We all know how important sleep is in maintaining mental health and mood stability. Results from a recent study confirm this and serve as a caution to parents and mental health professionals alike not to overlook sleep anomalies as early warning signs of depression, bipolar, or anxiety disorders in teenagers and young adults.

The lead author of the study is Nick Glozier, MBBS, MRCPsych, PhD, associate professor of psychological medicine at the Brain and Mind Research Institute and the Centre for Integrated Research and Understanding of Sleep (CIRUS) at the University of Sydney in Australia.

The study found that young adults (17-24 years of age) who get fewer than eight hours of sleep per night are at greater risk of experiencing psychological distress – a combination of high levels of depression and anxiety. The study showed a 14% increase for each hour of sleep less than eight hours.

During an acute and severe manic episode, a doctor is likely to treat mania more aggressively, perhaps by taking the following steps:

• Prescribing substantial doses of medications such as Abilify or Seroquel.
• Using loading doses of Depakote to reduce acute mania more rapidly. A loading dose is a higher initial dose than normally prescribed. Loading doses are used to ramp up a medication to a therapeutic level more rapidly.

These more aggressive interventions for mania are often performed in hospital. When providing outpatient treatment, doctors usually ramp up these medications more slowly to reduce side effects. Lamictal, which is used to prevent mood cycles, requires many weeks to reach a therapeutic level because of the risk of a skin condition that is much lower if the doses are increased very slowly.

Antidepressants are another story. Routinely, patients are told that they won’t be likely to experience any benefits from their antidepressants for at least a few weeks. Sometimes it can take much longer, and doctors rarely, if ever, suggest what to do in the meantime. Patients are often expected to tough it out. And if the person complains, the doctor often advises them to “BE PATIENT.” Easier said than done in the midst of debilitating depression.

My wife hates Daylight Savings Time. Whether we’re springing forward, as we did this past Sunday, or falling back, it usually upsets her circadian rhythm just enough to trigger a chain reaction toward mania. Simply put, it throws her sleep pattern out of whack.

While she’s waiting for her circadian clock to reset, she usually ups her dose of melatonin and uses other sleep aids to “knock herself out.” She does a pretty good job of getting herself back on track, but it usually takes a week or two.

Does setting your clock ahead or back upset your mood balance? If so, what do you do, if anything, to deal with it?

With this post, we continue our biweekly series on medications used to treat bipolar disorder and related symptoms. This week, we focus the spotlight on medications that can help you sleep.

Sitting: Peter Smole and Roman Peklaj and Maja Valic; Standing: Joe Kraynak, Darja Budja, Cecie Kraynak, Emi Kladnik, Ana Sorc, and Katja Jus

Cecie and I were invited to visit Ljubljana (lyoo-blee-ah-nah), Slovenia for the release of the Slovene edition of Bipolar Disorder for Dummies. We accepted and have been in Slovenia since this past Thursday, 10/8/2009. We flew into Venice on Thursday to meet our gracious hosts, Darja Budja (“j” is pronounced “y”) and her husband Simon Perko. Darja translated the book into Slovene and is a devoted bipolar advocate. She has created her own bipolar blog (bipolarna.si) and is one of the organizers of an active bipolar support group in Ljubljana.

With this post, we continue our sort-of-biweekly series on medications used to treat bipolar disorder and related symptoms. Several weeks ago, we covered Wellbutrin (bupropion), an antidepressant that’s in a class of its own. This week, we turn our attention to an older class of medications used to treat depression – Tricyclics.

I just read an article on eMax Health entitled “Bipolar Disorder Linked to Genes of Biological Clock.” The article cites a study presented at the Eighth International Conference on bipolar disorder, suggesting that “abnormalities in the genes that control circadian rhythms (rhythms of approximately 24 hours, also called biological clock) contribute to the development of bipolar disorder (manic depression).”

As many people have discovered, regulating sleep is often one of the best ways to regulate mood. Unfortunately, maintaining a regular sleep schedule is not always as easy as it sounds, especially if your neighbors, your family or roommates, your schedule, your lifestyle, or your sleeping arrangements do not cooperate.

Over the past couple weeks, my wife, who happens to have bipolar, has not been sleeping well, which is always a bad sign. For two weeks, she’s been trying to get something to help her sleep – to get her through the often manic days that seem to reach full bloom about the time school lets out. You can read the whole account, “Tragedy of Errors” on our Bipolar Blog.