You mentioned having a schedule-is that for sleep too?
It's interesting that you may have already been using some of these strategies. I can really relate to the BP II stuff and am looking to create a schedule and consistency on my own. Right now I don't adhere to a schedule for sleep or work or eating or anything really. I work a lot too, and my hours revolve around my responsibilities and team based work rather than a schedule.
My psychiatrist mentioned one of those light boxes too. Have you ever tried one?
Quote:
Interpersonal and Social Rhythm Therapy for Bipolar II Disorder
To address the complexities of BP II disorder adequately, it is necessary to tailor IPSRT to the meet the needs of this patient population. Below we describe six strategies we have used in adapting IPSRT for individuals with BP II disorder.
1. Providing rationale for making changes to social rhythms
In IPSRT, patients are asked to make changes to their social rhythms in order to lead “supranormal” lives. Indeed, scores on the SRM of individuals completing IPSRT are higher (more regular) than those of healthy controls (Frank et al., 2005; Monk et al., 1990). In order to provide the rationale for these changes to patients with BP I disorder, the therapist points to historic disruptions in regularity of rhythms (especially sleep) that almost always precede destructive manic episodes and hospitalizations (Malkoff-Schwartz et al., 1998) as a compelling way to argue for increased rhythm regularity.
It is typically more difficult to convince individuals with BP II to make significant changes in their daily routines because there is initially little apparent reason to make these unappealing changes (i.e., go to bed at a regular time every night). The argument that these changes will prevent hypomania is not persuasive, as patients may welcome hypomania as a relief from unrelenting depression, and hypomania is not typically accompanied by the negative consequences associated with mania. Patients with BP II disorder may have less insight into their symptoms than those with BP I (Pallanti et al., 1999) or may not recognize the symptoms of hypomania. Alternate strategies to encourage rhythm regularity include 1) emphasizing the likelihood that a depressive episode will follow a hypomanic one and that the goal of IPSRT is to improve overall mood stability, 2) revisiting the “benign” nature of hypomania as some patients will begin to recognize that these episodes are, in fact, more destructive than they had realized, 3) asking patients to try it as an “experiment” to see if it helps with overall mood, energy, and motivation. Some who are initially reluctant to make social rhythm changes may benefit from observing a slight worsening of mood during a period of instability in their schedule. If patients are able to observe their own mood changes as they fail to maintain a regular schedule, they may be more willing to invest in sustaining rhythm stability over time.
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Psychotherapy for Bipolar II Disorder: The Role of Interpersonal and Social Rhythm Therapy