Bipolar disorder treatment often relies on medication, but stabilizing moods can be significantly enhanced by addressing daily routines. Interpersonal and social rhythm therapy (IPSRT) is a structured approach that helps people with bipolar disorder reduce the intensity and frequency of mood swings by regulating sleep, meals, and activity levels.
The Science Behind the Therapy
Developed by psychologist Ellen Frank, PhD, IPSRT is rooted in the understanding that bipolar disorder frequently destabilizes a person’s circadian rhythm —the body’s internal clock. This rhythm governs essential functions like sleep-wake cycles, stress response, hormone release, and energy levels. When disrupted, it can worsen symptoms and increase relapse rates.
Why this matters: Disruptions in circadian rhythm aren’t just a side effect of bipolar disorder; they actively contribute to mood instability and increase suicide risk.
Key Components of IPSRT
IPSRT focuses on three core pillars to rebuild a stable daily rhythm:
- Sleep Consistency: Maintaining a regular bedtime and wake time, even on weekends, is critical. Sleep deprivation can directly trigger manic episodes, while consistent sleep stabilizes the entire circadian system.
- Meal Timing: Establishing consistent meal times is another key element. Aligning meals with your natural circadian rhythm—eating breakfast within two hours of waking, avoiding late-night eating—can also improve metabolic health.
- Morning Light Exposure: Getting sunlight or using light therapy in the morning helps regulate the circadian system. The brain and body use light to identify and reinforce a stable daily schedule.
Beyond Routine: The Role of Relationships
IPSRT doesn’t stop at personal habits. It also addresses how interpersonal connections can impact mood regulation. Fostering communication, resolving conflicts, and creating predictable schedules with loved ones can reduce stress and provide crucial social support.
Why this matters: Isolation and unpredictable relationships exacerbate mood instability in bipolar disorder. IPSRT aims to create a sense of predictability and connection.
Tracking Progress and Seeking Professional Support
To monitor effectiveness, tracking daily activities and mood levels is recommended. Tools like journaling, planners, or habit-tracking apps (Health Storylines, eMoods, Bearable, 90health, Daylio) can help identify disruptions and reinforce positive patterns.
Crucially, IPSRT should be done in collaboration with a mental health professional. Realistic goals and ongoing support are essential for long-term success.
The Bottom Line
Medication is vital for managing bipolar disorder, but lifestyle habits—particularly those that stabilize circadian rhythms—can dramatically improve treatment outcomes. IPSRT provides a framework for creating routines and tracking progress, but professional guidance is key to achieving lasting stability.
