The Farm and Ranch Life column, “Depression: Common for Farm People,” which was published around July 12, 2012, provides additional explanation.
Today’s article is a follow-up to last week’s column, “Bipolar Disorder: Difficult to Accept and Treat,” about the signs of this mood disorder and some medications used for this difficult-to-treat mental health problem. How persons who are prone to bipolar disorder manage themselves can help deter episodes of low mood (depression) or high states (mania).
“John,” a 45 year old farmer, had his first bipolar episode around age 25 and had been hospitalized several times during severe episodes when he felt suicidal or was so “high” his judgment got him into trouble (spending sprees, inability to complete his work satisfactorily). As he aged and went through successive episodes, John learned the signs of an episode and to give over temporary control of some aspects of his life (paying bills, completing farm chores) to “Pam,” his wife.
But Pam was tiring of “stepping in” and getting berated by John when she cajoled him to take his medication or found it necessary to arrange for his hospitalization during severe episodes. She needed help, as did John.
John usually found winters to be difficult because he felt down. His bipolar disorder had a “seasonal affective” component, such that he became depressed when the days were short.
Usually John stopped his mood-stabilizing medication, lithium, during the winter. Not everyone’s bipolar disorder is seasonal.
As spring approached and the amount of sunlight increased, John’s mood brightened and he became energized. There was optimism in his voice and outlook and he felt on top of the world.
Often John did not resume taking lithium because he liked feeling euphoric; he was convinced his ideas were superior to the cautions he was reaping from Pam and friends who could see him becoming manic. Plus, he felt rested after sleeping only four hours and there was so much to do, like his hog chores, driving around the countryside and going to the coffee shops and bars throughout the day.
The trouble was John seldom completed the tasks around the farm that he started. Pam noticed the hog feeders often were empty. She called me, asking for help.
Together, Pam and I pursued John’s hospitalization on a psychiatric unit to reinstitute and regulate his medication and to protect him until his judgment improved. Then we embarked on a plan to find others besides Pam who could give John beneficial feedback when he developed mood disorder symptoms in the future.
John chose whom he wanted to rely on for assistance. We met together for a discussion.
We found a light therapy system which John used while reading during the winter months when he was prone to feeling blue. These are available from many companies, most of which can be located online.
Low amounts of sunlight trigger depressed mood in persons with a seasonal component to bipolar disorder when the days are short because the pineal gland, which is sensitive to light, helps to regulate brain chemicals associated with mood, such as serotonin and melatonin.
When days are long and the sun shines brightly, or when regularly using a tanning booth, persons like Jon are prone to manic behaviors. During the spring and summer I asked John to wear a cap with a long bill to reduce the amount of sunlight signaling his pineal gland though his eye retinas.
As Richard Rapport’s book, Nerve Endings, indicates, there was a time when many of the earth’s first sea creatures had a “third eye” which pointed upward from the tops of their heads to detect sunlight. As animals and humans progressed from sea creatures, the “third eye” modified into the pineal gland, but it still serves a powerful role in regulating transmitter chemicals that influence the brain, called the circadian rhythm.
John felt better that he could take charge of regulating his mood to some extent through his behaviors, and he also realized he could moderate the amount of mood stabilizing medication he consumed as the seasons and his mood changed, under the guidance of his psychiatrist.
It also helped John to know that many well-known and respected scientists, musicians and political leaders learned to use the disorder to accomplish much in their lives, and by great dedication, to not let bipolar disorder wear them down to take their own lives or overcome their productivity. Lists of famous persons with bipolar disorder are available online.
It takes John effort and courage each day to gauge how he is doing, to manage behaviors under his control that affect his mood and to consume medication, but he is succeeding.