By Celine Ruscher

We explored seasonal affective disorder (SAD) in the previous newsletter and its connection to circadian rhythms. Paying attention to our internal clock and setting routines can help us feel better. This is particularly true for people living with bipolar disorder. Some research has shown that they experience disruption of their circadian rhythm, which can lead to mood episodes. Building a routine appears, therefore, as one of the key components for people living with bipolar disorder. This is the scope of Interpersonal and Social Rhythm Therapy (IPSRT).  

IPSRT, developed by Ellen Frank, PhD, at the University of Pittsburgh, focuses on stabilizing the daily routines that strongly influence mood. By maintaining consistent sleep, eating, and activity patterns, IPSRT reduces the likelihood of mood episodes triggered by disruptions in rhythm. It also strengthens interpersonal skills—like communicating needs, navigating conflict, and building supportive relationships—which can make it easier to manage stress and maintain stability. Together, these elements create a structured framework that supports long-term mood regulation and overall well-being. 

I did not attend IPSRT, but as part of my journey, I have identified a couple of situations that can exacerbate my symptoms. Skipping breakfast or my morning coffee can leave me irritable or exhausted for no apparent reason. When travelling, jet lag disrupts my mood for generally one week. Sleep is also an important aspect. I try to respect a relatively strict bedtime routine. If I don’t sleep enough, I see a rapid resurgence of hypomania. If I wake up too late, my mood is more negative, or I feel agitated. Having or not having interactions with multiple people during the day is also playing a role. Stimuli tend to trigger hypomanic symptoms or agitation.  

Paying attention to my feelings, my body, and my symptoms has allowed me to lead a meaningful life even during episodes. I know when more self-care and self-compassion are needed. I also know which situations I should avoid, and when it is not possible, what strategies I can use to prevent my mental health from deteriorating.  

References: 

Video: The Bipolar Clock: Stabilize Mood by Resetting Your Body Clock | Dr. Holly Swartz | #talkBD EP 40: https://www.crestbd.ca/2024/04/08/bipolar-clock/

Scientific journal article: Frank E, Swartz HA, Boland E. Interpersonal and social rhythm therapy: an intervention addressing rhythm dysregulation in bipolar disorder. Dialogues Clin Neurosci. 2007;9(3):325-32. doi: 10.31887/DCNS.2007.9.3/efrank.  

Scientific journal article: Gold AK, Kinrys G. Treating Circadian Rhythm Disruption in Bipolar Disorder. Curr Psychiatry Rep. 2019 Mar 2;21(3):14. doi: 10.1007/s11920-019-1001-8.  

Interpersonal and Social Rhythms Therapy website: https://ipsrt.org/overview/

List of general resources for bipolar disorder:  

International Bipolar Foundation: www.ibpf.org  

Bipolar not so much understanding your mood swings and depression, by Dr. James Phelps and Dr. Chris Aiken  

Bipolar not so much (website with products and tips from the book): https://chrisaikenmd.com/bipolar-not-so-much/  

Psych Education (psychoeducational resources): https://psycheducation.org/  

crest.BD talkbd bipolar disorder podcast: https://talkbd.live  

Lived experience (books):  

  • An Unquiet Mind by Dr. Kay Redfield Jamison 
  • BrainStorm: From Broken to Blessed on the Bipolar Spectrum by Sara Schley  

Lived experience (blog):