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Non-Pharmacological Treatments for Mood Disorders
Published in Dr. Ather Muneer, Mood Disorders, 2018
A single pilot trial showed that while exposure to light is antidepressant, exposure to dark can reduce manic symptoms as rapidly as antipsychotic drugs, when administered during the first weeks of the manic episode and patients might be more sensitive to chronobiological interventions.42 Also, the continuous mood swings of rapid cyclers appear to stabilize when maintaining a regular light–dark rhythm with an increased darkness period. This promising approach, which could reduce the need for antipsychotic drugs and lead to shorter hospitalizations, is still awaiting evaluation in randomized trials. Future research will clarify if the dark therapy approach might be clinically useful alone or combined with LT and SD to improve clinical efficacy.
Spectrophotometric properties of commercially available blue blockers across multiple lighting conditions
Published in Chronobiology International, 2022
Brooke J. Mason, Andrew S. Tubbs, Fabian-Xosé Fernandez, Michael A. Grandner
Individuals with bipolar disorder may also benefit from blue blockers. Light can influence neural substrates of mood and cognition, either directly mediated by ipRGCs (LeGates et al. 2012, 2014) or indirectly through behavioral and brain changes (Bedrosian and Nelson 2017). Abrupt changes in lighting conditions can provoke manic episodes (Bauer et al. 2015, 2012) and symptom severity often tracks alterations in circadian rhythmicity (Dallaspezia and Benedetti 2015). In fact, use of dark therapy, which imposes dark lighting for fourteen hours per day, may protect circadian rhythmicity in manic patients, and preliminary data indicate this intervention can decrease symptom severity and ease rapid cycling between mania and depression (Barbini et al. 2005; Wehr et al. 1998; Wirz-Justice et al. 1999). Use of blue blockers may achieve a similar effect, as two small studies reported that blue blockers decreased the intensity of manic symptoms after five days of inpatient use (Henriksen et al. 2020, 2014). While these preliminary data are encouraging, more rigorous studies are needed to confirm these effects.
Association between light exposure at night and manic symptoms in bipolar disorder: cross-sectional analysis of the APPLE cohort
Published in Chronobiology International, 2020
Yuichi Esaki, Kenji Obayashi, Keigo Saeki, Kiyoshi Fujita, Nakao Iwata, Tsuyoshi Kitajima
Light exposure, including seasonality and photoperiod, is closely associated with the pathophysiology of BD, such as altered mood symptoms, circadian rhythms, and sleep quality as well as risk suicide and hospitalization in emergency psychiatry (Aguglia et al. 2017, 2018; Geoffroy 2018; Aguglia et al. 2019; Bauer et al. 2019; Esaki et al. 2019a, b). For this reason, light regulation is widely used in the treatment of BD. Light therapy exposes patients to bright artificial light in the morning (Pail et al. 2011), and various studies have found that it is effective for bipolar depression (Sit et al. 2018; Tseng et al. 2016; Zhou et al. 2018). In contrast, darkness at night while sleeping is associated with reduction of manic symptoms in BD (Barbini et al. 2005). Findings from two case reports and one pilot study indicate that dark therapy (DT), which exposes patients to a dark room from 18:00 to 08:00 h, can exert striking beneficial effects on manic patients (Barbini et al. 2005; Wehr et al. 1998; Wirz-Justice et al. 1999). Additionally, a recent randomized placebo-controlled study demonstrated that virtual DT using blue-blocking glasses from 18:00 to 08:00 h significantly reduces mania scores relative to the scores attained with placebo glasses (Henriksen et al. 2016). Collectively, the results of these past investigations imply depression improves with morning/daytime light, whereas mania decreases with evening/nighttime darkness.
Block the light and sleep well: Evening blue light filtration as a part of cognitive behavioral therapy for insomnia
Published in Chronobiology International, 2020
Karolina Janků, Michal Šmotek, Eva Fárková, Jana Kopřivová
Many investigators have shown that blue-light shield eyewear is a feasible and acceptable tool (Perez Algorta et al. 2018) able to reduce sleep and circadian dysregulation (Ayaki et al. 2016; Heo et al. 2017) and improve neuropsychological functioning (van der Lely et al. 2015; Zimmerman et al. 2019). Apart from insomnia (Shechter et al. 2018), some studies even focused on using “dark therapy” to treat mental disorders associated with sleep problems, such as major depressive disorder or bipolar disorder (Esaki et al. 2017; Henriksen et al. 2016). Other methods, such as software filters (e.g. f.lux®, Iris®, Twilight®) and system features (night or reading modes) reducing the amount of blue light emitted from screens are freely available for the most used mobile platforms, their research application is, however, very sparse (Heath et al. 2014). Could these simple and easy-to-use interventions be the missing link to increase the efficacy of CBT-I treatment programs or an appropriate alternative to this treatment?