Several of my patients reported odd changes in their sleep and their energy level this past week, as though there was an epidemic of fatigue going around.
They noted that their sleep was a bit more disrupted and that they didn’t feel as rested in the morning and, for the first time in months, they began taking afternoon naps. Going along with that, they also found that they were the less alert and productive and energetic during the day.
Several of them wondered if there was some kind of viral illness going around, but they didn’t report other symptoms suggestive of an illness.
This mysterious condition coincides with a return of foggy weather in San Francisco and the first noticeable changes in the length of the day as we move towards fall and winter.
Because of the fog that is common in San Francisco we often experience this kind of early harbinger of fall in late August or early September. For me it serves as a reminder that it is time to prepare for fall and winter for those of us who experience depression.
This is probably true for almost everyone with bipolar or recurrent depression, whether or not they have a clear seasonal pattern of mood episodes.
The brains of people with mood disorder seem to be less efficient at regulating the circadian rhythms that are essential for good quality sleep and high energy daytime wakefulness.
Fortunately, we know a lot more than we ever did about how to offset this potential vulnerability.
The main external factors that control circadian rhythms are regular waking times and bright light exposure first thing in the morning, perhaps along with regulation of room temperature (see this fascinating article), and avoidance of exposure to light (especially blue light) at night. If you are also interested in avoiding depression then your goal should be to go to bed early and wake up early.
All of this puts us at odds with the technological world we have created.
Computers, smart phones, and televisions are excellent sources of blue light exposure at night when we need to avoid blue light. However, while technology created the problem it can provide us with a solution if we plan for winter now.
- Now is the time to buy a therapy light.
- To really regulate your sleep consider buying a set of blue blocking glasses.
You may also want to think about adding some room 
lighting so that it is a bit easier to get up in the morning.
Also, review this blog post about getting up early as it contains many tips that are relevant to getting up when it is dark and cold.
For most of us exercise becomes harder in the fall and winter, but it is even more important, both for its health effects as well as its effects on mood and anxiety. So, make sure that you have a fall and winter exercise plan, think about a gym membership, and buy clothes and any lights that you might need to exercise outdoors.