Living with a chronic mental illness poses challenges in building a routine and implementing healthy lifestyle changes. There comes a time in recovery when there is a need for a tangible tool to help facilitate change—something to bridge a person from acquired skills and knowledge to the creation of a healthy lifestyle and stable routine. A study by the American Psychiatric Association conducted by Ellen Frank, Ph.D., found, “patients who participated in a behavioral therapy designed to help them improve regularity in their daily routines averted new manic or depressive episodes longer than patients whose therapy focused just on regulating their mood symptoms and medication.”  Routines are good for everyone and are critical for good health.
The Intervention: Routines + Healthy Lifestyle Activities
A routine is a habitual series of things you do daily in a fixed time and order. For individuals with mental health disorders, the absence of a routine creates barriers in implementing healthy lifestyle changes, leading to increased stress, poor sleep, unhealthy eating habits, decreased physical health, and poor use of time. Structured routines and healthy lifestyle changes have a role in supporting recovery. When you feel good, it becomes easier to notice and intervene when symptoms arise. Overall, routines are important because they promote a well-rounded lifestyle.
Benefits of Routines
- They create structure, improve sleep, reduce stress, improve eating habits, and help monitor functioning.
- They improve executive functioning skills (time management, organization, prioritization), thus creating proficiency.
- Having a routine with dedicated times reduces procrastination and builds predictability into the day.
- They increase momentum to achieve goals and bolster self-confidence.
Components of a Healthy Lifestyle
Both medical and mental health care providers recommend implementing components of a healthy lifestyle (sleep routine, nutrition, exercise, social connection, being outdoors in nature, spirituality, rejuvenation), in addition to mental health treatment. These recommendations may, on the surface, seem “easy” to implement, but commitment and maintenance can be obstacles.
Barriers to Implementing Healthy Lifestyle Changes
- Lack of planning.
- Setting the goal too high.
- Not making the time.
- Low motivation.
- Not having the skills to carry out the goal.
Breaking down lifestyle components into individual activities, or “activity menus,” provides a way to overcome the barriers. Creating activity menus for each component makes it easier to implement by giving you daily choices. The use of a routine makes the activity predictable until it becomes a habit. It is an empowering intervention that lends itself to individual tailoring.
Examples Lifestyle Components/Activity Menus
- Sleep: Reflect on sleep hygiene, build mini routines (e.g., wash face, brush teeth, brush hair), read a book 15 min before bed, turn off screens an hour before bed, go to bed and wake daily at the same time, limit naps, make your bed upon rising, limit caffeine, etc.
- Nutrition: Drink water, create a balanced diet, plan meals, grocery shop with a list, substitute processed snacks with fruits and vegetables, premade meals, etc.
- Exercise: Stretch, walk, bike, swim, run, lift weights, etc.
- Rejuvenation: Meditation, prayer, progressive relaxation, biofeedback, rest and relaxation, yoga, etc.
- Social: Join online groups of interest, participate in local events, take classes, go to a church, invest in a few close friends, spend time with family, write letters, make phone calls, sit in a coffee shop.
- Outdoors/Nature: Buy a plant, hike, garden, sit outside, bird watch, star gaze, walk, etc.
- Spirituality: Keep a gratitude journal, altruistic activities (volunteering with organizations), participating in religious groups, connecting with nature, etc.
- Use 7 note cards to create the menus. On the front, write the component (e.g., exercise). On the back, personalize and list the activities. Try to find activities on a continuum from easy to difficult to provide choices when you have less capacity or time.
- Start with one healthy lifestyle component (e.g., sleep).
- Schedule a time into your routine for daily activities.
- Consider tracking progress with manageable goals and reinforcement.
- Add a new lifestyle component when the previous component is habitual.
The point is to do something every day, not an overextension of efforts. It is okay to miss a day. Just be kind and remember tomorrow is a new opportunity. The process of setting up a routine and doing new activities takes time. Remember, each activity is a small investment in the future.
About the Author: Stephanie Mallett, Ed.S., lives with schizoaffective disorder, practices as a licensed School Psychologist, and is a mental health advocate. She designed this routine strategy to implement into her own daily life. Consistent routines may ease bipolar disorder: regular sleep patterns and daily routines can help ease the symptoms of bipolar disorder. American Psychiatry Association – In Brief. February 2008. Vol 39, No.2. https://www.apa.org/monitor/feb08/consistent
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