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BiPolar Disorder
Bipolar disorder is fairly common, afflicting about 3% of the population. It used to be called manic-depressive disorder. A person who experiences bipolar disorder will experience periods of elation as well as periods of depression.
During the manic phase, bipolar people may report feeling on top of the world, that they can do and accomplish great things, that the world is their oyster. They may report needing little sleep, having endless energy and they may make decisions they later regret. They may make financial investments or purchase new cars, or other spending sprees they later regret. I've had bipolar patients that quit great jobs because they thought an even better job was coming. Or committed to new house payments based on a raise they "knew" they were going to get.
During a depressive episode the same patient may find it hard to even get out of bed. They may quit their job because they just don't think they can keep functioning. Their depression may become very debilitating, to the point that they can’t carry on with normal life duties and responsibilities and may become suicidal.
Lithium Treatment Started In The 1800s
In the past bipolar disorder was first treated with lithium. For many people, lithium was a miracle. Their life would even out, and they could lead healthy and productive lives. But many complained of the side effects, which for some were intolerable.
As you can imagine, with the side effects some people experienced, many people didn’t want to take lithium. Now there are a number of other drugs, called mood stabilizers that are also approved for this condition. Depending on the patient, some of these other drugs may have a better side effect profile, but some might be even worse. A patient that has already gained 20 pounds on lithium is not too happy when they gain another 30 pounds on some “new and improved drug”.
Another trap to avoid is using first line, or regular antidepressants to treat bipolar syndrome. Sometimes the patient first seeks treatment during a depressive phase and the doctor may not recognize that the patient actually has bipolar syndrome and needs a mood stabilizer.
Treating The Depression May Trigger Manic Episode
If a regular antidepressant is prescribed, it may throw the patient into a manic phase. The next time the doctor sees the patient, they may express how much better they feel and in the very next sentence offer the doctor a ride in their brand new Corvette, that they just cashed in their retirement to buy. If antidepressants are used for bipolar disorder, it requires a high degree of caution, very close monitoring and is usually combined with a mood stabilizer.
Thus, as in so many areas of medicine, the search for a better treatment, with less, or no side effects, that will help more patients, is ongoing. And that's why this study is so intriguing.
Bright Light Highly Effective, No Side Effects
Bright light therapy was used for bipolar patients in the depressive phase. Half of the patients experienced significant improvement in their depressive symptoms! That is a pretty good success rate for any treatment or drug for this condition and even more impressive is that the bright light therapy didn’t trigger a manic episode! No side effects of any type were reported.
The bright light therapy used in this study was the typical SAD lights that have long been used as a treatment for Seasonal Affective Disorder (SAD or winter depression). Recently researchers have discovered that SAD lights can be used for other types of depression and also bipolar disorder. However, this is the first study looking at how SAD lights affect the depressive symptoms of bipolar disorder.
In this study, the patients sat in front of the SAD lights for 30 minutes a day, very similar to the way people with SAD use the lights.
Sunlight Beats SAD Lights
As readers of this Newsletter may recall, anything you can do with SAD lights you can do better by going outside under the sun during the day. Even on a cloudy winter day, the sun beats SAD lights. Going outside has the additional advantage that you also will get the exercise of walking around. And sunlight is free!
Read the entire study in the January 2023 issue of the Journal of Affective Disorders, Volume 321, Pages 102-107.
The Take Home Message
In this age of anxiety, depression, stress and insomnia, all of us should take note that bright light has a mood stabilizing, antidepressant effect, strong enough to even help people with bipolar disorder. Obviously, bright light has something to offer all of us.
We should all go outside, under the sun daily, and get the best bright light this world has to offer. You can replenish your Vit D level and get the proven benefit of walking at the same time.
Take care and BE HEALTHY!
CW Jasper
August 2023
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