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Track daily routine stability — wake time, meals, activity, social contact, and bedtime — as routine disruption is a key trigger for mood episodes.
Routine stability is protective in bipolar disorder. Track your key daily anchors: wake time, meals, activity, social contact, and bedtime. Rate how consistent your routine was each day. Disruptions to social rhythms can trigger episodes.
Introduce as part of the active treatment and relapse prevention phases. Social rhythm therapy (Ehlers, Frank & Kupfer) is based on evidence that disruptions to social rhythms and routines can trigger mood episodes in bipolar disorder.
Explain the link between routine disruption and mood instability in bipolar disorder. Frame social rhythm monitoring as identifying which routines are most important for mood stability and where disruptions tend to occur. This is about finding a sustainable rhythm, not imposing rigid structure.
For clients with shift work, focus on protecting the most critical rhythms (especially sleep-wake cycle and meal times) within the constraints of their schedule. For those who associate routine with boredom or mania-related desire for novelty, explore the function of routine disruption.
Avoid imposing overly rigid routine expectations that may feel controlling or unrealistic. If the client resists routine monitoring, explore the meaning of routine — it may be associated with depression ('boring life') or may conflict with valued spontaneity.
The Social Rhythm Metric (SRM) provides a validated framework. Key rhythms to monitor are: wake time, first social contact, start of daily activity, dinner, and bedtime. Focus on consistency of timing rather than the specific time chosen. Weekends and holidays are high-risk periods for rhythm disruption.
Suitable for clients working with bipolar, social rhythm, routine, ipsrt, cbt, circadian, sleep-wake cycle. This tool can be used as a standalone worksheet or as part of a structured homework plan.
Create a free account to access 10 worksheets per month.
Identify personal early warning signs for both depression and mania/hypomania, and create a stepped action plan for each mood polarity.
Track daily mood on a depression-euthymia-hypomania/mania scale alongside sleep, medication, and key events.
A longitudinal formulation for bipolar disorder — mapping life events, episode patterns, and maintaining factors across time.
Identify and challenge positive beliefs about mania/hypomania that reduce motivation for relapse prevention — e.g. "I'm more creative when high."