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From Chaos to Balance

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Interpersonal and Social Rhythm Therapy

Many people who live with the challenges of bipolar disorder report grief and sadness about struggles in their relationships and interpersonal problems after or during either a manic or depressive episode. Sometimes individuals struggling with the symptoms of bipolar might experience chaos in their social environment of work, school, and other responsibilities. These stressors can lead to disruptions in sleep cycles that can exacerbate the symptoms and create a cycle of sleep problems, interpersonal problems, social problems, and mania or depression. Healthy interpersonal relationship, functional social interactions, and a good night sleep are all essential to your overall wellness.
If you are experiencing disruptions in your sleep/wake cycle while at the same time experiencing many interpersonal problems with difficulties and disruptions in your social rhythms, you might benefit for an innovative therapy referred to as IPSRT (Interpersonal and Social Rhythm Therapy) The therapy grew out of the idea that individuals with bipolar disorder may have a genetic predisposition to abnormalities in their sleep-wake cycles (circadian rhythms).

The idea is that when a life event occurs, whether positive or negative, the event can trigger a disruption in the sleep wake cycle that can then either exacerbate current symptoms of bipolar, or trigger a bipolar episode. The therapy combines behavioral techniques strengthening the ability to follow daily routines and resolving interpersonal problems with encouraging the adherence to medication regimens. The focus is on modulating the interdependent functions of both biological and psychosocial aspects of the individual to facilitate the reduction of the individual’s disruptions in sleep wake cycles. This is an evidence based program and research indicates that this approach has good outcomes and can help an individual improve his or her overall functioning and to better manage potential chaos of bipolar disorder symptoms. [i]

The intervention was originally developed as a type of psychotherapy that helps individuals to improve their moods by understanding and working with their social and biological rhythms. However, it has grown over time as is not offered in group and can be found in both inpatient and outpatient settings. The skills that and individual which is living with the challenges of bipolar learns through the work of IPSRT is designed to help protect them against the development of future depressive or manic episodes.

Additional Reading Suggestions:

isISRT- International Society for Interpersonal Psychotherapy; Interpersonal Social Rhythms Therapy, by Ellen Frank, PhD;

[i] Interpersonal and social rhythm therapy: managing the chaos of bipolar disorder

Frank, Ellen et al.Biological Psychiatry , Volume 48 , Issue 6 , 593 – 604

From Chaos to Balance

Dr. Barbara Bachmeier

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APA Reference
Bachmeier, D. (2015). From Chaos to Balance. Psych Central. Retrieved on March 18, 2019, from


Last updated: 19 Apr 2015
Last reviewed: By John M. Grohol, Psy.D. on 19 Apr 2015
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