Chris Aiken, M.D.  Psychiatry & Psychotherapy

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This site is for information only and is not intended as a substitution for psychiatric treatment.

Social Rhythm Therapy

 

Social Rhythm Therapy is a form of psychotherapy which can help prevent mood swings. Every day we come in contact with important signals or events that help set our body’s clock and regulate our mood and hormone levels.  Examples include sunlight, sleep, exercise, meals, exercise and stress.  By regulating your exposure to these events you can increase the stability of your mood for the long term.

 

Prevention when you feel well: How to keep mood swings from returning

1) Keep a regular schedule.  When you have a mood disorder, your body’s internal clock doesn’t always set right, so you need to schedule things that help set your clock.  Sleep, meals sunlight and exercise are important: do these at the same time each day (within ½ an hour).

2) Identify mood-restorers.  List activities that tend to restore your sense of daily rhythms. Examples might be walking, bedtime rituals, time with a close friend or partner, bathing, taking medicine, reading or a favorite TV show. Try to increase the number of these activities and do them at the same time each day (within ½ an hour). 

3) Identify mood-deregulators.  What things make you feel off-balance, over-stimulated, or disrupt your sleep?  Make a list; examples could be arguments or intense discussion, travel, late-night projects, bright lights, caffeine, noise, or crowds.  Try to avoid mood-deregulators at night to protect your sleep.  When possible, plan ahead for how to manage mood-deregulators.

4) Self monitoring.  Learn the symptoms of mood swings (see list at right) and chart them on a mood chart; learn your personal warning signs for mood swings.

 

Manage early signs of a high mood (activated, irritable, impulsive or manic)

1) Preserve Sleep.  Try to sleep at least 6 hours a night. Don’t be stingy with sleep meds; using them early-on can keep you from needing larger amounts later. Use what you need to fall asleep and call your doctor if that’s not working.  At night, turn down the lights and use bedtime rituals. Read more about sleep restoration.

2) Manage conflict. The 3-volley rule:  When an argument escalates to “3 volleys”, stop the talk and walk away.  A “volley” is an angry or argumentative statement.  For example, if you say 1. “I hate it when people interrupt me!” and your relative counters with, 2. “Don’t get angry, I thought you were finished talking!!” and you counter with 3. “That’s because you weren’t listening!!!”… that’s 3 volley’s, and a sign that you both need to disengage.

3) Manage impulses. The rule of 2’s:  If you have an idea that might be impulsive, try waiting two days before acting on it, or asking two people if they think it would be wise.  If it really feels uncontrollable, set a timer for one hour.  If the craving is still uncontrollable after one hour, allow yourself to indulge it.

 

Manage early signs of a low mood (depressed or empty)

Click on self-activation to learn more. 

Updated 9/14/7 by Chris Aiken, M.D.

 

Signs of Mood Swings

 

High Symptoms (activated, irritable, impulsive or manic mood)

·        I need less sleep

·        I feel more energetic and more active

·        I am more self-confident

·        I enjoy my work more

·        I am more sociable (make more phone calls, go out more)

·        I want to travel and/or do travel more

·        I tend to drive faster or take more risks when driving

·        I spend more money/too much money

·        I take more risks in my daily life (in my work and/or other activities)

·        I am physically more active (sports, etc.)

·        I plan more activities or projects

·        I have more ideas, I am more creative

·        I am less shy or inhibited

·        I wear more colorful and more extravagant
    clothes/make-up

·        I want to meet or actually do meet more people

·        I am more interested in sex, and/or have increased sexual desire

·        I am more flirtatious or am more sexually active

·        I talk more

·        I think faster

·        I make more jokes or puns when I am talking

·        I am more easily distracted

·        I engage in lots of new things

·        My thoughts jump from topic to topic

·        I do things more quickly or more easily

·        I am more impatient or get irritable more easily

·        I can be exhausting or irritating to others

·        I get into more quarrels

·        My mood is higher, more optimistic

·        I drink more coffee

·        I smoke more cigarettes

·        I drink more alcohol

·        I use more drugs

 

Low Symptoms (empty, depressed)

·        I feel sad, down, depressed

·        The future seems hopeless

·        I feel like a failure

·        I don’t enjoy much in life

·        I have little motivation

·        I am more self-critical

·        Life doesn’t seem worth living or I have thoughts of suicide.

·        I don’t do very much

·        I feel anxious or inhibited

·        I cry a lot

·        I feel slowed down

·        I feel tired or have little energy

·        I’m withdrawn from other people

·        I have trouble making decisions

·        I can’t concentrate well

·        I have trouble falling asleep and need more sleep than I’m getting

·        I wake up earlier than expected

·        I sleep too much

·        My sex drive is low

·        I eat more than usual

·        I eat less than usual

·        I crave sweets or carbohydrates

·        I feel worthless

·        I tend to worry and ruminate

·        I feel easily hurt or rejected

·        My muscles feel agitated or tense 

·        My muscles feel slow and weak   

·        My limbs feel heavy, like lead      

·        I feel angry, irritable                     

·        Nothing interests me much           

·        It’s hard to start things                 

  • I feel empty or have no feelings

 

Mixed Mood

When symptoms from a high and low mood overlap significantly in a single day, it is called a “mixed mood.”