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Ask the Experts

Question:

Is there any recommended method to minimize risk in multiple-time zone travel for bipolar patients?

I have spent a lifetime dreaming of overseas travel, only to now learn that it generally triggers bipolar episodes. Yet there must be many bipolar celebrities who cross multiple time zones safely. How do they do it safely? Or should I just resign myself to staying in the U.S.?

Answered by: Michael Terman

If you have the time and the cash, going by steamship is the best alternative, since jet lag is not an issue.

Bipolar switching during and after jet travel is not the norm, though it is certainly a risk. A detailed recommendation for handling the switch risk will vary with the individual: your chronotype (see AutoMEQ at cet.org), your history of switching (mostly springtime, or unpredictable?), your home location, and the date, time, duration and trip destination. Of course you will maintain your mood stabilizing medication throughout.

Here’s one additional protective measure that could make a big difference: on the day of your flight, and for several days after arrival at your destination, wear high-quality blue-blockers (example shown at cet.org) whenever you are in bright light – in-flight, indoors or outdoors – when at home it would be late evening, night or early morning. This will protect against sudden disruption of your internal circadian clock that might otherwise trigger the switch. Also, before the trip, try to get an appropriate hospital referral so you can best handle an emergency if it happens. Bon voyage!