Sticking to a Medication Schedule When You Lose Track of Time During COVID-19

During the COVID-19 pandemic, many people have reported experiencing an unusual perception of time. On one hand, you may feel like it’s still March of 2020 and you’re stuck in a Groundhog Day scenario. On the other hand, you may feel like it’s been years since you first became familiar with coronavirus pandemic-related terms like social distancing, quarantining, and face masks.

In a July 2020 survey of 604 participants published in the journal PLOS One, researchers found that social distancing had warped the sense of time in most participants during lockdown in the United Kingdom in April. While just 13 percent of participants noted that time seemed normal to them during the previous week of lockdown, 39 percent experienced it as going more slowly than usual and 48 percent experienced it as going more quickly than usual.

Although it’s been a running joke for the past year (how many times have you heard someone jest that it’s the 250th day of March?), this loss of time perception can have more serious implications if you’re responsible for taking medications for a chronic illness on a regular schedule.

Daily or weekly medications may become less top-of-mind when your morning, afternoon, and evening schedules and environments blend together — and biweekly (every two weeks) or monthly injections can become even more tricky to keep track of.

Here’s why this disillusion with time is occurring during the COVID-19 pandemic, and tips you can use to stay on track with your medications if you’re experiencing it.

What Shapes Our Sense of Time

During the pandemic, it’s easy to feel like days blend together. There’s one key thing that has contributed to that loss of time perception: the absence of new events in our everyday lives.

“We register time in terms of novel events, meaning the things that are new in our lives,” says Adrienne Meier, PhD, a licensed psychologist who practices in California and New York. “One of the most consistent things about the pandemic for a lot of us is that we are not having new experiences. Every day feels like the same routine in the same environment.”

While there may be a lot happening in the news, there are likely very few things that are new to your everyday life. These experiences don’t have to be big events like a trip or moving to a new town, either, to shape your perception of time.

“Novel experiences include small things like meeting a new person or trying a new restaurant,” says Meier. “Because those aren’t happening as much, we don’t have the same markers for time passing as we usually do.”

Other things can play a role in your sense of time too, including fear and anxiety about the pandemic (which can make it feel like time is moving more slowly) or having the same exact schedule and routine every day (which can make it feel like time is moving more quickly).

“It can simultaneously feel like time is moving both slow and fast, even within the same person,” says Dr. Meier. “If you want time to go faster, stick to a routine and keep your head down. If you want to help time slow down, incorporate new experiences in your life, whether it’s trying a new recipe or attending a virtual Zoom party.”

What Warped Time Perception Means for Your Medication Schedule

Losing track of the days can be inconvenient, but it’s also risky if you need to stick to a medication regimen, depending on your medical conditions and the types of drugs you take.

“Missing a medication like prednisone [a corticosteroid] can be dangerous since the body becomes dependent on it within a few weeks,” says Lynn Ludmer, MD, Medical Director of Rheumatology at Mercy Medical Center in Baltimore. “It’s possible to go into shock from missing a dose, especially if you are ill at the time.”

Reach out to your rheumatologist or pharmacist if you forget to take a dose of any medication, take an extra dose by mistake, or if a mail-order prescription is late (in this case, it may be appropriate to purchase a temporary supply from your local pharmacy).

In deciding on the next steps after a missed dose of medication, your health care professional will consider which drug is being used and the disease it’s treating — and how well-controlled that disease is.

“For example, even though patients with rheumatoid arthritis who are stable may be encouraged to skip two doses of methotrexate after they receive the flu shot to improve the response to the vaccine, missing three or four doses can cause a disease flare-up,” says Dr. Ludmer. Methotrexate for inflammatory arthritis is typically administered once a week, either as pills or an injection.

“Meanwhile, it may not be appropriate for patients with a disease that causes serious inflammation to the lungs and kidneys to miss any doses of methotrexate, due to concerns of organ damage from inflammation,” she adds.

Even if you forget a dose of your medication, don’t take it late without your doctor’s approval.

“It depends on the specific medication, but there are also risks to doubling up on doses of certain medications,” says Dr. Ludmer. “In some cases, it’s better to miss a dose than to double up, depending on how long it’s been. But it does vary and it’s important to check in with your doctor or a pharmacist about the medication in question and how long it has been since the dose was missed.”

Keep in mind that your doctor or pharmacist wants to help, so be honest about any changes to your medication schedule.

“We’re all human beings and people are going to miss a dose occasionally,” says Dr. Ludmer. “Patients need to feel comfortable discussing medicine questions with their doctor and partnering together on what works best for them.”

How to Stay on Track with Your Medication Schedule

If you feel like you’re losing track of time during the pandemic, here are practical tips for remembering to take your medication.

1. Finally get yourself a pill box

You may be thinking, “I don’t need a pill box — I can remember!” But using these handy organizers doesn’t mean you’re forgetful. Everyone can use a little help keeping track of the days during COVID-19, and this is a smart way to do it.

It’s also a great solution to prevent second-guessing whether you actually took your medication dose on a given day.

“Having a pill box that you fill up at the beginning of the week can make you more accountable,” says Dr. Ludmer. “I find pill boxes to be incredibly helpful because people often do routine things unconsciously. It’s easy to peek inside to reassure yourself you took the dose in question or to identify a missed dose.”

You may also find it to be a time-saver (and easier on your joints) to organize all of your medications or vitamins on a weekly, biweekly, or monthly basis, rather than twisting open each individual bottle on a daily basis.

There are several types of pill organizers available, including ones that come with daily alarms and those that are designed to be easy to open for sensitive joints.

Try it:

• Arthritis-Friendly Ezy Dose Weekly Push Button Pill Organizer (XL) ($5.99)
• XINHOME Monthly Pill Organizer Box – 31 Day AM/PM Daily Pill Case ($17.77)
• 7-Day AM/PM Pill Organizer with Reminder Alarm ($15.88)

2. Incorporate your medications into your regular routines

Although you may have fewer daily routines than you used to, determine a task you do during the same time increments as your medication calls for (daily, weekly, biweekly, monthly, etc.) and pair your medication with that activity.

“I try to have people coordinate their pill taking with other things that they do,” says Dr. Ludmer. “So brushing teeth, for example: Most people brush their teeth twice a day, and that might be a good time to take medication you need twice a day, especially if you don’t have young kids and can leave your pill box right on the counter next to your toothbrush or toothpaste.”

If it’s not a risk for anyone who lives in your household, you can also place your medication next to a coffee maker or tea kettle you use each morning.

“It becomes more challenging when medications are not taken on a daily schedule,” says Dr. Ludmer. “If you are on weekly, biweekly, or monthly injections, you have to come up with some sort of system to remember. For instance, tying in a once-a-month injection with a rent or mortgage payment might be helpful.”

Some pharmaceutical companies also provide emails or text messages on the day you’re supposed to take a given medication, so check to see what services are available for the medications you take.

3. Flip your pill bottles over

If you don’t want to use a pill box for your daily medication, it may be helpful to flip your pill bottle over each time you take your medication, suggests Michigan Medicine. Before you go to bed each night, put a reminder on your nightstand to flip the bottle over again to start fresh in the morning.

4. Create written reminders and notes

Put sticky note reminders in places you’ll see them regularly, like on your bathroom mirror, recommends Michigan Medicine. You can also track the medications you’ve taken on a dry-erase board and erase reminders after each dose to keep track.

There may be a benefit to writing it all down: “I think that paper in some ways is more tangible than electronics, so journaling or keeping some other type of calendar helps us track time a little bit better,” says Dr. Meier. “But at the end of the day, either version can help you to keep track of time and orient yourself.”

5. Take advantage of free smartphone medication reminder apps

If you do prefer to get reminders electronically, it can be as simple as setting a daily alarm — which may be easier to do during COVID-19 when you’re at home more often (no need to worry about a blaring alarm going off in a conference room or crowded elevator). Or you could create a digital calendar reminder to take your medications. This may be particularly helpful for drugs that you take less frequently, such as a monthly biologic.

However, there are also a number of free smartphone apps that offer medication reminder alerts, including:

• Mango Health
• Medisafe
• CareZone

You can also talk to your doctor, who may have recommendations for remembering to take medications based on what their other patients have found helpful.

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