Morning Faces Therapy For Bipolar Disorder: A Story (Part 2: First Two Months)

In the 1990s, I discovered that if I see faces on TV early in the morning, I feel better (happier, more eager, more serene) the next day, but not the same day. Faces Monday morning, for example, make me feel better on Tuesday but not Monday. I studied this effect extensively. The results suggested that a circadian oscillator controls our mood and sleep and needs morning face exposure to work properly. Absence of morning face exposure, this theory says, increases your risk of depression — a view not compatible with the “chemical imbalance” explanation of depression but one supported by the strong association between depression and insomnia.

I told friends about this. One of them had devastating bipolar disorder. As he describes here and here, he got great benefit from looking at faces in the morning. After I posted his account of his experience, a man I’ll call Rex wrote me that he was going to try it. At 29, he was diagnosed with bipolar disorder. At 32, he slit his wrists. He is now 37.Since then he’s been in and out of mental hospitals. Now he lives at home. I wanted to follow his use of morning face therapy “prospectively” — before knowing what would happen. I posted this, about his background, around the time he started.

Treatment details. He began about two months ago. He gets up naturally (no alarm) at about 8 am. He starts watching faces on TV — Squawk on the Street (CNN) — soon after he gets up. He watches for 1-2 hours on a 43-inch high-definition TV; the faces are roughly life-size. He sits 10 feet away.

Mood. Before starting the faces, he was in a depressed mood 5-7 days per month. During those days he had low energy, low motivation, and a bad attitude. The low phases would last a few days, then he’d start feeling better. Now, he says, “my mood is better first thing in the morning. I feel ready to go, turn the TV on, watch something. I feel a little lighter. I no longer feel the early morning doom that I used to feel. I’ve never been a morning person, but I feel that way more now than any time I can remember. I haven’t had any depressed moods since I started the faces. I haven’t had any really adverse or negative emotions. Things are going very smoothly. I have less worries, I feel a more uplifting, upbeat tempo throughout the day. Everything seems better.” (Note: Morning faces likewise shifted me toward being a morning person.)

Medication. He used to take an antidepressant every day (Simbalta, 60 mg/day). Now he takes 30 mg once every 3 to 4 days. He’s tried to stop taking it entirely but gets withdrawal symptoms (headache, nausea) when he does that. Note that he still had 5-7 days/month of depressed moods every month even when taking the antidepressant. In the spring his depression was better so he cut back slowly on the medication.

Sleep. For a long time he has had great difficulty falling asleep. He would lie in bed for an hour without falling asleep. He took sleep medication, usually Lunesta or Ambien, very often. “Lots of times in the past I would give up [after lying in bed a long time] and go watch TV. Or start to read, stay up to 2:30. That’s always been a problem — ever since I was in college. In college, my sleeping schedule went nuts. When I got into the working world, it continued to where I would stay up late and couldn’t sleep.” Since he started the morning faces, his sleep is much better. He usually falls asleep within 20 minutes of lying down, a very noticeable difference. He has taken much less sleep medication — about 20% of what it was before. (He still takes it when he knows he has to get up early or he feels wired.) At one point, when he took antipsychotics, he did fall asleep quickly “but the side effects were awful,” he said. “Grogginess, foggy head all day. I didn’t have as much mania and depression but I would sleep 11 hours per night and I couldn’t get out of bed in the morning. I couldn’t concentrate. I couldn’t go back to college, because I couldn’t think clearly.”

At the same time he started the faces, he started getting blue light exposure in the morning from a blue light box called the Apollo Health goLITE. He started with 20 minutes of exposure. It did seem to improve his mood and make him feel tired earlier. However, it also made him feel anxious and tense. To try to get rid of this effect, he reduced the exposure: 10 minutes, 5 minutes, 2 minutes. After a week, he stopped using it altogether.

“I’m just ecstatic about the results,” he said.

 

Morning Faces Therapy For Bipolar Disorder: A Story (Part 1: Background)

In the mid-1990s I discovered that seeing faces in the morning raised my mood the next day. If I saw faces Monday morning, I felt better on Tuesday — not Monday. This discovery and many other facts suggest that we have an internal oscillator that controls our mood — in particular, how happy we are, how eager we are to do things, and how irritable we are. For this oscillator to work properly, we must see faces in the morning and avoid faces and fluorescent light at night.

In rich countries, almost everyone gets nothing resembling the optimum input. One of the problems this may create is bipolar disorder. A week ago I posted how a friend of mine used my faces/mood discovery to control his bipolar disorder. After that post, a man I’ll call Rex wrote to me thanking me — that post had inspired him to try to control his own bipolar disorder that way. Before knowing anything about whether he would be successful, I decided it would be good to follow and record what happens. Either way — successful or not — it should be revealing.

I am going to post his story in several parts. The first few parts are background.

My first full-blown bipolar episode was at 29 years of age. (I am now 37.)

I was a civil engineer working for the government in an Eastern State. I had self-diagnosed myself as having Seasonal Affective Disorder (SAD), also known as the morning blues. The symptoms are mild to severe depression, lethargy, apathy and weight gain. A form of treatment for SAD is the light box. Mine is an Apollo GoLite Box. As soon as I read about this device, I was excited. It came via UPS. I plugged it in during my lunch break soon after it arrived. By the end of the work day my mind was in overdrive. I was a total motor mouth, with racing racing thoughts and unusual activities such as inventing things, writing songs and books for the first time. Friends knew I was totally not myself. I went without sleep for days at a time. I began drinking heavily and not going to work. My mind could not rest. Alcohol or extreme exercise were the only medicine. I stopped eating, lost about 30 pounds in 30 days. I became paranoid and shut everyone out of my life including my friends, family, and co-workers. I was buying hundreds if books and dozens of bottles of supplements. Overall I was turning into a different person with new interests.

Finally my parents stepped in because of my isolation and irresponsible behavior. This led to a three week outpatient clinic stay in Illinois. Right away I was diagnosed as Bipolar I. I was vaguely familiar with it, but was quite stunned I had it. On the other hand, it was a huge relief to have a name to this craziness I was feeling. I was put on four medications and went through extensive therapy, including talk therapy, group therapy, family talks, and letter writing. It was a wonderful experience that helped me to deal with painful past experiences. It had an excellent scheduled program with early-morning group therapy and prayer. [Note the morning exposure to faces.] This was a Christian-based psychiatric clinic. Then daily small classes on mental health issues, then one-on-one discussions with a licensed therapist and plenty of other group activities and meals on the town. Lots of love, support and scheduled work.

That was an ideal setting. After three weeks I came home. I slowly went back to those sad, frustrated days. The drugs seem to stop working. My moods began turning sad or mad, for no particular reason. [Note that this downturn happened soon after exposure to morning faces — via group therapy — stopped.] The frustrations of an unfulfilled, boring and dead-end career grew worse. Maybe the worst was a lonely life. Silence in the mornings and only late-night television before bed.

The disappointments of my life were bad, but the bipolar manifestations of the highs and lows seemed to magnify all emotions to the nth degree. My medications were replaced by the new ones, without expired patents. Perhaps I have been prescribed ten different anti-depressants overall, sometimes in combinations, but I only found relief in narcotics such as prescription xanax or klonopin.

They truly numbed the pain, but led to regrettable behavior. I took to cutting myself as a sort of punishment for the unwarranted guilt and self-absorption (for feeling depressed and angry) and to ease the pains with the endorphin releasing that was given by cutting with a razor blade. It seems insane now, but at the time it was the quickest release. These cuttings not only led to my first surgery, but led me back into a different psychiatric hospital in Vanderbilt at age 31. I had a tendon transfer surgery from my the top of my wrist to closer to my thumb, where I had severed my tendon. It was very embarrassing to my family and myself. I came clean to my employer and became eligible for FMLA (The Federal Medical Leave Act).

During these last couple of years, my manias have been much rarer and weaker. I faithfully take my medication daily. I still experience mild depression, but to a lessor extent, a more numbing feeling. I still feel sad but not the weepy, nostalgia I felt overwhelmed with previously.

To be continued.