Only blue light sets the circadian rhythm, so blocking it gives the brain physiologic darkness: amber lenses for the two hours before bed, a really dark bedroom, and nightlights that emit no blue light. The trials in inpatient mania are mixed, and on a wing lit at night only with amber light far fewer patients had a positive Broset checklist (3 versus 80 over six months). It is harmless and works for about half of patients, so if the glasses do not help, keep trying other tools.
What it is
Around 2000 it was discovered that different wavelengths of light affect the brain differently, and only one of them, blue light, sets the circadian rhythm. So the absence of blue light is physiologic darkness.
“in the year of about 2000, it was discovered that not all light is created equal. The different wavelengths of light affect our brain differently, and only one of them sets circadian rhythm, and that is blue light”
33:10How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode Also said in 1 more episode
“So if it's blue light that sets your circadian rhythm, then the absence of blue light is physiologic darkness”
33:43How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode Even a little light, more than three candles, is enough to suppress melatonin: people who stay up all night doing paper-and-pencil tests in a lit room show no melatonin rise at all.
“when they are invited to stay up all night and do paper and pencil tests all night in a lit environment, their melatonin never goes up at all. You've suppressed it. Even a little bit of light, more than the three candles, is enough to suppress your melatonin”
34:04How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode When the same people wore amber lenses and stayed up all night doing the same tests, their melatonin rose when it was supposed to. They were in physiologic darkness even though they were awake.
“When they wore the amber lenses, stayed up all night, just like before, paper and pencil tests all night, their melatonin went up when it was supposed to. They were in physiologic darkness, even though they were awake”
35:06How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode
The evidence
Two randomized trials of darkness for inpatient mania have shown efficacy against placebo; the most recent one did not.
“there are two randomized trials of darkness for the treatment of inpatient mania that did show efficacy and then this most recent one that did not, efficacy relative to placebo”
23:32Dr. Jim Phelps’ Bipolar Treatment Tier List: Lessons from 30+ Years in PsychiatryJul 2026Guest episode In a randomized trial on an inpatient unit in Norway, patients admitted with a manic episode got either amber lenses or a gray control lens that did nothing from a circadian point of view. On top of the unit's usual treatment, the amber group had half the number of antipsychotics and got out of the hospital earlier.
“The people who wore the amber lenses, in addition to the rest of treatments that happened on this inpatient unit routine, had half the number of antipsychotics that the group with the control lens got and got out of the hospital earlier”
47:11How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode Also said in 1 more episode
“There was a randomized trial on an inpatient unit in Norway where half the people, people who are admitted with a manic episode, who signed a consent for this, half of them were randomized to get the amber lenses and half of them got a gray control lens that really didn't do anything from a circadian point of view”
46:47How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode A fairly close replication in Canada was not so striking, which leaves one positive study and one that was basically negative.
“Dr. Joseph Fedorowicz in Canada, Pretty close replication, and it was not so stunning. Oh, darn it. Now we got one positive study and one study that was basically negative”
47:59How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode Builders made two identical wings, one with conventional lighting and one lit at night only with amber light. Nurses completed the Broset checklist every shift, and over six months 80 people on the conventional unit had a positive checklist versus three in the amber-lit environment.
“he managed to get the builders, there were two identical wings, to build one wing with conventional lighting and one wing that was lit at night with only amber light”
49:14How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode Also said in 2 more episodes
“They used something called the broset checklist. This is a checklist that the nurses complete every shift”
50:14How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode “Result, over six months, the people on the conventional unit, there were 80. How many people had a positive BROSA checklist? 80. How many people on the amber lenses and the amber lit environment? Three. In six months, 80 or three”
51:22How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode The reduction held whatever the diagnosis, except major depression, where violence did not change.
“It didn't make any difference what your diagnosis was to see this reduction in events, except for major depression. Major depression was the one thing where violence didn't change”
51:59How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode
How we use it
Glasses that block just the blue wavelength and let everything else through let patients keep their light: when you do not see blue, your brain thinks you are in the dark.
“you can block the blue wavelength with Glasses that block just that wavelength and let everything else through. So you can have your light as long as you take the blue out of it, because then physiologically, when you don't see blue, your brain thinks you are in the dark”
25:05Dr. Jim Phelps’ Bipolar Treatment Tier List: Lessons from 30+ Years in PsychiatryJul 2026Guest episode Use them in a two-hour window before bedtime, such as 8 to 10 p.m. Patients can keep using electric lights then, as long as the amber lenses block the blue, and the circadian rhythm still recognizes that it is dark and time to go to sleep.
“So you can stay up from 8 until 10 p.m. using electric lights if you block the blue part of it by putting on your amber lenses”
35:51How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode Also said in 1 more episode
“So that's the game plan then is we're going to use these between the hours of 8 and 10 p.m., some two-hour window before bedtime in order to facilitate your circadian rhythm, recognizing that it is dark and it's time to go to sleep”
38:03How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode Make the bedroom really dark: in one study, three lux or more raised the risk of a manic recurrence. Use dark curtains, or for a desperate patient who rents and has no money, literally tinfoil on the windows.
“anything three lux or more actually was shown in one study to raise the risk of having a manic recurrence. So a really dark bedroom, whether that's dark curtains or if you're desperate and you rent your place and you don't have any money, literally putting tinfoil on the windows”
26:45Dr. Jim Phelps’ Bipolar Treatment Tier List: Lessons from 30+ Years in PsychiatryJul 2026Guest episode Give patients nightlights of a kind that emits no blue light. Older patients who get up in the night to go to the bathroom should not walk into a lit room, but they should not fall on the way either.
“We're going to give you some nightlights, but a particular kind of nightlight that doesn't emit blue light. And we'll come back to the blue light story in a moment”
18:11How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode Also said in 1 more episode
“If, for example, your older guys have to get up in the middle of the night and go to the bathroom, You don't want them to walk into a lit environment, but you don't want them falling down on the way there either”
41:14How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode For someone working late into the night, as in a hospital, spin the whole principle of darkness and light around: start putting on the amber lenses while still at work.
“You're going to take the whole principle of darkness and light and just spin it around so that when you're working late into the night in the hospital, starting at when, you start putting on your amber lenses while you're right there in the hospital”
1:11:23How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode
What to expect
In our experience it works for only about half of patients. The other half come back saying it did nothing; responders call the glasses amazing and say they fall asleep almost an hour earlier, fall asleep more quickly and stay asleep better.
“The other unfortunate part of the story clinically is that this only works for, in my experience, about 50% of people”
36:25How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode Also said in 2 more episodes
“Whoa, when I put these things on at 8, I fall asleep like almost an hour earlier and I fall asleep more quickly and I stay asleep better. So there are some people who are going to come back with their amber lenses and go, yeah, darn it, this really works”
37:27How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode “about 50% of people would come back and go, yeah, that really didn't do anything. The other 50% came back and said, these are amazing. When I wear these things, I fall asleep an hour earlier”
28:35Dr. Jim Phelps’ Bipolar Treatment Tier List: Lessons from 30+ Years in PsychiatryJul 2026Guest episode Patients will not wear the clunky plastic glasses that slip over their corrective lenses for very long. In our experience they will do it for a couple of weeks.
“the sad part of this is that people are not going to wear these clunky looking plastic things that slip on over your corrective lenses. They're just not going to do this for very long in my experience. They'll do it for a couple of weeks”
36:04How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode These are harmless and, as the research literature shows, robust treatments, with no side effects or long-term risks. Few treatments in psychiatry are this robust.
“these are harmless. How many treatments do we have in psychiatry? And these are robust treatments as the research literature shows. How many treatments do we have that are this robust? They have no side effects or long-term risks”
38:56How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode
Talking to patients
It probably helps about half of people, so keep trying different things until the patient is in the half that is helped. It might not be the amber glasses; it might be the dawn simulator.
“it probably helps with 50%. So if we keep trying different, different things, eventually you're going to be in one of the 50%. It might not be the amber glasses. It might be the sun simulator”
52:49How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026 Tell patients the story behind it. In our experience it holds people's attention very strongly, and when you want a story to help drive a behavior change, this one really is worth telling.
“in my clinical experience, people's attention is held very strongly by this story. So when you want to tell a story to facilitate a behavior change, this is a story that really actually is worth telling”
32:32How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode It is worth buying 10 pairs of the amber lenses you want patients to try, keeping them in the front office and selling them at your cost.
“It's really worth it for you as a clinician to go ahead and buy 10 pairs of the amber lenses that you want people to try and have them in your front office and then sell them back at your cost”
39:36How to Stabilize Mood without Medications: Social Rhythm Therapy Anyone Can Use with Dr. Jim PhelpsNov 2026Guest episode
From these episodes
Every point above is something said on the Psychofarm podcast, with the words as spoken and a link to the moment in the episode. It is education, not medical advice, and an episode reflects what we thought when we recorded it.