Interpersonal and Social Rhythm Therapy

Another approach to staying healthy is to decrease behaviors or experiences that may make symptoms more likely to occur. Interpersonal and social rhythm therapy (IPSRT) focuses on reducing risk factors that could contribute to relapse. For example, there is strong evidence that sleep deprivation can trigger manic symptoms (Colombo et al. 1999). There is also good evidence that stress and interpersonal conflict can trigger depressive symptoms for a person with bipolar disorder (Johnson 2005a). In IPSRT, you learn strategies for reducing these risk factors. Research shows that when IPSRT is combined with medication, it is helpful for decreasing symptoms of depression and preventing future depressive episodes (Miklowitz et al. 2003; Frank et al. 2005).

IPSRT is designed to address the disruption to circadian rhythms that commonly occurs in bipolar disorder. Circadian rhythms are the internal biological cycles that regulate many of the body's daily processes, such as sleeping and waking. IPSRT includes strategies to help you recognize events that can disrupt your schedule, such as traveling to another time zone, doing shift work, or not having a regular daily routine. Stress and changes in relationships can also disrupt schedules and sleep. IPSRT focuses on helping you develop a regular routine for important activities like sleeping, eating, taking your medications, and exercising, and this can aid in preventing relapses. To that end, an IPSRT therapist might work with you to record and improve your sleep habits and daily routines.

A second set of skills in IPSRT involves identifying key stressors and social difficulties and working to improve those areas of your life. In IPSRT, you might choose one or two central sources of stress and work with your therapist to come up with a game plan for addressing them.

Interpersonal and Social Rhythm Therapy Model

Interpersonal Problems


Disruption in Daily Routines

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