Despite the rapid daily shifts in moods, many parents are no strangers to the seasonal aspects of bipolar disorder with their children; there is a noticeable depressive slump during the fall and winter months, followed by an upswing and stirrings of mania during spring and summer. Here are seven things to know:
#1 History of the seasons and bipolar
The seasonal recurrences of depression and mania have been an unexplained phenomenon since ancient times, notes bphope columnist and author Demitri Papolos, MD. There have been documented seasonal episodes of illness in some manic-depressive patients with a preponderance of manic episodes in the spring, and depressive episodes in the winter, as far back as the fifth century.
#2 Seasonal ebb and flow
“Many children not only experience seasonal perturbations of mood—their hour-to-hour mood and energy level may vary as well,” explains Papolos. Children and adolescents, during the fall, will often experience lower energy in the morning, and then increased irritability and anxiety, whereas the evening period this is lower. This pattern is often reversed during the spring.
#3 Sleep patterns change
Many parents notice that starting in the spring, when the light begins to change and the days are longer, their child’s sleeping patterns will change. So, the child or teen who slept deeply and for long hours during the winter is suddenly awake at 4 a.m. or 5 a.m. He may be unaware that others in the household are sleeping or that he should be sleeping as well. He will have boundless energy for school and other activities and may obsess about them.
#4 Seasons and management of bipolar
Knowing how the seasons impact the symptoms of bipolar, also gives indications to the management of the disorder. Parents should consider talking to their child’s psychiatrist about adjust the medication protocol to reflect this mood fluctuation throughout the year. The dosage of meds that may have previously stabilized the child may not be as effective during the periods of change in the light/dark cycle.
#5 Biological behaviors
Neuropeptides, neurotransmitters and hormones all play a part in our brain activity and our behavior. “The timing of events within the central nervous system is at least as important as the special arrangements of the central neuronal activity in the brain,” explains Papolos. This may explain the therapeutic effects of bright light treatment in “seasonally-cycling bipolar patients.”
#6 Seasonal affective disorder
The term Seasonal Affective Disorder (SAD) was coined in 1984 by Norman Rosenthal, MD. He described the seasonal pattern of depression and bipolar disorder. Rosenthal reported that the depression symptoms, or ‘winter blues,’ improved when patients received daily bright light therapy during the fall and winter. In looking at children with bipolar disorder, it is shown that perhaps light therapy tends to work better as a preventive treatment, so recognizing the pattern and potential for relapse during the year is important.
#7 Light therapy explained
As a complement to medication, psychotherapy and a lifestyle wellness plan, light therapy boxes may be a viable option. The box provides a balanced spectrum light equivalent to natural daylight and can help regulate the body clock function and help synchronize sleep/wake patterns as well. The patient sits in front of a bright light unit (a portable box) for a specific amount of time and during an optimal time of day. The timing of using such a therapy option should be considered, as exposure too fast or using the light box for too long may in fact bring on manic symptoms of bipolar disorder.
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