Bipolar disorder is a mood disorder characterized by depressed and elevated mood episodes. It usually starts in the late teens to the early twenties. During depressive episodes, people experience low moods, loss of self-confidence, despair, poor sleep, and appetite. Manic episodes are characterized by an increase in energy, a pleasant mood or fast-changing mood, increased self-confidence, and a decrease in the need for sleep. People may experience a mood every few years, or frequently several times a year.
Bipolar disorder can be treated with medication and psychotherapy. Some chronic remedies – methods designed to harness and normalize the body’s natural rhythms, such as mild remedies – may also help, according to a recent systematic review of the research.
Why might light treatments help?
Daily rhythms, our normal 24-hour clock, are disrupted in bipolar disorder. In addition, people with bipolar disorder appear to be more sensitive to light.
One way to treat bipolar disorder is to manipulate the circadian rhythm. This can be accomplished through bright light therapy, dark therapy, sleep deprivation, and certain types of psychotherapy.
Bright light, dark light, sleep deprivation
- Bright light therapy. Animals and humans face seasonal and daily rhythms of the body’s functions and behavior affected by light, among other environmental factors. The light activates the retina in the eye, which creates a stimulus that moves from the eye to the hypothalamus in the brain. The hypothalamus helps regulate mood. In bright light therapy, a lightbox using fluorescent bulbs emitting 7,000 to 10,000 lux of bright white UV-filtered light is placed on a table at eye level. (There are also head-mounted units or light protectors.) Depending on the light output, the required time ranges between 30 minutes and 2 hours per day. It makes sense to think about this treatment to help prevent or treat depression episodes. It may be especially useful if a person has a problem carrying medications.
- Dark therapy. Just as light therapy can improve moods, low light can reduce symptoms of mania. To treat mania, amber glasses that block blue light are worn in the evening.
- Sleep deprivation. The appearance of antidepressant effects can be quick and striking. In the event of complete sleep deprivation, the person remains awake for 36 hours, all night and the next day. In the event of partial sleep deprivation, one sleeps only four to five hours at night. Unfortunately, the improvement in mood is short-lived. Switching to mania has been reported, so it should only be used with mood stabilization.
- Despite its widespread use, at this time there is insufficient evidence to support the use of melatonin supplementation in bipolar disorder, according to researchers.
Usually, mild treatments are combined with other treatments for bipolar disorder, including those described below. Often times, it may be effective if used alone.
Additional ways to change circadian rhythms
Psychotherapy techniques can help people control irregular sleep patterns. In fact, for typical insomnia, cognitive behavioral therapy, not medication, is the preferred treatment. The treatment works by controlling or eliminating negative thoughts and procedures that maintain alertness.
- Treating personal and social rhythm. This treatment is centered around the observation that indicates depression or mania is often associated with a relationship difficulty leading to sleep deprivation. The therapist helps the patient in the work to organize the routine as well as the problem of personal relationships.
- Cognitive-behavioral therapy. Originally aimed at treating severe depression, this treatment aims to relieve stressful life events that interact with negative cognitive patterns of mania and depression.
These treatments can be combined with each other and used with medications, such as mood stabilizers and antipsychotic drugs. This may allow a person to take an overdose of antipsychotic medication to treat symptoms. There are no absolute contraindications to bright light or dark treatments. However, using bright light therapy in the evening may aggravate insomnia, and dark therapy should not be used in depression. Sleep deprivation is only used during the depression phase because it can provoke or make the symptoms of mania worse.
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