Why shorter autumn days, the end of Daylight Saving Time, and interrupted sleep can trigger mood symptoms, and how to fight back with a solid daily routine.
Joan has always considered herself a night owl. As a night editor for her local newspaper, she would happily plug away until the early morning hours. She would sleep until midday, then spend the afternoons on errands, appointments, family time, and “me” time before beginning her next shift.
“It’s my ideal schedule,” says the 37-year old from Dover, Pennsylvania.
When Joan left her job of nearly 16 years and returned to a more traditional 9-to-5 workday, she struggled to readjust. It was midwinter when she made the transition, and the shorter days and longer nights didn’t help.
“When it was 8 a.m. and dark outside, it was hard as heck for me to get up,” says Joan, who has bipolar I disorder.
And with work soaking up prime daylight hours, it was harder for her to get out for her regular walks. Set off balance by her sleep problems and disrupted routine, Joan noticed a larger pattern.
“My mood in general heads south in the fall,” she says, adding: “My mood issues are much better now that I’m more proactive in my care.”
Joan makes it a point to consult her psychiatrist for medication adjustments as needed. She’s learned to make getting outside during the day a priority. And despite her natural tendency to stay up till all hours, she made a pact with her wife to head down to their lower-level bedroom and retire for the night together.
“Even if I’m not sleeping, I’m putting myself in a position to go to sleep,” she says.
OUT OF SYNC
Whether you’re naturally a night owl or a morning lark depends on the “master clock” in your brain, which coordinates a network of “mini-clocks” throughout the body to regulate biological functions throughout the day.
The master clock governs cycles of alertness and sleepiness, hunger and metabolism, body temperature, hormones, and more, collectively known as circadian rhythms.
For some folks, the body clock gets easily “dysregulated” by even minor shifts in schedule: starting work at different times throughout the week, staying up extra-late for a celebration, even exercising at a different time of day. As a group, people who have bipolar disorder seem especially vulnerable to disruptions in routine.
Colleen McClung, PhD, a professor of psychiatry at the University of Pittsburgh, researches the intersections between circadian genes and mood disorders. She puts it this way: “The internal clock is fragile” in individuals with bipolar.
In general, the human body clock syncs up with the 24-hour light-dark cycle, so that most people feel sleepy at a “normal” bedtime and alert at the customary start of the day. Yet many people with bipolar prefer to stay up late and sleep in, says McClung.
Those with bipolar also tend to be more affected by seasonal changes, a known trigger for mood episodes.
One possible explanation: Genes that control circadian rhythms may also regulate processes in regions of the brain linked to mood, rewards, and impulsivity, McClung says.
Genetic variations may dictate, in part, why people with bipolar are more sensitive to changes in routine and daylight. However, evidence suggests the influence goes both ways: Keeping your daily routines and sleep habits stable may help prevent mood shifts.
Sticking to a regular schedule can create a predictable rhythm to your day and help train your internal clock, “help stabilize and amplify it,” says McClung.
There’s a reason light, particularly daylight, has such a big effect on circadian rhythms. Light-sensitive cells in the eyes convey information directly to the master clock—technically, the suprachiasmatic nucleus, a cluster of neurons in the hypothalamus
In nature, fading daylight cues the master clock to order up more melatonin, a hormone that promotes relaxation and sleep. Ideally, melatonin levels peak as you get ready for bed, explains Mary Fristad, PhD, a professor emerita of Ohio State University’s College of Medicine (now affiliated with Nationwide Children’s Hospital in Columbus) whose research focuses on mood disorders.
The bright light of morning—and in our world, the glow from artificial lighting and electronic screens in the evening—triggers a drop in melatonin production, thus reducing sleepiness.
Research suggests that individuals with bipolar are more sensitive to this process. Burgess, of the University of Michigan sleep lab, cites a study in which participants were exposed to different intensities and frequencies of light. Individuals with bipolar showed more melatonin suppression than a comparison group of people without the diagnosis.
Getting less exposure to daylight due to longer nights, gloomy weather conditions, or even skyscraper shadows can disturb a delicate circadian system.
That’s the case for E.B. Howell, author of the semi-autobiographical novel As Much As I Care to Remember. Howell, 47, generally feels out-of-sorts during the autumn and winter months—dull, cranky, and less energetic.
She was living in New York City when she noticed how light linked to her moods.
“I could feel this change each fall,” says Howell, who took long walks in Central Park to chase the sun.
She now lives in Beaufort, South Carolina, where milder winter temperatures make it easier to spend more time outside.
In one way, Howell says, the seasons of shorter days have an upside as far as living with her bipolar I. Since she tends towards mania, fall and winter can feel like a respite.
“It seems like Mother Nature is telling me to slow down, sleep, do those winter chores, and find balance,” she says.
In addition to shorter days, fall brings the end of Daylight-Saving Time. (This year, we set the clocks back an hour on November 1.)
For many people, “the autumn time change is like swimming with the tide. We drift an hour later, which is in tune with our natural biological rhythm,” says Helen Burgess, PhD, professor of psychiatry and co-director of the Sleep and Circadian Research Laboratory at the University of Michigan.
For anyone with an extra-sensitive body clock, however, the time change comes as more of a jerk backward. That’s why individuals with bipolar should stay extra-alert to signs of a mood shift during this period. Plus, the added hour of darkness in the morning may be especially hard on those prone to depression.
Mike, a 45-year-old nonprofit professional from New Orleans, has the opposite problem during the summer months.
Not too long ago, Mike went through a period of excessive drinking, amped-up energy, and talkativeness. He started skipping work and ended up losing his job and his home.
“I don’t want that to happen again,” says Mike, who has a bipolar II diagnosis.
As he recovered from that episode, he worked with a therapist who emphasized the importance of keeping a regular sleep schedule. Mike now knows he needs roughly eight hours of sleep to keep his moods in check. Since he wakes up around 5 a.m. for work, he aims to hit the sack before 9 p.m.
In the summer months, that often means getting ready for bed while it’s still light out. When he’s feeling good and his mood is stable, he says, he’d rather be out enjoying the longer days.
“I don’t want to be in bed. I don’t want to be lying down and sleeping all the time,” he says.
That can start a dangerous cycle. He wonders if he’s sleeping too much, which can be a sign he’s heading into a depressive episode. He wakes up multiple times during the night to check if it’s time to get up.
To help create a routine around his early bedtime, Mike uses his TV as a prompt.
“I watch the Food Network. I know what night it’s going to be Guy Fieri and what night it’s going to be Chopped,” he says.
When he sees these shows come on, he knows that it’s past 7 p.m. and it’s okay to start winding down for the night—even if the sun hasn’t yet set.
Your daily activities—not only when you go to bed and get up, but also when you eat, exercise, work, and socialize—count among the environmental factors that influence your internal clock. Researchers refer to the pattern of self-directed activities as social rhythm.
“These are timekeepers in our day,” says Fristad. “Anything that keeps your social rhythm in order can help regulate your circadian rhythms.”
That’s one reason why a good sleep schedule looms large in bipolar management. In fact, getting enough rest on a regular basis can help smooth out disruptions in your circadian rhythms and serve as a buffer against bipolar episodes. A 2015 study published in the Journal of Consulting and Clinical Psychology found that when individuals with bipolar I were treated for sleep problems like insomnia, their mood improved and they functioned better.
“Decreased sleep can be a sign of a manic episode, but it can also be a trigger,” explains Fristad. “Disruption of your sleep, such as [from] an international trip, a shift in your work schedule, or a sick child, could produce a mood episode.”
For Gabe of Bartlett, Illinois, the birth of his two youngest children less than two years apart has meant endless nights of interrupted sleep.
“Having two children nearly back-to-back, I don’t have a schedule anymore and struggle to wake up. I’m often moody and spaced out throughout the day. It exacerbates my bipolar II by a hundred-fold,” says the 37-year-old.
As a result, he’s cycled through emotional highs and lows and periods of feeling agitated.
Gabe has been trying to establish better sleep habits and a solid daily routine. He says physical activity like yard work takes the edge off, tires him out, and helps him fall asleep. He also sets himself realistic daily goals, which helps him feel less overwhelmed and more in control.
Scout, 29, is also a firm believer in routine. She was diagnosed with bipolar II when she was 20, says having structure in her day helps ground her mind and body, and ward off depressive episodes.
She leans into practices such as daily morning pages (a free writing practice), gratitude, and prayer. She fits in a 30- to 45-minute power walk, too, which helps her stay focused while running her public relations company.
Since feeling tired can trigger depression for Scout, her evening rituals are important. Every night, the San Diego, California, resident puts away her phone and computer and meditates.
“It’s the perfect way for me to fall asleep,” she says.
But settling into a routine wasn’t easy. Scout hit rock bottom after she dropped out of college and was hospitalized. She had also come to a crossroads with her then-boyfriend (now her husband).
“He said to me, ‘I don’t care if you’re depressed. If you’re depressed and hopeful, I can work with that. If you’re depressed and hopeless, I can’t do this.’ My entire world shifted in that moment,” she says.
“I’ve lost jobs, internships, and opportunities. How many more things am I going to lose because of bipolar? I’m not going to lose him,” she says of her mind state at the time.
She began going to support groups three times a week and trying new things until she found a regimen that worked for her.
“There’s a self-confidence that comes from keeping promises to yourself. So, you keep showing up for yourself,” she says. “I started to figure out what I need to do to take care of myself. I used to be a college dropout and couldn’t hold a job. Now I run my own business.”
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