Studies indicate that individuals with bipolar disorder experience an increase in manic episodes and suicide rates during spring, which is commonly referred to as "spring mania." To address this phenomenon, one woman with bipolar disorder shares how she prepares for springtime each year.
Bipolar Disorder and Seasonal Affective Disorder (SAD)
Sandra Rosenthal, PhD, experienced racing thoughts, sleepless nights, unbridled energy, and emotional turmoil several decades ago, which ultimately led to an episode of psychosis, a hospitalization, and, after five years, a diagnosis of bipolar disorder. This mental health condition causes extreme shifts in mood, alternating between unusually elated, energetic, or irritable moods (mania or hypomania) and deeply sad and hopeless moods (depression).
Rosenthal later realized that her symptoms were worse in the spring, when she would feel a burst of energy or mania that led to sleeplessness. She had seasonal affective disorder (SAD), which means that someone's mood disorder follows a seasonal pattern. As many as 25 percent of people with bipolar disorder have symptoms that follow a seasonal pattern. Most commonly, it manifests as an increased risk of depressive episodes in the winter and mania or hypomania in the spring and summer.
Spring Mania and Its Risks
Spring mania can be dangerous or even life-threatening, as manic episodes can lead people to do risky or reckless things they wouldn’t ordinarily do, such as spending money wildly, engaging in sexual activity with people they barely know, or walking into traffic. The rates of mania and suicide tend to be highest during the spring months, according to a report published in March 2018 in Psychiatry Investigations.
Severity and Duration
The length and severity of spring mania varies from person to person. In Rosenthal’s experience, the heightened arousal is normally at its peak for at least one week but can persist for months. It is important to recognize and manage the symptoms of spring mania to prevent potential harm to oneself and others.
Expert Insights
Jonathan E. Alpert, MD, PhD, who is the Dorothy and Marty Silverman Chair in psychiatry and the chair of the department of psychiatry and behavioral sciences at Albert Einstein College of Medicine in the Bronx, New York, warns about the dangers of spring mania. He advises those experiencing bipolar disorder and SAD to seek professional help and to be aware of their symptoms, particularly during the spring months.
Possible Causes of Spring Mania in Bipolar Disorder
Disrupted Circadian Rhythms
One hypothesis for the cause of spring mania in people with bipolar disorder is disrupted circadian rhythms. Harvard University experts suggest that individuals with bipolar disorder have an abnormal body clock that operates on a 24-hour cycle. The changes in daylight that occur as winter transitions to spring may exacerbate this issue. According to a review published in Neuroscience & Behavioral Reviews, the increase in daylight at winter’s end may push people with bipolar disorder to their limits. The study hypothesizes that it is not just longer days that cause spring mania, but how quickly the change occurs.
Suprachiasmatic Nuclei
The suprachiasmatic nuclei (SCN) may be another factor contributing to spring mania. The SCN is a region of the brain that controls circadian rhythms. According to a review published in Neuroscience & Behavioral Reviews, the SCN may be less genetically capable of accommodating rapid changes in darkness and daylight among people with bipolar disorder.
Melatonin Levels
Melatonin is a hormone produced by the body in response to darkness, which helps regulate sleep. Some researchers believe that increased sensitivity to light among people with bipolar disorder may lead to lower levels of melatonin production. According to research published in the Journal of Psychiatric Practice, the lengthening of daylight in the spring and summer may disrupt sleep and circadian rhythms, potentially trigering mania.
9 Strategies to Manage Spring Mania Symptoms
For people with bipolar disorder, spring may bring an increased risk of mania. However, there are ways to manage this risk and reduce the severity of symptoms.
Here are some strategies recommended by experts:
1.Stick to your medication plan
Bipolar medications are crucial for managing symptoms and preventing mood episodes. Always follow your doctor's guidance and never make changes to your medication without consulting them.
2.Consider trying interpersonal and social rhythm therapy
This form of talk therapy helps individuals with bipolar disorder understand and manage their biological and social rhythms, such as sleep and meal times, and can help them detect and prevent mood changes.
3.Set a consistent daily routine
Consistency is key for people with bipolar disorder. Establishing a routine for meals, exercise, socializing, and sleep can help keep mood stable and reduce the risk of manic and depressive episodes.
4.Chart your moods
Journaling and smartphone apps can help individuals monitor their moods and detect patterns that may signal an impending manic episode.
5.Limit your light exposure
People with bipolar disorder are more sensitive to light, and adjusting light exposure can help regulate circadian rhythms and stabilize mood. Heavy-duty blackout shades can be useful during spring and summer when daylight is longer.
6.Make your bedroom a "no screens" zone
Good sleep hygiene is critical for people with bipolar disorder, and avoiding electronic screens in the bedroom can help promote restful sleep.
7.Avoid all-nighters
Staying up all night can worsen symptoms of mania, and practicing mindfulness meditation can help calm the mind and promote sleep.
8.Steer clear of caffeine and alcohol
Stimulants like caffeine can trigger manic symptoms, and alcohol can worsen bipolar symptoms.
9.Maintain regular communication with your healthcare provider
Regular appointments with your doctor can help ensure that your treatment plan is effective and adjusted as needed.