Recommendations from the International Society of Bipolar Disorders (ISBD) Task Force on Chronobiology and Chronotherapy and the Society for Light Treatment and Biologic Rhythms (SLTBR)
The COVID 19 pandemic is currently posing major challenges for all of us. As a consequence, a variety of measures such as self quarantine, self-isolation and above all the so-called “social distance” are currently determining our everyday life. While these measures are necessary to limit the spread of the virus and protect our health systems from overburdening, they can also negatively affect factors that normally promote and stabilize our mental health.
Our biological clock, which is located in the brain, contributes significantly to our daily well-being. This clock ensures that our body and our behaviour remain in harmony with the daily 24-hour cycle of light and darkness. Predictable daily plans and regular routines can help to keep this inner clock in time, so that we feel noticeably better.
The loss of normal routines such as going to work every day, hobbies, or social contact at work or in private life, makes it much more difficult for our body clocks to keep “in time”. This can lead to symptoms that we usually experience when we are slightly jetlagged or after a night shift. Symptoms can include loss of appetite, lack of energy, sleep problems, tiredness or a depressed mood. We can counteract this by following regular daily routines to stabilize the internal clock.
Here are some simple tips to improve the regularity of your daily routines, even though much of your life may feel irregular at this time.
Self-management Strategies for Increasing Regularity of Daily Routines
- Set up a routine for yourself while you are in (self-)quarantine or self-isolation or working from home (home office). Routines help to stabilize the body clock.
- Get up at the same time every day. A regular time of getting up is very helpful for stabilizing your body clock
- Spend time outside every day, especially in the early morning. Your body clock must “see” the light in the morning to know “what time” it is.
- If you cannot go outside, try to spend at least 2 hours next to a window or, if available, on the balcony to see the daylight and try to relax.
- Set times for some regular activities each day such as talking to friends on the phone, physical fitness exercises, a meditation exercise or cooking. Do these activities at the same time every day.
- Challenge your body and stay active every day, ideally using different exercises at the same time every day. The exercise also helps you fall asleep better in the evening.
- Take meals regularly and at the same time every day. If you are not hungry, eat at least one small snack at the prescribed time.
- Social interaction is important, even during social detachment. Seek social contact often, where you can exchange thoughts and feelings with another person in real time. Video chats, phone or even chats without pictures are better than spending time flipping through the news and social media. Schedule these interactions at the same time every day.
- Avoid naps during the day, especially later in the day. If you can’t resist a nap, limit it to 30 minutes and avoid naps in the late afternoon or evening. A nap makes it harder to fall asleep in the evening.
- Avoid bright light (especially blue light) in the evening. This includes computer screens and smartphones. The light of the blue spectrum suppresses melatonin, the hormone that helps us fall asleep. Use a night shift mode and reduce the brightness of the display.
- Stick to a consistent sleeping and waking time that matches your natural daily rhythm. The daily rhythm is very individual and perhaps your rhythm is different from that of your fellow human beings. Just make sure that you fall asleep and get up at the same time every day.
These recommendations have been adapted and translated on the basis of a publication by the “Task Force” of the International Society for Bipolar Disorders (ISBD) on chronobiology and chronotherapy and the Society for Light Treatment and Biological Rhythms (SLTBR).Further information can be obtained from Prof. Christian Cajochen or staff members of the Centre for Chronobiology of the University Psychiatric Clinics Basel, Switzerland