every Sunday. I had a bubble bath every evening before bed. The majority of housework was scheduled on weekends during the day followed by a period of leisure in the evening, etc, etc. I also found it helpful to turn on the radio as soon as I got out of bed instead of the TV if I wanted my days to be more productive. Thanks for reminding me everyone how important structure can be. I used to balk at that sort of thing but now I understand the value of it especially for us bipolars.
It's hard for me to maintain a routine. Our household is always in flux with everyone's schedules different every day. But because I stay at home and am alone from mid-morning through mid-afternoon I am able to create a routine for that time. No, it doesn't help my sleep cycle. That is dictated more by when everyone else chooses to go to bed. And no, it leaves me with non-routine and often whirlwind-hectic mornings and evenings. But that mid-day routine still helps me recharge and I'm glad I at least have that. As bipolar folks we get our help and stability where and when we can. Every little bit counts.
Routine is definitely one of the best ways to help fight it. Unfortunately, due to the medication I'm on, setting a regular bed time and time to get up aren't always possible, but I try to keep it between a 1 1/2 hour span either way.
Another commenter above (Julia) spoke on how self-implemented routines aren't possible with her, and I have to agree that there are some who can't do regular routines on their own. I am definitely one of those. It's part of why I function better in a job where I have regular, steady hours, because it forces me into a routine, and I do become much more higher-functioning again. When I was laid off and without work, trying to implement that routine was next to impossible. It would work some days, but others I just couldn't stick to it, no matter how persistent my intentions were.
There definitely has to be a healthy balance, and whether the routine is imposed or self-imposed, it helps. I was fortunate that when I first started my journey to recover, even though I wasn't working (and then was, but with a crazy irregular schedule), my mom and sister both worked hard to keep me in a routine, sending me to bed if I wouldn't go on my own and ensuring to wake me up in the mornings so that I was always up at a regular time.
As some other people have already commented on, this whole push towards part-time, irregular jobs is definitely a negative for those of us who struggle, and it's unfortunate, as revealing the need for a schedule can put people in a precarious position. Hopefully as mental health and mental illness become more spoken of, and people are more educated, the ability to make those kinds of requests will one day not count against us.
@KOMBUCHABABY: I am in similar situation as I've been out of work since end of May. I am discouraged with my job hunt as some employers do not care about an employee's need for a fixed schedule. For me to reveal WHY I need routine would jeopardize my being hired. I'm not glad you're in this situation, but am glad I am not the only one. Hope you've found some sort of job. I need to find work soon so that I can support my kombucha habit. ;) Thanks also to Ms. Tracy for this article.
I am going to a psychiatrist tomorrow. I'm pretty sure it's bipolar II and ADHD and possibly PTSD as well. I'm off work for stress leave and a total wreck as far as getting things done and sleep and mind going a million miles an hour. At work I had anxiety attacks and crying jags every day. Can't go on like this anymore. Been off since June but don't feel that I would be any different once back at work. I have to do something to make a living! Anyone find a job that works with this condition?
Ok, well, I have severe adhd and bipolar, among other things, and keeping to a strict routine like that is just not possible. Especially one that is self-imposed. I've found that exterior structure works best (like the job I once had, or having things outside my apartment that I do and go to).
I am doing better with dishes. I usually maintain laundry pretty well. I don't have to clean the tub because I take my showers at the gym--to save on my water bill. I use a programmable thermostat so it's not subject to my possibly fluctuating temperatures.
I always wake up at the same time, but I don't get u at the same time. Getting out the door in the morning is nearly impossible still.
I always take my night meds at the same time. My therapist, who also has adhd, told me that we adhders only have to get one thing done a day. Do that, and call it a success!
This article was very valuable to me, because i have a very hard time sticking to a routine. I feel the very nature of our illness makes that a challenge. I am going to try your suggestions. However, I am proud to say that I have improved a lot as far as sticking to things-and I at least am able to accomplished things I am proud of.
In supporting my husband wh has a bipolar diagnosis, I began to to also notice he remained more stable the more we kept our lifestyle to a routine. When he has a day where is routine is either broken or increased stimulation, I make adjustments over the next course of a few days & impose less demands on him & make sure he gets his naps. Over time he's encountered less episodes as a result.
I was planning an amazing vacation with my boyfriend and suddenly I became petrified to go. I was so afraid that changing my routine would send me into a manic episode (as this has happened on other occasions). Thankfully I am better medicated now and I did fine. Just wish I wasn't so tired all the time.
This works for me, too. In fact, if anyone suggests that I upset my routine, I get very anxious and apprehensive about it. Like, "will you work for me on xxx?". It's a huge deal for me to go along with that. Don't mess with my schedule!! I would love to be a "go with the flow" type person, but it's not good for my brain at all.
I am really struggling with maintaining my daily routine. I am in a mildly (yeah right) depressed state right now. I just want to pull the covers over my head and stay in bed all day. I had to take a of leave of absence from my job (hope I can get back soon) and am now on short term disability. Therefore, it is possible for me to spend the whole day in bed. I don't think that I agree with my therapist and psychiatrist that I had to stop working. I really miss work... it provided me with a routine for eight hours a day, 40 hours a week. I only struggled with weekends and evenings after trying to act 'normal' all day at work. Now I am struggling every day with trying to keep/follow a strict routine. Anyone have a suggestions on how to establish and keep a routine... I know that I am much more stable when I follow a strict routine.. But I just can't seem to find a way to establish a 'new' routine...argh...going back to bed to hide from the rest of the world...and myself.