Body Rhythms and Bipolar Disorder

Circadian rhythms are natural bodily processes that regulate a number of physiological functions, such as sleep, hormone production, etc. Research has shown that these rhythms play a vital role in the development and manifestation of symptoms in bipolar bisorder (or BD) patients.

If you or someone that you know has been diagnosed with BD, understanding this relationship will assist in effectively managing BD and its symptoms. ^[1]

What are Circadian Rhythms?

As we have already mentioned, circadian rhythms are natural, internal processes that regulate different physiological functions of the body. These rhythms follow a 24-hour cycle and are influenced by external factors, such as light exposure and temperature. Overall, circadian rhythms play an integral role in maintaining good health and well-being for both BD patients and the general public. ^[1]

The key functions of circadian rhythm include:

• The sleep-wake cycle – Circadian rhythms regulate the timing of sleep and wakefulness. In other words, it causes us to feel tired at night and awake in the morning. This helps ensure a healthy and consistent sleep cycle.
• Hormone production – Important hormones, such as melatonin and cortisol, follow circadian rhythms. This impacts a number of critical daily processes, including stress management, metabolism, and sleep.
• Body temperature – Circadian rhythms also affect our core body temperature, which typically fluctuates in a somewhat predictable manner. It’s generally lower at night and slightly higher during the day.
• Digestive function – Circadian rhythms also influence our eating habits and digestive system. It affects how the body processes food and its nutrients.

How Does Circadian Rhythm Disruption Affect Bipolar Disorder?

Disruptions in circadian rhythm can have a significant impact on individuals diagnosed with BD. To be more specific, these disturbances can trigger or exacerbate bipolar symptoms, including:

• Mood episodes: Disruptions in circadian rhythms are likely to trigger manic episodes in BD patients, characterized by heightened energy levels, a reduced need for sleep, and incredibly impulsive behavior without consideration for consequences. Irregular sleep-wake cycles are linked with depressive episodes characterized by intense feelings of sadness, extreme fatigue, and hopelessness.
• Disturbances in sleeping patterns: Disturbances in an individual’s circadian rhythm will lead to difficulty falling or staying asleep. It could also cause hypersomnia, which is characterized by excessive sleepiness and prolonged periods of sleep, which, over time, will exacerbate mood symptoms.
• Hormone imbalances: Disruptions in melatonin production can also lead to mood instability. Abnormal cortisol levels are often linked to an increase in stress and anxiety, which heavily impacts the individual’s overall mood and energy levels over time.

Causes of Circadian Rhythm Disruption

When it comes to disruptions in circadian rhythm, there are a number of factors that play a role. These include:

• Work schedule – Shift work can lead to a misalignment between the body’s internal clock and its external environment. Night shifts are particularly problematic, as they go against our body’s natural patterns.
• Travel – Jet lag is caused by traveling across different time zones. For example, it could be nighttime in your new location and the middle of the day at home. This has a massive impact on your sleep schedule, as you will have to adapt to the new time zone.
• Screen time – Prolonged exposure to artificial light (specifically blue light and just before bedtime) can disrupt the natural sleep-wake cycle.
• Irregular sleep patterns – Inconsistent sleeping patterns are linked to a disrupted circadian rhythm. It’s always recommended that we maintain a consistent sleep schedule, such as falling asleep by 10 PM every night and waking up at 7 AM every morning. More so, the average adult should get at least 8 hours of sleep every night in order to feel fresh and rejuvenated.
• Substance use – Certain substances, namely alcohol and caffeine, can interfere with the body’s natural sleep-wake cycle. ^[2]

Signs of Circadian Rhythm Disturbances in People with Bipolar Disorder

Signs and symptoms of circadian rhythm disturbances can present themselves in a number of ways, especially in people with BD. To manage the condition, it’s essential that we know exactly what to look out for.

A few of the most common signs are:

Sleep Disturbances

This is arguably the most noticeable symptom in anybody who struggles with a disturbance in circadian rhythm. Firstly, they are likely to develop an inconsistent sleeping pattern. This could mean insomnia, which is characterized by difficulty in falling or staying asleep, or hypersomnia. More so, someone with a disturbed circadian rhythm will frequently jolt in their sleep or be woken up by frequent and intense nightmares. Over time, the inconsistent sleep pattern will lead to chronic fatigue and sleep deprivation.

Mood and Energy Fluctuations

While BD patients already struggle with mood fluctuations, those with a disturbed circadian rhythm will have even more trouble controlling their emotions and actions. These individuals are synonymous with rapid and unpredictable shifts in mood.

Sometimes, they will experience manic episodes, which are characterized by increased energy levels, a reduced need for sleep, and impulsive behavior. Other times, they will go through depressive episodes, which are characterized by persistent sadness, fatigue, and low motivation.

Cognitive and Behavioral Changes

A BD patient struggling with a disturbed circadian rhythm will have difficulty concentrating, mainly due to a disrupted sleep schedule and mood instability. They also tend to be incredibly impulsive, acting on their intense emotions without considering the consequences. Frequently, they will also withdraw from or simply avoid any social interactions.

Physical Symptoms

There are also a number of physical symptoms that could present themselves over time. This includes persistent fatigue due to prolonged patterns of inconsistent sleep. There may also be changes in appetite, such as sudden extreme hunger or a lack thereof. Finally, you may also notice body temperature variations. This includes unusually high or low temperatures that may affect the person’s overall well-being. ^[3]

How to Regulate Your Circadian Rhythm

Knowing precisely what causes disturbances in circadian rhythm is crucial in understanding how we can go about regulating it.

Developing a Consistent Sleep Cycle

Maintaining a consistent sleep cycle is crucial in regulating circadian rhythm. This includes going to bed and waking up at the same time every day – even on weekends. If you need to shift your sleep schedule, be sure to do it gradually. Over time, this will help to regulate your internal body clock.

Reduced Exposure to Artificial Light

To help wake your body up in the morning, be sure to expose yourself to plenty of natural light. This could mean stepping outside for a few minutes or going for a walk. At night, be sure to avoid overexposure to bright and artificial light. More so, consider using blue light filters on your phone and turn off any devices at least an hour before going to bed.

Creating the Ideal Sleep Environment

To help establish your internal clock, experts recommend creating a sleep-friendly environment at night. This means keeping your bedroom dark, quiet, and cool, all in an attempt to promote restful and undisturbed sleep.

A Healthy Pre-Sleep Routine

A healthy pre-sleep routine can work wonders for improving both the quality of our sleep and our sleeping schedule. This could include reading, listening to peaceful music, practicing meditation, or deep breathing exercises. This will signal to your body that it is time to sleep and help to reduce any stress. ^[3]

Does Bipolar Medication Affect Circadian Rhythms?

Research shows that bipolar medications can have a positive impact on regulating circadian rhythms.

Understanding how these medications interact with the body’s natural cycle is very important in improving and personalizing treatment plans, as well as the overall well-being of the individual.

For example, antipsychotics offer sedative effects that influence sleep patterns. In other words, they actually help to regulate circadian rhythms, ultimately improving sleep patterns and helping to manage moods. Lithium is one of the most commonly prescribed mood stabilizers, as it also has a big impact on regulating sleep-wake cycles. ^[5]

Can Chronotherapy Help People with Bipolar Disorder?

Chronotherapy is essentially a manner of administering medication. It’s designed to align with an individual’s circadian rhythm, all in an effort to enhance the effectiveness of the medication, as well as minimize any potential side effects. Studies suggest that chronotherapy is particularly effective in people diagnosed with BD. ^[4]

When to Seek Professional Help

BD is a very serious condition that, if gone undiagnosed or unmanaged, can lead to a poor quality of life. Because of this, it’s essential to seek the help of a mental health professional if you or someone you know experiences any of the following symptoms:

• Persistent mood swings, such as manic or depressive episodes.
• Impulsivity or thoughts of self-harm.
• Difficulty functioning or relationship strain.
• Severe sleep disturbances or other physical symptoms. ^[5]