Why Do I Have To Have a Regular Schedule?

Young hooded boy“Why do I have to have a regular schedule” was the lurking question that hung over my conversation with Ann.

She didn’t actually ask me that question but I could see that there was a rebellious child hiding in the corner of the room who was making the conversation we were having about getting regular sleep much less productive than it could have been.

The evidence about the ability of strong and regular circadian patterns of activity and sleep to help manage mood is increasingly strong. A recent post on Mood and the Brain’s Clock highlights just one of the studies on the subject.

I’m not going to focus on that evidence or even on the question of what the ideal schedule should be. I’ve talked about that a lot in other blog posts and I’ll reference some of them at the end of this one.

What I do want to talk about his the process of rebellion and how it affects us once we are no longer children.

All of us, to a greater or lesser extent, remember feeling frustrated with our parent’s seemingly irrational demands and requests.

And a certain amount of rebelliousness is inherent in the creativity which is one of the hallmarks of bipolar mood.

Variations on this theme are pretty common in my experience working with people with bipolar. My struggle as a clinician is to try to avoid accepting the parental role. Not to take responsibility for trying to change another adult’s behavior.

This may be particularly important if the person I am coaching grew up in an unstable environment, perhaps with a bipolar parent, for example.

Children growing up in a world of changing rules may have learned to avoid change of any kind. Just to wait and see.

If I am not very careful my conversation with Ann will become a power struggle between an authoritarian doctor and a free-spirited patient. Or between an irrational and authoritarian doctor and a patient who is not sure which recommendations should be followed and which resisted.

I need to avoid tapping into this pattern because in reality what is happening is no longer an external struggle. The struggle is between the person and his or her body and brain, or between the person and his or her bipolar moods.

An expression from the 1970’s comes to mind: “Don’t try to fight the river.”

Or in terms that are very relevant to this website, don’t try to fight the tides or even the waves of mood… instead surf them, use adult knowledge to create a better life with bipolar.

For More Information

Getting Up Early

Sleeping at the Right Time

How Light Affects the Brain

Staying Up Late

Take Action… Why Do I Have to Pick Up My Room?

 

The Power of Daily Rituals: A Morning Walk

Morning Walk - The Daily RoutineWhat is the power of a morning walk? Even such a simple daily ritual can have profound effects on mood.

After two years working with a young woman who is now heading off to graduate school and bright future, we were reflecting on lessons learned.

“I can be a bit dense about cause and effect. I am surprised when something I do works. I remember getting up early and going out into the light for several days in a row. My whole being felt different. It was such a shift from the despair I was in before. Oh, I can give this to myself, it works to attend to my needs with the kind of deliberateness that I would give to another person, a child or someone I have the impulse to care for.”

She is moving to a Northern European city and we were thinking about challenges she might face…

“Getting up early in the morning, when it is dark, even when I don’t have to, is the main challenge.”

I sometimes am struck by how simple things can be very powerful.

Wrapped up in this one action is a series of things that we know helps improve mood –

  • A healthy pleasure. Walking in a beautiful place, around a lake, observing nature with real eagerness.
  • Bright morning light.
  • Daily exercise.
  • Proactivity. Doing something that she knows is good for her.
  • Negative ions. She walks near the sea and thus exposes herself to negative ions that have been shown to be have an antidepressant effect.

Sometimes simple things make all the difference.

The Morning Ritual – Daily Routines Part 1

For people learning to live with moods, it is often very important how the day starts. The morning sets the stage for the rest of the day and, for instance, we know that one of the best ways of getting depressed, is lying in bed after you wake up for the first time thinking about how you really “should” get more sleep….

I outline here some thoughts that people have found helpful in establishing a morning ritual.  What works best is for you will be unique, you should do some experimenting.

The time of getting out of bed in the morning should be roughly the same every morning. I suggest no more than 45 minutes of variation from day to day… and don’t think that you can “catch up” on sleep by sleeping in on the weekend, many studies show that it doesn’t work.

You should get up early enough that you have at least a half an hour for things other than eating breakfast, getting dressed, getting to work, etc.. Starting your day in a rush is a bad idea. You will feel behind the entire rest of the day. All that it takes is getting up a few minutes earlier to feel in control.

Interestingly enough, you can sometimes get up earlier and feel more rested… It sounds odd but if you use one of the many techniques designed to wake you up at a time when you are in a light sleep (which happens every ninety minutes) –  for example setting a pre-alarm that will softly signal it is time to get up, not loud enough to wake you from a deep sleep but loud enough to get you up if you are sleeping lightly – you will actually feel more rested than if you wake up a half an hour later from a deeper sleep. You can improve your odds of doing that if you go to sleep 7 and a half hours before you plan to wake up (7 and a half hours is 5 90 minute cycles – so at around that time you should be more alert and ready to wake up).

Many people find that a cup of coffee or tea is a useful way of getting started in the morning.

To the extent possible, things should be set up so that that beverage is ready soon after getting out of bed.

Some people like to go straight into a bath or shower, others prefer to take some time for the morning ritual right after getting up.

The ritual itself involves taking at least 30 minutes to sit in a place where there is abundant natural light, preferably even a view (if that isn’t possible consider buying a therapy light). This time is spent either in meditation, yoga practice, or in thinking about the day in a planful way, not an anxious way. Email is NOT a good way to start the day as it is often about urgent, but not terribly important, messages. Instead you should think about what is truly most important to you based on your personal values, and how to integrate those values into what you do.