Blue blocking glasses may be a useful adjunct to medications for mania.
Bright light is one of the most rapidly effective treatments for depression and may be helpful for depression even in people without a clear seasonal pattern (winter depression). A recent study suggests that the opposite may be true, that avoiding light may treat mania.
The portion of the light spectrum that affects circadian rhythms the most strongly is blue light, which is why the GoLite, which only puts out blue light, is so effective in treating seasonal depression. The authors of this study examined whether glasses that blocked blue light might be helpful in treating mania.
The idea behind light-blocking glasses is simple: light therapy reduces depression so it makes sense that dark therapy might help patients experiencing bipolar mania.
Psychiatric News summarized previous studies of this idea…
“In 1998 researchers at the National Institute of Mental Health tested this idea in a bipolar patient who was rapid cycling by putting him in a dark environment for 14 hours a day. They found that the patient’s mood and sleep patterns quickly stabilized.
A few years later, Italian researchers conducted a pilot study with 16 bipolar inpatients and found that patients who had received the 14-hour dark therapy for three consecutive days, in addition to their regular medication, experienced a reduction in symptoms, required less medication, and were discharged earlier from the hospital.
While these studies pointed to the benefits of dark therapy, there were questions of how practical the technique might be outside of a hospital setting. A discovery in 2001 that the brain specifically uses the blue light wavelength to signal light/dark status suggested patients might also benefit from the “virtual darkness” created by blocking blue light.
Recognizing the tools to achieve this were already in place (welders have long made use of blue-blocking [also known as amber lenses] safety goggles to shield their eyes from intense blue welding sparks, and the goggles are known to increase visual clarity in the outdoors), Phelps began sending patients with bipolar disorder home with blue-blocking glasses.
According to Phelps, more than half of the bipolar patients he sees have reported improvements in manic symptoms, like insomnia, after using the blue-blocking glasses.”
Study shows blue-blocking glasses have an antimanic effect
The study looked at the impact of this intervention on physical activity measured with actigraphy (you probably carry one of these with you since most smart phones measure physical activity this way) and daily ratings of mania by clinicians.
Less medication was needed in those who wore the blue blocking glasses.
Mania scores were significantly lower after 3 days of BBs and continued to improve through 7 days. There was a very large effect size (number needed to treat (NNT), >1.5). NNT is one of the most useful ways of assessing the impact of an intervention. The smaller the number the greater the effect of the treatment. To put this finding into context, the NNT in all trials of atypical antipsychotics for mania was 5. In other words, in this one small study, BBs were much more effective than atypical antipsychotics.
Side effects were minimal…
“Two patients using BBs experienced emerging depressive symptoms. One improved after decreasing BB duration by 2 hours; the other stopped it for one night, and mood rapidly elevated. One patient and three healthy controls reported headaches.”
Comments from patients
Here are some comments from patients who have tried the blue blocking glasses –
“Within a day or two I was calmer and less irritable, and my sleep improved… The wrap around type were easier to use…”
“…Relaxed surface skin and muscle activity in my face. I stopped squinting or the feeling of squinting. My face became very relaxed. Not sure what I looked like, but everything got easier…”
“…Easier to read things as everything was equally muted. There wasn’t any signal to noise issues with colors, shapes or words. It’s like it was all equally calm and soft and my brain could choose what to prioritize. This was pretty neat…”
“…Using the blue blocking glasses I felt completely relaxed and ready for sleep as soon as I wanted to sleep. The lack of stimulus is profound. My personal fitness trainer also uses them and he also says they’re life changing and hasn’t missed a night of using these since he got them 3 weeks ago…”
“…size and fit was not great. So they’re too big to fit well, however it’s good they are large and wrap around…. [This refers to the Uvex glasses, not the ones we recommend below]…”
“…the biggest material impact for me was that my “wind down” activity of looking at Instagram on my phone late at night, which can go for an hour instead of 5 mins, now only goes for 5 mins. My eyes and brain are just too sleepy after 5 mins to give a shit and I put the phone down. So in that regard, mission accomplished in 48 hours!”
“…Without exaggeration I can say I’ll use them every day. It’s like being a teeth grinder and getting a mouth guard, or having feet that roll in and getting orthotics. Your body sends you instant and very loud “thank you” messages from the first usage…”
If you want to try them
Wear these glasses from 6 pm to 8 am, except when you are sleeping or going to sleep in a dark room, be sure to wear them when you are using a screen (smart phone, TV, computer screen) as this is a significant source of blue light exposure.
There are two sources of these glasses, our preferred source is from LowBlueLights.com. Another source is a set made by Uvex and available on Amazon at a much lower price. These are, however, pretty uncomfortable and I suspect if you start with them and they work you will want to switch to a pair from Low Blue Lights.
Henriksen TE et al. Blue-blocking glasses as additive treatment for mania: A randomized placebo-controlled trial. Bipolar Disord 2016 May; 18:221. (http://dx.doi.org/10.1111/bdi.12390)
Zagorski, N. Blue Light–Blocking Glasses May Reduce Bipolar Mania. Psychiatric News. Published online: August 18, 2016