Travel, Jet Lag and Mood Disorders

“I really adjusted fast, it was miraculous…”  Patients who travel are familiar with warnings and advice we give about the potential for moods to get unbalanced or even out of control as a result of jet lag and time changes on international flights.  Recently, Jason, who was making a 15-hour time change for his honeymoon, reported back on the helpfulness of the jet lag calculator on his way out, and the comparative difficulty of return when “I didn’t do the work.  I didn’t plan it out.”  Going out, he said, he experienced maybe two days of increased tiredness.  Coming home, “I ended up having to take melatonin to kind of regulate and get back to the right sleeping pattern.  It took like four or five days.”

Long distance travel (more than three time zones crossed) can have an uncomfortable effect on circadian rhythms and sleep and waking times.  This “jet lag” can result in precious time in your new environment being lost to sleep or sleepiness.  Moreover, the stresses of travel and jet lag can have pernicious effects on mood and mood disorders in ways that vary depending on direction of travel, weather patterns, diet and other factors.  People with bipolar and other mood disorders need to make careful plans for possible disruption when traveling.

The most important factor is light exposure, especially blue light.  Find out the daylight times in your destination, and begin light exposure at morning times and blocking at evening times.  Blue light blocking glasses can be very helpful in changing your body’s circadian rhythms to match that of the destination, even two or three days before departure.  While traveling, try as much as possible to match meal times and light exposure to the schedule of your destination, and upon arrival try not to allow yourself to sleep in the middle of the day during your adjustment period.  All these steps will be made easier if you use the jet lag calculator, as Jason recommends, because it does the math for you.

Another concern for long-distance flights is the different effects of flying east to west, or west to east.  Research done on travelers having mental health emergencies in airports have found that travelers going east (London to New York; or San Francisco to Tokyo) are more likely to experience hypomania or mania while westbound travel is associated with depressive symptoms.  It’s not entirely clear why this happens, but the effect is significant, so it’s worth making some preparations, just in case.  Moreover, north-south travel (or the reverse) can result in significant differences in day light length and temperature, and travel from the northern hemisphere to the southern can result in complete changes of season, all of which affect the body’s circadian rhythm because of differential light exposure.

Crisis prevention planning

Light exposure and time changes are a major cause of disruption while traveling, but, of course, other types of crises can also arise without warning.  Especially in the case of international travel, where you may not have easy access to resources you are familiar with, a crisis plan is essential.  What will you do if you lose your medications?  Have a manic episode? Find yourself in a hospital where you can’t readily explain your mental health needs?  For these reasons and others, a crisis prevention plan is essential.  Take time before departure to carefully think through some realistic possibilities and write down step-by-step instructions for yourself to follow in case of emergency.

Be prepared

True, it’s more work, as Jason experienced, but the work pays off in a better travel experience and less wear-and-tear on the body and mind.  Please share any travel tips you have found in the comments box below.