Morning Faces Therapy for Bipolar Disorder: Follow-Up Questions

In May I posted a friend’s story about how he used my morning-faces discovery to improve his life. It helped enormously (“It felt like a giant headache was just lifted off me”). I asked him some follow-up questions.

What time of day do you look at your face in a mirror? For how long?

I look at my face in a mirror for an hour starting at about 6:20am (Daylight Saving Time). It doesn’t feel weird or vain to me. I usually listen to C-SPAN, Comedy Central, or music during the therapy.

You wrote: “I’m able to enjoy life and relate to others in ways that I never could my entire life.” Could you elaborate?

In my letter I said that my initial reaction to the face therapy was that it felt like a giant headache was just lifted off of me. That “headache” was the weight of depression and anxiety on my mind. My whole life I have been burdened by that weight, under its shadow to one degree or another. Another angle on this: Your initial reaction was “I felt great – cheerful and calm, yet full of energy”. I am quite certain that before the therapy I was never in that state of mind. But I’m not just talking about typical enjoyment—hearing the music, conversing and laughing, a fine meal, etc. In The Simpsons episode “Barting Over”, Homer is twirling slowly high in the air on a skateboard, and a novel idea pops into his head: if he buys two kinds of nuts separately, he can combine them at home to get “mixed nuts”. That sensation of weightlessness, with little solutions to little problems just popping up, is new to me. When you add up hundreds of those solutions, you find life itself less burdensome. You make more room for appreciation, gratitude, friendship, and so on. You begin to get an inkling of what a full human life could be.

People “automatically reject the idea”, you wrote. What happens?

“That’s the most ridiculous thing I’ve ever heard” was the comment of a woman in the bipolar support group. Some in the group of the if-it-sounds-crazy-enough-I-believe-it persuasion would nod their support. My sister theorized that it was all just meditation (!) and finished by saying, “I get enough faces at work.” My dental hygienist was somewhat persuaded by the fact that a newborn can recognize its mother’s face within hours of birth.

Do you continue to see a psychiatrist and/or a psychologist? If so, are they curious about how well you are doing without meds? If they’re not curious, how do they explain it?

My psychiatrist and psychotherapist are glad that I’m doing well, but they are not curious about the face therapy, the bright lights, or the fish oil. They are skeptical toward alternative treatments. I gather they think that my improvement is due to remission, or an upswing in the illness’s cycle, or the accumulated years of talk therapy. Or they abandon reason altogether, saying, “Whatever works for you.”

Why do you need to go to bed “early”? What happens if you don’t? What makes it difficult or discipline-requiring to go to bed “early”?

If I go to bed late, I need to take an hour nap the next day, which is a drag. At 10pm I’m almost never tired enough, plus I usually feel that I haven’t accomplished enough for the day. At your suggestion, I am trying to reset my circadian rhythm by getting 2 hours of morning light from approximately 7:30am to 9:30am.

What effect does the early morning bright light therapy have? How do you do it (e.g., equipment, time of day)? Why did you start it?

As I recall, the lights helped me to wake up early, fairly rested and alert. I started in 1997 at your suggestion with a bank of four GE F40SP65-ECO tubes, 40 watts each, 48 inches long. I now cover half of the bank to reduce the intensity. I get thirty minutes of exposure starting at about 6:50 am (Daylight Saving Time).

In 1997, what made you decide to try the faces?

I was primed for the idea that a big change might help. Six months prior, I had made a somewhat beneficial switch to Depakote after taking lithium for 11 years. Also, you claimed that you already had good experimental results with several people, and that Andrew Gelman at Columbia University was impressed with your work.

“I hadn’t needed Moban since 1999,” you write. Why not?

From 1999 to 2003, the face therapy was so effective that I didn’t need an antipsychotic (e.g. Moban). From 2003 to 2006, when I didn’t use the face therapy, I kept certain habits that I had adopted during that therapy: keeping a fairly normal sleep schedule, avoiding fluorescent lights at night, and getting a decent amount of social interaction.

With the benefit of hindsight, why do you think it did not keep you out of the hospital in 2003?

When I told my psychiatrist in 1999 that I was going to use the face therapy instead of medications, he exclaimed, “That’s like taking off a cast and trying to walk right away!” Indeed, for 12 years my mind had been numbed with psychiatric drugs. Although the face therapy was seemingly miraculous, it couldn’t restore all that was lost. Yet with little support from others I was trying to “walk”: I had the goals of getting a job and a social circle; I had a dream of leading the way for all depressed people. It was unrealistic to expect that I could do much more than crawl through life. By 2003, I needed the hospital because I was in over my head.

Why did back pain and stress put you back in the hospital? Why did they lead to a suicide attempt?

My mental state deteriorated because of lack of sleep, which in turn was due to back pain and stress. Both back pain and stress are manageable—given enough time and attention. Unfortunately, at the time I was overwhelmed with many new problems and many lingering old problems. I had just moved. The house had far more traffic noise and housemates than I was accustomed to. I didn’t have the money or strength to move again; I was falling out with an old friend; my wrists and feet were injured. If I went back to the mental health system, I would be more handicapped than ever. The situation seemed hopeless.

Why did publicity related to The Shangri-La Diet make you try this again?

I actually thought that Diane Sawyer might call me after saying to herself, “Wow, what else has Professor Roberts discovered?” So I wanted to shape up my mood fast! I assumed that the Shangri-la Diet in its way must be about as great as the face therapy. I didn’t suspect that the media would treat your diet like any other—as an offbeat fad.

You wrote: “In August of 2010, dissatisfied with my low energy level, I decided to go off medications completely again. What did you do?

I had been “stabilized” on 250 mg of Depakote, which is a sedating anti-manic drug, and 20mg of Prozac, which is an antidepressant that can induce mania. About once a month, I got rid of the sedation by skipping the Depakote for a few days. On one occasion, when I tried to skip the Depakote for 9 successive days, I became slightly hypomanic and had trouble sleeping. Over the course of several months, I reduced the Prozac to 10mg, and even to 5mg, but still I couldn’t stay off the Depakote for more than about 7days without problems.

You wrote: “Getting off just the two drugs was tricky, because of the difference in half-lives.” What was “tricky” about it?

I was boxed in by the difference in the drugs’ half-lives. Prozac has a plasma half-life of about 10 days, while Depakote has a half-life on the order of only 10 hours. I considered splitting the enteric-coated Depakote, but never did. I decided that the only way out was to stop taking the Prozac, but continue taking the Depakote for 10 days until the Prozac was out of my system. So I tolerated being depressed and sedated until I could stop the Depakote, too.