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How Much Melatonin to Take For Bipolar Disorder

06.27.2019 by Molly McHugh // 2 Comments

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How much melatonin to take for bipolar disorder? Is there a recommended nightly dosage for those who have been diagnosed bipolar? If so, what is it?

How Much Melatonin to Take For Bipolar Disorder
We All Need to Sleep. With Bipolar Disorder it is Critical to Functioning Normally and Preventing Episodes.

Melatonin Studied in Bipolar 1 Disorder as Adjunctive Treatment

Here is a study of Manic Depressive patients who were taking antimania medications and given 3 mg of melatonin to help with sleep. It worked.

The below is quoted from a Progress in Neuro-Psychopharmacology & Biological Psychiatry study abstract:

“Eleven patients, eight males and three females, aged 22-43, meeting DSM IV diagnostic criteria for Bipolar Disorder, Manic Type, were selected for the presence of insomnia not responding to usual hypnotic therapies (benzodiazepine).”

“All the patients were on antimanic treatment. MLT 3 mg per os was administrated at 22.30 h for 1 month, without changing the previous antimanic and hypnotic treatments. All patients showed a significantly longer duration of sleep following MLT add-on. The severity of mania showed a parallel significant decrease.”

Source: Melatonin Add-on in Manic Patients with Treatment Resistent Insomina.

If Taking Large Doses of Psych Meds Melatonin May Not Help

I am not on any ‘antimanic treatment’ and have not been for more than 24 years. If I was, I honestly do not think melatonin would work as well as it does for me.

I share my story of withdrawing from high doses of lithium here: If I Can Get Off Psych Meds Anyone Can.

A psych med is like using a wrecking ball on your system, and disrupts many body functionings.

Taking a low to moderate does of the natural sleep aid melatonin is more like giving your circadium rhythms a gently but persuasive nudge to get going and do their stuff.

If you’ve got a chemical wrecking ball in there already, swaying back and forth, knocking around whoever dares to step in its path and all that is on both sides… that gentle nudge may not be felt.

[bctt tweet=”Melatonin Has Been Studied in Bipolar 1 Disorder Patients and Found to Be Effective.”]

Your pea-sized pineal gland may start to release nightly doses of melatonin like it is supposed to, but you’ve got so much other chemical crap in there doing God knows what it doesn’t give the result nature intended.

It’s overriden by bully, psych med-saturated molecules that are trying to bully other brain chemicals and molecules in the effort to get you to sleep. That wrecking ball-style solution may help for short-term relief if manic, but is not a smart long-term solution.

Some Bipolar Patients Say Melatonin Does Not Work

Many who are bipolar, try melatonin and then say ‘it doesn’t work’ are most likely on large doses of other medications that are interferring with its ability to help.

I still have many restless nights – but I almost always get a few hours of deep sleep, which then helps me function normally during the day. That’s the goal.

I’ve taken various amounts of melatonin off and on over the years and have been taking 3 mg regularily for about the past three years.

No, I’ve never read that study quoted above until this morning. That amount – same used in the study for Manic Depressive patients – is just what I have found works best for me. And I’d up the dose if I felt I wasn’t getting enough rest to function during the day, be able to work and get some enjoyment out of my life.

The results of the above study – considering the fact the test subjects were on other medications – are incredibly hopeful.

Here are 10 more medical studies: 10 Medical Studies About Circadian Rhythm and Bipolar Disorder.

Many who are not bipolar use melatonin for sleep and take larger amounts than 3 mg. I know one very successful woman who takes 10 mg at night. Yikes. I’ve never even considered that amount.

And she swears by a sublingual (dissolves under your tongue) brand you can buy at Costco. I personally have taken many different brands and all have given positive effects.

Why Doesn’t My Psychiatrist Tell Me To Try Melatonin?

Because they are not in the business of alternative medicine. They are in the business of psychotropic medication-selling.

Melatonin is a natural supplement, not a Big Pharma-produced product. The above study would not be of interest to a Big Pharma psychiatrist – they only want to promote and write prescriptions for psychotropic medications.

These kinds of docs love to prescribe antipsychotics to take at night. They are wrecking ball, russian roulette game supporters.

You decide whether that is the best approach for your health and healing – especially for the long term.

Cheers, Molly

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Categories // Alternative Treatments, Sleep Issues

10 Medical Studies About Circadian Rhythm and Bipolar Disorder

10.08.2017 by Molly McHugh // 2 Comments

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Ten medical studies about circadian rhythm and bipolar disorder – a hopeful avenue of research that can lead to better treatment options.

10 Medical Studies About Circadian Rhythm and Bipolar Disorder
Better Understanding of Circadian Rhythm Affecting Bipolar Disorder Mood States Could Lead to Better Treatment Options.

Circadian rhythm is your bodies internal 24 hour clock that regulates your sleep/wake cycle. Each listing includes a quote from the study abstract and a link to the study.

1. Genetic and Functional Abnormalities of the Melatonin Biosynthesis Pathway in Patients with Bipolar Disorder. Human Molecular Genetics, September 15, 2012.

“Patients affected by bipolar disorder (BD) frequently report abnormalities in sleep/wake cycles. In addition, they showed abnormal oscillating melatonin secretion, a key regulator of circadian rhythms and sleep patterns.”

“The acetylserotonin O-methyltransferase (ASMT) is a key enzyme of the melatonin biosynthesis and has recently been associated with psychiatric disorders such as autism spectrum disorders and depression.”

2. The Role of Sleep in Bipolar Disorder. Nature and Science of Sleep, June, 2016.

“A convergence of evidence suggests that sleep problems in bipolar disorder result from dysregulation across both process C and process S systems.”

“Biomarkers of depressive episodes include heightened fragmentation of rapid eye movement (REM) sleep, reduced REM latency, increased REM density, and a greater percentage of awakenings, while biomarkers of manic episodes include reduced REM latency, greater percentage of stage I sleep, increased REM density, discontinuous sleep patterns, shortened total sleep time, and a greater time awake in bed.”

3. The Role of Melatonin in Mood Disorders. ChronoPhysiology and Therapy, November, 2015.

“Mood spectrum disorders, including bipolar disorder (BD), major depressive disorder (MDD), and seasonal affective disorder (SAD), have been observed to be accompanied by circadian dysregulation as well as dysregulation in melatonin secretion.”

“Simultaneously, it has also been documented that disruptions in circadian rhythms, including the sleep/wake cycle, though environmental means can produce mood-related problems in vulnerable individuals. These findings suggested that altered circadian rhythms might be biological markers of these disorders.”

4. Melatonin in Bipolar Disorders. New Developments in Melatonin Research (book), January, 2013.

“Circulating melatonin is a main synchronizer of the sleep/wake cycle control and human mood and behavior.”

“Exogenous melatonin exerts a therapeutic effect in bipolar patients by normalizing the sleep/wake cycle and may improve both sleep duration and quality and, in addition, recent research has shown that exogenous melatonin can have a marked improvement in affective symptoms.”

5. Circadian Activity Rhythm Abnormalities in Ill and Recovered Bipolar I Disorder Patients. Bipolar Disorders, March, 2008.

“Activity rhythms are highly abnormal in acute phases of BPD; we compared circadian activity rhythms in BPD I patients during ill and recovered states to those of normal controls to test the hypothesis that some abnormalities may persist.”

6. Sleep and Circadian Rhythms in Bipolar Disorder: Seeking Synchrony, Harmony, and Regulation. American Journal of Psychiatry, 2008.

“While sleep disturbance and circadian dysregulation are critical pathophysiological elements in bipolar disorder, many questions about the mechanisms that underpin the association remain.”

“The author presents a model that recognizes a role for genetic vulnerability and suggests that there is a bidirectional relationship between daytime affect regulation and nighttime sleep such that an escalating vicious circle of disturbance in affect regulation during the day interferes with nighttime sleep/circadian functioning, and the effects of sleep deprivation contribute to difficulty in affect regulation the following day.”

7. Circadian Rhythm Dysregulation in Bipolar Disorder. Current Opinion in Investigating Drugs, July, 2010.

“Animal data based primarily on genetic manipulations and clinical data from biomarker and gene expression studies support the notion that circadian abnormalities underlie certain psychiatric disorders.”

“In particular, bipolar disorder has an interesting link to rhythm-related disease biology; other mood disturbances, such as major depressive disorder, seasonal affective disorder and the agitation and aggression accompanying severe dementia (sundowning), are also linked to changes in circadian rhythm function.”

8. Circadian Markers and Genes in Bipolar Disorder. Encephale (French journal), September, 2015.

“Quantitative and qualitative circadian abnormalities are associated with bipolar disorders both during acute episodes and euthymic periods, suggesting that these altered circadian rhythms may represent biological trait markers of the disorder.”

9. Circadian Rhythm Dysregulation in Bipolar Spectrum Disorders. Current Psychiatry Reports, April, 2017.

“Relative circadian phase delay (e.g., later melatonin peak, evening chronotype) is associated with BSD, particularly in the depressive phase.”

“More consistent evidence supports irregularity of social rhythms, sleep/wake and activity patterns, and disruptions of social rhythms by life events, as stable trait markers of BSD and potential vulnerabilities for BSD onset.”

10. Sleep and Circadium Rhythm Disturbance in Bipolar Disorder. Psychological Medicine, July 2017.

“Forty-six patients with BD and 42 controls had comprehensive sleep/circadian rhythm assessment with respiratory sleep studies, prolonged accelerometry over 3 weeks, sleep questionnaires and diaries, melatonin levels, alongside mood, psychosocial functioning and quality of life (QoL) questionnaires.”

“Twenty-three (50%) patients with BD had abnormal sleep, of whom 12 (52%) had CRD and 29% had obstructive sleep apnoea. Patients with abnormal sleep had lower 24-h melatonin secretion compared to controls and patients with normal sleep. Abnormal sleep/CRD in BD was associated with impaired functioning and worse QoL.”

Note: For this last study you do need to request the full transcript from Cambridge University Press.

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Categories // Alternative Treatments, Root Causes of Bipolar Disorder, Sleep Issues

Bipolars Have Irregular Sleep Patterns

04.25.2016 by Molly McHugh // Leave a Comment

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Bipolars have irregular sleep patterns. Most who have bipolar disorder have trouble sleeping at times. For some erratic sleep patterns may be a prominent part of their illness.

For others with ‘soft bipolar’ or less severe forms of the illness such as cyclothymic disorder sleep problems may be intermittent and coincide with occassional mood cycling.   Will Melatonin Help?

Bipolars Have Irregular Sleep Patterns
Time for a Cat Nap

When you don’t get a decent nights sleep and have a tendency toward irritable moods or have an actual mood disorder such as bipolar it can affect your functioning during the day greatly. And irregular sleep patterns are a very common symptom of this illness.

Lack of sleep not only may affect how you get through the day and your ability to be productive at work, socialize, handle the responsibilities of being a parent, etc. but it can also possibly trigger an illness episode.

How Do Bipolars Differ From Regular Folks?

Didn’t get a good nights rest? Big deal many would say. Some normal folks – for the purpose of this article we are using that term to describe anyone without bipolar disorder – actually thrive on little sleep.

Doctors are famous for having to work long hours with little sleep and still function at a high level professionally.

Some people are night owls who work evening shifts and nap during the day, thriving off of only a few hours of deep, restful sleep daily.

So why can’t most bipolars do that? Because for someone with this mood disorder lack of sleep can trigger an illness state. You may become hypomanic with racing thoughts, irritable mood, no patience for others, yell at the kids or your adorable new puppy for no reason, etc.

Hypomania is an elevated mood that can be pleasurable (for normal folks) or problematic (for someone with bipolar disorder).

For someone with the most serious form of the illness – Manic Depression now called Bipolar 1 Disorder – lack of sleep can trigger an actual manic episode and could lead to hospitaliztion.

Related post: I Was Hypomanic and all is Fine.

What Sleep Personality are You?

According to the National Sleep Foundation there are ‘Five Sleep Personality Types’ each with an associated unique sleep pattern. Which one are you?

Using data derived from the answers to poll questions, NSF found five clusters or “sleep personality” types. The commonalities are based on sleep habits and more than 40 other factors including age, marital status, gender, employment status, diagnosed medical conditions, how often they feel tired/fatigued/not up to par, and the amount of caffeinated beverages consumed daily.

1. Healthy, Lively Larks – model citizen, not affected by sleep problems, a morning person.

2. Sleep Savvy Seniors – average age 60 years old, get most sleep at around 7.3 hours per night, take naps.

3. Dragging Duos – most likely to have a partner and be employed, twice as likely to get less sleep than they need, partner may have symptom(s) of insomnia.

4. Overworked, Overweight and Over-caffeinated – night person, longest work week of all types, feel need less sleep and drink more caffeine than others.

5. Sleepless and Missin’ the Kissin’ – night owls who think they have a sleep problme or insomnia, least likely to say got a good nights sleep.

You’ve got to love those descriptive, fun titles they came up with for each category. I definitely do ๐Ÿ™‚

I wish I could say I fit into one of those categories but I don’t. I am far from normal as a person who has BP-1 and I have sleep issues that are unique to having a major mood disorder mixed with chronic fatigue from CFS/ME and fibromyalgia.

The above descriptions have been shortened by me for the sake of this blog post, you can read the full article here: Five Clusters of Sleep Patterns.

Why do Bipolars Have Irregular Sleep Patterns?

Someone with bipolar illness may feel they fit into one of the categories above and that is great – they are probably high functioning and employed full time; kudos to them.

Others are more like me, with a severe form of bipolar that may include a lack of response to medications. In addition, medications used to treat the illness can actually trigger unwanted mood states such as insomnia leading to hypomania or depression from a suppressant effect.

Our sleep patterns are irregular (unless successfully treated and controlled) because our systems are not normal. Our mental/physical bodies are different from others. For reasons not clearly known our systems go into hyperdrive at times, at other times drop into the ‘almost dead’ zone.

And they like to stay there in those abnormal states that lead to problems with moods and daily functioning. They don’t want to be propped up with a couple cups of coffee then take on the day or chilled out with a glass of red wine in the evening then off to bed for a good nights rest.

To put it bluntly… bipolar body systems are f’d up.

F’d up and kind of mean to us. They refuse to respond to that nice sleep aid the medical researchers developed so that we will be able to control our circardian rhythms (24 hour biological clock) and live productive lives.

Or our systems overreact to that stimulant medication meant to help with the debilitating fatigue caused by a depressive episode. We feel better for a short time but then have to report to the doctor that we stayed up all night and are in hyperdrive though wanted to sleep. Mean, mean, mean.

The illness is not well understood from a biological standpoint. Why our sleep patterns are so irregular and can lead to such extreme mood states that make us ill is not clearly understood. And like any illness, all sufferers are unique to a certain extent.

I started a ‘Thriving with Bipolar Disorder‘ interview series for others to share their stories and what helps them so that others can not feel so alone and possibly find suggestions of things that may help them they haven’t tried.

A list of all interviews is here: Thriving with Bipolar Disorder Interviews.

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Categories // Sleep Issues

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