Bipolar disorder can have a very significant impact on the lives of individuals who live with it, and while there are several effective medications that treat mania symptoms, as a functional medicine doctor and integrative psychiatrist I am curious about adjunctive treatments that may allow for maximizing the periods of stability and reducing the need for higher doses of medications. Lifestyle factors such as sleep, health diet, a regular schedule, avoidance of substances and care for overall physical health have a major role in the treatment of bipolar disorder and learning how to stay well. Blue light blocking lenses may be one additional tool in the natural treatment of bipolar disorder.
Recent research shows that blue light-blocking (BB) glasses can be effective in relieving the symptoms of mania in patients with bipolar disorder (Henriksen, Skrede, Fasmer, Schoeyen, Leskauskaite, Bjørke-Bertheussen, Assmus, Hmare, Grønli & Lund, 2016). Most current treatment options rely mainly on anti-psychotic and mood-stabilizing agents—but these methods can be slow to take effect, which has led scientists and psychiatrists to propose that there is probably a better way to address the physiological causes of manic episodes in patients. According to a recent case report and research study, blue light-blocking glasses are a promising new treatment option that seems to produce quick, effective results to relieve bipolar manic symptoms.
Our eyes contain blue light-sensitive photoreceptors that tell our brains the difference between day and night. This feature controls the body’s circadian rhythm, which influences important bodily functions such as sleep/wake cycles, body temperature, and hormone release—for example, the brain’s perception of “night” often corresponds with a release of melatonin, which makes you sleepy. Many conditions—including insomnia, depression, seasonal affective disorder, and bipolar disorder—have been linked to abnormal circadian rhythms (Circadian Rhythms Fact Sheet, 2012). Previous research has shown that dark therapy (DT), in which the patient spends 14 hours at night in total darkness, while effective, can cause unwanted side effects due to the dramatic sensory deprivation, and as a result many patients choose not to adhere to the treatment. That’s where BB glasses come in: they are orange-tinted or clear glasses that block blue light from the eye’s photoreceptors, which makes it possible to regulate the patient’s circadian rhythm without the need to live in darkness for 14 hours a day.
BB glasses were first tested to treat mania in a 2014 report from Norway, and showed promising results (Henriksen, Skrede, Fasmer, Hamre, Grønli & Lund, 2014). A 58-year-old Caucasian male with bipolar I was hospitalized during a manic episode. He received medication treatment, plus a two-week blue light blocking trial that consisted of seven days in clear (non-light blocking) glasses, one day without glasses, and six days with orange-tinted blue light blocking glasses. No change in manic symptoms was observed during the first seven days, but the introduction of the blue light blocking glasses corresponded with a marked decrease in manic symptoms—including an increase in overall sleep time, better sleep quality, and an increase in regularity of sleep intervals. The patient was released from the hospital 20 days earlier than the average length of his three previous instances of being hospitalized for manic episodes.
Four years later, the same core research team published a three-year study on the subject, with similarly positive results. In this trial, 23 patients hospitalized for bipolar mania were recruited from five clinics around Norway. In addition to their regular treatment, 12 patients were assigned to wear blue light blocking glasses and 11 patients were assigned to wear placebo (clear) glasses from 6 p.m. to 8 a.m. for 7 days. Their activity was monitored by actigraphy and daily assessment according to the Young Mania Rating Scale (YMRS), a point-based evaluation in which more points corresponds with increased manic symptoms. After only three days, the difference in YMRS between the two groups became pronounced, and only grew stronger. After seven days, the mean drop in YMRS score for the BB group was 14.1, compared with only 1.7 in the placebo group (Henriksen et al., 2016). These results indicate that light—specifically blue light—is a significant factor in sustaining manic episodes in bipolar patients, and furthermore that BB appears to be an effective addition to medication treatment in mania.
These research studies show that blue light and the circadian rhythm play an important role in the physiology of patients experiencing mania and furthermore that “BB glasses, used in accordance with our protocol, are a safe and efficient intervention for bipolar mania that should be utilized in treatment efforts” (Henriksen et al., 2016).