Light Therapy: Timing Matters?

Research in the realm of light therapy seems to be accelerating. There are several groups now suggesting specific times of day for use of a light box -- not just "first thing in the morning" as we've been advising people for years.

There are at least two systems for determining when a light box ought to be used. One is a research group, led by Drs. Terman and colleagues in New York. The other is also online -- but comes from a light box company! That usually would make so suspicious I'd be looking elsewhere. Worse yet, to get the results after you take their test, you have to enter a valid email address (I tried to sneak around that, no go. Of course you could use that junk email address you're using for all the other online things you sign up for...).

However, this time I think the light box company may have the better of the two tests -- in part because I've had telephone and email conversations with the research leader there, Dan Adams, who is very knowledgeable in this realm (somewhat overwhelmingly so) and who seems really dedicated to getting doing accurate, valid research as well as selling a very good product.

In any case, if you're using or thinking about using a light box, have a look at my updated page on Light Therapy, including particularly the section on When To Use It. Good luck with the process of figuring it out -- which I say not as a joke, but as a well-wish, knowing that we don't know yet all we need to know about this.

Dr. Phelps

A Great Book on What Bipolar Depression is Really Like

There are many good books out there about bipolar disorder. Several have been written by people with this condition. They're good writers, entertaining. But here's one that I think really warrants attention -- and you can get a lovely sample of it by reading the author's blog before you buy.

John McManamy is one of the most respected writers about bipolar disorder. He's been a member of the International Society for Bipolar Disorders for years and is well known to many of the researchers in the field through his work there. But his greatest asset, and thus his book's greatest value, is in his ability to put into words the experience of bipolar depression.

So if for any reason you would find useful a thoughtful, well-crafted description of what life is like for people who know despair like most of us don't -- but one which also captures the funny, creative, brilliant side of the experience: this is a great one.

His information on treatment is most useful for those who need an introductory overview. This is not the strength of the book; and in not too long, as is the fate of any such book, this section will be out of date. But the most valuable part of this book -- the first half, describing the experience-- will remain valuable for years. Indeed as doctors are pressured to spend less and less time with patients, Mr. McManamy's book will become even more important for them. I can't think of a better book for third-year medical students rotating in Psychiatry, for example. It ought to be required reading there, worthy of replacing nearly any textbook currently recommended.

After all, what is the most important thing for anyone (medical student or otherwise) who is just beginning to try to understand a new subject? You don't need the physiology first, nor the molecular explanations. You need to get a good feel for the thing you're studying, as though you could experience it yourself. Mercifully, Mr. McManamy has supplied this for you, saving you this hard learning. Indeed, perhaps if you understand it like he does, you'll be less likely to find yourself there. At minimum you won't be there without a map, as has so long been the case (as it remains, even now for some, in the realm of bipolar depression when the hypomanic or manic side is minimal or absent).

If you've already "been there" yourself, I think you'll find great comfort in seeing your experience so artfully described. I can imagine people who've struggled with depression buying this book so that they could hand it to a loved one and say "here, read this: it will help you understand me better than I can explain myself". Although first you'll want to go through it yourself, several times I'll bet, gleaning all the gems of self-care the author has collected from his website readers, and his own experience.

You'll see: have a taste of his writing. And order his book right from there. Bon appetit.
JP

Serotonin Transporter Lab Testing?

A reader just emailed to let me know he'd found a lab which offers a test which will determine your gene type for the "serotonin transporter". The significance of this particular gene is a long but very interesting story, which I've tried to tell in plain english on my webpage about "Yellow People and Blue People". This story is a young one. There is a lot more to learn. But for now it looks pretty clear: this is a gene which has an impact on mood, and probably anxiety -- in some people.

Most people, upon hearing this story, want to know where they can get tested. At least that's a first reaction. But whether to get tested or not is a tricky decision. That warrants another page on my site, considering the pro's and con's.

This used to be a theoretical issue, but with at least one lab actually offering the test, it's time for a more deliberate consideration of these pro's and con's. The justification being offered for the test by the lab is strong -- but very narrow. There is one particular purpose the test may indeed serve well (it's a little early to conclude even that much). But now that the test is available, I fear people will start using it for other reasons. This is going to be tricky.

For now I think it's so tricky I'm not even going to link the lab. You could probably figure it out if you really wanted. Read the pro/con essay first though. Good luck thinking that through.