Interpersonal and Social Rhythm Therapy (IPSRT)

Interpersonal and social rhythm therapy (IPSRT) is a therapeutic approach developed specifically to target bipolar disorder. It developed out of the successful interpersonal therapy approach, but added emphasis on social rhythms because setting and maintaining a regular schedule can have a regulatory effect on mood swings. In particular, emphasis is placed on setting a regular bedtime and prioritizing sleep, since lack of sleep is thought to contribute to symptom severity.  Other social rhythm points of focus include meal planning and social interaction.  Therapy may also lend itself to developing structure around exercise and medication adherence.

The Origins of IPSRT

IPSRT builds off the success of interpersonal therapy, because the basic problems with relationships that underlie depression may also pose challenges for people with bipolar disorder. However, researchers also believe that disruption of daily rhythms, especially sleep patterns, can contribute to bipolar disorder.

Individuals with bipolar disorder often have both genetic and developmental/environmental vulnerabilities that predisposes individuals to experience greater-than-usual consequences in the event of:

  • Major life events, such as a loss or an important role change
  • Disruptions in social rhythms

To address this challenge, practitioners borrow techniques from social rhythm therapy and cognitive behavioral therapy (CBT) to help individuals reduce the frequency of manic and depressed episodes and lengthen the time between episodes.

How IPSRT Works

IPSRT, like interpersonal therapy starts by narrowing in on the relationship aspects of one’s life that contribute to symptom severity. In addition to the four basic problems that interpersonal therapy focuses on, IPSRT identifies “grief for the lost healthy self” as a potential contributor to mood problems.

In addition to identifying underlying interpersonal problems, IPSRT also works to identify an individual’s routine, or lack of routines, and encouraging the individual to establish and maintain for consistent structure.  There is emphasis on prioritizing activities necessary to basic health maintenance, such as meal times, exercise, and especially going to bed and waking up at regular times. In addition, individuals are encouraged to add activities that help boost mood and improve social connectedness, such as regularly spending time with friends and family. The individual and therapist will work together to identify disruptive triggers that interfere with routines, such as travel or shift work, and develop strategies to cope with them.