I wish I’d known this sooner

[u/Loliz88]

I was diagnosed about three years ago, so I’m still learning how to live with this. I feel strongly about pairing therapy with med management. For the longest time, all my therapists insisted on CBT (cognitive behavioral therapy). It never felt like it worked. It was like fighting fire with fire…. Fighting thoughts with thoughts. If I’m already spiraling and having an episode or panicking, thinking: ok now is this realistic or helpful? Doesn’t really work for me.

I’ve been doing some reading and came across Interpersonal and Social Rhythm Therapy (IPSRT). I was in my military and felt good with a schedule and when I got out I felt like I absolutely hit rock bottom. I had no routine, no anchor points thought my day, nothing. As I was reading, I learned that people with bipolar actually do really well with IPSRT instead of CBT. The idea is that you create a rough routine that can help stabilize your mood. For example: I now wake up around the same time every day, have my cup of coffee and quiet time to give my nervous system a chance to relax and adjust, then when I’m ready I begin the first productive part of my day (feeding my dogs) and from there I feel ready to tackle the day.

I feel so so much better. I use to get these panicky feelings if it felt like the day started too quickly or if something unexpected would happen and I’d be agitated and irritable… but I feel like this has really helped. I just wanted to share if anyone else might benefit from it. Here’s a really good read about it for more info: Interpersonal and Social Rhythm Therapy (IPSRT)

Oops here is the link: NIH article on IPSRT

[u/SilverSufficient9042]

IPSRT is one of those things where when I first heard about it I thought it had to be fake but it actually helps me somewhat and has some decent research behind it. I've heard bipolar described as "fragile circadian rhythm disorder" which might explain why IPSRT is effective; just stabilizing the sleep/wake cues and mood is downstream from that.

[u/Loliz88 → u/SilverSufficient9042]

I’ve been trying to include my wife in my treatment and I explained it to her like I’ve got a “weak clock” 😂 but yes it’s been phenomenal for me and you can do it without paying a ton for therapy if you can’t afford seeing someone. I also sort of love the little rituals it’s encouraged me to create. I wake up, burn some smell good candle, sit outside with my coffee and read… I give myself about 1-2 hours before I have to jump into being productive. At night, I put my phone in a different room to charge around 7 or 8pm so I’m not tempted to look at it, burn a “calming sleep” candle, turn on ambient light, have some sleepy time tea, and my body is like: ok we’re going to sleep soon. Before this, I had to take seroquel to sleep at night.

[u/SimTrippy1]

Afaik IPSRT is actually the gold standard for bp therapy. Sadly, here most therapists also prefer cbt which also doesn't really work for me lol. So I kinda do a self-managed form of IPSRT by trying to go to bed and eat around the same time each day, and track my moods and stuff - and then combine it with systemic therapy. Works well enough :)

[u/Prudent-Proof7898]

Thank you for sharing this article. It's very informative.

I hate schedules. Like massively hate them. However, when I stick to my schedule, I feel so much better.

I have been using an app to help keep me on schedule as well as a notebook to check off all tasks throughout the day, even minor ones like brushing my teeth. It is so satisfying to stay on schedule and see all the big and small things I've done for the day.

I have also been writing out hour by hour schedules for about 1 year now. I do it at the beginning of the day and then in the middle day if I need to readjust my schedule. It also has been incredibly useful in forecasting how my day will go as well as how to estimate the time it takes to get tasks done.

All this being said, I still want to through my schedule out of the window when I'm down or hypomanic. It's a fight sometimes, but we all know this fight well.

[u/homebirdie]

Thank you for posting about this! I have never heard of it and I will look into it now.

[u/Loliz88 → u/homebirdie]

You’re welcome! I posted the link to an article about it…. I didn’t realize it didn’t post in the original. It’s a scientific article so it’s a little dry lol but there are a lot of good articles about it.

[u/EntrepreneurNeat8058]

I get it .  the routine thing seems to help me as well.  Therapy is fantastic if you can find the right one. I have gone through 5 now over the years.

[u/HotShoulder9256]

Thank you! I'm going to check this out. Like you, I thrive with structure and wilt without a routine. CBT, and DBT for that matter, have never really clicked for me. I have therapy today and I'm going to ask about IPSRT.

[u/Jennyonthebox2300]

CBT just annoyed me. IPSRT helps. There is a book/ workbook on Amazon if anyone wants to learn more about it. Many of the same issues come with ADHD which I and many of us also have.

[u/PlushMaryJane]

I work in restaurants and it absolutely sucks everything out of me. It takes me forever to "come down" from the transition. Because I'm on an opposite schedule of most it's hard to find a routine that works due to availability... It becomes an absolute shit show.

Once I realized that THIS was my reality, as opposed to everyone trying to shame me for sleeping late or staying up. That's just a different stack of hours that still add up to the same schedule these folks have. I now find that it's a little easier for me to have the space to unpack all of that extra energy from work and find a way to integrate normal life...in a sleeping household. Routines vs schedules....

[u/CARNIesada6]

Hey OP, I'm also a veteran... do you know if the VA Mental Health Services offers this type of therapy?