Bipolar & The Body Clock

For some people with bipolar just one night without sleep is sufficient to trigger mania. Whilst this represents a particular sensitivity to disrupted sleep, we know that many people with bipolar do react to changes in daily routine and sleep patterns. The standard activities of life for some people like taking a vacation, moving house or switching shift patterns can all spell a major disruption for the body clock of the person with bipolar, and with that, the increased risk of an episode.

There is a delicate and somewhat complex relationship between wellbeing and sleep. Our natural circadian rhythm is structured around a 24 hour cycle of being asleep and being awake. During this period, and in response to light changes, the body will change temperature and vary its endocrine and hormone production. The type of food we eat, the things we drink and the time we consume them are all activities that support or disrupt the body clock. Add to this work, family life, lifestyle, stress, age and health issues and the situation can be even more disruptive.

The body clock is genetically programmed. There is some speculation that this is disrupted in people with bipolar and that lithium may affect the genes that regulate the body clock. It is certainly the case that up to 30 per cent of people with bipolar find themselves affected by seasonal changes such as depression in winter or with hypomania or mania peaking in spring when daylight hours increase (Hallam et al., 2006).

Adding structure to the day may help to reduce risk and many people with seasonal disorder find the use of light therapy helpful.

Sources:

Berk, L., Berk, M., Castle, D., Lauder, S (2009) Living With Bipolar: a practical guide for those with the disorder, their family and friends. Vermilion.