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Mania and the Need for Routine


I had a routine that worked to keep me stable, and then…

Stay-at-home orders have not been kind to people who use routines to help manage their mental illness. Suddenly everything is different.  Families are crammed into the same house, 24-7, and work schedules are destroyed.

In-person meetings with friends and therapists are out.  I’m getting used to Facetime and Zoom, but I’ve found that, especially with therapy, the time alone spent travelling to and from the session was a great time for introspection and review.  It was, possibly, as important as the therapy itself.

Now all I get before and after therapy is a plunge right back into homeschooling and the overstimulation of a house alive with people.

My routine is finished.

Here’s what I used to do, every day:  Get up early and write; get everybody else up and off to school and work; write for a few more hours; exercise, shower and meditate; walk the dogs; get my daughter from school; spend the rest of the day with my family.

For years.  Sounds boring, but it helped manage my moods.  Sticking to a routine has helped me avoid a serious episode of mania or a mixed state for years.

We’ve all been home for three weeks now, and I’m still struggling to create a new routine that works for everybody.  I’m struggling with swinging moods, too.

Everyone gets up at different times and they’re still trying to figure out their own schedules.  Our school district, an inner city one with lots of inequity, has given us absolutely nothing.  No on-line classes, no lesson plans.  Teachers aren’t even allowed to communicate with their students on academic topics.  I’m trying to create a curriculum so this school year isn’t a total waste and still get some time in for me.

A study on interpersonal and social rhythm therapy and bipolar disorder put the active group on a strict schedule of sleep, meals, physical activity and social interaction.

The control group received the same medical and talk therapy interventions, but established no strict routine.  The groups were followed for 2.5 years.

The group with the strict routine suffered far fewer mood swings and reported better physical health.

Circadian rhythms are the key, and they have to do with more than just sleep.  Emotional regulation is supported by regular sleep and a regular daily routine.

Another study (cited in the same report) took mice and removed the genes responsible for circadian regulation.  The mice almost immediately began to exhibit manic symptoms.

I feel like the mice who had the circadian genes removed.

My family is being supportive.  We’ve sat down and worked to develop schedules to keep everyone engaged and sane.  But it’s still different, and not as rigid as I need it to be.

Many people who have managed their mental health through routines are now having the same experience. We have to do our best.

I’m trying to mediate more, although at different times of day, and leverage more frequent dog walks just to get outside and get everyone doing the same thing at the same time for at least a little while.

Anyone familiar with the chaos of mania or the murder of waking hours of depression knows that eliminating chaos from the day can help with moods.  Consistency works well to regulate moods.

But we’re living in a time of chaos and inconsistency and grave uncertainty about what comes next.  Planning for anything seems futile.  We don’t know what’s coming.   The days grind on.

There’s no real conflict in the house, but there’s no consistency either.  Uncertainty kills a routine like nothing else.

I know that when mania begins the last thing I want to do is settle down into some boring day-to-day schedule.  I’m lucky, I have a great family and good friends who know how to help at times like these.  I’ll be OK.

I’m just concerned for those with bipolar disorder who have routines that have been disrupted and don’t have the strong support network.  If that’s you don’t forget the telehealth and teletherapy companies that are out there.  Talk to someone.  Plan with someone.

Try to do the same thing at the same time every day.  Even if now it’s different.

 

For information on mediation, movement and meaningful work please join the Facebook group Practicing Mental Illness.

Source:  https://www.apa.org/monitor/feb08/consistent

Mania and the Need for Routine


George Hofmann

George is the author of Resilience: Handling Anxiety in a Time of Crisis, from Changemakers Books. Visit George's site www.practicingmentalillness.com or join the Facebook group Practicing Mental Illness


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APA Reference
Hofmann, G. (2020). Mania and the Need for Routine. Psych Central. Retrieved on August 4, 2020, from https://blogs.psychcentral.com/older-bipolar/2020/04/mania-and-the-need-for-routine/

 

Last updated: 10 Apr 2020
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