Bright light therapy for bipolar depression

– Bright light therapy for depression, that’s what I’m gonna
be talking about today. I’m Dr. Tracey Marks, a psychiatrist, and this channel is about
mental health education and self improvement. If you don’t wanna miss an episode, click subscribe and the notification bell. One of my early videos
on YouTube was about how to use light therapy,
and it was from 2012. And in it, I focus on using light therapy to help your sleep and your mood, but I warned you about the potential for triggering a manic episode in people with bipolar disorder. Well, that was seven years
ago, and at the time, using light therapy for bipolar
disorder was kinda sketchy and it was something that we
only advised with caution. But things have changed since then and evolved with the research, and now we’ve had enough studies that show an improvement in depression symptoms when you’re in the depressed
phase of bipolar disorder. I’ve referenced several
studies in the description for you to take a look at if
you wanna see the evidence, but for this video, I’m gonna focus on how to use light therapy. And by the way, if you
have unipolar depression, meaning you have episodes
of depression but no mania, don’t feel left out. I do have a video for you on
wake therapy for depression. It combines bright light
therapy and sleep deprivation, and I’ll link it in the
corner and in the description. Here’s how the therapy works. It’s a little different
from the way we use traditional light therapy for depression. With that, you use it
first thing in the morning within 30 minutes to an hour of waking up. If you’re a late riser,
you’re supposed to make sure you use the light before 8 a.m. With bipolar depression, you use the light in the middle of the day
between noon and 2 p.m. You start with 15 minutes and increase by 15 minutes every week for a maximum of 60 minutes. This is different from the
light therapy with depression where you start with 30 minutes, but going slower reduces the risk of destabilizing your mood. But because you’re going slower, the improvement may also be slower. Another update from my original
recommendations is that to really be effective,
you need a large light. They make smaller lights like this one that fit neatly and conveniently
in the palm of your hand and feel a little less
like you’re doing treatment because of that, but to really get the best effect, it’s recommended that you have a light that’s 12 to 17 inches in size giving off 10,000 lux
of bright, white light. Some studies use between five and 10,0000, but I think the general consensus is that 10,000 really is best. The light box selected
should emit a full spectrum of white light with a UV filter, so you don’t need to use the blue light that’s been typically more
helpful for shifting your sleep. I’ll have a separate video
where I review some light boxes. It’s best to sit with the light above you and sit about a foot away but
really no further than that, and you wanna have it at about a 45 degree angle from your face, preferably above your head. You don’t wanna stare directly at it, but you can do other
things like read, eat, check your Instagram feed, but you just wanna make sure that the light hits your eyes indirectly. You don’t wanna have your head down where the light doesn’t
even hit your eyes. How long should you use
the bright light therapy? If you respond to the
bright light therapy, it’s reasonable to continue doing it for the next 12 months after
your depression resolves, and this would be similar to continuing anti-depressant therapy for a year. In the maintenance phase, you
may be able to get by, though, with using it three times a week, but if you notice your depression symptoms starting to return, then
go back to using it daily. Another point to this. You do stay on your regular
medication for bipolar disorder. In fact, if you’ve stopped
your mood stabilizers for whatever reason,
you’re definitely at risk of switching into hypomania or mania if you use the light therapy
as your only treatment. This therapy is designed to be used during the depressed
phase of bipolar disorder instead of using an anti-depressant, but if your doctor has
you on an anti-depressant along with your mood stabilizer
and you’re still depressed, you can decide to use this therapy but keep an eye out for the hypomania. And of course, if you improve after only 15 minutes of the light, then no need to increase the timing of it. Just, you can stay at the 15 minutes. So, what are some adverse
effects of bright light therapy? Bright light therapy is
pretty well-tolerated without a lot of side effects, but the most common side
effects include things like headaches, eye strain,
nausea, and agitation, and the adverse effects are not permanent and tend to resolve either from decreasing the time that you use the light or just stopping it all together. With bright light therapy, more is not always better, so you wanna keep the light
exposure only to what you need and not go beyond a maximum of 60 minutes. If you feel better on it,
don’t try to do it more, do more of it late in the
afternoon or the evening. The evening light exposure
can actually interfere with your falling asleep. So, that’s the nuts and the
bolts of bright light therapy. Why wouldn’t everyone do this? Well, you do have to purchase the device, but it is a one-time cost, and some of the devices are under $100. But I think the real barrier
to this is just the time and the commitment necessary to do this. I mean, we are talking about
15 minutes up to an hour that you’ve gotta take out
in the middle of the day and set aside that time. If you’re working, you’ve
gotta have the time to do that plus have the privacy
to be able to do that. Because, after all, if you’re
using a device like this, you’re gonna need some privacy. So, it’s got its pluses and minuses to it, but if you’re someone for
whom you’ve not done well during the depressed
phase of your disorder and none of the medication,
adjustments seem to help you, this is a real consideration that maybe you could talk
with your doctor about and bring up and see what he or she thinks about that for you. I know in my own experience, the depression is the
harder phase to treat. I think that’s pretty much the general consensus with people. It’s much easier in someone who’s in a
throes of a manic episode to dampen them down with or dampen down the fire with medication. But to pull someone up out of depression is a much harder feat, so this could be something that could be a good solution for you
during those episodes. Alright, well, thanks for watching. Share this video with someone
that you think it may help, and let me know what you
think in the comments. Have a great one. See you next time. ♪ I am what I am today ♪ ♪ ‘Cause I did it my way, ♪ ♪ Nothin’ ya’ll can say ♪ ♪ In this life or the next one. ♪

About the author


  1. Not saying for anyone to do this but I was doing some light tanning for a trip and it’s really seem to lessen my bp depression. Only saying that I need to look into the light therapy. When I’m depressed I rarely go outside and get any kind of light.

  2. Hi Dr Marks. Thank you for your fantastic videos! You provide information in such a digestible manner!
    I want to try wake and light therapy for dysthymia. I have a question. I live in South Africa, so the equipment is not as readily available as in other countries. What are the lighting options if I can't find a light box? Can I rely on apps or other household lights? Many thanks in advance.

  3. What is the reason behind doing it mid-day instead of the morning? Could it trigger mania more easily when done in the morning?

  4. I just discovered your channel yesterday and I love it! You have an awesome approach to these topics and you're very likable. I especially loved the video you did on Bipolar and Impostor syndrome. It came at a good time as I have been having many difficulties with that lately. If you have the time and interest, would you be willing to ever do a video talking about prodromal phases of psychosis or schizophrenia spectrum disorders? Is it possible to remain in a prodromal phase with many symptoms yet never become fully psychotic (or if in bipolar, never acutely psychotic outside of mood episodes, but still experiencing residual, mild psychotic symptoms?

  5. Hello, I wanted to know : Is light from computer screen enough if I go on google image or something and search for a big white image, or only "true" light works ? I think I will try it even if I go out a lot so I get light from the sun

  6. Thanks awsome video!! … can you make a video about “signs you should quit your job” for me it is difficult to separate my mental illnesses from reality and lately I’ve been feeling melancolic all the time specially at night and in the morning just before I go to work … I don’t want to make a bad decision. Maybe it’s my job … maybe it’s just me.

  7. I kind of use bright light therapy when making videos.. lol But it doesn't work but I am glad things come out to help different people. Thanks for sharing

  8. Awesome and very helpful video that gives hope! I actually have a big 10000 Lux Philips lamp. It is a bit old, but I will try this again. I did not know I should do it mid day. I did it early in the mornings with no effect, I only got nauseous, and pain in my eyes as I stared straight info the light. I did it wrong three years ago. Mid day is much better, since I work mostly evening shifts and usually only sleep in the mornings. I hope this light therapy will help with ultra ultra rapid cycling bipolar depression as well. I will start testing it tomorrow. Great tips and video!🌞💡 Thank you so much!🌟🌼

  9. Dr Marks,
    I looked online for the full spectrum lighting white light therapy SAD therapy etc. 10,000 LUX I found them but the largest screen I can find is 10 x 6 ? And there are about $50 I was considering picking one up because I used to use my tanning bed yeah I know I’m asking the wrong person I’m Italiano I like my tanning bed I have a 7 foot 3200 W tanning bed 220 V that we bought Used from a salon that one out of business I absolutely love this tanning bed but you mentioned not to use or maybe you mentioned UVA and UVB rays are not needed but I remember when I used to use it many years ago I didn’t get depressed in the winter ❄️ And here it is winter and I’m having a terrible time with depression this year I think it’ll do the job what are your thoughts 💭 Dr Marks?
    General repair

  10. Hello, I’m lucky enough to be set with a job in the behavioral health field that allows me time in the afternoon for an hour lunch break. Can I substitute bright light therapy for a walk in the sunshine, or just outside, daily?

  11. Hi, doctor. I was recently diagnosed bipolar. I first realized I was bipolar after watched one of your videos. My psychologist told me that is gonna take me around a year to figure what kind of bipolar disorder I have. I would like to see a video about what to do once you are diagnosed, what changes? How to accept it? What is waiting for us after the diagnose? Thank you.

  12. Hello Dr Tracey Marks, I am new to your channel. However, I was diagnosed with Bipolar in 2012 and in 2014 changed to Multiple personality disorder with Manic depression and psychosis ect.

    I am a single parent of 3 and my family feels that I inform my children of too much. I searched your topics and did not see much on how to manage parenting with these disorders. See additional questions below.

  13. Has there been any research on people whom have been on long term opioids for 10+ years or any long duration. I may self have been prescribed high doses of OxyContin 60mg every 8 hours. It's been three years since I've been of them but have never felt the same in my head, or body.

  14. I have a friend with bipolar type I , his mood typically crashes in January/February. It is dark at that time of the year where we live. This year he ended up in the hospital after a suicide attempt. They are completely re-working his medication, I wonder if they've thought of bright light therapy. I think I will ask him.

  15. Another great video! I received a light therapy lamp for Christmas and wasn't sure if the protocol for someone with bipolar would be different, so I was a little uneasy to use it. (My psychiatrist didn't seem to be very knowledgeable about it, despite being the one to recommend getting one lol) I'm going to start using it and see if it has any benefits. Thanks so much! Your videos are so informative and I always learn something new 🙂

  16. I realize this is an off topic question because it doesnt relate to the video but I was curious if you know the best way to explain mental Illnesses like depression to family members who don't understand? A lot of people and parents are uneducated about it and just assume that therapy is for loonies and that people cant have depression unless something traumatic has happened to them. I just want to explain it in a way for them that is simple and they can grasp without getting frustrated and blaming their kid for their symptoms please

  17. Hello Tracey, I found your latest video because I feel you would be more likely to see this comment this way, I'd just like to let you know that you have saved my life! I've been diagnosed with Separation anxiety, health anxiety, and many other forms of anxiety. Health anxiety is the worst, at first, before I had been diagnosed, I felt like I was going to die in my sleep every night, and if I felt the slightest tension in my chest, or if I ever got a headache, I would think I had a brain tumor or some sort of cancer! 

    I'd also test myself, by say looking at the time and saying to myself If that clock gets to 7:30 before I finish counting to 10, I'm going to die in my sleep tonight Stupid I know, but its really scary!

    I've been watching your videos a lot lately, and you have helped me so much, and seeing the lovely people who watch you and comment, made me feel like I wasn't alone, I'm getting better now, and I watch your videos pretty much every day!

    I'm so grateful to have found your youtube channel, I can't believe you only have 44K you deserve so much more recognition for the things you do! and the help you give, Thank you.

  18. Hi! After listening and watching your video several times (diagnosed w/BP1 and w/ extreme anxiety and panic attacks), I bought a Light therapy pad (it is by Tress Wellness). My problem is that I still do not understand how to really use it. The pad has four different light settings. I am not the smartest person in the world, and some times I get lost and can't focus on the simple things. Can you please give me some extra help?

  19. Hi Dr. Tracy. I’m currently going through a break up. I felt like I was doing really well with the help of therapy and medication. I knew my relationship wasn’t doing to well but this shocked me. He said he no longer wanted to be my emotion crutch. He was fed up with even the littlest things now. I felt like he’s just given up on me. This is making me slip back into my depression. How do I keep letting my depression hurt the people I love?

  20. This is one of the most informative channel on mental health. I will be looking forward to a video on social anxiety disorder.

  21. I forgot the type of therapy my psychologist told me about!! It’s where you watch a movie type thing and they measure your brain scans when you watch it. If you know what I’m talking about help me out girl! Love u btw!

  22. I dont really know if I have bipolar or not. I am 13 years old girl and following are my symptoms.
    1) I am always hiding my emotions because nobody understands me not even my own parents
    2) I daydream a lot. Even right now when I am writing this I am struggling to come out of my imagnary world
    3) I feel motivated for no reason and sometimes I feel demotivated for no reason
    4) I cant rest I dont know why. I keep walking the whole day
    5) I have racing thoughts or you can say too many thoughts in my mind
    6) In past I had depression because my parents were abusive they still abuse me but not that much. I got abused by my ex too who told me to play on road so that a car hits me and I die he really hates me a lot. The day when he abused me I started trying my best to come out of depression and I was successful.
    7) sometimes I feel very good and then suddenly I start feeling bad for no reason
    8) I am irritated and annoyed by everyone
    9) sometimes I get so annoyed and then suddenly I feel normal
    10) I cant act normal. This is difficult for me to explain but I actually try to act normal but I have to tell you I am not normal at all. When I am alone I do things that a normal person dont do (such as laughing,crying or getting scared for no reason and changing moods)
    11) I talk to myself a lot
    12) sometimes I self harm myself for no reason but that happens very rarely
    13) my parents tell me that I dont act normal sometimes while I feel normal.
    14) I keep chaging myself and my interests. This includes my personality too I change my habits a lot too and then for no reason I switch back to my old habits.
    15) I forget things easily.
    16) I cant concentrate
    17) I don't know how to socialize properly I have no social skills because since I was a kid my parents locked me at home I could only go to school but I rarely met my own relatives
    18) sometimes I get angry often the other times I don't get angry at all
    19) I dont live in America I live in Pakistan and I am a girl. Life here for a girl is difficult my country has been ranked as the world,s second most dangerous for women and I hate being a women because my life is totally meaningless
    20) sometimes I suddenly become interested in different topics then I leave them after a while well this is actually good because its the reason why I know about so many things that other don't
    21) I think very deeply and act mature than my age some adults said that I might become a philosopher when I grow up but I think I will only become an idiot.
    22) one thought never leaves my mind which is "humans exist but humanity does not dont expect kindness from anyone" this thought sometimes makes me hate everyone.
    23) sometimes I hate myself then I suddenly start loving myself for no reason…
    24) I dont know what I want from myself some times..

    Honestly I hate living like this…I cant even tell anyone how I feel.

  23. Hello Dr. Marks! Thank you so much for your videos! I wanted to ask if you could give us some help for partners who are in a relationship with a bipolar person. For example what if the person doesn’t realize they need help, maybe in short moments they do but mostly reject to seek help. What are the moments when a person realizes that they need professional help?

    Also I would like to ask how being with a bipolar person can effect a relationship. Is it likely that if after years of no professional help, also the partner starts to suffer from depression because of navigating the partners up and downs?

    I would really appreciate if you have time to touch on those topics!
    Thank you very much!

  24. Is this better for mood than getting regular time in the sun? I’ve heard that summer can trigger mania for some people because of all the sunlight people are exposed to.

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