Routine Maintenance: How Sticking to a Schedule Helps Maintain Balance By Sasha Kildare

Following a regular daily routine helps keep our body’s internal clock ticking steadily, and it contributes to both better sleep and more balanced moods.

Toting my workout bag, I pass a co-worker in the hallway who remarks, “You are so good about exercising.”

I muzzle myself to keep from voicing my instant reaction: “Fear of psychosis is a pretty good motivator!” Instead, I smile and say, “Too much sitting.”

I’m faithful to my exercise routine—30 minutes of intense activity, six days a week—because it helps me sleep through the night and combats the tentacles of depression.  Two other simple routines have kept me from flirting with mania for years: Taking my medication by 10 p.m. and getting to bed by 10:30.

It turns out there’s a lot of science to back up the importance of regular daily habits when you live with bipolar disorder. In fact, some researchers have suggested that bipolar links to an “underlying circadian pathology.”

A bit of background: Circadian rhythms are biological cycles that occur roughly every 24 hours. They are governed by a countless array of individual “clock genes” throughout the body as well as a “master clock” in the brain called the suprachiasmatic nucleus (SCN).

Greg Murray, PhD, a leading researcher into bipolar and circadian rhythms, describes it this way: “The circadian system is like the drummer in a band. Everyone in the front line can play their solos and melodies, but if the drummer is unreliable, the people in the front line can’t engage with the audience and be present.”

Murray, who is a professor at Swinburne University in Melbourne, Australia, uses phrases like “arrhythmic” and “prone to dysregulation” to describe the circadian system in people with bipolar.

In another colorful metaphor, he urges the need for scaffolding—in the form of daily routines—to shore up the shaky mechanism and achieve a good quality of life.

“The regularity of activity, separate of the types of activity … keeps the body clock in tune,” he says.

The bottom line: Regular habits help regulate the running of your biological clock.

“Everything we do sends messages to the brain. Every activity affects body temperature, cortisol levels, and more,” explains David J. Kupfer, MD, a distinguished professor emeritus of psychiatry from the University of Pittsburgh Medical Center.

“That first meal of the day and the last meal of the day are very important. When you exercise, in terms of regularity, is vital. You should take naps at the same time.”

In some ways, Kupfer says, “doing everything at the same time every day … can be just as powerful as taking medication.”