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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by manowar on January 25, 2002, at 17:47:18
I ran across this old article from Medline below (very short). It states that light therapy can be beneficial for Cyclothymia. I've never heard this before. At the end of the article it also claims that, "Bright-light treatment is also effective against depressive disorders in non-seasonal depressions."
Again, I've only heard about the efficacy of bright light treatment for folks that have Seasonal Affective Disorder (SAD).
Any comments would be appreciated.
--Tim
[Effectiveness of bright light therapy in cyclothymic axis syndromes--a cross-over study in comparison with partial sleep deprivation]
[Article in German]
Heim M.
Klinik fur Frauenpsychiatrie, Bezirkskrankenhauses fur Neurologie und Psychiatrie Arnsdorf bei Dresden.
In a preliminary crossover study, fifty patients with a cyclothymic axial syndrome were given bright-light treatment, while fifty other such patients were treated by means of partial sleep deprivation, 60% of the patients responded to bright-light treatment, as opposed to 50% of the patients partially deprived of sleep. The superior results of the bright-light treatment (Hamilton Depression Scale) are confirmed on the Nurses' Observation Scale for Inpatient Evaluation and the Profile of Mood States. Comparatively young patients with a not so extremely marked depression show the best response rates. Bright-light treatment is also effective against depressive disorders in non-seasonal depressions.
Here's the link:
http://www.mentalhealth.com/dis-rs/frs-md03.html
Posted by IsoM on January 25, 2002, at 21:03:34
In reply to Is light therapy effective for Cyclothymia?, posted by manowar on January 25, 2002, at 17:47:18
Tim, I've read & heard the same thing about sunlight affecting moods too. I do believe there's something to it.
My experiences with a light box doesn't show a big benefit but I have trouble sitting under the light for 1/2 hour when I first wake up. I need to get busy doing something or I'll just want to go back to bed. Also, the amount of light (10,000 lux) is equivalent to a overcast day, bright enough apparently to benefit a person, but not anything like a sunny day.
A friend I have who is seriously down in winter found something interesting. One summer, she spent almost all her time outdoors, unlike what she usually does. She was putting in a large garden, renovating her yard. When that winter came, it was the first time she wasn't seriously depressed. She wondered why & tried to think what might've been different. the only thing changed was the loads of sun during the summer. Her own hypothesis was all the sun changed her brain chemistry enough to last her though the winter. My plan this summer is to do the same & see what the results are. Generally I garden in the cool of the day as it gets darker. Not this summer!
>
> I ran across this old article from Medline below (very short). It states that light therapy can be beneficial for Cyclothymia. I've never heard this before. At the end of the article it also claims that, "Bright-light treatment is also effective against depressive disorders in non-seasonal depressions."
Posted by Ritch on January 30, 2002, at 0:26:01
In reply to Is light therapy effective for Cyclothymia?, posted by manowar on January 25, 2002, at 17:47:18
> I ran across this old article from Medline below (very short). It states that light therapy can be beneficial for Cyclothymia. I've never heard this before. At the end of the article it also claims that, "Bright-light treatment is also effective against depressive disorders in non-seasonal depressions."
>
> Again, I've only heard about the efficacy of bright light treatment for folks that have Seasonal Affective Disorder (SAD).
>
> Any comments would be appreciated.
>
> --Tim
>
> [Effectiveness of bright light therapy in cyclothymic axis syndromes--a cross-over study in comparison with partial sleep deprivation]
>
> [Article in German]
>
> Heim M.
>
> Klinik fur Frauenpsychiatrie, Bezirkskrankenhauses fur Neurologie und Psychiatrie Arnsdorf bei Dresden.
>
> In a preliminary crossover study, fifty patients with a cyclothymic axial syndrome were given bright-light treatment, while fifty other such patients were treated by means of partial sleep deprivation, 60% of the patients responded to bright-light treatment, as opposed to 50% of the patients partially deprived of sleep. The superior results of the bright-light treatment (Hamilton Depression Scale) are confirmed on the Nurses' Observation Scale for Inpatient Evaluation and the Profile of Mood States. Comparatively young patients with a not so extremely marked depression show the best response rates. Bright-light treatment is also effective against depressive disorders in non-seasonal depressions.
> Here's the link:
> http://www.mentalhealth.com/dis-rs/frs-md03.html
Hi,Interesting notion. Well, I have BP-II and my major depressions are seasonally synched. In fact I can predict with fair accuracy the entire year how I am going to feel. Major depressive, mixed state depression, bubbly hypomania, etc. Haven't done the light box stuff yet, but came close-Wellbutrin this latest episode. There is a theory that I have about my mood cycling troubles. I came up with it when I tried Adderall (a pstim) during a winter depressive episode. I had no depressive symptoms at all, but I got anxious (could have been SSRI withdrawal). I also didn't have *any* cycling (I wasn't taking anything but Adderall 5mg AM and Neurontin 100mg 3x daily).
The theory goes like this:
1) My mood cycling is caused by some neuro-endocrine disturbance that has a direct relation to the environment around me (time of year-amount of sunlight-heat, whatever).
2) IF I sleep soundly at nite I am more alert during the day-which results in an increased level of *contrast* between daytime brain activity and nightime sleeping.
3) Somehow, this is connected up with ADHD, in the sense that kids with ADHD are drowsy during the day and sleep lightly at night.
4) When I tried Adderall it *increased* the amount of brain *exercise* during the day and I felt *tired* at night and my sleep became more sound and more *regular*.
5) The increased *regularity* of the sleep/wake cycle had an *anti-cycling* effect.Maybe your idea about the light therapy for mood *cycling* has an anticycling effect for these type of reasons???
Anybody got any thoughts.....
Mitch
Posted by manowar on February 1, 2002, at 20:58:31
In reply to Re: Is light therapy effective for Cyclothymia? » manowar, posted by Ritch on January 30, 2002, at 0:26:01
> > I ran across this old article from Medline below (very short). It states that light therapy can be beneficial for Cyclothymia. I've never heard this before. At the end of the article it also claims that, "Bright-light treatment is also effective against depressive disorders in non-seasonal depressions."
> >
> > Again, I've only heard about the efficacy of bright light treatment for folks that have Seasonal Affective Disorder (SAD).
> >
> > Any comments would be appreciated.
> >
> > --Tim
> >
> > [Effectiveness of bright light therapy in cyclothymic axis syndromes--a cross-over study in comparison with partial sleep deprivation]
> >
> > [Article in German]
> >
> > Heim M.
> >
> > Klinik fur Frauenpsychiatrie, Bezirkskrankenhauses fur Neurologie und Psychiatrie Arnsdorf bei Dresden.
> >
> > In a preliminary crossover study, fifty patients with a cyclothymic axial syndrome were given bright-light treatment, while fifty other such patients were treated by means of partial sleep deprivation, 60% of the patients responded to bright-light treatment, as opposed to 50% of the patients partially deprived of sleep. The superior results of the bright-light treatment (Hamilton Depression Scale) are confirmed on the Nurses' Observation Scale for Inpatient Evaluation and the Profile of Mood States. Comparatively young patients with a not so extremely marked depression show the best response rates. Bright-light treatment is also effective against depressive disorders in non-seasonal depressions.
> > Here's the link:
> > http://www.mentalhealth.com/dis-rs/frs-md03.html
>
>
> Hi,
>
> Interesting notion. Well, I have BP-II and my major depressions are seasonally synched. In fact I can predict with fair accuracy the entire year how I am going to feel. Major depressive, mixed state depression, bubbly hypomania, etc. Haven't done the light box stuff yet, but came close-Wellbutrin this latest episode. There is a theory that I have about my mood cycling troubles. I came up with it when I tried Adderall (a pstim) during a winter depressive episode. I had no depressive symptoms at all, but I got anxious (could have been SSRI withdrawal). I also didn't have *any* cycling (I wasn't taking anything but Adderall 5mg AM and Neurontin 100mg 3x daily).
>
> The theory goes like this:
> 1) My mood cycling is caused by some neuro-endocrine disturbance that has a direct relation to the environment around me (time of year-amount of sunlight-heat, whatever).
> 2) IF I sleep soundly at nite I am more alert during the day-which results in an increased level of *contrast* between daytime brain activity and nightime sleeping.
> 3) Somehow, this is connected up with ADHD, in the sense that kids with ADHD are drowsy during the day and sleep lightly at night.
> 4) When I tried Adderall it *increased* the amount of brain *exercise* during the day and I felt *tired* at night and my sleep became more sound and more *regular*.
> 5) The increased *regularity* of the sleep/wake cycle had an *anti-cycling* effect.
>
> Maybe your idea about the light therapy for mood *cycling* has an anticycling effect for these type of reasons???
>
> Anybody got any thoughts.....
>
> MitchHi Mitch,
Man, I agree with your theory big time.
This is what I’ve found with my Cyclothymia/ADD (Inattentive/Deep Limbic):
I call it the ying/yang theory of depression and it goes like this:
It is VITAL that I sleep well and not for too long. When I’m depressed, I sleep too much, and I think I get too much REM sleep which researchers say causes depression.
I take Klonipin (1.5 mg in the evening) and now I’ve added Clonidine (2mg). The Klonipin is primarily for the mood swings, though as an added benefit it is also a great sleeping agent. Sometimes when I think I need it, I double the dose of Klonipin to 3 mg in the evening. I asked my doctor if he would try me on a higher dose of Klonipin; instead he started me on the Clonidine to augment the Klonipin last month. Man, I sleep sound! I’ll go to bed at 1:00 AM and get up at 7:50—ten minutes before my alarm goes off. I then make a pot of coffee and take Wellbutrin –150 mg, Modafinil-200 mg or Adrafinil 600 mg. Also, if I feel I need it, I also take a 54 mg of Concerta.So in a nutshell, the Klonipin/Clonidine combo is my Ying while the Wellbutrin/Adrafinil/ sometimes Concerta + Coffee is my Yang.
Now, I know this sounds crazy, but by God it seems that the huge contrast from day to night makes a BIG difference in my overall mood, and activity level.
I told my doctor about my theory, and surprisingly he didn’t shoot it down. It could very well be crap, because I don’t know much, but for me at least, my theory seems to hold true. And yes, I think lots of sunlight and exercise during the day also adds much to the equation.
--Tim
Posted by Ritch on February 1, 2002, at 22:40:34
In reply to The Ying-Yang theory of depression recovery » Ritch, posted by manowar on February 1, 2002, at 20:58:31
> > > I ran across this old article from Medline below (very short). It states that light therapy can be beneficial for Cyclothymia. I've never heard this before. At the end of the article it also claims that, "Bright-light treatment is also effective against depressive disorders in non-seasonal depressions."
> > >
> > > Again, I've only heard about the efficacy of bright light treatment for folks that have Seasonal Affective Disorder (SAD).
> > >
> > > Any comments would be appreciated.
> > >
> > > --Tim
> > >
> > > [Effectiveness of bright light therapy in cyclothymic axis syndromes--a cross-over study in comparison with partial sleep deprivation]
> > >
> > > [Article in German]
> > >
> > > Heim M.
> > >
> > > Klinik fur Frauenpsychiatrie, Bezirkskrankenhauses fur Neurologie und Psychiatrie Arnsdorf bei Dresden.
> > >
> > > In a preliminary crossover study, fifty patients with a cyclothymic axial syndrome were given bright-light treatment, while fifty other such patients were treated by means of partial sleep deprivation, 60% of the patients responded to bright-light treatment, as opposed to 50% of the patients partially deprived of sleep. The superior results of the bright-light treatment (Hamilton Depression Scale) are confirmed on the Nurses' Observation Scale for Inpatient Evaluation and the Profile of Mood States. Comparatively young patients with a not so extremely marked depression show the best response rates. Bright-light treatment is also effective against depressive disorders in non-seasonal depressions.
> > > Here's the link:
> > > http://www.mentalhealth.com/dis-rs/frs-md03.html
> >
> >
> > Hi,
> >
> > Interesting notion. Well, I have BP-II and my major depressions are seasonally synched. In fact I can predict with fair accuracy the entire year how I am going to feel. Major depressive, mixed state depression, bubbly hypomania, etc. Haven't done the light box stuff yet, but came close-Wellbutrin this latest episode. There is a theory that I have about my mood cycling troubles. I came up with it when I tried Adderall (a pstim) during a winter depressive episode. I had no depressive symptoms at all, but I got anxious (could have been SSRI withdrawal). I also didn't have *any* cycling (I wasn't taking anything but Adderall 5mg AM and Neurontin 100mg 3x daily).
> >
> > The theory goes like this:
> > 1) My mood cycling is caused by some neuro-endocrine disturbance that has a direct relation to the environment around me (time of year-amount of sunlight-heat, whatever).
> > 2) IF I sleep soundly at nite I am more alert during the day-which results in an increased level of *contrast* between daytime brain activity and nightime sleeping.
> > 3) Somehow, this is connected up with ADHD, in the sense that kids with ADHD are drowsy during the day and sleep lightly at night.
> > 4) When I tried Adderall it *increased* the amount of brain *exercise* during the day and I felt *tired* at night and my sleep became more sound and more *regular*.
> > 5) The increased *regularity* of the sleep/wake cycle had an *anti-cycling* effect.
> >
> > Maybe your idea about the light therapy for mood *cycling* has an anticycling effect for these type of reasons???
> >
> > Anybody got any thoughts.....
> >
> > Mitch
>
> Hi Mitch,
>
> Man, I agree with your theory big time.
> This is what I’ve found with my Cyclothymia/ADD (Inattentive/Deep Limbic):
> I call it the ying/yang theory of depression and it goes like this:
> It is VITAL that I sleep well and not for too long. When I’m depressed, I sleep too much, and I think I get too much REM sleep which researchers say causes depression.
> I take Klonipin (1.5 mg in the evening) and now I’ve added Clonidine (2mg). The Klonipin is primarily for the mood swings, though as an added benefit it is also a great sleeping agent. Sometimes when I think I need it, I double the dose of Klonipin to 3 mg in the evening. I asked my doctor if he would try me on a higher dose of Klonipin; instead he started me on the Clonidine to augment the Klonipin last month. Man, I sleep sound! I’ll go to bed at 1:00 AM and get up at 7:50—ten minutes before my alarm goes off. I then make a pot of coffee and take Wellbutrin –150 mg, Modafinil-200 mg or Adrafinil 600 mg. Also, if I feel I need it, I also take a 54 mg of Concerta.
>
> So in a nutshell, the Klonipin/Clonidine combo is my Ying while the Wellbutrin/Adrafinil/ sometimes Concerta + Coffee is my Yang.
>
> Now, I know this sounds crazy, but by God it seems that the huge contrast from day to night makes a BIG difference in my overall mood, and activity level.
>
> I told my doctor about my theory, and surprisingly he didn’t shoot it down. It could very well be crap, because I don’t know much, but for me at least, my theory seems to hold true. And yes, I think lots of sunlight and exercise during the day also adds much to the equation.
>
> --Tim
Hi Tim,Thanks for the response. I just can't get over how that pstim completely remitted my seasonal depression and I could stay quiet and *listen* to people(on 5mg/day...)! Listening to people turned into an interesting new event of sorts-What do they think about x, what do they feel about y? I think there *has* to be a way to incorporate a low-dose pstim into my regimen and *not* get panicky and anxious. You mentioned "deep limbic ADD". Well, my nephew who is on Ritalin fits that to a tee. I fit that to a tee for nearly half of the year.
The "Yin-Yang theory" I like that. When I am depressed or even hypomanic it seems like the "contrast control" is turned way down (sleeping/waking is just a relatively undifferentiated blurr). When I get hypomanic OR depressed it seems that I never fully deeply rest at nite.
I have increased my exercise level, sunlight exposure, caffeine intake, etc. midday and have adjusted meds a little (200mcg.of melatonin now at bedtime) to try to "shut myself down" at nite and it definitely seems to be helping.
Mitch
Posted by manowar on February 4, 2002, at 16:49:05
In reply to Re: The Ying-Yang theory of depression recovery » manowar, posted by Ritch on February 1, 2002, at 22:40:34
Hi again,
Hope all is well. I just have a couple questions and some comments to your last post...
> Hi Tim,
>
> Thanks for the response. I just can't get over how that pstim completely remitted my seasonal depression and I could stay quiet and *listen* to people(on 5mg/day...)! Listening to people turned into an interesting new event of sorts-What do they think about x, what do they feel about y? I think there *has* to be a way to incorporate a low-dose pstim into my regimen and *not* get panicky and anxious. You mentioned "deep limbic ADD". Well, my nephew who is on Ritalin fits that to a tee. I fit that to a tee for nearly half of the year.I new that I was spelling “Yin” wrong, but I just couldn’t think of it-ha.
I don't know if you had this problem, but for me it's great to be able to really listen to people without butting in or just ignoring people, not by choice but by default.
Did you just start taking pstims? I guess that you're taking 5 mg a day of Adderal, do you mind if I ask what else you take? Have you tried Ritalin, Provigil, Wellbutrin, Dexedrine or any other stimulating drugs? Adderal helped me, but kind of put me on edge or something. The Concerta (which is just an extended release Ritalin) and Provigil/Adrafinil do the job well for me.
>
> The "Yin-Yang theory" I like that. When I am depressed or even hypomanic it seems like the "contrast control" is turned way down (sleeping/waking is just a relatively undifferentiated blurr). When I get hypomanic OR depressed it seems that I never fully deeply rest at nite.Absolutely, me too!
>
> I have increased my exercise level, sunlight exposure, caffeine intake, etc. midday and have adjusted meds a little (200mcg.of melatonin now at bedtime) to try to "shut myself down" at nite and it definitely seems to be helping.
>
> MitchBTW: One other thing I've noticed in the past is that I truly feel better when I used to go to a tanning bed. No *hit! It's been years since I've been to one, but I think I'll start going again, what the hell?
Tim
Posted by Ritch on February 4, 2002, at 23:46:18
In reply to Re: The Yin-Yang theory of depression recovery » Ritch, posted by manowar on February 4, 2002, at 16:49:05
> Hi again,
> Hope all is well. I just have a couple questions and some comments to your last post...
>
>
> > Hi Tim,
> >
> > Thanks for the response. I just can't get over how that pstim completely remitted my seasonal depression and I could stay quiet and *listen* to people(on 5mg/day...)! Listening to people turned into an interesting new event of sorts-What do they think about x, what do they feel about y? I think there *has* to be a way to incorporate a low-dose pstim into my regimen and *not* get panicky and anxious. You mentioned "deep limbic ADD". Well, my nephew who is on Ritalin fits that to a tee. I fit that to a tee for nearly half of the year.
>
> I new that I was spelling “Yin” wrong, but I just couldn’t think of it-ha.
>
> I don't know if you had this problem, but for me it's great to be able to really listen to people without butting in or just ignoring people, not by choice but by default.
My sentiments exactly. I like that-"by default". I have always have had GRAVE problems with understanding speech and paying attention to people when they are talking. When it comes to *written* communication-that is somewhat different. It is static-stuck in space-in front of me-it's frozen instead of fluid(I can scan the contexts reiteratively). I have trouble with certain *sounds* people make when enunciating. I know this girl who is from the UK and I talked to her over xmas and she said something really simple and I repeated back to her what I thought she said: "Take two pecans and put them into place"??, and she looked back at me puzzled and told me I had trouble with listening to her, right? YES. There is such a thing as CAPD-which is cognitive auditory processing disorder, and there are some circuits involved with that which get crossed up with my ADHD and bipolar as well.There is one insight I had about this whole subject lately I would like to share: There are two different aspects of distractibility that relate to ADHD and bipolar. I experience both of these. One is the ordinary day to day problems with staying with a *task* and going through all of the *subtasks* to get the primary task accomplished and followed through. The bipolar aspect is the "Eureka response", where you believe that you have discovered something important-which leads to a chaining and tangential spinning off of *ideas*. I have noticed with age that the "idea-oriented" distractability is waning away and the "task-oriented" distractability is becoming the primary problem. This leads me to think that many BPII people could possibly be simply therapeutic subsets of adult ADHD. Otherwise, how would the "kindling" theory fit in here...???
> Did you just start taking pstims? I guess that you're taking 5 mg a day of Adderal, do you mind if I ask what else you take? Have you tried Ritalin, Provigil, Wellbutrin, Dexedrine or any other stimulating drugs? Adderal helped me, but kind of put me on edge or something. The Concerta (which is just an extended release Ritalin) and Provigil/Adrafinil do the job well for me.
I got dx'ed as bipolar 23 years ago. That got changed to BP-II when the differentiation of BP types came about. I saw a behavioral neurologist about 4 years ago who did some EEG stuff who thought I was having temporal or frontal lobe seizures-but I was very skeptical at the time and didn't want to do an MRI or sleep-deprived 24-hr EEG to further investigate it (there was no obvious seizure activity on the standard evoked potentials, EEG, etc.). He thought I had some form of ADHD at that time because of my forgetfullness and needing to have rituals to remind myself of everything.
I got dx'ed as adult ADHD three years ago (by subsequent pdoc-neuro retired). Now it is a three-way comorbid diagnosis which includes social phobia/panic. I tried Adderall only once and only in combination with Neurontin (5mg AM Adderall + 100mg Neurontin 3x daily). It worked great for a few weeks, but I started getting panicky. I had stopped an SSRI before I started the Adderall, so it makes me wonder whether it was an SSRi withdrawal or the *need* to take an SSRI to prevent panic-rather than the Adderall being responsible for the panic. I had stopped an SSRI before I tried the Adderall and had similar things happen that required restarting the SSRi (always at low-doses).NOW: I am taking Neurontin 100mg tid, Klonopin .5-1.0mg, Celexa 2.5 mg 4-5x during the week, Wellbutrin 1/4 of 75mg tab in the morning with some strong coffee. It is working fairly well. The WB just doesn't seem to touch the ability of the pstim for being able to stay on task and ability to listen, however.
Thanks for sharing that info about Ritalin. I have only tried Adderall, but not Ritalin. I mentioned Provigil to my pdoc last visit and that is being *considered*.
> >
> > The "Yin-Yang theory" I like that. When I am depressed or even hypomanic it seems like the "contrast control" is turned way down (sleeping/waking is just a relatively undifferentiated blurr). When I get hypomanic OR depressed it seems that I never fully deeply rest at nite.
>
> Absolutely, me too!
>
> >
> > I have increased my exercise level, sunlight exposure, caffeine intake, etc. midday and have adjusted meds a little (200mcg.of melatonin now at bedtime) to try to "shut myself down" at nite and it definitely seems to be helping.
> >
> > Mitch
>
> BTW: One other thing I've noticed in the past is that I truly feel better when I used to go to a tanning bed. No *hit! It's been years since I've been to one, but I think I'll start going again, what the hell?
>
> Tim
I used to do that back in the early '80's when it was first popular and it did seem to help, but OTOH I was interested in it mainly was I was feeling hypomanic in April and May.
Mitch
This is the end of the thread.
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