Why Sleep Is Even More Essential For People With Bipolar Disorder


Sleep: The Other Half of Bipolar MedicationDespite having lived with bipolar disorder for over twenty years, it wasn’t until my current psychiatrist and psychologist incorporated regular dialogues about sleep that I finally tuned in. My psychologist reminded me at many appointments that sleep was the other half of my medication.

And it finally stuck.

Though when I thought back to all the mental health professionals over the years, I wondered why this knowledge wasn’t ingrained in me sooner. Surely, they must have brought this up. Was I not listening? Or, had emphasis not been placed on it back then? According to PubMed a.k.a. NCBI, the U.S. National Center for Biotechnology Information, mania and sleep were linked. Still, those were only part of the equation, there were also circadian rhythms, our twenty-four hour clocks, to contend with.

One study showed bright light and sleep restriction acted as an antidepressant and sometimes triggered mania. WebMD stated that for three out of four people with bipolar disorder sleep problems were the most common signal a period of mania was about to occur. This is why being aware of our sleep patterns is of paramount importance though often our loved ones see it first.

After reading a fast-forward research article by Dr. Ellen Frank PhD, I tracked her down for more insight. Dr. Frank is the author of Interpersonal Psychotherapy, a distinguished Professor of Psychiatry and Professor of Psychology at the University of Pittsburgh School of Medicine, Western Psychiatric Institute and a member of the Pittsburgh Mind-Body Center. She shared this:

Both our clinical experience and our research studies into the effects of life events on the course of bipolar disorder show the fundamental importance of sleep in maintaining wellness. Staying up all night to study for an exam or to finish a project may be perfectly safe for someone who does not have bipolar disorder, but it is extremely risky for someone who does. Likewise, people who don’t have bipolar disorder may be able to manage rotating shift work without much in the way of consequences. For someone with bipolar disorder it’s poison….like asking someone with lung disease to take a job removing asbestos.

Countless times in my early twenties I proved this to be true though unaware at that time. I was young and sleep was the last thing on my mind. One of the careers that enticed me was a flight attendant, though instinctively I knew it would not end well. Apparently, jet lag can kick off a hypomanic or manic episode.

Dr. Frank continued, “It seems that individuals who have bipolar disorder are just much more sensitive to any kind of challenge to their circadian system – the change to daylight savings time or jet lag, for example, and have much more difficulty resetting the body’s clock when it’s been challenged. That’s why it’s crucial for their sleep to be regular, at the same time each night and consistent.”
Interested in circadian rhythms, I sought out private psychiatrist Dr. Robert C. Bransfield, MD, DFAPA, PC in Middletown, NJ.

Dr. Bransfield said, “Greater amounts of light during the spring and early summer, working on computers at night, large screen TV sets and household lighting increase the light exposure to our retina and disrupts the circadian rhythm. Improving sleep can reduce the risk of a manic episode.”

This only drove home the importance of sleep, but it has been difficult, especially in times of hypomania. With each passing year though I became more vigilant , after all the dreaded “episode zone” and hospital are two places I have not enjoyed visiting.

These are some of my sleep wellness tips.

Wendy’s Sleep Tips:

  1. Try for 8-9 hours a night.The longer, the better especially if you are manic.
  2. Turn off cell phone ringer. I do use mine for alarms, but keep it silent for calls.
  3. Read rather than watch TV to fall asleep. This helps me fall asleep faster and avoids the bad habit of watching TV in the bedroom.
  4. Sleep with white or background noise. Besides the fantastic white noise machines that I swear by (on-line around $50.00) they also have free white noise apps. Air-conditioners and fans work like a charm too.
  5. Maintain consistent daily routine and sleep schedules. Aim to sleep the same hours each night, and keep your schedule steady. Although this is a struggle during times of hypomania, keep at it.
  6. Get the temperature right. If you’re too hot or too cold, you will likely flip around or have to get up to adjust the temperature.
  7. Take seasonal precautions, when necessary. During times of the year such as change of seasons, fall and spring especially, my doctor changes one medication to help me sleep. If this is your pattern, make an appointment early.
  8. Keep pets out of your bed. Of course we love them but it’s not okay if Fido or Tigger interrupt our sleep. I constantly ask myself, is it more important that my cat is happy and comfortable or that I am healthy? Resist the urge, I know it’s hard.

Remember, sleep is the other half of our medication. We are not talking counting sheep and sweet dreams, this is about our mood stabilization and staying out of the hospital. Remove any obstacles or distractions and make a pact to prioritize your wellness.

This just may one of the few advantages to having bipolar disorder. Who doesn’t love to sleep? So pull up the covers, my fellow bipolarians, tuck yourselves in and stay well!

Related Online CEU Courses:

Bipolar Disorder in Adults is a 1-hour online CEU course that provides a brief overview of the signs and symptoms, diagnostic considerations and treatment options for BPD in adults.

Bipolar Disorder in Children and Adolescents is a 1-hour online continuing education (CE/CEU) course that discusses bipolar disorder in children and teens, including signs and symptoms, differences between child/adolescent and adult BPD, diagnostic types, medications for BPD, and other therapies.

Treating Bipolar Disorder is a 6-hour CEU course that presents a powerful approach for helping people manage bipolar illness and protect against the recurrence of manic or depressive episodes.

Professional Development Resources is approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. Professional Development Resources maintains responsibility for all programs and content. Professional Development Resources is also approved by the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (CDR); the California Board of Behavioral Sciences; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board; the South Carolina Board of Professional Counselors & MFTs; and by theTexas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.


Cognitive Behavioral Therapy Effective for Bipolar Disorder


Cognitive Behavioral Therapy Effective for Bipolar DisorderWhen someone begins treatment for bipolar disorder, I always recommend therapy along with medication because we know from studies that the combination of the two treatments works better than either alone.

However, most people think about psychotherapy (talk-therapy) when the word therapy is mentioned. That is not a bad thing. Psychotherapy has helped many people with and without bipolar disorder lead fuller, happier lives.

But another option that is effective for many people is cognitive behavioral therapy. This therapy has only been applied to bipolar disorder in the last decade, but it has been used to treat depression even longer. Studies on its effectiveness in bipolar disorder are preliminary, but so far the evidence suggests it is effective.

What is Cognitive Behavioral Therapy?

Cognitive behavioral therapy is different than traditional therapy in that it is short-term and doesn’t involve delving into historic issues. Cognitive behavioral therapy is about the here and now and is about giving you tools to deal with the symptoms of bipolar disorder that you are experiencing today.

Cognitive behavioral therapy is an analytical process that encourages people to look at their behavior, feelings, and motivations to learn what triggers these situations and what can be done to handle them.

For example, in cognitive behavioral therapy:

  • The patient is asked to explore their distorted thinking such as “I am god” when manic or “I am worthless” when depressed.
  • Patients are encouraged to develop interpersonal routines such as sleeping and waking at the same time each day.
  • Patients work to understand the warning signs of oncoming mood episodes and learn how to cope with these symptoms to avoid episodes where possible (relapse prevention).
  • Patients are aided in exploring what triggers episodes or specific emotions.

Cognitive behavioral therapy may be delivered one-on-one or in groups.

For Whom Does Cognitive Behavioral Therapy Work?

It is my belief that anyone can benefit from cognitive behavioral therapy in some way; however, statistically, people with fewer than six mood episodes have been shown to have greater success with this therapy. Also, people who are in the midst of a crisis—either mania or depression—may not be in a place emotionally or intellectually to optimally benefit from cognitive behavioral therapy. Some degree of stability should be attained before attempting this therapy (medication and traditional psychotherapy may help achieve this).

It is recommended that specialists in cognitive behavioral therapy deliver the treatment for greatest success. If therapy is not available in your area, workbooks are available to walk you through the therapy although this likely won’t be as beneficial as a live therapist (and likely won’t be bipolar-specific).

Cognitive Behavioral Therapy Is About Tools

Cognitive behavioral therapy is not a magic bullet for mental illness but it is an assortment of tools that can help you battle the illness every day. It helps you deal with the symptoms that may linger in spite of treatment with medication or while searching for the right medication.

Find out more about cognitive behavioral therapy from Simon Fraser University’s Core Information Document on Cognitive Behavioral Therapy or visiting Healthline’s page on cognitive behavioral therapy.

Source: http://www.healthline.com/health-blogs/bipolar-bites/cognitive-behavioral-therapy-effective-bipolar-disorder

Related Continuing Education Courses:


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