Category: Nansen

Morning Faces Therapy for Bipolar Disorder: What One User Has Learned

Seth RobertsLeave a comment

A friend of mine has been using morning faces therapy to improve his mood — he suffers from bipolar disorder — for 15 years. He is the first person I told about it. I recently asked him how his use of it has changed over the years. He replied:

I began the morning faces therapy in April, 1997. I can think of only two significant changes over the years in my use of the therapy: 1) I use a mirror instead of videotapes, and 2) I accept that once or twice a week I’m too tired to start as early as I’d like (so I get more sleep instead). To elaborate:

1) When I restarted the treatment in 2006 after having been hospitalized, I was too depressed to deal with videotaping. In fact, I was too depressed to get out of bed so early. The mirror solved both problems, because I could easily prop it on my mattress top. After a few days I was able to get up, allowing me to listen to music, use bright lights, etc., during the treatment.

2) Whether for lack of discipline or the proper genes, I simply can’t go to sleep early enough so that I can get up early every morning. (Granted, I haven’t tried everything, but for the sake of the argument, let it stand.) This shortcoming used to bother me a great deal. Then on October 6th, 2011, I read in this blog about someone else who didn’t always start the treatment early, because he was “too tired to get up early”. Well! It didn’t seem so bad if someone else had the same problem. Over the years I’ve found that starting 30-60 minutes late once or twice a week doesn’t seem to perturb my mood enough to cause great concern.

I asked how the therapy has helped him. He replied:

The benefits of the morning faces therapy have been both 1) quantitative and 2) qualitative.

1) I have had bipolar disorder for 27 years. With the therapy, I’ve been medication-free for 6 years, and I was on much reduced doses of medication for about 7 years. So it’s fair to say the therapy has reduced the severity of the illness by around one half. Also, the lithium that I took in part caused kidney disease, whereas, obviously, there are no side effects from looking at faces in the morning.

2) The qualitative difference seems far more important to me. I am basically content with life; I am comfortable in my own skin. I’ve never felt like this before, and life without this is empty.

Note to skeptics: you might think, well, bipolar disorder is known to go in remission, and maturity often brings contentment. But this fails to explain why stopping the treatment brings back both the illness and the essential sadness.

Morning Faces Therapy Improvements

Seth Roberts3 Comments

A friend with bipolar disorder writes:

I began the morning faces therapy in April, 1997. I can think of only two significant changes over the years in my use of the therapy: 1) I use a mirror instead of videotapes, and 2) I accept that once or twice a week I’m too tired to start as early as I’d like (so I get more sleep instead). To elaborate:

1) When I restarted the treatment in 2006 after having been hospitalized, I was too depressed to deal with videotaping. In fact, I was too depressed to get out of bed so early. The mirror solved both problems, because I could easily prop it on my mattress top. After a few days I was able to get up, allowing me to listen to music, use bright lights, etc., during the treatment.

2) Whether for lack of discipline or the proper genes, I simply can’t go to sleep early enough so that I can get up early every morning. (Granted, I haven’t tried everything, but for the sake of the argument, let it stand.) This shortcoming used to bother me a great deal. Then on October 6th, 2011, I read in this blog about someone else who didn’t always start the treatment early, because he was “too tired to get up early ”. Well! It didn’t seem so bad if someone else had the same problem. Over the years I’ve found that starting 30-60 minutes late once or twice a week doesn’t seem to perturb my mood enough to cause great concern.

Morning Faces Therapy for Bipolar Disorder: Follow-Up Questions

Seth Roberts9 Comments

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.

 

 

Comment on “Morning Faces Therapy For Bipolar Disorder”

Seth Roberts7 Comments

In yesterday’s post, a friend of mine with bipolar disorder told how he used my faces/mood discovery. It allowed him “to enjoy life and relate to others in ways that I never could my entire life,” he wrote. Partly because it allows him to stop taking the usual meds prescribed for bipolar disorder, which have awful side effects.

What do I think about this?

To begin with the obvious, I am very happy that something I discovered has helped someone else. Practically all science has no obvious use. (A tiny fraction is eventually helpful.) In experimental psychology, my field, I can’t think of a single finding that’s helped many people. Because of this background, managing to help someone via science seems like a fairy tale. It’s too soon to say the story has a happy ending — it isn’t over — but it is beginning to have a happy ending.

Thank heaven for blogs. Something like my faces/mood discovery is difficult to publicize, yet without accumulation of evidence it will go nowhere. It wouldn’t be easy to publish in a psychiatric or psychotherapeutic journal because I’m not a psychiatrist or psychotherapist. Even if published, the chances of interesting psychiatrists and psychotherapists are low because it doesn’t involve a treatment you can make money from (gatekeeper syndrome). It should greatly interest persons with bipolar disorder but they are not the typical readers of the scientific literature on mood disorders. However, like all sufferers, they search the Internet.

In my internal calculus, the story provides what I think of as “ industrial strength” evidence. Industrial-strength evidence is evidence that something works in practice, not just in the lab. In a laboratory setting, which to some extent includes me studying myself, you try to keep things constant. You want to reduce noise. Noise reduction makes signals clearer. An effect you can see easily in a lab experiment, however, may be too small to matter outside the lab, where more powerful forces push people around. Whether your lab experiment — in which you have managed to control Force X — has practical value depends on the size of Force X relative to other forces at work outside the lab. An example is the theory behind the Shangri-La Diet. Does that theory tell us anything useful about why people are fat? Does it explain the obesity epidemic, for example? I knew the theory had plenty of truth because it had led me to several new ways of losing weight and had helped me lose considerable weight and keep it off forever. But that was far from showing (a) it was the only thing that controls weight or even (b) one of the big things. Lab experiments can’t do that. It’s been claimed that obesity is due to a virus. Experiments support the idea. Yet the idea is irrelevant to everyday life, I’m sure. No one has written How to Lie With Laboratory Science but it could be written. The only way to find out if a “true” idea explains enough of reality to be useful is to use that idea in real-world situations. Which is what my friend did.

But that isn’t the biggest thing. The biggest thing, from my point of view, is that what my friend has done helps keep this idea alive. When it comes to ideas, grow or die. My friend’s story keeps the idea alive by expanding it. It gives it a new and personal dimension. It isn’t just about mood measurements, it’s about living a reasonable life. I’ve given talks about this idea, but this story makes it much easier to talk about to a general audience.

 

 

 

 

Morning Faces Therapy for Bipolar Disorder

Seth Roberts4 Comments

In 1995, I discovered that seeing faces in the morning improved my mood the next day. If I saw faces Monday morning I felt better on Tuesday — but not Monday. The delay was astonishing; so was the size of the effect. The faces not only made me cheerful, they also made me eager to do things (the opposite of procrastination) and serene. This is the opposite of depression. Depressed people feel unhappy, don’t want to do anything, and are irritable. Eventually I found that the mood improvement was part of a larger effect: morning faces produced an oscillation in mood (below neutral then above neutral) that began about 6 pm on the day I saw the faces and lasted about a day. As strange as this may sound, there was plenty of supporting data — the connection between depression and insomnia, for example.

After I had observed the effect on myself hundreds of time, I urged a friend with bipolar disorder to try it. Recently he wrote me about how it has helped him.

Here is the very short story of my experience with this treatment.

I have used your treatment since 1997. As an indication of its effectiveness, from 1999 to 2003 I was completely off of medications, and now I’ve been off again since August of last year.

I was severely ill when I began the treatment. I was first hospitalized in 1985 for manic psychosis, and I was hospitalized later for suicidal thoughts and then again for psychosis. In 1997 I was 46 years old, taking Prozac, Depakote, and Moban (an anti-psychotic), and I was barely functioning.

The initial reaction, after three days of the treatment, was astonishing. It felt like a giant headache was just lifted off me. But the [new] clarity of mind enabled me to see my awful condition, and I had acute suicidal thoughts for a day or two. After that initial bounce, the improvement in mood was more subtle, but definitely correlated to how early I started looking at faces.

The early years of the treatment were often rocky. You were still working out some of the kinks in the treatment. The biggest surprise came when you found that exposure to fluorescent lights at night cancelled the effect of the faces. Another problem, also having to do with fluorescent lights, arose when I added early-morning bright-light therapy: the start-time and duration had to be adjusted by trial-and-error. At least six times I was one step away from becoming delusional, and then the treatment would pull me back within 48 hours. You were indispensable during those early years because I could call you and you would give me advice and the will to pull through.

By 2003, I had made some good progress. I had moved back to Berkeley, I was living with “normal” roommates instead of with other bipolar guys, and I had even been able to work for short periods. But along the way I had accumulated several minor pains. Back pain and stress made it difficult to get more than 4 hours of sleep. Sleeping pills did not solve the problem. I was scared that I would have to return to the mental health system; I would be a failure at the only thing I ever cared about [using the face treatment to stay out of the mental health system]. I made a pathetic attempt at suicide and wound up back in Herrick Hospital.

It was back to the crappy life—dulling medications, the psychiatrist and the psychotherapist, the support group, a volunteer job. Then, in 2006, the publicity for your diet book motivated me to try the “faces in the morning” treatment again. By that time, you had found that using a mirror was as effective as using videotapes [such as C-SPAN Booknotes recordings], which greatly simplified the process.

By 2009 I had reduced my doses of Prozac and Depakote to only 10 mg and 250 mg, respectively. (I hadn’t needed Moban since 1999.) In August of 2010, dissatisfied with my low energy level, I decided to go off medications completely again. Getting off of Prozac and Depakote gradually was tricky, because Prozac, which can induce mania, has a plasma half-life of about 10 days, while Depakote, which is anti-manic, has a half-life on the order of only 10 hours.

Today, most people would no doubt say that I’m still a loser. No matter, I’m able to enjoy life and relate to others in ways that I never could my entire life. I’m a Total Believer in the treatment. I don’t proselytize, though. People automatically reject the idea, and in any event I don’t want to be (directly) responsible if the treatment doesn’t work for someone. (Example: My nephew has clinical depression; he also has guns. If he tried this treatment, went off of medications, and then for some reason killed himself, my sister would never speak to me.)

The most difficult aspect of the treatment for me has been simply going to bed early. Even though I feel better the earlier I go to sleep, 10:45 pm is the best I can do on a regular basis.

To sum up, I believe you have discovered a powerful anti-depressant treatment that, in my case, has been effective for severe bipolar disorder. As a complete substitute for medications, however, it has entailed serious risks, and it requires substantial discipline to maintain. It is also important to note that “face therapy” is not the only alternative therapy that I use. In addition to the bright-light therapy that I mentioned above, I currently take 3 grams of omega-3 per day in the form of fish oil capsules.

There are a few more details and observations in these blog posts:

https://sethroberts.org/2007/05/06/life-size-faces/#comment-10539

https://sethroberts.org/2007/07/31/more-about-faces-and-mood/

https://sethroberts.org/2009/10/15/more-about-faces-and-mood-2/

Tomorrow I will comment on this.