Life with bipolar disorder can sometimes feel chaotic. It might be hard to predict your mood; sometimes you might find it very hard to get out of bed, and at other times you feel like you hardly need to sleep at all. You might take your medication in the morning sometimes and in the evening sometimes, which can make it hard to remember. You might feel like a social butterfly sometimes, and at other times not want to see anyone at all.

Interpersonal and social rhythm therapy (IPSRT) is an evidence-based treatment method that helps you build healthy routines and improve your interpersonal relationships. It’s based on the idea that when your social rhythms are stable, the rest of your life becomes stable, too – making it easier to deal with unexpected challenges and life events.

I use IPSRT in my practice to treat bipolar disorder. Today, I’ll be talking all about what it is, how it works, and how it could help you.

What is interpersonal and social rhythm therapy (IPSRT)?

IPSRT helps people with mental health disorders build healthy routines and minimize disruptions. It was designed to support people with bipolar disorder, but it can also be used for other mood disorders like depression.

It’s based on the knowledge that if you live with bipolar disorder (or another mental health condition), then you’re more likely to experience mood changes when your daily routines – also called your social rhythms – are disrupted. These social rhythms can include things like:

When you wake up and go to sleep every day
Meal times
What time you start and leave work
When you interact with certain people each day (for example, talking to family members when you get home from work)
Regular hygiene routines (i.e. taking a shower every morning)
Scheduled time for leisure activities and hobbies

IPSRT pays especially close attention to changes in your relationships, which is where the “interpersonal” part comes into play. For example, we might explore how conflicts with a friend or big changes like divorce impact your mood and daily routines. By understanding these connections, we can work on strategies to improve your relationships and maintain emotional stability.

IPSRT and your circadian rhythm

It’s not just that disruption to these routines is stressful – it can also literally cause changes to your body’s natural rhythms. The circadian rhythm, sometimes called the “biological clock,” is your body’s internal 24-hour cycle that responds to changes in daylight. Your circadian rhythm plays a role in so much, including your sleep, hormones, and appetite.

IPSRT can help you regulate your circadian rhythm, which makes it easier for you to cope with big changes in your life.

How IPSRT can help with bipolar disorder

Research shows that people with bipolar disorder are more likely to have circadian rhythm abnormalities. This can often make symptoms worse – for example, you might be more at risk for a manic episode if you’re not sleeping regularly, or forget to take your daily medication because you don’t have a consistent routine.

When I use IPSRT with clients who live with bipolar disorder, I help them create regular daily routines that support their mental health. This means finding consistent times for things like sleeping, eating, and socializing. We focus on keeping these rhythms steady, even when life gets challenging, so they can better manage their moods and feel more balanced overall.

It’s important to note that IPSRT isn’t meant to replace other types of bipolar disorder treatment, like mood stabilizing medication. But you might be surprised to see how much better you feel when life as a whole is consistent and stable.

Benefits of IPSRT for bipolar disorder

Some of the specific benefits of IPSRT if you live with bipolar disorder include:

Helps you keep a regular schedule for sleep, meals, and activities to balance your mood and energy levels.
Makes it easier for you to manage emotional ups and downs.
Strengthens your relationships by improving communication and resolving conflicts.
Identifies and addresses triggers that might disrupt your routine or affect your mood.
Teaches you how to handle changes and challenges while staying steady and grounded.
Encourages healthy habits that support your long-term mental health.

How IPSRT works: Stages and what to expect

It can be anxiety-provoking to start a new type of treatment, so I want to give you some information about what to expect throughout the process. IPSRT happens in 3 general stages, which helps us start slowly by building a therapeutic relationship.

Here’s more information about each of the stages of IPSRT.

Initial phase

In the initial phase, we’ll work together to understand how mood changes are connected to your daily routines and relationships. We’ll review your mental health history and discuss how stable routines can help manage your mood – I might also provide some education about bipolar disorder in general. Sometimes, we'll have a primary interpersonal problem area to focus on, such as grief, role transitions (like suddenly being an empty-nester or going through divorce), relationship conflicts, or other concerns like being socially isolated or not knowing how to be assertive.

This is also where I’ll introduce the Social Rhythm Metric (SRM), which is a tool we’ll use throughout the treatment process to track your daily activities and interactions.

Intermediate phase

In the intermediate phase, we’ll get to work on helping you create regular daily routines. We’ll also do some work to address whichever interpersonal problem area you've chosen. Between sessions, you'll use the SRM to log your activities and social interactions; when we meet, I’ll help you identify patterns and make gradual changes to stabilize your routines. We might also talk about sources of stress in your life, like work, and learn how to manage any trigger that impacts your mood and routines.

Maintenance phase

During the maintenance phase, you’ll work on reinforcing the skills you've learned to keep your routines steady and manage relationships more effectively. You’ll continue to use the SRM to monitor your mood and identify any changes in your routine. This phase is about maintaining the progress you've made and preparing to handle potential disruptions.

Ideally, you’ll continue to apply the skills you’ve learned independently, and learn to recognize early warning signs of manic or depressive episodes so you can work toward preventing them.

Get IPSRT therapy in Irvine, CA

If you live with bipolar disorder and life is starting to feel a little bit chaotic, then IPSRT could be for you. Bipolar disorder can be hard to live with, but symptoms can be managed – so many of my clients with bipolar disorder have built successful, fulfilling lives for themselves.

If you’re looking for a therapist who specializes in bipolar disorder, get in touch with me!

Let's schedule a consultation

Interpersonal and Social Rhythm Therapy (IPSRT) for Bipolar Disorder: What it Is and How it Can Help You