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Recommendations from the International Society of Bipolar Disorders Task Force on Chronobiology and Chronotherapy and the Society for Light Treatment and Biologic Rhythms.
The COVID-19 pandemic poses a serious health threat to the world population. In response, governments are implementing a variety of new policies including self-quarantine, self-isolation and social distancing. While medically necessary to limit spread, these new social policies can disrupt many of the stabilizing factors in our lives that support mental health.
One of the most important brain systems contributing to daily wellbeing is the body’s internal biologic clock. This system of clocks keeps our body and our behavior synchronized with the 24-hour cycle of light and dark. Predictable daily schedules and regular routines help to keep the body clock running smoothly. When our body clocks run smoothly, we feel better. Research shows that disrupted body clocks are associated with many physical and mental health conditions, including depression, diabetes, obesity, and cancer.
When faced with major upheavals in our lives-such as those caused by the COVID-19 pandemic-our body clocks have much more difficulty re-establishing regular biologic rhythms. Absent the normal social routines of work, childcare, and socializing, the biological clock system may be confused or challenged. As a result, we may experience negative physical symptoms similar to jet lag such as disturbed sleep, appetite, energy, and mood.
If you have a mood disorder such as depression or bipolar disorder, research suggests that you have a sensitive body clock. Your body clock is more prone to losing track of time when the environment is disturbed, and a disrupted body clock may lead to mood episodes. Paying attention to routines may be especially important during times of stress to keep your body clock regular and your mood stable.
Helping your body clock to stay on track during major life disruptions such as the COVID-19 pandemic may help you feel better. Here are some easy tips for improving the regularity of your daily routines, even when nothing about your life feels regular.
Self-Management Strategies for Increasing Regularity of Daily Routines
• Set up a routine for yourself while you are in quarantine or working from home; routines help stabilize body clocks
• Get up at the same time every day: a regular wake time is the most important input for stabilizing your body clock
• Make sure you spend some time outdoors every day, especially in the early morning; your body clock is regulated by the light – dark cycle
• If you can’t go outside try to spend at least 2 hours by a window, looking into the daylight, and focusing on being calm
• Set times for a few regular activities each day such as home tutoring, telephone calls with a friend, or cooking; do these activities at the same time each day
• Exercise every day, ideally at the same time each day
• Eat meals at the same time every day; if you’re not hungry, at least eat a small snack
• Social interactions are important, even during social distancing; seek out “back and forth” social interactions where you share thoughts and feelings with another person in real time; videoconferencing, telephone, or real-time text-messaging is preferred to scrolling through messages; schedule these interactions at the same time every day
• Avoid naps during daylight hours, especially later in the day; if you must nap, restrict the nap to 30 minutes-napping can make it hard to fall asleep at night
• Avoid bright light (especially blue light) in the evening (eg, computer screens, smartphones); blue spectrum light suppresses the hormone that helps us sleep
• Stick to a consistent sleep and wake time that fits your natural rhythms; if you are a night owl, it’s ok to stay up a little bit later and get up a little bit later than others in the household, but make sure you go to sleep and get up at the same time every day.
Submitted on behalf of the International Society of Bipolar Disorders Task Force on Chronobiology and Chronotherapy and the Society for Light Treatment and Biologic Rhythms. Dr Gottlieb is Assistant Clinical Professor of Psychiatry, Feinberg School of Medicine, Northwestern University, and Medical Director, Chicago Psychiatry Associates, Chicago, IL. He reports no conflicts of interest concerning the subject matter of this article.