Interpersonal and Social Rhythm Therapy: What Is It and Who Can It Help?
If you or someone you love lives with bipolar disorder, you’ve probably noticed how quickly things can unravel when your daily routine is thrown off. Likewise, you have probably also noticed how conflict in your relationships can affect your mood.
Interpersonal and Social Rhythm Therapy (IPSRT) is an evidence-based treatment that is designed to stabilize your daily routines and relationships. It was developed specifically for bipolar disorder. Does it work? Yes! Research has demonstrated that it leads to fewer mood episodes and a better outlook for long-term stabilization.
Let’s take a closer look at this therapy.
What Is Interpersonal and Social Rhythm Therapy?
IPSRT is a therapy for treating bipolar disorder and other mood disorders. It has been around since the 1990s. It was developed by Dr. Ellen Frank and other researchers at the University of Pittsburgh.
What’s the Theory Behind IPSRT?
The theory behind IPSRT is called the social zeitgeber theory. This theory has to do with how daily routines in a person’s life follow a natural rhythm. This rhythm is closely tied to their circadian rhythm, which is the body’s 24-hour clock. This clock regulates sleep, appetite, and other core biological functions. The theory suggests that disruptions in a person’s natural rhythm can result in mood disturbances.
Two things are thought to affect our natural circadian rhythm:
Social rhythms: Our biological clocks (circadian rhythms) are deeply affected by our daily habits, especially when it comes to social interactions, meals, sleep, and exercise.
Relationships: Relationship stress, role transitions (like becoming a wife/husband), and grief can throw off your daily rhythm. This can trigger or worsen mood episodes in people with bipolar disorder.
Social Rhythms and Bipolar Disorder
Numerous research studies have found that bipolar disorder is linked to disruptions in circadian rhythms. When your body clock is running smoothly, you feel better emotionally and physically. When you don’t sleep well or get out of your daily routine, you might feel tired, fatigued, or even irritable. This can trigger mood episodes in those who have bipolar disorder.
What kinds of things throw off your circadian rhythms? Things like traveling through time zones, staying up late at night, and changing your work schedule. IPSRT helps make your daily rhythms more consistent. This helps prevent mood episodes.
Related: Managing Bipolar Disorder With a Daily Routine
What the Research Says
IPSRT is backed by lots of empirical evidence. A 2005 study published in JAMA Psychiatry found that people with bipolar 1 disorder who received Interpersonal and Social Rhythm Therapy had fewer mood episodes and longer periods of stability compared to those who received typical interpersonal psychotherapy.
Other studies have also shown the value of IPSRT. It’s been found to improve social functioning and reduce hospitalizations. IPSRT is especially effective when combined with medication.
Who Is IPSRT Meant to Support?
Interpersonal and Social Rhythm Therapy (IPSRT) was designed specifically for people living with bipolar disorder, particularly bipolar 1. Since then, it has been used with people with bipolar II, cyclothymia, depression, anxiety, post-traumatic stress disorder (PTSD), schizophrenia, and other conditions.
What Happens in IPSRT Therapy?
Interpersonal and Social Rhythm Therapy (IPSRT) is typically delivered through individual therapy sessions. Although this therapy follows a clear framework, it’s flexible, as well. It’s broken down into four stages:
The Foundation Phase of treatment is focused on assessment. The therapist will learn more about your symptoms, relationships, and other important life areas. During this stage, your therapist will instruct you on how to track your daily activities and rhythms. They might use specific clinical tools like the Social Rhythm Metric to help you track your daily rhythms.
In the second phase, you will build stability. Your therapist will help you adjust your daily routines. Your therapist will help you come up with ways to ensure that things like going to bed, waking up, eating, exercising, and socializing happen at the same time each day.
During the third stage, you will begin to work on adjusting your daily rhythms and strengthening confidence. You will address interpersonal stressors that throw off your daily routines, such as arguments with a loved one or conflicts with a friend. You’ll develop new interpersonal and coping strategies to manage these issues.
In the final and maintenance stage, you’ll start to slowly decrease sessions.
Benefits
There are many benefits to IPSRT. Here are some of the scientifically-proven ones:
Improved sleep: Fewer episodes of insomnia.
Reduced mood episodes: Reduced risk of hypomania, mania, and depression.
Less conflict in relationships: IPSRT directly addresses relationship issues.
Related: Counseling for Bipolar Disorder: Social Rhythm Therapy, CBT, and More
Want to Try IPSRT?
If you're interested in Interpersonal and Social Rhythm Therapy, the first thing to do is to try to find a therapist who’s trained in it. Try searching Google using your city or state plus the words “Interpersonal and Social Rhythm Therapy.” For example, if you live in or near Chicago, search “Chicago, IL + Interpersonal and Social Rhythm Therapy.”
If there are no IPSRT-trained therapists near you, don’t worry. We’re currently creating a self-guided IPSRT workbook. Keep an eye out—it’s coming soon!
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