“There are limited effective treatments for the depressive phase of bipolar disorder,” said Dorothy Sit, M.D., assistant professor of psychiatry and the study’s first author. “While there are treatments that are effective for mania, the major problem is the depression, which can linger so long that it never really goes away.”

In this study, women with bipolar depression were given light boxes and instructed on how to use them at home. The women used the light boxes daily for two-week stretches of 15, 30 and 45 minutes. Some patients responded extremely well to the light therapy, and their symptoms of depression disappeared. The responders to light therapy stayed on the light therapy for an additional three or four months. Four patients received morning light, and five used their light boxes at midday. Participants also continued to take their prescribed medications throughout the study period.

“Three of the women who received morning light initially developed what we call a mixed state, with symptoms of depression and mania that occur all at once — racing thoughts, irritability, sleeplessness, anxiety and low mood,” said Dr. Sit. “But when another group began with midday light therapy, we found a much more stable response.”

Of the nine women treated, six achieved some degree of response, with several reaching full recovery from depressive symptoms. While most attained their best recovery with midday light, a few responded more fully to a final adjustment to morning light. “People with bipolar disorder are exquisitely sensitive to morning light, so this profound effect of morning treatment leading to mixed states is very informative and forces us to ask more questions,” said Dr. Sit. “Did we introduce light too early and disrupt circadian rhythms and sleep patterns?”

People with bipolar disorder are known to be sensitive to changes in outdoor ambient light and to seasonal changes. Researchers are asking whether the risk of suicide in patients with bipolar disorder could be linked to changes in light exposure.

“In our study, 44 percent of patients were full responders, and 22 percent were partial responders,” Dr. Sit and her colleagues write. “Light therapy, therefore, is an attractive and possibly effective augmentation strategy to improve the likelihood of full-treatment response.”

Optimal response was observed with midday light therapy for 45 or 60 minutes daily, noted Dr. Sit.

Other study authors are Katherine L. Wisner, M.D., Barbara H. Hanusa, Ph.D., and Stacy D. Stull, M.S., all of the Women’s Behavioral HealthCARE program at Western Psychiatric Institute and Clinic; and Michael Terman, Ph.D., Columbia University. Article: doi/full/10.1111/j.1399-5618.2007.00451.x

Researchers report funding from the Stanley Foundation, the University of Pittsburgh School of Medicine, National Institute of Mental Health, U.S. Department of Health and Human Services, Pfizer Inc., GlaxoSmithKline and the National Institute of Neurological Disorders and Stroke.

John Carroll University students sip hot chocolate and roast s’mores over a fire pit outside Grasselli Library the night before exams begin. Earlier that evening, a “blessing of the brains” will occur at a Mass.

Final exams at many of Ohio’s public and private universities are given over the next two weeks. A mix of activities, including games, crafts and music, are offered by student affairs staff, while those in counseling and wellness centers provide stress- and anxiety-reducing advice and programs, including meditation and petting dogs provided by the college.

The goal is to get students to relax and to keep their lives balanced.

“During finals you can feel the stress — it becomes kind of palpable,” said Lori Morgan Flood, an assistant dean and director of the Center for Leadership in Health Promotion at Oberlin.

There has been an increasing emphasis on wellness over the last five years, said Flood, who has been at the college 13 years.

“I am not sure if it is that the students are more able to acknowledge their stress level and ask for help or the nature of the college experience,” she said. “Students really take their education seriously and get really driven and forget to sleep, eat well and hydrate. We help them remember what is important.”

Melanie Scanlon, assistant director for student activities and leadership at Case Western Reserve University, agreed.

“We realize finals can be a stressful time,” Scanlon said. “We want to make sure students are mentally healthy and take time for breaks and to eat. They need to take care of themselves.”

Kelsey Gilbert, 20, an education, French and international studies major from The Dalles, Ore., decorated a picture frame with fellow juniors Sarah Lukowski and Andrew Jorgensen, both 20.

“Some people bring their work with them and get food and then study,” she said. “It’s nice to just get out of the library and relax a little.”

Sophomore Molly Francis, 19, sat down with friends to eat. A mechanical engineering major facing five finals, she was feeling the stress.

“I kind of want to claw my eyes out,” she said. “It’s really crazy, but I still wanted to come to this because it’s a fun thing to do that doesn’t involve finals.”

CWRU, like many universities, offers breakfast at midnight in dining halls, where faculty, staff and administrators serve food from 11 p.m. to 1 a.m. the night before exams begin.

Some programs became so popular during finals week that they now are offered year-round.

For instance, the art therapy program at Oberlin allows students to release stress by painting, drawing and doing other art projects. Students at Baldwin-Wallace College use the Mind Spa, which includes relaxation CDs, a chair massage and a light box to treat Seasonal Affective Disorder.

Universities are always seeking new activities for finals week, officials said.

Oberlin’s five-minute dance marathon was introduced this fall during midterms, Flood said. Since most students study in the library, there are music breaks at 5 and 11 p.m.

When a song, chosen by students in an online poll, played from an iPod plugged into speakers, more than 100 students there stood up and danced, she said.

“There are limited effective treatments for the depressive phase of bipolar disorder,” said Dorothy Sit, M.D., assistant professor of psychiatry and the study’s first author. “While there are treatments that are effective for mania, the major problem is the depression, which can linger so long that it never really goes away.”

In this study, women with bipolar depression were given light boxes and instructed on how to use them at home. The women used the light boxes daily for two-week stretches of 15, 30 and 45 minutes. Some patients responded extremely well to the light therapy, and their symptoms of depression disappeared. The responders to light therapy stayed on the light therapy for an additional three or four months. Four patients received morning light, and five used their light boxes at midday. Participants also continued to take their prescribed medications throughout the study period.

“Three of the women who received morning light initially developed what we call a mixed state, with symptoms of depression and mania that occur all at once — racing thoughts, irritability, sleeplessness, anxiety and low mood,” said Dr. Sit. “But when another group began with midday light therapy, we found a much more stable response.”

Of the nine women treated, six achieved some degree of response, with several reaching full recovery from depressive symptoms. While most attained their best recovery with midday light, a few responded more fully to a final adjustment to morning light. “People with bipolar disorder are exquisitely sensitive to morning light, so this profound effect of morning treatment leading to mixed states is very informative and forces us to ask more questions,” said Dr. Sit. “Did we introduce light too early and disrupt circadian rhythms and sleep patterns?”

People with bipolar disorder are known to be sensitive to changes in outdoor ambient light and to seasonal changes. Researchers are asking whether the risk of suicide in patients with bipolar disorder could be linked to changes in light exposure.

“In our study, 44 percent of patients were full responders, and 22 percent were partial responders,” Dr. Sit and her colleagues write. “Light therapy, therefore, is an attractive and possibly effective augmentation strategy to improve the likelihood of full-treatment response.”

Optimal response was observed with midday light therapy for 45 or 60 minutes daily, noted Dr. Sit.

Other study authors are Katherine L. Wisner, M.D., Barbara H. Hanusa, Ph.D., and Stacy D. Stull, M.S., all of the Women’s Behavioral HealthCARE program at Western Psychiatric Institute and Clinic; and Michael Terman, Ph.D., Columbia University. Article: doi/full/10.1111/j.1399-5618.2007.00451.x

Researchers report funding from the Stanley Foundation, the University of Pittsburgh School of Medicine, National Institute of Mental Health, U.S. Department of Health and Human Services, Pfizer Inc., GlaxoSmithKline and the National Institute of Neurological Disorders and Stroke.

Winter Blues, Revised Edition: Everything You Need to Know to Beat Seasonal Affective Disorder by Norman E. Rosenthal

Snooze… or Lose!: 10 “No-War” Ways to Improve Your Teen’s Sleep Habits by M.D. Dr. Helene A. Emsellem

Seasonal Affective Disorder and Beyond: Light Treatment for Sad and Non-Sad Conditions by Raymond W. Lam

A Clinician’s Guide to Using Light Therapy (Cambridge Clinical Guides) by¬†Raymond W. Lam and Edwin M. Tam

The Bipolar Child: The Definitive and Reassuring Guide to Childhood’s Most Misunderstood Disorder by Demitri Papolos M.D. and Janice Papolos

Winter Blues: Seasonal Affective Disorder: What It Is and How to Overcome It by Norman E. Rosenthal

Seasonal Affective Disorder For Dummies by Laura L. Smith and Charles H. Elliott

The Seasonal Affective Disorder Association:

http://www.sada.org.uk/

Daily Strength – Seasonal Affective Disorder Support Group:

http://www.dailystrength.org/c/Seasonal-Affective-Disorder/support-group

Mental Health America:

http://www.nmha.org/go/sad

Facebook group for Seasonal Affective Disorder:

http://www.facebook.com/pages/Seasonal-affective-disorder/106176212746152

The top 5 things to do:

1. Understand the problem РYou need to recognize that SAD is a real problem and affliction.  Someone who suffers from SAD may look okay but can be having major difficulties in functioning.  Your relative or friend with SAD needs more light and can benefit from your support and understanding. Once you understand the mood and energy problems of SAD, you will be able to handle them better.

2. Just be there РJust your presence and company can do a SAD sufferer good.  Even though they may seem withdrawn and unfriendly, they appreciate the company. Many like the people being around, but you need to remember that you will probably not get a lot out of them.

3. Encourage the seasonal person РRemind them that this phase will pass, and they will feel better again.  Remind them of some good times you have had, they may simply have forgotten.  Because you understand that it is a seasonal problem, it can help just to remind them that it will pass.

4. Help with simple things РJust getting out of bed can be huge step.  But asking them what you can do to help is greatly appreciated.  It can be getting the kids ready and off to school, making breakfast or lunch or even dinner, getting groceries, household chores, doing the laundry or even paying the bills.  Some things are simple and will take a couple of minutes, but it can make a huge difference.

5. Try to understand the seasonal person when they are in the other phase Р It may come as a shock when the sufferer all of a sudden is  happy and successful.  But you need to understand that you need to be supportive either way.  Sufferers can become a bit wired from the sudden abundance of sunlight.  Many can  show  poor judgment or impulsiveness.  If you see this happening you may want to speak with your doctor.

Eyestrain, jitteriness, headache, agitation, nausea, vomiting, irritability, fatigue, dry mouth, sleep problems and mania.

Side effects are usually mild, if they do occur. After a few days of light therapy, they tend to go away on their own. ¬†The easiest way to manage these problems by reducing treatment time, moving farther from your light box, taking breaks during long sessions, or changing the time of day you use light therapy. But talk to your doctor for additional help and advice, or if your side effects don’t go away or get worse.

Should You Not Use Light Therapy?
There are some light boxes don’t filter out or shield harmful ultraviolet (UV) light. UV light can cause skin and eye damage, just like in a tanning bed. Individuals taking certain medications such as Lithium, tricyclic antidepressants, and neuroleptic and individuals with¬†conditions¬†such as diabetes or retinal degeneration should be monitored by an ophthalmologist. ¬†Consulting your doctor first if you are taking medications that react with sunlight, your skins is sensitive to light or if you have an eye condition that makes your eyes vulnerable to light damage.

Concerns for Bipolar Disorder, Severe Depression
Light therapy, like antidepressant medications, occasionally will cause someone to switch into a manic state. Be sure to talk to your doctor or mental health provider before starting light therapy or at any time during treatment if your condition gets worse.

Reference to Mayo Clinic http://www.mayoclinic.com/health/light-therapy/MY00195