Circadian Rhythms and Fixing Bipolar's Wonky Clock

When nothing else worked, Social Rhythms Therapy got my bipolar under control. That's why Ellen Frank is my mental health hero. She invented it.

A few years ago, I spent four weeks summarizing Frank's book, Treating Bipolar Disorder: A Clinician's Guide to Interpersonal Social Rhythms Therapy. My goal was to create a patient's guide. Here is the link to Part Four. It includes links to the earlier posts.

Frank describes Interpersonal Social Rhythms Therapy like this: IPSRT [is] a treatment that seeks to improve outcomes that are usually obtained with pharmacotherapy alone for patients suffering from bipolar I disorder by integrating efforts to regularize their social rhythms (in the hope of protecting their circadian rhythms from disruption) with efforts to improve the quality of their interpersonal relationships and social role functioning.

Circadian rhythms are at the core of IPSRT. People with bipolar have difficulty maintaining the stability of our circadian rhythms, because our internal clocks, governing everything from sleep cycles to blood sugar levels to body temperature are, well, wonky.

Social Rhythms Therapy basically is a strategy to keep resetting the clock throughout the day by making sure key events (clock setters) happen the same time each day. For me that means getting up, greeting my wife, eating, beginning to write, and going to bed, each at the same appointed time each day.

People who do not have bipolar don't need to reset their clocks on a daily basis. Their brains accommodate little variations in schedule. But even they occasionally knock their clocks off the table: jet travel across time zones, changing work shifts, sleeping in on weekends. These knocks may not precipitate a mood episode. But they do have other deleterious effects.

Here is an explanation of circadian rhythms and, in particular, how they affect metabolism for all the rest of you.

So it turns out, while I have been simply trying to not go crazy, I also have been controlling my weight, taking care of my liver, and improving heart health too.

I hope you can learn the same lesson without paying the tuition I have paid!

book cover from
flair from Facebook


  1. I really appreciated this book review. Social Rhythms Therapy seems to have great potential for moving beyond the "wake up time/go to bed time" approach to circadian rhythms. I'm a writer on the blog at MoodSurfing dot com, and we linked a post of ours to this one. I hope you get some new readers out of it!


Popular Posts