There's nothing routine about having bipolar disorder. Also commonly referred to as manic depression, this is a psychiatric disorder that causes serious shifts in mood, energy, thinking, and behavior, explains Alicia R. Camlibel, PhD, LPC, a psychotherapist in Liberty Corner, New Jersey. Psychotherapy and taking prescribed medications as directed are always the first line of defense, but having a daily routine in place is one more tool that can supplement these essential steps.

Navigating the Highs and Lows

If you suffer from bipolar disorder, you are no doubt familiar with mood shifts. One moment you may be feeling quite euphoric; a short time later you find yourself down in the dumps. Further, the depression that occurs with bipolar disorder can be quite severe and at times, difficult to shake. "The mood swings of bipolar disorder are so intense they can impact your ability to function," the therapist says. For many people, these sudden (or ongoing) shifts can make it difficult to manage their daily responsibilities, sustain personal relationships, and fulfill professional responsibilities.

The Benefits of a Routine

While there is no cure for bipolar disorder, Camlibel says the predictability of a routine can help patients feel more in control of their condition and be better able to cope with and manage their symptoms. A study conducted by scientists from the University of Pittsburgh School of Medicine and published in the Archives of General Psychiatry (now called JAMA Psychiatry) in 2005 found that having a routine resulted in longer periods between the onset of bipolar episodes.

The researchers looked at 175 patients with severe bipolar disorder. All of the patients continued taking their prescribed medications for their condition, while half of them also engaged in social rhythm therapy, a type of psychotherapy developed for people with bipolar disorder that helps identify and maintain routines based on the body's natural rhythms for sleeping, waking, and eating. Although both groups had equal severity and length of bipolar episodes, the group that added the social rhythm therapy, or a routine, realized a longer period of time between episodes.

All People Need Routines

These findings can serve as a reminder of the importance of developing a regular routine, along with using other conventional treatment methods, including medication and therapy, to treat bipolar disorder. "Regular routines are healthy. All human beings do well with a regular routine that should encompass eating three healthy meals a day; sleeping eight hours at night to help the body rest and heal, and putting aside time for self care, which may incorporate exercise, spending time with people you like, or participating in a hobby or activity you enjoy," Camlibel says.

She also recommends keeping a daily journal since this makes it easy to track any changes in mood, eating, sleeping, socialization, and work performance. A journal can help track medication doses and side effects, too—information that can show patterns and help doctors identify areas of concern.

Overcoming Challenges

Of course while the concept of establishing a routine sounds easy, Camlibel notes that for people with bipolar disorder and other forms of mental illness, the act of developing and sticking to a routine can pose challenges. But she stresses that it can indeed be done, and the benefits you'll get in return will make it well worth the effort.

"I have seen with my patients that establishing a routine allows them to remain stabilized and functional for longer periods of time, regardless of the illness," she says. It's also essential for people with bipolar disorder to avoid alcohol and drugs, take care of other medical problems, and have a good treatment team in place that includes a primary care doctor, a psychiatrist, a therapist, and a good personal support system. Camlibel adds that taking these steps will go a long way toward helping patients cope with their illness.

Alicia R. Camlibel, PhD, LPC, reviewed this article


Frank, Ellen, PhD, et al. "Two-Year Outcomes for Interpersonal and Social Rhythm Therapy in Individuals With Bipolar I Disorder." Archives of General Psychiatry. 2005 September. 62(9):996-1004. doi:10.1001/archpsyc.62.9.996. Web.

Alicia R. Camlibel, PhD. LPC, psychotherapist. Email interview 14 February 2014.