Circadian rhythms are an important component of mental health. Humans have naturally evolved to live in the 24-hour light-dark cycle that our planet creates for us, and we run into difficulties when this pattern is disrupted.
Depression and bipolar are conditions that may create circadian disruptions, or they may stem from an ongoing breakage in the circadian pattern. In either case, restoring patterns of life, such as sleep times, waking times, mealtimes and work routines has been shown to have a clear effect on modulating mood swings and strengthening mood homeostasis.
Social Rhythms Therapy
Circadian rhythm treatment doesn’t focus on adding something healthy, like exercise, or removing something unhealthy, like television watching, it merely looks at the rhythm of the day and works to keep each event at roughly the same time and also to time events so that they help to stabilize sleep/wake cycles. The idea is that each of the actions you take every day gives your brain a cue about what time it is, and if you can keep the rhythm steady, the brain is less likely to get a wonky sense of time, which could trigger mood episodes.
A relatively new therapy approach that shows some promise is “social rhythms therapy” (SRT) which considers the rhythm and routine of each day, and encourages patients to be sure to perform the same actions at the same time each day. It is hypothesized that those struggling with mood disorders need more “time-givers” each day than just a wake-up time and a go-to-bed time. Social rhythms also include the first contact with another person (either by phone or in person, either in the same household or not). Also included are meal times and the times of beginning work, housework, exercise, or whatever else is in the daily routine.
While a lot of research and trialing remains to be done, some people are already benefiting from SRT. Willa Goodfellow, in her blog “Prozac Monologues” writes that SRT got her bipolar under control “when nothing else worked”. She reviews the book Treating Bipolar Disorder: A Clinician’s Guide to Interpersonal Social Rhythms Therapy1 and gives it an enthusiastic recommendation.
Daily Routines and Mental Health
MoodSurfing has looked at circadian rhythms mostly in the context of treating insomnia, but we have also found that routines, especially morning routines, are a helpful point of attention for many people living with mood disorders. In parallel with the comments above about interpersonal contact routines, we have also looked at the role of pets in mental health. Pets, especially dogs, require their owners to keep to a regular routine, and that can help the owner be more intentional about their own routines as well.
- Frank, Ellen. Treating Bipolar Disorder: A Clinician’s Guide to Interpersonal Social Rhythms Therapy. Guilford Press; 2005.