Spring Mania: A Different Kind of Spring Fever

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Sweet springtime: The birds start chirping again, the days warm up, and the skies are brighter and longer. The hibernation of winter ends, and seasonal depression begins to lift. Spring fever is in the air.

However, for those who struggle with mental health concerns, most notably bipolar disorder, spring fever can have an entirely different meaning. As the days get longer and the weather warms, there is also an increased risk for hypomanic or manic episodes. Research on bipolar disorder points to the phenomenon of "spring mania," and although not all mechanisms underlying this condition are clear, several key factors are understood to increase its prevalence.

Light and Circadian Rhythms

Following the 24-hour cycle known as our circadian rhythm, the human body adapts and adjusts to light and dark. Our ability to adapt to these light and dark changes is not only physical but mental, behavioral, and emotional. Further, it can be easy to misalign our circadian rhythms through light, activity, medications, or "pushing through the sleep window."

In mammals, circadian rhythms are generated by the suprachiasmatic nuclei (SCN) in a structure of the brain known as the hypothalamus, with the day-night cycle as the primary environmental time cue that synchronizes the circadian system to the 24-hour day (Cho and Lee, 2018). According to Baron et al. (2014), because the endogenous circadian system can also be sustained without external time cues, misalignment between the endogenous circadian system and an individual’s 24-hour environmental and behavioral cycles is possible; it has been suggested that such misalignment can be related to health problems, especially mental illnesses.

It is thought that in patients with bipolar disorder, the circadian phase can be easily shifted by the disturbance of sleep-wake cycles and by inappropriate artificial light use. Cho et al. (2016) observed that significant delays in the circadian pattern of salivary cortisol levels, when an individual is exposed to bright light before bedtime, are related to subthreshold bipolarity.

In short, those individuals who live with bipolar disorder are significantly more sensitive to light and circadian rhythm shifts. Additionally, the speed at which daylight hours lengthen is thought to be problematic.

Sleep and Melatonin

With increased light comes increased energy levels and a decrease in melatonin. Melatonin is a hormone secreted by the body in response to darkness that triggers sleep. With the sun setting later and rising earlier, there is a shift in melatonin production that tends to be significantly lower compared to winter months.

Again, it is believed that the speed of this shift tends to be problematic for those with bipolar disorder. Mattingly et al. (2021) found that, generally, wake times are earlier during the spring, and sleep duration decreases (as compared to winter). Sleep duration also modestly decreases when day lengths get longer, which can account for struggles with insomnia, sleep quality, or reduced sleep. Individuals with bipolar disorder tend to be more sensitive to these changes.

Stress

Most notably, for students, the spring semester tends to be stressful. On average, mid-terms tend to be around mid-March, followed by further exams, projects, and papers until the end of the semester. This stress, paired with rapid changes in circadian rhythms and decreased sleep quality, is an ideal concoction to trigger a manic or hypomanic episode.

In addition to school stress, many students must navigate housing changes. As the semester ends, leases may end, or students may need to move out of their dorms. These changes can be stressful and, when added to other existing stressors, can become significant.

Tips to Manage

The following tips can help people manage the transition into spring:

1. Take vitamin D regularly in the winter months to make the spring transition easier.
2. Use blackout curtains to prevent early-morning waking.
3. Eliminate nighttime screen usage and blue lights.
4. Supplement with melatonin at night to help ease insomnia or restless sleep.
5. Talk to your doctor about any current medications and whether dosage changes could be helpful.
6. Schedule consistent therapy appointments to manage moods.
7. Get psychoeducation to understand your condition and why changes may happen

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