Light, Dark, and Bipolar Disorder: Some Practical Guidance

Interventions affecting circadian rhythm can be therapeutic, with some approaches more effective than others.

Chronotherapies, interventions that affect the circadian rhythm, have been studied in both the depressive and the manic stages of bipolar disorder through the years (e.g., NEJM JW Psychiatry Nov 2017 and Am J Psychiatry 2017; 175:131; NEJM JW Psychiatry Nov 2009 and Biol Psychiatry 2009; 66:298). In this review, the authors have compiled the evidence and recommendations from an International Society of Bipolar Disorders task force. The major treatments include:

Bright light therapy: This modality appears to be effective for bipolar depression. Bright light (7000–10,000 lux) can be given in the morning or at midday. Patients should receive mood stabilizers before chronotherapy begins. Exposure should start with 15 minutes and can increase to …

Reviewing Author

Jonathan Silver, MD

Disclosures

RoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions

Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience

Leadership Positions in Professional SocietiesNorth American Brain Injury Association (Board Member); National Institute on Disability, Independent Living, and Rehabilitation Research (Chair of Data Monitoring Safety Board for study of donepezil on cognition after traumatic brain injury)

Jonathan Silver, MD

Disclosures

RoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions

Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience

Light, Dark, and Bipolar Disorder: Some Practical Guidance

Topics

Reviewing Author