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Harmonize Your Life: Social Rhythm – Tune in to the Beat of Well-Being!

This therapy is designed to help people improve their moods by understanding and working with their biological and social rhythm.

This therapy focuses on techniques that helps to improve on medication adherence, manage stressful life events and reduce disruption in social rhythm.

Dr. Damanjit Kaur (MD Psychiatry)

The social zeitgeber hypothesis:

This is the basis of IPSRT (interpersonal social rhythm therapy). Zeitgebers (“time givers”) are actually environmental cues/ hints that synchronize biological rhythm to 24-hour light/dark cycle. For e.g. sun is physical zeitgebers, personal relationships, social demands or life tasks are social zeitgebers.

Disruption in circadian rhythm can lead to somatic and cognitive symptoms and individuals at risk gets vulnerable to have episodes of depression or mania. So, the goal of IPSRT is to identify the triggers and work on it.

Phases of IPSRT:

It has 4 phases:

  1. Initial phase- involves reviewing a mental health history, identifying the association between social routine disruption, interpersonal problems and mood episodes.

  2. Intermediate phase – focus on social rhythm metric which helps in assessing the amount of activity(regularity/irregularity) being engaged in and the impact of activity on mood. Also, it focuses on identifying stressor and soothers in patient’s life.

  3. Maintenance phase- aims to reinforce the techniques learnt, discussion of early warning signs of episodes. Made the patient to learn to note any shifts in mood.

  4. Final phase- involves termination in which session are gradually reduces in frequency.

  5. Usually, patients with BAD benefit from higher level of stability in their sleep and daily routine. To get this streamline some of the following can be done:

Encourage proper sleep hygiene.

Maintain regular mealtimes throughout the day.

Encourage medication adherence and regular schedule (use alarms on phone, use daily pillboxes).

Monitoring frequency and intensity of social interactions using SRM.

Minimize overstimulation of social interactions for e.g. frequent parties/events.

Addressing under stimulation by engaging in activities that bring sense of mastery.

Identify interpersonal sources of stabilizing and destabilizing influences.

What is social rhythm metric (SRM)?

This is a kind of workbook where you log daily events with goals of bringing consistency. E.g., of SRM are: time you get out of bed (not just awakening but physically up form bed).

Time of your first contact with another person.

Time you start your main activity. for e.g. work/school/office or family care.

Time you eat dinner.

Time you go to bed.

It is a score based, how many events happened at the same time or close to the same time each day.

Dr. Damanjit Kaur (MD Psychiatry)

Faith Hospital, Chandigarh

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