The COVID-19 Pandemic and Emotional Wellbeing: Tips for Healthy Routines andRhythms During Unpredictable Times
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 poses a serious health threat to the world
population. In response, governments are implementing a variety of newpolicies 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 which support mental health.
One of the most important brain systems contributing to daily wellbeing is
the body’s internal biologic clock. These clocks keep our body and ourbehavior synchronized with the 24-hour cycle of light and dark. Predictabledaily schedules and regular routines help to keep the body clock runningsmoothly. 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 theenvironment 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 yourdaily 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 forstabilizing your body clock
Make sure you spend some time outdoors every day, especially in the earlymorning. Your body clock needs to “see” light in the morning to know “when” it is.
If you can’t go outside try to spend at least 2 hours next to a window, looking into thedaylight, and focusing on being calm.
Set times for a few regular activities each day such as home tutoring, telephone callswith a friend, or cooking. Do these activities at the same time each day.

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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 snackat the prescribed time.
Social interactions are important, even during social distancing. Seek out “back andforth” social interactions where you share thoughts and feelings with another person inreal time. Videoconferencing, telephone or even real-time text-messaging is preferred toscrolling 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
them to 30 minutes. Napping makes it hard to fall asleep at night.
Avoid bright light (especially blue light) in the evening. This includes computer
screens and 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 anight owl, it’s ok to stay up a little bit later and get up a little bit later than others in thehousehold. Just make sure you go to sleep and get up at the same time every day.

Please circulate freely.
Attribute text to International Society of Bipolar Disorders (ISBD) Task Force on Chronobiology
and Chronotherapy and the Society for Light Treatment and Biologic Rhythms (SLTBR)