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Strategies for Daily Balance

The therapy modality called Interpersonal and social rhythm therapy (IPSRT) is designed to treat frequent recurrence of bipolar disorder, as well as problems of non compliance with medication treatment, reaction to stressful life events, and disruptions in social rhythms. IPSRT focuses on circadian rhythms and the importance of maintaining regular daily routines to facilitate stability and remaining free of both depression and manic states. The idea is that sleep deprivation, and/or disruption of sleep patterns can trigger or exacerbate bipolar symptoms. Currently there is data that does suggest that this intervention does have a significant positive effect on the course of bipolar disorder.[i]

The ideas of IPSRT, or Interpersonal and social rhythm therapy were introduced by Ellen Frank, PhD at the University of Pittsburgh. The book titles Treating Bipolar Disorder, a Clinician’s Guide Interpersonal and Social Rhythm Therapy was written by her and explains her theories about Interpersonal and social rhythm therapy.

IPSRT focuses on stressors that can interrupt an individual’s circadian rhythms and disrupt the sleep cycle. The individual can develop strategies for structuring his or her life in such a manner that any imbalances that will help him or her regain balance quickly should an interpersonal, social or other problem disrupt the person’s routine.

Therapy includes identifying living patterns that include daily routines and sleep patterns, while learning about the importance of circadian rhythms. This may include keeping “social rhythm metric” charts and becoming aware of daily activities with their corresponding stimulation levels and identifying those that are mostly likely to lead to mood disruption.

The individual learns to reset and adjust his or her living patterns to support healthy sleep and living patterns as well as triggers that might interrupt those patterns. Focus may include develop healthy and consistent routines and habits for activities such as eating, sleeping, walking, exercising, socializing, etc. with an emphasis on developing a very regular routine. This is combined with tracking daily moods and identifying the individuals daily moods cycles. With an increased awareness of mood cycle, the individual can develop healthy routine strategies for managing daily mood fluctuations, decreasing the likelihood that the person will be triggered into an episode. Likewise, the individual learns strategies for managing and/or resolving interpersonal issues that might provoke thought patterns such as worry etc. as well by developing healthy interpersonal relationships and relationship skills. This is also to help the individual ensure that their routines and sleep patterns will remain stable.


[i] Frank, E., Swartz, H. A., & Boland, E. (2007). Interpersonal and social rhythm therapy: an intervention addressing rhythm dysregulation in bipolar disorder .Dialogues in Clinical Neuroscience, 9(3), 325–332. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202498/ (retrieved 4/25/2015)