Night Shift/Day Shift

Photographed and written by Julianne Armijo
Edited by Naomi Raicu and Claire Shudde

I worked many years as a night shift nurse. Insidiously, I began experiencing unusual elation, recklessness, and impulsiveness, often followed by depression. For years, this cycle continued, and I didn’t know why. I was finally diagnosed with bipolar disorder when a new antidepressant medication catapulted me into a manic episode. After several hospital visits, I stabilized on lamotrigine, a ketogenic diet, and regular sleep. I’m now stable and thriving.

Bipolar disorder is a chronic condition characterized by swings between the lows of depression, the highs of mania, or a mix of the two. These mood states can lead to interpersonal difficulties and professional troubles. While the mechanism of bipolar disorder is poorly understood, genetic, environmental, and neurobiological factors are believed to have a strong influence. The disorder can be managed through a combination of medications, psychiatric care, and therapy.

Self-management can also help through diet, exercise, and, importantly, regular sleep. People of all backgrounds experience bipolar disorder, but those in the healthcare professions, particularly nurses, often work night shifts. Sleep and bipolar disorder experts advise against working night shifts and rotating night/day shifts because rapid alterations to sleep patterns can incite episodes.¹ 

I conceived the idea for “Night Shift/Day Shift” as a play on duality: mania and depression, my night and day shift work, and perhaps most poignantly, my experience as a provider and a patient. It’s possible to thrive with bipolar disorder and live a whole and content life. However, it takes work and diligence…. night and day.

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