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DSM-5: The Handbook

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)is the 2013 update to the Diagnostic and Statistical Manual of Mental Disorders, the handbook used by health care professionals in the United States and much of the world as the authoritative guide to the diagnosis of mental disorders. DSM-5 contains descriptions, symptoms, and other criteria for diagnosing mental disorders. It is the fifth edition, meaning it has been revised four times from the first DSM. Its authors arethe American Psychiatric Association.

There has been criticism of the fifth edition both before and after it was published. Critics assert, for example, that many DSM-5 revisions or additions lack empirical support; inter-rater reliability is low for many disorders; several sections contain poorly written, confusing, or contradictory information; and the psychiatric drug industry may have unduly influenced the manual's content (many DSM-5 workgroup participants had ties to pharmaceutical companies). We have to acknowledge that the bottom line for Pharmacuetical Companies is Profits and they have found an open-ended market with Mental Health Patients. 

Bipolar Mood Disorder

There are many manifestations of Bipolar Mood Disorder, and it was previously called Manic-Depression. This gives you an indication of the nature of this illness. Mania or High Periods and Depression or low periods is its signature. Name changes and reclassifications are updated in the DSM-5. With continuous research, medications have also changed.  The Broad Spectrum of the Bipolar Mood Disorder is:

Bipolar Type 1 (Most Severe)

Bipolar Type 2(Less Severe)

Rapid Cycling

Mixed Episodes

Ultradian Bipolar Disorder 

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(Ultra-Ultra-Rapid-Cycling-Bipolar-Disorder)

Ultradian Cycling Bipolar Disorder:

- Should be treated in the same way that Mixed States in Bipolar Disorder are treated.

- Can also be thought of as mixed moods as per current diagnostics guidelines.

Light and Darkness as Treatment

Dark Therapy for Ultradian Bipolar Disorder: Dark and Light are important in Bipolar Disorder and contribute to sleep cycles as well as mood cycles. You should be controlling your blue light intake in evenings. 

Blue light:

Blue light is part of the natural electromagnetic energy spectrum. Most of your exposure to blue light is from the sun, but some health experts have raised questions about whether artificial blue light could be damaging your eyes. Some studies have shown that blue light damages cells in laboratory animals.

Blue light is needed for good health: It boosts alertness, helps memory and cognitive function and elevates mood. It regulates circadian rhythm – the body's natural wake and sleep cycle. Exposure to blue light during daytime hours helps maintain a healthful circadian rhythm.

Blue light from electronics is linked to problems like blurry vision, eyestrain, dry eye, macular degeneration, and cataracts. Some people have sleep issues.

Blue light has a dark side

What is blue light? The effect blue light has on your sleep and more.

Although it is environmentally friendly, blue light can affect your sleep and potentially cause disease. Until the advent of artificial lighting, the sun was the major source of lighting, and people spent their evenings in (relative) darkness. Now, in much of the world, evenings are illuminated, and we take our easy access to all those lumens pretty much for granted.

But we may be paying a price for basking in all that light. At night, light throws the body's biological clock—the circadian rhythm—out of whack. Sleep suffers. Worse, research shows that it may contribute to the causation of cancer, diabetes, heart disease, and obesity.

What is blue light?

Not all colors of light have the same effect. Blue wavelengths—which are beneficial during daylight hours because they boost attention, reaction times, and mood—seem to be the most disruptive at night. And the proliferation of electronics with screens, as well as energy-efficient lighting, is increasing our exposure to blue wavelengths, especially after sundown.

Everyone has slightly different circadian rhythms, but the average length is 24 and one-quarter hours. The circadian rhythm of people who stay up late is slightly longer, while the rhythms of earlier birds fall short of 24 hours. Dr. Charles Czeisler of Harvard Medical School showed, in 1981, that daylight keeps a person's internal clock aligned with the environment.

Is nighttime light exposure bad?

Some studies suggest a link between exposure to light at night, such as working the night shift, to diabetes, heart disease, and obesity. That's not proof that nighttime light exposure causes these conditions; nor is it clear why it could be bad for us.

A Harvard study shed a little bit of light on the possible connection to diabetes and possibly obesity. The researchers put 10 people on a schedule that gradually shifted the timing of their circadian rhythms. Their blood sugar levels increased, throwing them into a prediabetic state, and levels of leptin, a hormone that leaves people feeling full after a meal, went down.

Exposure to light suppresses the secretion of melatonin, a hormone that influences circadian rhythms. Even dim light can interfere with a person's circadian rhythm and melatonin secretion. A mere eight lux—a level of brightness exceeded by most table lamps and about twice that of a night light—has an effect, notes Stephen Lockley, a Harvard sleep researcher. Light at night is part of the reason so many people don't get enough sleep, says Lockley, and researchers have linked short sleep to increased risk for depression, as well as diabetes and cardiovascular problems.

Effects of blue light and sleep

While light of any kind can suppress the secretion of melatonin, blue light at night does so more powerfully. Harvard researchers and their colleagues conducted an experiment comparing the effects of 6.5 hours of exposure to blue light to exposure to green light of comparable brightness. The blue light suppressed melatonin for about twice as long as the green light and shifted circadian rhythms by twice as much (3 hours vs. 1.5 hours).

In another study of blue light, researchers at the University of Toronto compared the melatonin levels of people exposed to bright indoor light who were wearing blue-light–blocking goggles to people exposed to regular dim light without wearing goggles. The fact that the levels of the hormone were about the same in the two groups strengthens the hypothesis that blue light is a potent suppressor of melatonin. It also suggests that shift workers and night owls could perhaps protect themselves if they wore eyewear that blocks blue light. Inexpensive sunglasses with orange-tinted lenses block blue light, but they also block other colors, so they're not suitable for use indoors at night. Glasses that block out only blue light can cost up to $80.

LED blue light exposure

If blue light does have adverse health effects, then environmental concerns, and the quest for energy-efficient lighting, could be at odds with personal health. Those curlicue compact fluorescent lightbulbs and LED lights are much more energy-efficient than the old-fashioned incandescent lightbulbs we grew up with. But they also tend to produce more blue light.

The physics of fluorescent lights can't be changed, but coatings inside the bulbs can be so they produce a warmer, less blue light. LED lights are more efficient than fluorescent lights, but they also produce a fair amount of light in the blue spectrum. Richard Hansler, a light researcher at John Carroll University in Cleveland, notes that ordinary incandescent lights also produce some blue light, although less than most fluorescent lightbulbs.

Protect yourself from blue light at night

Use dim red lights for night lights. Red light is less likely to shift circadian rhythm and suppress melatonin.
Avoid looking at bright screens beginning two to three hours before bed.
If you work a night shift or use a lot of electronic devices at night, consider wearing blue-blocking glasses or installing an app that filters the blue/green wavelength at night.
Expose yourself to lots of bright light during the day, which will boost your ability to sleep at night, as well as your mood and alertness during daylight.

image: © Innovatedcaptures | Dreamstime.com    

Light and sleep

Darkness is the unsung friend of people with Bipolar Disorder. Regularly timed light-free darkness is your friend. Inner Clock = Circadian Rhythm. Biorhythms are all around us:

- Circadian Rhythms

- Cycles of the Moon

- Inhalation and Exhalation

- Ocean Tides

Put the Power of Biorhythms to work for you. Biorhythms are a powerful tool for changing your destiny. Everybody has a biological clock. It's the gizmo that sets your biological rhythms everyday.

Biological Clock

Bipolar has many causes - neurotransmitters, stress, inflammation, hereditary, - but the determined predominant cause is Circadian Rhythm Disruption. In other words, a broken biological clock.

Light and Darkness are the main signals that set the biological clock, and this is a natural therapy that stabilises Bipolar Disorder by accentuating those signals. It involves extra light in the morning, and a strong dose of darkness in the evening.

Each morning, light sets the biological clock by shutting down melatonin production, the hormone that makes us sleep. This daily reset is essential for everyone - not just people with Mood Disorders - because the average biological clock runs 15 minutes slow. In Mood Disorders, this morning reset is even more essential. 

Two aspects with major implications for treatment of Bipolar Disorder:

1. Sleep and Rhythm (Sleep Therapy)

2. Darkness and light (Dark Therapy)

Mood/Energy/Sleep/Focus - The bottomline for your overall health is: Keep regular hours of sleep, even on weekends. Natural Remedies and Natural Therapies will reduce your need for medication.