Do Seasonal Changes Cause More Frequent Episodes of Bipolar Disorder?

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Winter is the coldest seasons of the year. With temperatures tanking well below zero, winter is a period of less outdoor activities and less exposure to sunlight in contrast to spring and summer. Both seasonal changes from fall to winter and from winter to spring may affect your circadian rhythm and can be a significant factor in triggering depressive episodes in people with bipolar disorder. Even in healthy individuals, these seasonal changes may also trigger feeling of sadness called SAD (seasonal affective disorder) during the winter months.

Originally called manic depression, bipolar disorder (BD) is a mental illness that has been the focus of experts. It’s unlikely that BD will get less attention because it’s the 6th leading cause of disability worldwide. Although the underlying cause of the disorder is not fully understood, there is likely contribution from genes, stressors and circadian variations. This article delves into effects of seasonal changes on mood and how you can manage through these difficult periods.

As the name suggests, bipolar disorder is a two-dimensional condition. Bipolar disorder is essentially a combination of two disorders, namely depression and mania. People with bipolar disorder experience dramatic and unpredictable alternating periods of extreme highs (manic episodes) and extreme lows (depressive episodes). Both extreme states are dangerous because during the excited mood, they are likely to take part in risky behaviours and activities, and during the lows, there is high occurrence of suicidal thoughts.

Quick Facts About Bipolar Disorder:

• Affects approximately 1-3% of the global population;

• It’s the 6th leading cause of disability worldwide;

• About 2.8% of US adults aged 18 or older have BD in a given year;

• Similar prevalence among men and women;

• About 4.4% of US adults will experience BD at some point in their lives.

Bipolar disorder usually begins to occur in late adolescence and early adulthood. Although experts believe the age of onset can vary. On the average, most people begin to experience symptoms at the age of twenty-five. Occasionally, children may also experience this disorder.

What Causes Bipolar disorder?

Science is yet to uncover the exact cause of bipolar disorder (BD). Researchers say it’s a complex interaction of multiple factors. Genetics, the brain’s structure, life events and environment are the most-investigated risk factors.

Genetics: Bipolar disorder tends to run in families. Your chance of experiencing the disorder increases if you have a first-degree (parents or siblings) relative with BD. Twin studies have established a high heritability of bipolar disorder, according to the American Journal of Psychiatry. In fact, the concordance rate, that is the probability that a twin will both exhibit BD, is between 60-80%. Despite this strong genetic correlation, most clinicians say the incidence of bipolar disorder among multiple family members over several generations is uncommon. This means that there are other factors that contribute to the development of this disease.

Brain: Investigators have proposed two possible links between bipolar disorder and the brain. Growing evidence associates the condition with altered brain structure. A 2021 study of 1232 individuals found an association between structural brain changes and mania episodes.

Also, people who have bipolar disorder are thought to have an imbalance in their brain’s chemicals. It’s thought that low and high levels of norepinephrine (NE) may trigger depression and mania, respectively.

Is There A Link Between Bipolar Disorder And Seasons?

This Healthline article summarizes the effect of seasons on bipolar depression. In addition, here’s what research says:

Mania and Seasons: In a study that included 730 patients, admission rates for mania increased during periods of maximum sunlight exposure. There is a strong link between hours of sunshine and episodes of mania.

A systematic review of 51 literatures found that manic episodes peak during the spring and summer. Thus, exposure to sunlight is an important clinical parameter during treatment.

Depression and Seasons: Conversely, more hospital admission rates are observed during early winter. Scientists associate a shortage of sunlight in fall and winter with depression. A form of depression influenced by seasons is called seasonal affective disorder (SAD).

It’s not clear how seasons affect bipolar disorders. But experts believe seasons alter the sleep-wake cycle and interfere with day-to-day activity. Changes in sleep routine may trigger mood changes. It also alters the activity of mood-regulating hormones.

What Are The Symptoms Of Bipolar Disorder?

Symptoms vary from person to person. Here is a list of both depressive and manic symptoms

Depressive symptoms:

• Constant sadness and anxiety;

• A feeling of restlessness and irritability;

• Loss of interest in things you like to do;

• Low energy and fatigue;

• Feeling hopeless;

• Altered sleep patterns;

• Headache and digestive problems.

Manic Symptoms:

• Physical agitation;

• Aggressive behavior;

• Increased sex drive;

• Increased energy;

• Euphoria.

What are the treatment options for bipolar disorder?

Bipolar disorder has no permanent cure. However, some treatment and management options are available. The aim of treatment is to reduce the severity and frequency of manic and depressive episodes.

Antipsychotics: Antipsychotics are used to treat psychotic symptoms of bipolar disorder, such as delusions and hallucinations. One commonly prescribed drug is latuda (lurasidone HCl). Adults and children taking latuda alone reported 44% and 37% reduction in their depressive symptoms, respectively. Other antipsycotics for bipolar disorder include: Olanzapine, Risperidone, Abilify.

Lithium: Lithium is used to treat both manic and depressive symptoms of bipolar disorder. Lithium carbonate is the tablet form, while the liquid form is lithium citrate. Adults and children over 12 years can take it.

Anticonvulsant: Antiepileptic drugs like Tegretol, valproate and Lamictal are commonly used to treat bipolar disorders. However, the use of anticonvulsants as mood stabilizers in children remains sketchy.

Are there non-drug treatments for Bipolar disorders?

Scientists have probed the efficacy of non-drug measures in bipolar disorder. Still, it’s not clear if these interventions are effective alone. Mostly, the non-drug measures are to be used in conjunction with prescription medications.

Psychotherapy is the mainstay of non-drug treatments. About 75% of people who entered psychotherapy responded positively, according to the American Psychological Association (APA). The following are some of the commonly used psychotherapy methods.

Cognitive-Behavioral Therapy (CBT): CBT proposes an association between what you think about your experience and how you react. What it does is to identify and change your negative or distorted views about your experience.

CBT is found to be helpful in depression and psychosis. Some research has found that CBT helps prevent relapse of depressive and manic episodes when combined with medication.

Psychoeducation: The goal of psychoeducation is to educate people about their own mental health. It teaches people to be conscious of their mood and how to manage stress for example, reading articles like this. However, psychoeducation is most helpful when a patient is still healthy.

Peer Support: This intervention relies on the experience of other people experiencing bipolar disorder. The wisdom behind peer support groups is that bipolar patients enjoy social interaction and less stigma. An article published by the lancet journals found peer support groups to be as effective as psychoeducation in preventing relapse.

Other non-drug measures include: healthy diet, exercise, yoga and mindfulness, light therapy during the winter season, stress management, avoidance of known triggers.

In conclusion, bipolar disorder is a mental health illness without an established known cause or permanent cure. Seasonal changes affect episodes of depression and mania, with more depressive moods occurring in winter months and more manic episodes during spring and summer. Prescription medications, non-drug treatment or a combination are both effective in management of episodes. The disease affects men and women equally. It is important to talk to your doctor about your symptoms. After proper assessment the doctor will recommend the best therapy options for you.

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