Spring’s longer days and brighter light can raise mania risk, but sleep, structure, and support can help you stay steady.
Key Takeaways
- Tracking your mood can help you spot seasonal patterns, such as lower mood in winter or rising energy in spring.
- A steady routine for sleep, meals, and social connection helps keep your body clock more balanced.
- If you notice early signs of mania, like needing less sleep or talking faster, reach out to your healthcare provider.
- Use light therapy only with professional guidance, since too much light exposure may increase the risk of mania.
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Spring is synonymous with renewal, romance … and, for some people with bipolar disorder, a return of symptoms.
“It’s true that my phones do ring a lot in March,” says Chris Aiken, MD, a psychiatrist and director of the Mood Treatment Center in Winston-Salem, North Carolina, and a clinical instructor at Wake Forest University School of Medicine.
Margie P., of New Jersey, can relate. She once sang on stage after more than a decade, reclaiming a piece of herself. Her last hospitalization stemmed from a springtime manic episode, so she completely relates to the lyrics of the jazz standard “Spring Can Really Hang You Up the Most”:
Spring came along, a season of song,
Full of sweet promise
But something went wrong.
“My grandiosity led me to apply for jobs for which I had none of the qualifications, start businesses for which I had no funding, hear voices that were not there, and struggle with severe agitation and restlessness,” Margie recalls.
Not everyone with bipolar disorder is vulnerable to mood episodes that coincide with the seasons. For those who are, the typical pattern is depression that recurs in winter and hypomania or mania in springtime or summer.
Why Preventing Spring Mania Is Important
Managing springtime symptoms is vital because the transition into mania can disrupt work, relationships, and overall stability. Dr. Aiken notes that springtime mania is often a mixed state, where you’re tired, wired, and urgent, yet also distressed and anxious. “You feel driven to do something, but don’t know what to do,” he says.
It can be difficult for individuals to realize what’s going on, Aiken adds. “Most people will identify the depression in the winter,” he explains. “But it will take a lot of pulling for them to identify the mixed episodes in the spring.”
Understanding Depression, Hypomania, and Mixed Episodes
It’s even harder when hypomania simply feels like a welcome rebound from winter’s depression. Aiken identifies three common warning signs: sleep irregularity, rapid speech, and physical hyperactivity.
Check, check, and check for Steve F., who traded the stress of life in Los Angeles for the calmer pace of a small town in Pennsylvania.
“When I was in L.A., it didn’t seem like I could get much sleep,” he says. “In the big city, it was like mania every day. I had a case of the ‘gottas.’ ‘Gotta’ go meet someone new. ‘Gotta’ get smarter. Gotta, gotta, gotta,” he says.
Yet, in his small town, he gets “cooped up,” he explains. “You get locked in and snowed in for months. When spring comes, it’s almost like somebody puts me in a slingshot and thrusts me out the door.”
As a stagehand, Steve goes through a lull in work during the heart of winter. Springtime brings more assignments, which can challenge his sleep schedule, which, in turn, can trigger his mania. “Spring is when that kicks in, and I just go into overdrive,” he says.
How Circadian Rhythms Affect Mood Stability
According to Anthony Levitt, MD, a researcher of mood disorders and a scientist at Sunnybrook Health Sciences Centre in Toronto, about 50 percent of individuals with bipolar disorder have seasonal mood shifts.
As far as what sets off spring mania, he says, “It’s not just one thing; it’s a combination of things.” This can include someone’s psychological reaction to spring’s arrival, how they respond to weather factors, and an underlying biological sensitivity to day length.
Longer days often mean more evening activities and more opportunities to socialize, which can translate to less sleep. But Aiken says, “A lot of research shows that it’s not the quantity of light — it’s the rapid change in light.”
Aiken points out that the fastest rate of change in daylight occurs around the equinox, the point when there are equal hours of day and night. The reason that matters has to do with our circadian rhythms — our body’s natural sleep-wake cycle, per Cleveland Clinic. The circadian rhythm also influences things like when we’re hungry and when we feel most alert. It can also be influenced by a variety of external factors.
According to one review article, people with bipolar disorder are particularly susceptible to disruptions in circadian rhythm, and there’s a strong link between those disruptions and onset of symptoms.
Daily Habits That Help Prevent Mania
Consistency is the foundation of mood management. “Most definitely, people with bipolar have trouble with change regarding circadian rhythms — jet lag, changing seasons, and change in routine of any kind,” Dr. Levitt says.
There’s a psychosocial intervention called interpersonal social rhythm therapy (ISRT), which is based on evidence that people with bipolar benefit from greater structure in their lives. The therapy also addresses issues that can throw someone’s routine out of whack, such as work stress and relationship problems.
Maintaining a consistent treatment plan is the first line of defense against seasonality. Yet there are important self-help strategies, such as awareness and lifestyle accommodations, that help smooth out seasonal moods.
1. Keep Track of Your Moods to Identify Patterns
Using a mood tracker over a long period of time makes it easier to pick out seasonal patterns, notes Levitt. He stresses the importance of using separate scales for depression and mania.
Candida Abrahamson, PhD, a counselor outside Chicago, Illinois, emphasizes the value of outside input from family and friends who know you well. They are often adept at recognizing early signs of a mood shift, she notes.
Steve maintained a daily mood journal for two years. He says greater self-awareness helps him keep mania at bay. “I have learned how to channel that energy into something positive,” he explains.
As a shortcut, Dr. Abrahamson recommends reviewing events that occurred before your last manic episode to identify circumstances that made things worse. Then, evaluate whether any of those circumstances could be modified. You might discover behaviors you can manage — skipping a late movie or limiting time with friends.
2. Pay Attention to Mood Triggers
Keeping a mood journal helped Steve decipher seasonal patterns and manage symptomatic behavior.
“After about two weeks, I began to recognize what type of people — and what type of situations — would set me off and trigger my emotions,” he recalls.
Now, he’s better at catching himself. Instead of reacting with anger, he’s trained himself to remain quiet. He practiced this new behavior for an entire year until it became almost automatic. Journaling also showed him the connection between nightmares and waking up anxious, allowing him to use morning yoga to defuse tension.
3. Regulate Your Daily Sleep, Eating, and Exercise Habits
Because people with bipolar tend to have fragile circadian rhythms, it’s important to manage your daily routine. Physical activity, sleep, and eating habits all affect your internal clock.
Aiken notes that while exercising too much can be a sign of mania, “Exercise strengthens the brain ways that prevent mania.” For example, the timing and intensity of exercise can influence how well you sleep. Generally, evening exercise is not recommended for anyone who struggles with insomnia.
The following habits have the biggest impact on your day:
- The time you get out of bed in the morning
- Your first significant contact with people
- The time that you start your work or chores
- The time you eat dinner
According to Levitt, avoiding dramatic fluctuations in biological processes from one season to the next is key. It’s important to be consistent not only in when you eat, for example, but also in how you eat. You may feel less inclined to prepare good meals at different times of the year, but it’s important to push yourself to stay on track.
Regulating sleep is critical, too. “You really can’t have an episode of mania with normal sleep,” Levitt says.
4. How to Manage Light Exposure in Spring
Aiken explains that those with sensitive circadian rhythms need a strong sunlight signal to set their internal clocks, which tend to run a little slowly. He says light therapy can help buffer the rapid shift in daylight during transition periods.
But as spring approaches, light therapy should be tapered off — overexposure to light can throw off rhythms. “In someone with bipolar, light therapy has to be done with the same kind of consideration as if you were using antidepressants,” Levitt explains.
When to Adjust Your Treatment Plan
If you notice signs of a “flare-up” as the days get longer, consult your doctor. A number of years ago, Kate R., from southern California, realized that her worst manias occur in May and June. Such episodes find her pacing, feeling uncomfortable everywhere, and struggling to sleep.
Kate’s psychiatrist suspects that sensitivity to light may factor into her vulnerability to spring mania. Kate also uses a mindfulness practice to stay in tune with body changes and relies on her support team. “My support systems are crucial,” she says. “I know I can go to any of them at any time.”
When Kate has panic attacks in the winter, however, she follows the doctor’s advice to “Go sit in the sunlight.” She says she’s incorporated it into her routine now.
Margie, meanwhile, has managed to stay out of the hospital for the past several springs through a combination of exercise, support groups, and monitoring her mood and medications. “I’m also cutting back if I am going in too many different directions,” she adds.
For now, she lives in the day. “I pray that if I continue to do the next right thing … I will be able to remain in the community and not have to check back into the hospital.”
And currently, with her wellness plan in place, she can hum along to The Beatles:
Here comes the sun
Here comes the sun, and I say
It’s all right.
Editorial Sources and Fact-Checking
UPDATED: Printed as “Spring Fever,” Spring 2014
