- In this paper, we argue that atypical cognitive, perceptual and behavioral characteristics associated with serious mental illnesses should be taken into consideration when designing health technologies. While applications have been developed to assist in the treatment of these illnesses, the specific psychological characteristics of these disorders have rarely been considered extensively in the design process. Here, we explore how an understanding of the low-level characteristics of bipolar disorder, combined with a clinically-validated treatment and patients’ lived experience, can inform mHealth design. We present a novel method — in situ design — to support ecologically valid design, and demonstrate its use through the co-development with 9 individuals with bipolar disorder of MoodRhythm, a mobile application designed to track and stabilize daily routines. We provide evidence that mHealth design elements tailored to the characteristics and needs of individuals with bipolar disorder can result in engaging interactions.