Q. I am at my wits end with myself. I definitely suffer cyclic depression, mostly moderate but 3x severe enough to put my life in jeopardy. I believe I also suffer from some form of bi-polar (runs in family) my highs aren't like others I've seen, I'm just very "alive" in the fall/early winter and all my senses are heightened. The problem is, even though I have been on Wellbutrin, Zoloft Effexor and Levoxyl (for thyroid) alone and in various combinations I am tired beyond compare. I am known to sleep 14 hrs a day when I can. If I cant, (I work full time in sales) I get angry, emotional and usually end up leaving the job. I have been like this in cycles all my life, but this time for 3 yrs straight. Another interesting point is if I am left to operate on my natural body clock of being awake nights, I do better. If I am put on a day schedule things get worse and my immune system gets sluggish as well. I am 40 yrs old, with a well above average IQ and there is no reason that I shouldn't be able to work past this. I have also gained 30 lbs in these 3 sick yrs. When I was younger I could drink with the best of them, eat junk every day, and stay up 48 hrs if I had to - between the tired phases which lasted only a month or two - and never put on an ounce! Now a donut puts me down for two days! Please if anyone has any suggestions, even if I'm just lazy, or bored how to overcome this, I want a life!! Thanks!

A. It is difficult to know exactly what you need, not knowing what you have tried in the past or more details about your sleep cycles. What you describe sounds like either bipolar II (depression and hypomania) or SAD. Hypomania can be used to describe both the pleasantly heightened spring feeling you experience and the emotional, irritable state you experience when you are "short" on sleep. Since this illness has at times been serious to endanger your life and you are on antidepressants, I would suggest it is probably bipolar II. Nevertheless, it appears to be seasonal in nature, so you will probably benefit from SAD therapies.

I do not generally give advice on medications, but I would suggest that if you are bipolar your doctor should consider a mood stabilizer instead of or as well as antidepressants.

To learn about using nutrition and natural therapies to help combat bipolar, please read through the archives for Healing Health as well.

Your body clock seems to be key to your illness. Sleep and depression are inexorably intertwined. Oversleeping can cause depression, and depression can cause oversleeping. Under-sleeping can cause mania or hypomania, as you have experienced. The flagship treatment for SAD is light therapy, also called phototherapy. Short exposure to full-spectrum or blue-green spectrum lighting is prescribed. There are commercial light boxes, visors, and dawn simulators available, or you can make your own, or take a walk outside in the sun. Twenty minutes a day of light therapy is generally recommended, but since you already know that you are susceptible to hypomania, I would start at five minutes and gradually work your way up until you are starting to feel well-rested and happier. Research suggests that you should do your light therapy approximately 8-9 hours after your body starts secreting melatonin (ie. When you go to sleep). It is suggested that if you are a night owl, you should do your light therapy at 8 or 9 o'clock, and if you are a lark, you should start around 5 a.m. This should help to re-set your body clock so that you feel well on around eight hours of sleep.

If you do not experience any change with light therapy, you should try to get into a sleep clinic, where they can evaluate your sleep and see if they can figure out a physical cause for your sleep problems.

A more recent addition to the treatment of SAD is negative ions, which I have mentioned here before. Negative ions are created by falling water, sunlight, certain rock formations, etc. and give you that fresh, energized feeling after a rainstorm or beside a waterfall. You can purchase negative ion generators. You can also generate negative ions anywhere that you can put very small water-droplets in the air. Showers, fountains, small waterfalls, humidifiers/vaporizers, etc. can all increase the negative ions in your home. Note that the ions will be confined to the room that you generate them in, so you probably want sources located in several of the rooms you spend most of your time in.

Positive ions, by the way, are produced by computer and audio/video equipment, so pay particular attention to the rooms where these are located.

Pam