[[Interpersonal and Social Rhythm Therapy]] Source [[Books - Treating Bipolar Disorder. A clinican's Guide to Interpersonal and Social Rhythm Therapy]] *What is the assumption of problem, human?* --- # Theoretical Foundation of IPSRT It is an integrative theory that explain mood disorders may be associated with biopsychosocial factors. - Genetics - Heredity (same as psychosis) - The person Circadian rhythm - body clock - Fragile body or inflexible biological clock - Flexible or adaptable biological clock - Psycho - Persons coping, social support gender, temperament etc - Social - Social relationships - Social events Specifically, the theory state that stressors/changes in life affect the circadian rhythm. And some people are vulnerable to develop mood disorders because of such disruption. ![[Screenshot 2022-03-03 at 11.13.40 AM.png]] When the person have life events that come along, it affect the circadian rhythm, most of time people can adjust and cope with it. But to a vulnerable person, it will bring about risks to develop mood disorders. ## Social Zeitgeber Theory (In German, “zeitgeber” means “time giver,”) There are physical regulators (Zeitgeber) which are well established. This theory bring a new thing which is social regulators (Zeitgebers) - Physical - Light as zeitgeber - Physical exercise as zeitgeber - Nutrition as zeitgeber - Melatonin as zeitgeber - Temperature as zeitgeber - Sound as zeitgeber - Social - Life events, relationships. ==All this zeitgebers affect sleep associated hormone, cortisol levels, and REM. Biological changes associated with mood episodes, such as sleep abnormalities, may actually precede the reporting or observation of clinical symptoms (Ehlers, Wall, Wyss and Chaplin, 1988) - == [[HOPES Project Index]] - Thus, important to monitor passive tracking data of sleep, REM. Is cortisol levels, related to heart rate, blood pressure? Can that be tracked? Is HRV correlated to stress or cortisol level? Sleep quality can be observed by the sleep data (rem?) There are protective and risk factors to patients - Having a stable social rhythm - Both Interpersonal psychotherapy (IPT) and CBT also work on creating social relations, and establish regular daily routines in their approach. (page 24) ==Mood stablising medication adjust the biochemistry of the brain, but may also have a secondary effect of affecting sleep physiology - restoring the body clock. == Page 23 ## What are the regulators of Circadian - Physical - Genetic https://www.zeitgeber.net/what-determines-my-circadian-rhythm/ - Age - Social - Relationships - Marriage, divorce, - Life events - new born, new or loss jobs, grief and loss, ## What are the Disturbers of Circadian Rhythms 1. Time Zone - Transmeridian Flight. Jauhar & Weller, 1982 - Flight that lose a night of sleep more apt to become manic. Flight that gain more sleep, more likely to depressed. 2. Shift Work 1. ==Perhaps patient with mood issues better don't do shift work. Better stick of routine, regular kind of work hours== --- Next: How is it applied? # Chapter 4: [[A Brief Overview of Interpersonal and Social Rhythm Therapy]]