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When you live with bipolar depression, your body clock may be off kilter. It’s called circadian disruption.

Your circadian rhythm is the 24-hour cycle that dictates your body’s schedule. When you don’t keep a regular routine, you’re at higher risk of interrupting that natural cycle and even setting off a depressive episode.


How Your Circadian Rhythm Works

Multiple genes in your body control your circadian rhythm.  It guides your body temperature, hormonal cycles, hunger, and importantly, your sleep-wake cycle. It also helps control the formation of long-term memory while you sleep, along with promoting healing in your body. 

The circadian sleep phase is influenced by your environment, especially light and dark. Most people start to feel sleepy as a response to the day getting darker. But the exact timing varies from person to person. 

Your circadian patterns can also affect how well you cope emotionally in your  life. It influences qualities like your assertiveness and your ability to rationalize. 

If your circadian rhythm is irregular, it has a negative impact on your sleep and your ability to function well.

How a Routine Can Help

With bipolar depression, setting a healthy daily routine is one of the best management skills you can develop. It helps calm your anxiety because you know what to expect out of your day. It also sets patterns and habits like exercising and taking meds on time. 

Regular sleep and exercise help rstabilize your mood. As part of your daily routine, make sure to include downtime -- space you carve out of your day to relax, unwind, and do something you enjoy. This can help keep your stress low and improve your mood. 

Your schedule also gives you something else to focus on as you go through your day. There may be changes to your routine from time to time, but if you have a foundation to go back to, it helps you reset more quickly.

One of the most basic and necessary parts of a routine is going to sleep and waking up at the same time every day. If you’re struggling to keep a sleep schedule, try shifting it forward or backward to see if you sync better with your circadian rhythm. This may mean an adjustment in your social calendar. 

You can use a bright light in the morning to help wake you up. At night, keep things dim (put away screens) so your body gets the cue you’re getting close to bedtime. 

Other Ways to Protect Sleep

In addition to keeping a routine every day, good sleep hygiene can improve the quality and quantity of your shut-eye. Some tip include:

  • Avoid screen time and bright lights at least 60 to 90 minutes before you go to sleep. Instead, read a book in dim light, listen to gentle music or an audiobook, or meditate to prepare for bedtime. 
  • Keep your sleep space quiet, dark, free of distraction, and at a temperature that helps you relax. 
  • Keep meals light leading up to bedtime. Eating too much can make it harder to sleep.
  • Lower your caffeine intake or cut it out completely. 
  • Try to move your body in some way during the day. Physical activity helps your body be naturally tired.

Interpersonal and Social Rhythm Therapy (IPSRT)

Another method to help you better sync with your circadian rhythm is interpersonal and social rhythm therapy (IPSRT). This type of psychotherapy helps you better understand your biological and social rhythms.

IPSRT is based on the connection between daily routine or rhythm disruptions and mood destabilization. It focuses on the relationship between your mood and life events. A therapist typically has you track your mood and sleep patterns. They also teach you strategies to better manage changes in your schedule from day to day.

Research on using IPSRT as treatment for bipolar disorder shows it helps improve depressive, manic, and anxious symptoms as well as your overall ability to function. People who do ISRT also tend to respond better to mood stabilizer medications.

Show Sources

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Brain and Behavior Research Foundation: “Circadian Rhythms and Bipolar Disorder.” 

Sleep Foundation: “Circadian Rhythm.”

Harvard Health: “Why your sleep and wake cycles affect your mood.”

Psycom: “6 Tips to Live Better with Bipolar Disorder.”

CDC: “Tips for Better Sleep.”

Annals of General Psychiatry: “Efficacy of the interpersonal and social rhythm therapy (IPSRT) in patients with bipolar disorder: results from a real-world, controlled trial.”