M1 Psychology

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Interpersonal and Social Rhythm Therapy for Bipolar Disorder

What is interpersonal and social rhythm therapy for bipolar disorder – and how does it work? 

A person with bipolar disorder experiences high, elated moods, coupled with low, depressive episodes – ups, and downs just like a roller coaster. Usually it is not diagnosed until an extended period of depression impacts on the individual’s daily life.

Bipolar is a life long condition, however with the right medication, support and therapy, people with bipolar can lead rewarding and fulfilling lives, just like any member of the population.

Two Elements of Bipolar Disorder

The symptoms of bipolar are split into two areas – depressive (the downs) and manic (the ups).

  1. Depressive: While in the depressive phase, the individual may experience the usual symptoms associated with depression: sadness and low mood, isolation, losing interest in activities that are normally enjoyable, changes in appetite or sleeping habits, neglecting personal care, thoughts/intent/plans to self-harm or suicidal tendencies.
  2. Manic: This stage is characterised by a feeling not unlike a “high” – elevated mood, euphoria, overwhelming self confidence. The individual may be more talkative than usual, with rushed speech and racing thoughts, or focus on one or more projects to the point of obsession, even showing a lack of concern for their own safety eg through impulsive spending, promiscuity or substance misuse. Usually the person feels wonderful, and

People who experience this episode describe it as being wonderful, like they can achieve anything and feel invincible. However, it is just as concerning as a depressive episode, mainly as the individual tends to lose their inhibitions and take risks.

Types of Bipolar Disorder

Even within a diagnosis of bipolar disorder, there are several different categories or types:

  • Bipolar I Disorder—manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depression and manic symptoms at the same time) are also possible.
  • Bipolar II Disorder—similar to Bipolar I, but not the full-blown manic episodes described above.
  • Cyclothymic Disorder (also called cyclothymia)—numerous periods of hypomanic symptoms as well as numerous periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms are not severe enough to meet the diagnostic requirements for a hypomanic episode and a depressive episode.
  • Other Specified and Unspecified Bipolar and Related Disorders—bipolar disorder symptoms that do not match these categories.

Treating bipolar usually involves a multi-disciplinary approach drawing on the skills of various health professionals, including a psychologist, to help the individual to better manage the emotional roller coaster.

What is Interpersonal and Social Rhythm Therapy?

One therapy which has proved extremely successful in treating and helping people with bipolar is Interpersonal and Social Rhythm Therapy (IPSRT). The process of IPSRT involves the following three stages:

Initial Stage: During the first few sessions, your psychologist will gather information about your current mood state and prior mood episodes, and explore the behaviours and relationships associated with changes in your mood. Together you and your therapist agree on a primary interpersonal problem area as the main focus for the interpersonal part of the treatment.

Intermediate Stage: You will be asked to complete a form to track social rhythm regularity every week, which you will review with your psychologist. This helps you and your therapist regulate your social rhythms, particularly in your selected interpersonal area.

Later, as your confidence and skills build, you will be asked to put into practice some of the strategies you have been learning, to manage changes in routine such as holidays or a change of job. Weekly sessions may be reduced to monthly or bimonthly at this time.

Final Stage: As you become more skilled, you may find that you can gradually reduce or put an end to your sessions.

Therapy is essential in recovering from bipolar and at times it can feel like you are in danger as paranoid thoughts can consume you. This is why care plans and a crisis plan is imperative in your recovery, and to help you gain back control of your life.

Author: M1 Psychology

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