Bipolar Disorder and Seasonal Affective Disorder
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Q: I'm doing okay..holding my own.  Traditionally this isn't the best time of year for me, and I've been having some mixed moods - you know, the hypomania with the tears just under the surface ready to brim over at the slightest provocation...to depression and seclusion...had to have my meds tweaked some, but nothing too serious so far.  Funny, I did a search on the seasonal variation of mood changes in Bipolar Disorder and came up with very little..but I KNOW for a fact that in many people there is a relationship.  Spring and Fall...I've heard it way too often to be coincidental.

Dear Colleen --
You're right, there is a recognized connection between bipolar disorder and seasonal affective disorder (SAD).  People with BPD are more likely to have SAD than the general population.  The most common pattern is fall depression and spring hypomania, but there are a few other variations, usually having to do with summer heat.

Some people with your pattern can respond to the standard, research-demonstrated treatments of light therapy.  Most people with your symptoms will have heard about the "light box" approach, which can help about 50% of people with SAD.  Seems like that number should be higher, but that's how it comes out in most studies.  However, there's a lesser known gizmo called a "dawn simulator", which happens to be considerably cheaper, and if it works, a lot easier to use.  You should make sure you try each of these two approaches.  Be careful, though: light boxes have been known to cause manic symptoms, usually when people get too high a "dose".

The dawn simulator works by "tricking" your suprachiasmatic nucleus (SCN) (for a picture of this part of the hypothalamus, see this image; for a look at the hypothalamus overall, go here).  That's the "biologic clock" in humans that responds to daylight and keeps us "entrained" to the light/dark cycle of day/night rhythms.  The SCN "knows" that it's winter coming, you see, by the later arrival of light.  So you can "trick" it, by having light arrive about the same time it would in the summer.  That's what the "dawn simulator" does: it just gradually turns on your bedside lamp(s), no fancy "light box" required, so that when you wake up you are waking up to light, not darkness.  For example, if you usually wake at 6:45 a.m., the dawn simulator starts turning on the light very gradually at 6:00 a.m.  By the time your alarm clock goes off at 6:45, your room is full of light.

Tech-heads can use these instructions to build a dawn simulator for less than $100.  If you buy the device itself, don't spend more than $127.00 for the pi-square company's sun-rizr, which does the job just fine.  Scroll down to that product for that price on this site.

Dr. Phelps


Published October, 2000

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