Let There Be Light!
As I make connections with others in the bipolar community, I am consistently gob-smacked by the number of “controversial” treatment options available. This seems to apply to nearly every course of action that is considered common practice.
Some may declare a specific psychotropic medication to be the holy grail of treatment. Yet simultaneously, others will malign the product as a soul-sucking compound designed to lobotomize the user. What information can you really trust? And how do we even begin to address the tactfully withdrawn research, which never even makes it to the peer-review process in the first place? Even published studies can be criticized for their structure.
I began to think about what elements affect me on a daily basis, and are supported by basic biology. What treatment needs do I have, that can’t be denied? My conclusion = sunlight, and controlled sleep.
People with bipolar disorder seem to be universally affected by the amount of daylight they are exposed to, with regards to mood and energy levels.
I have found that while spending time with my family in cold northern locations (generally Ireland or New England), the draw to sleep at odd hours is profound. My energy levels plummet, and the possibility for creative bursts are infinitesimal. I must be very careful to adjust my schedule so I rise with the morning sun, very early in the day, or else when the 4:30 darkness rolls in, I will be ready for an ill-timed nap (only leading to the dreaded wee-hour insomnia and compounding irritability).
This pattern of existence is quite opposite from my usual Californian routine. My workstation, outside of San Francisco, is situated beside a floor-to-ceiling window, which basks me in sunlight nearly everyday without pause. I often have a terrible time reigning in the resulting energy and inspiration after a day’s worth of writing and research. It’s quite clear to me that this affect can be summarized in the following poorly constructed diagram:
sunlight => energy => creativity => ability => productivity => ‘normal’ fatigue
Everyone can’t relocate to a climate that is supportive of constant sun exposure. So what else can be done? It was suggested to me, when I was residing in the dense fog of San Francisco itself, that I employ the use of a full-spectrum light. I was very skeptical of this method. It felt far too simplistic – even gimmicky.
That said, I ordered one, because I am open to trying almost anything that might bully bipolar into the background where it belongs.
I must say that I believe it helped me achieve a better energy-sleep rhythm. If I used it regularly, 45 minutes each morning, I did notice improvement in my energy during the morning hours, and improved ability to sleep at night. It does not compare however to my current set-up, which, includes full workdays soaking in the California sunshine with very little interruption to the flow of cosmic energy.
Perhaps if I were still working in the white-out fog of San Francisco, I would swear by the full-spectrum lamp throughout the day, in the hopes of achieving the same affect. I did read a few very convincing studies on this topic. One I will quote here, and I believe you’ll find the results rather astonishing.
“This analysis of randomized, controlled trials suggests that bright light treatment and dawn simulation for seasonal affective disorder and bright light for nonseasonal depression are efficacious, with effect sizes equivalent to those in most antidepressant pharmacotherapy trials.”
(Source: http://www.dsm.psychiatryonline.org/article.aspx?articleid=177447&RelatedWidgetArticles=true )
You read that correctly, light therapy can be compared to the potential power of an antidepressant.
In other studies the use of sleep-deprivation coupled with light therapy produced a rapid anti-depressant effect in people with bipolar disorder.
“The combination of total sleep deprivation (TSD) and light therapy (LT) in bipolar depression causes rapid antidepressant effects, and its mechanism of action has been hypothesized to involve the enhancement of all of the monoaminergic systems targeted by antidepressant drugs (serotonin, dopamine, norepinephrine)…. Two‐thirds of the patients responded to treatment (50% reduction in Hamilton Depression score).”
(Source: http://informahealthcare.com/doi/abs/10.1080/07420520701649455 )
I can say with great personal certainty that limiting my sleep to 7 hours per night and coupling it with sunlight exposure has dramatically improved my life, overall. I have more prolonged energy throughout the day, and a general feeling of happiness and enthusiasm for my work (and family) commitments.
I’m noticing how the absence of such a light and sleep routine, while on vacation, leads to great dips and spikes in my energy and mood. One would think the excitement of being on vacation would overcompensate for the darkness, fog, and precipitation in the northern climates we tend to frequent. But I am not a typical human being. I have bipolar. As I accept this label to be very fitting, I shall toast to midnight bedtimes, and morning basking, as a result. It’s profound what a difference these two non-pharmaceutical approaches can make.
I can’t help but ask, why not try sleep deprivation and sunshine, before ECT or other truly controversial treatments? As always, a discussion with you physician is in order before you should adjust anything in your treatment protocol. But perhaps, your doctor will feel this is a cause worthy of further exploration. This tactic provides further proof that we can take control of this beast called bipolar, sometimes through simple actions.
My advice: Set a bedtime, and an alarm-clock, and I sincerely hope you’re able to find some light, be it artificial or more divine in origin. It will lead to a stronger state of wellness.