What is Interpersonal and Social Rhythm Therapy?

A New Behavioral Approach to Bipolar Disorder

Jun 7, 2009

Interpersonal and Social Rhythm Therapy is one of the only therapies shown to be effective for bipolar disorder specifically. It targets the body, mind, and heart.

Interpersonal and Social Rhythm Therapy, or IPSRT, is a treatment for bipolar disorder based on the theory that stabilizing circadian and social rhythms can reduce the frequency and severity of manic and depressive episodes.

IPSR therapists look at things like a patient's sleep-wake cycle, daily routines, and social relationships to help identify how disruptions to these social and bodily "rhythms" can trigger bipolar episodes.

What Happens In A Typical IPSR Session?

In a typical first session with an IPSR therapist, the patient will discuss the times he wakes up and goes to sleep, what times he eats, what times he has his first and subsequent interactions with other people, and whether those interactions are happy, stressful, stimulating, boring, or sad.

The patient might be asked to keep a diary of his daily routines and moods, noting each activity and how stimulating it was. The purpose of this exercise is to identify which habits and patterns may be exacerbating the patient's bipolar disorder.

For example, disruptions in sleep are a common trigger for manic episodes, and highly stimulating, stressful social interactions throughout the day can worsen both mania and depression. By keeping a mood/activity journal, the patient can discover which habits and situations have an impact — either positive or negative — on mental health.

Mood Journals Help Patients With Bipolar Disorder Discover Their Social and Biological Rhythms

Using the information from the patient's mood/activity journal, the therapist will help the patient establish the best possible "rhythm" of daily life. A therapist will often recommend regular sleeping and waking times, regulating the number of high-stimulation activities and social situations the patient engages in, and scheduling for regular exercise and relaxation time. IPSR therapists can also help the patient learn to cope with difficult relationships and family situations.

Once the patient has established a steady rhythm of routines and social interactions, an IPSR therapist will help the patient develop strategies for dealing with situations that disrupt his rhythm, such as changes in work schedules and sickness in the family. IPSRT emphasizes stress-management and developing insight into how the patient's own physical and mental habits and social relationships play into his bipolar disorder.

IPSRT - A Biopsychosocial Approach to Treating Bipolar Disorder

This form of therapy is particularly useful for people with bipolar disorder because steady routines and relationships, combined with an appropriate course of medication, have been found to slow the recurrence of manic and depressive episodes.

Ultimately, the purpose of IPSRT is to give the patient the skills and insight necessary to regulate his own daily life to maximum benefit — and minimum bipolar. By becoming aware of the relationship between his own physical, social, and psychological systems, the patient can have much greater control over the course of the illness.

The copyright of the article What is Interpersonal and Social Rhythm Therapy? in Bipolar Disorder is owned by Hilary Smith. Permission to republish What is Interpersonal and Social Rhythm Therapy? in print or online must be granted by the author in writing.