Routines: sleep, meals, and a regular day
Regular routines hold a day together. Meals at roughly the same times, getting up and going to bed at about the same time, a shower, and getting dressed can slip first when mood is low, and their loss can make everything else harder.
Behavioral activation counts these as activities in their own right. Planning breakfast at the table or getting dressed by 9 isn’t too small to count. It’s often where people start.
Sleep matters here too. Sleeping much more or much less than usual, or at very different times, can keep mood low. If sleep is a big part of what’s hard, Sleep Toolbox, another free Everyday Insight tool, has a sleep diary and the self-help parts of CBT for insomnia.
Mark routine activities as Routine under What it’s for, so you can see in your week whether the basics are holding.
Why routines matter
Martell and his colleagues pay close attention to routines that have come apart. A job loss, a move, a breakup, a new baby, or retirement can take away the structure that used to shape the day. Without it, meals drift, sleep drifts, and whole days can pass without much in them. Part of behavioral activation is rebuilding enough of that structure to stand on.
Social rhythms
In 1988, Cindy Ehlers, Ellen Frank, and David Kupfer proposed that the everyday events of social life help set the body clock. The time you get up, the first person you talk to, when you start work, and when you eat all act as cues. They called these social zeitgebers, from the German for time givers.
When a life event takes those cues away, they suggested, the body’s rhythms can drift, and in people prone to depression that may help bring on a low stretch.
Ellen Frank and her colleagues later built a therapy around this idea for people with bipolar disorder, interpersonal and social rhythm therapy. In a two-year trial, people who made their daily rhythms more regular during treatment were less likely to have a new mood episode afterward.
Sleep and mood
Sleep and mood are closely tied. In long-term studies that followed people over years, those with insomnia were about twice as likely as good sleepers to develop depression later. That’s a pattern in large groups, not a prediction about you, but it’s one more reason to give sleep some attention.
Where to start
If routines have come apart, you don’t have to rebuild all of them at once. Pick one anchor and hold it for a week or two before adding another.
For many people the best first anchor is a steady wake time, every day, weekends included. It helps keep the body clock steady, and the rest of the day can hang from it. After that come the first meal, the last meal, and a rough bedtime.
A week might look like this. Up at 7:30 every day. Breakfast by 8:30, even if it’s toast. Dinner around 6:30. Lights out around 11. Each one can be a plan in the app, marked Routine.
When a regular day is hard to hold
Shift work, small children, caregiving, school schedules, and stretches without work can all make a fixed routine hard. Aim for regular within your own week rather than for an ideal day. If your shifts rotate, keep the anchors you can, like a meal before each shift or the same wind-down after one. If nights are broken by a baby, a steady time to get up and get dressed may be the one anchor that holds.
If you have bipolar disorder
Changes in sleep and routine affect bipolar disorder more strongly. Losing sleep is one of the best-known triggers for mania. Plan changes to your activity and your sleep with your clinician, and keep your routines as steady as you can. “When to get more help” has more.
References
- Martell, C. R., Dimidjian, S., & Herman-Dunn, R. (2021). Behavioral activation for depression: A clinician’s guide (2nd ed.). Guilford Press.
- Ehlers, C. L., Frank, E., & Kupfer, D. J. (1988). Social zeitgebers and biological rhythms: A unified approach to understanding the etiology of depression. Archives of General Psychiatry, 45(10), 948–952. doi.org/10.1001/archpsyc.1988.01800340076012
- Frank, E., Kupfer, D. J., Thase, M. E., Mallinger, A. G., Swartz, H. A., Fagiolini, A. M., Grochocinski, V., Houck, P., Scott, J., Thompson, W., & Monk, T. (2005). Two-year outcomes for interpersonal and social rhythm therapy in individuals with bipolar I disorder. Archives of General Psychiatry, 62(9), 996–1004. doi.org/10.1001/archpsyc.62.9.996
- Baglioni, C., Battagliese, G., Feige, B., Spiegelhalder, K., Nissen, C., Voderholzer, U., Lombardo, C., & Riemann, D. (2011). Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies. Journal of Affective Disorders, 135(1–3), 10–19. doi.org/10.1016/j.jad.2011.01.011
- Wehr, T. A., Sack, D. A., & Rosenthal, N. E. (1987). Sleep reduction as a final common pathway in the genesis of mania. The American Journal of Psychiatry, 144(2), 201–204. doi.org/10.1176/ajp.144.2.201
Helpful links
Everyday Insight’s tools are for education and personal reflection. They are not therapy or medical care, and they are not for emergencies. In an emergency, call 911. If you are in crisis in the United States, call or text 988. Mental health resources