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Daily Routine May Help Bipolar Disorder

Study Shows Regular Sleeping and Eating Patterns May Help Stabilize Patients
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WebMD Health News

Sept. 8, 2005 -- Most of us function better when we maintain a regular daily routine, but for people with bipolar disorder, routine may make a big difference in recovery.

Researchers from the University of Pittsburgh School of Medicine report that bipolar patients fared better when their treatment stressed the importance of establishing daily routines for things like sleeping and eating.

Social rhythm therapy, as it has been dubbed by the researchers, is based on the idea that irregular sleeping habits and those associated with other daily activities can trigger manic episodes by disturbing the body's sleep-wake (circadian system) clock.

"We see patients with bipolar disorder as having exquisitely sensitive and fragile body clocks," researcher Ellen Frank, PhD, tells WebMD. "They need to be more attentive than the rest of us to things like when they get up and go to bed and when they eat their meals."

'A Manageable Problem'

Once known as manic depression, bipolar disorder is characterized by extreme swings in mood, energy, and ability to function. Periods of highs and lows are referred to as manic or depressive episodes. Medications such as lithium are prescribed to people with bipolar disorder; these drugs can help stabilize mood swings.

According to the National Institute of Mental Health, more than 2 million Americans have bipolar disorder.

The study by Frank and colleagues included 175 severely ill patients with the disorder, all of whom were treated with medications. In addition, about half of the patients got social rhythm therapy from the beginning of the study.

The Importance of Routine

These patients learned the importance of establishing regular routines, and they also learned strategies for anticipating and coping with stress.

"We teach them to think of their illness the way someone with diabetes or asthma would; as a health problem that can be managed," Frank says. "A diabetic has to be careful about what they eat and when they eat. And people with asthma probably shouldn't have three dogs and two cats in the house."

The study is published in the September issue of the journal Archives of General Psychiatry.

No difference was seen between the two treatment groups in the time it took to emerge from a manic episode. But patients who got the social rhythm therapy had longer periods of stability between such episodes. Those who were most successful in establishing regular routines saw the most improvement.

The intervention translated into a 72% increase in time between manic events, Frank says.

A Holistic Approach

Depression and bipolar disorder patient advocate Sue Bergeson, who suffers from depression herself, says the study by Frank and colleagues shows for the first time in scientific terms what many patients have long understood.

Bergeson is vice president of the Chicago-based Depression and Bipolar Support Alliance.

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