Light Therapy For Bipolar Disorder

Introduction

Bipolar disorder is a mental health condition that causes extreme mood changes. Mood swings are referred to as hypomanic, manic and depressive episodes. People affected by bipolar disorder also experience a normal mood known as euthymia. These mood swings affect a person's sleep, energy, behaviour, judgement and ability to think clearly. These changes in behaviour can interrupt a person's day-to-day activity.¹

Light therapy is also known as exposure therapy, circadian light therapy or bright light therapy. This therapy helps in treating certain health conditions through exposure to artificial light. During the light therapy, the person affected sits in front of a device known as a light therapy box. That emits a bright light that is similar to natural sunlight.² 

Our body function and behaviour are influenced by environmental factors, including light. The light activates the retina in the eye, resulting in a stimulus to the hypothalamus in the brain, which helps manage mood.^3,5

Understanding bipolar disorder

Bipolar disorder is a mental health condition that causes extreme mood changes. These affect sleep, energy, activity, behaviour and ability to think properly. Bipolar disorder involves significant fluctuation in mood such as, manic, hypomanic and depressive moods.¹

Types of bipolar disorder

1. Bipolar Ⅰ disorder: In this type, people may have experienced one or more episodes of mania. To diagnose bipolar Ⅰ disorder, the person should at least have a manic episode for a week alternating with a depressive episode. Mania is a condition where the person has an elevated or irritable mood, as well as changes in emotions, thoughts, response and activity level. People in a manic stage are involved in activities that cause them harm. Occasionally, they develop psychotic symptoms like delusions and hallucinations, so it becomes difficult to differentiate from mental health conditions like schizophrenia (it is a severe psychiatric condition that affects the physical and mental well-being of a person).
2. Bipolar Ⅱ disorder: In this type of disorder, the person experiences hypomania, which is less severe than the manic episodes. People affected by hypomania have episodes that last for a few days. The episodes are less severe, so it does not affect the day-to-day activity.
3. Cyclothymic disorder (cyclothymia): The person affected has an unstable mood, where they experience hypomania and mild depression. In between the mood changes, they may have a small period of normal mood.
4. Other specified and unspecified bipolar disorder: If a person affected by bipolar disorder does not have symptoms like bipolar Ⅰ, Ⅱ and cyclothymia but still experiences clinically significant abnormal mood fluctuation, this is considered as an unspecified or specified disorder. 

Signs and symptoms

Diagnosis

The psychiatrist or psychologist diagnoses the condition and advises proper treatment.

• A physical examination is conducted
• A healthcare provider takes a complete medical history of the patient
• They also enquire about family history related to the same condition
• Blood tests are conducted to verify any other hormonal imbalance that may be causing the symptoms
• They use the diagnostic and statistical manual of mental disorder (DSM) to diagnose bipolar disorder

Treatment and management

Treatment is advised by a psychiatrist or psychologist. The treatment plan is decided according to the severity of the condition; it consists of a combination of certain therapies. 

• Psychotherapy: It is a way of treating mental health illness by talking to a psychologist, psychiatrist or other mental health provider. During this therapy, we can understand how thoughts, emotions and behaviours affect the mood. Therapy helps to learn and control behaviour and makes the patient respond thoughtfully in challenging situations. It is also known as talk therapy, counselling or therapy.⁷
• Medications are prescribed by the doctors to maintain a balance in mood swings. Mood stabilisers, antipsychotic drugs and antidepressants are prescribed. In some cases, antidepressants trigger manic episodes. 

• Hospitalisation: Doctors recommend hospitalisation if the patient’s condition is severe, behaving dangerously to themselves and others, or having suicidal thoughts.

Understanding light therapy

Light therapy is a type of therapy which helps in treating certain mental health conditions using light. A light therapy box is used where bright light is emitted in a way that is similar to natural light. Light therapy helps in treating insomnia, circadian rhythm sleep disorders and depression. Circadian rhythm (body clock) is disrupted in bipolar disorder, and the patient suffering seems to be more sensitive to light.⁸ Using light therapy, circadian rhythm is manipulated, and bipolar disorder is treated.^2,4,5,6

Mechanisms of light therapy

A specially designed light box is used for light therapy. The light box is intended to emit bright light intensity measuring 10,000 lux without the harmful UV rays. To avoid damage to the eye, the light is positioned to shine indirectly into the eyes.^5,6

During a light therapy session, the light activates the retina in the eye, stimulating the hypothalamus in the brain.³ Certain chemicals like melatonin and serotonin are affected in the brain, these are responsible for regulating the sleep-wake cycle. The light delays the melatonin production in the brain, makes the person wake up and lifts their mood. Certain following conditions can be treated by light therapy, and they are: 

1. Insomnia: It is a condition in which the person consistently has difficulty falling asleep or staying asleep. Insomnia can occur on its own; when this happens for more than a week or months, it becomes chronic. Light therapy helps in treating insomnia in certain cases.⁹
2. Jet lag: This occurs when a person travels from one-time zone to another; the circadian rhythm remains synchronised with the old location. This leads to a situation where the person feels sleepy in the middle of the day or wakes up early at 4 am. Spending time outside helps in the treatment of jet lag, and also light therapy accelerates the healing process.
3. Seasonal affective disorder: This is a seasonal depression, which occurs when there is a change in sunlight or during a change in the season. The individuals may complain of difficulty in sleeping and hypersomnia (excessive daytime sleeping). This occurs when the chemical melatonin is released more in the brain, resulting in depression, tiredness and mood swings.
4. Depression: It is a condition where the person feels persistent sadness and loss of interest. Depression leads to a variety of emotional and physical disease conditions. It may also interfere in day-to-day activities.

Types of light therapy devices

Light therapy can be done even at home. There are a wide variety of light therapy products available, while during the session the person can read, write, use phone or computer. Light therapy boxes are available in all shapes and sizes. There are light therapy boxes designed for insomnia and designed to treat skin disorders. The light therapy boxes designed to treat insomnia, mood swings and depression only filter out UV light, whereas the light box for skin disorder emits UV light. 

Light therapy for bipolar disorder

Bipolar disorder can be treated with proper medications and psychotherapy. Circadian rhythms are disrupted in conditions like bipolar disorder; manipulating the circadian rhythm is a way of treating bipolar disorder. This can be treated with bright light therapy and dark therapy.^5,6

• Bright light therapy: Our body function and behaviour changes according to the light, among other environmental factors. During light therapy, the bulb emits 10,000 lux of UV-filtered bright light, which is placed above the eye level. During this process, light activates the retina in the eye, which leads to a stimulus in the hypothalamus of the brain. The hypothalamus helps regulate mood, and it prevents or treats episodes of depression.^2,4,10

• Dark therapy: As light therapy improves the mood, decreasing the light improves the manic symptoms. During the evening, amber glasses are worn as they block blue light, which helps in treating mania.

FAQs

Is light therapy good for bipolar disorder?

Bright light therapy stimulates the hypothalamus of the brain and regulates the sleep-wake cycle. This helps in treating bipolar disorder by decreasing depression and improving mood swings.

Do bipolar people know they are bipolar?

Most commonly, people affected by bipolar disease are unaware that they are having manic episodes. After the episodes, they believe that other people are being negative and unhelpful toward them.

What does light therapy do?

Light therapy is a therapy that uses a light box that emits UV-filtered lights, which stimulates the brain and lifts mood, increases sleep, and decreases depression. 

What makes bipolar disorder worse?

Bipolar disorder is triggered by stress, hormonal changes and usage of alcohol and drugs. However, in certain cases, episodes occur without any triggers.

Summary

Bipolar disorder is a mental health condition that causes extreme mood swings. These affect sleep, energy, activity, behaviour and ability to think properly. Bipolar disorder involves significant fluctuation in mood such as, manic, hypomanic and depressive moods. Light therapy is a type of therapy which helps in treating certain mental health conditions using light. A light therapy box is used where bright light is emitted similar to the natural light. Light therapy helps in treating insomnia, circadian rhythm sleep disorders and depression. Circadian rhythm (body clock) is disrupted in bipolar disorder and the patient suffering seems to be more sensitive to light. Using light therapy, circadian rhythm is manipulated, and bipolar disorder is treated.