Spring brings more than flowers to bloom

As a psychiatric mental health nurse practitioner with a few years in the inpatient, outpatient and long-term mental health settings, I have learned to mark my calendar by more than just the equinox. Every Spring my schedule begins to fill with urgent calls from panicked parents and family members saying things like, “My child has not slept for days!” “My husband is spending the rent money on the slot machines again,” or “My wife won’t sit still and cannot stop talking.” Yes this is indeed a time of year when we see a peak in symptoms of mania and hypomania.

There is data to back up what we see in our inpatient and outpatient settings.. Mania and hypomania episodes rise sharply in the Spring. There are multiple studies that show consistent sharp rises in admissions to hospitals  for bipolar mania and this seems to peek between March and May in the northern hemisphere. Patients who have been stable all winter suddenly find themselves racing at 3 am, full of grand plans and boundless energy.

The culprit is light-specifically, the rapid increase in daylight after the winter solstice. Longer days and brighter mornings  suppress melatonin earlier and more dramatically. For most of us this feels refreshing. For brains wired with bipolar disorder it can flip the switch from euthymia to mania within days. Circadian rhythms that were already fragile get knocked off balance. Serotonin surges while sleep evaporates, creating the perfect neurochemical storm.

I have seen the same patterns play out year after year. Patients who maintained perfect medication adherence through the winter suddenly “forget their evening dose because they don’t need as much sleep now.” By the second week they are irritable, euphoric, or both. Family members describe the classic signs: rapid speech, grandiosity, hypersexuality, reckless spending, and that terrifying sense that everything makes perfect sense now.

Spring also brings pollen, temperature swings, and social pressure to “get outside and live.” All of this hits the body at the exact moment that the brain is already running hot.

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So is there anything that can be done to help?

1.) Track sleep like it owes you money. Even one night under six hours of solid sleep is a red flag. I tell every bipolar patient to log bedtime and wake time starting in February.

2.) Protect the dark. Blackout curtains, blue-light blocking glasses after 8 p.m., and a strict “no screens in bed” rule become non-negotiable in March.

3.) Med check-ins. I try to schedule extra appointments in the late winter just to review mood stabilizers and antipsychotics before the light changes.

4.) Tell someone early. Mania feels amazing until it doesn’t. The window between “feeling great” and “out of control” is narrow.

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Spring can be a beautiful sight to those of us who have borne the battle with old man winter and have come through with a weary mind and worn out body, but for some it can be medically treacherous. For those living with bipolar disorder it can be a very difficult time. If you love someone who starts sleeping less, talking faster, or feeling invincible, please do not wait to reach out.  We are here, we have seen this movie before. Early intervention can turn a potential crisis into a manageable bump in the road on your way to memorable summer.