Maybe our bodies know what they're doing...

[[Ho...]]

Maybe.

 

"Nov. 16, 1999 (Indianapolis) -- No, it's not a dream: not getting enough sleep can actually help treat depression. A review article in a recent issue of Biological Psychiatry suggests that doctors may soon be using sleep deprivation therapy to treat depression as regularly as they did some 20 years ago.

 

In the 1970s, a depressed insomniac discovered that getting much less sleep than he wanted surprisingly improved his mood the next day. Doctors who treated depression began using sleep deprivation as a form of therapy. But sleep deprivation's popularity was brief, and soon the evolution of highly effective antidepressant medications made it all but obsolete.

 

Now, however, doctors are reconsidering the often striking improvement sleep deprivation can make in a person with depression. "The remarkable transformation of often deeply depressed, psychotic, and suicidal patients in the course of a few hours into their normal ... 'selves' convinced many psychiatrists [in the 1970s] of the extraordinary importance of this phenomenon," writes Anna Wirz-Justice, PhD. "Many studies followed, resulting in widespread [agreement] that sleep deprivation can have antidepressant effects. [However, it] also turned out that subsequent sleep tends to reverse the improvement. [so the] original interest and investment in clinical research went away."

 

Wirz-Justice, of the Chronobiology and Sleep Laboratory at the Psychiatric University Clinic in Basel, Switzerland, notes that sleep deprivation was shown to be effective in more than half the patients treated and in many types of depression. And if one course of sleep deprivation treatment didn't help relieve depressed patients' symptoms, often a second course did.

 

Used alone, however, sleep deprivation's effects were both temporary and unpredictable. Lacking a way to standardize sleep deprivation treatment, most doctors soon abandoned its use in depressed patients.

 

So why is sleep deprivation making a comeback now? Because use of newer antidepressant drugs together with sleep deprivation treatment is proving effective for helping to prevent return of depressive symptoms after sleep deprivation and for improving depressed patients' response to their medication.

 

"Antidepressant medication has little influence on rates of response to sleep deprivation but may prevent relapse," says Wirz-Justice. And "there is evidence ... that ... the addition of drugs can [help] the sleep deprivation effect."

 

She also notes that there are studies showing that doctors can use sleep deprivation to improve depressed patients' mood during the period of days or weeks required for antidepressant medication to become fully effective.

 

Ellen Leibenluft, MD, a mood disorders researcher at the National Institute of Mental Health in Bethesda, Md., agrees with Wirz-Justice that sleep deprivation has been underutilized. Leibenluft, who was not involved in the study, suggests that sleep deprivation might be particularly useful in depressed patients who aren't helped by standard treatment methods and in patients -- for example, severely depressed and suicidal patients -- who need to have their mood lifted quickly. She adds that sleep deprivation's use may also help expand doctors' knowledge about what happens in depression and how antidepressant medications work.

 

"One important point in the article is the fact that research into the mechanism of circadian [24-hour body] rhythms and various cycles is really growing by leaps and bounds," Leibenluft notes. "The original sleep deprivation research predated this recent explosion of the development of techniques to probe these systems. Now that we have the mechanism and tools to understand so much more about circadian rhythms and the sleep-wake cycle, we need to look closer at sleep deprivation and what it can tell us about depression." http://www.webmd.com/depression/news/19991116/benefits-sleep-deprivation-depression

[[Be...]]

I have heard of this before, Holly, but it seems the depression comes back when you get a good night's sleep.  Here's a link to a more recent article with this protocol described:

 

"Some researchers are trying to manipulate the body's hormonal tides by having patients stay awake through the early morning hours for about a week. Doctors at the University Hospital of Freiburg in Germany tried this experiment on a group of depressed patients who felt better after one night without sleep: They told the patients to go to sleep at 5 p.m. that evening and rest until midnight the next night -- a total of 31 hours. Then the patients gradually eased back to a normal sleep cycle over the course of the week. One night they slept from 6 p.m. until 2 a.m., the following night from 7 p.m. until 3 a.m., until finally they returned to an 11 p.m. to 6 a.m. sleep cycle. Remarkably, the majority -- 75% -- didn't relapse into depression, according to results published last fall in the European Archives of Psychiatry and Clinical Neuroscience."

 

http://www.medicinenet.com/script/main/art.asp?articlekey=50800

[[Ho...]]

All of this is really fascinating to me. I know that it seems that the depression returns with the presence of REM sleep, which sucks because there doesn't seem to be a clear-cut answer/protocol to use that would "work" for sure.

 

I remember even as a child I would get very slap-happy and my mood would become remarkably better even if I stayed up just a few hours later than usual. All of this just makes me feel guilty about drugging myself out of my mind in order to get the sleep I think I must have in order to function, when, since depression is a major problem for me right now, it turns out that less may be better for me. Especially those nights I feel suicidal.

 

 

I do feel much better emotionally on nights I sleep very little, as long as I didn't try to drug myself the night before and force the sleep to come. But those drug-free nights are very rare these days.

 

I wonder how I'd be feeling if I were to just let my body do its thing right now.  

[[Wh...]]

This is very interesting and I concur that our bodies know what they're doing.  I've noticed that when I sleep my brain gets wonky and it takes awhile to pass.  I also thought of how when you put a child down for an afternoon nap that they mostly wake up cranky.  Wonder what that is too.  Oh man there is just so much that we don't know.

[[cr...]]

When i had depression bad in the beginning this exactly happened to me, i read about this a few months ago.  When i got to much sleep i was really depressed, to little almost a manic state, this was actually a really old method of treating depression.  Some psychiatrists use it in very dire depression situations along with anti depressants.  When i got more than 8 hours of sleep i felt like crap, because i was actually going into the REM sleep.  So crazy that REM doesn't allow serotonin get to normal levels.  I still swear by exercise, more prominent studies show just how beneficial it is for you.  Within one week of heart pounding exercise, depression was gone, anxiety cut in half.  i wasn't worry about how i was breathing or that i was going to have a heart attack, my mind eased and relaxed, not totally gone but way better than before.  my body forced myself to start eating better, i even sleep ate because i didnt want to eat during day and my body made me eat half sleep in the middle of the night. i slept about 6-7hrs a day.  i did have to exercise an hr or two after i woke up though to get the full effect at night.  im still not better 100 percent, im maybe at 50 percent, jumping this thurs at .625.  my head has cleared up quite a bit from taking next to nothing of the benzos, my short term memory improved after my first big cut and kept going.  i still get a tinge of depression, bad anxiety here and there, but it isn't 100 percent of the day like it was.  D/P and D/R has started coming back after my last cut, not real bad but still there and annoying. Tinnitus has started to go away.  Been shaking a lot inside sometimes..  some neck pain, tension headaches.  EVERYone will get better they just have to find their niche to getting rid of it. 

[[Be...]]

I feel the exact opposite. I become completely depressed when I don't sleep. However I haven't slept worth a crap in years, so this may be why.It's not the same as taking someone who gets 6-8 hours of normal sleep and implementing this. I've amassed a huge sleep debt, and am in a constant fight for any sleep I can get.

 

This study is interesting for sure, but short sighted imo. Sleep is imperative to good health; even if depression could be lifted from a sleepless night- what then? Keep sleep depriving the depressed patient? If it increases serotonin levels, I'd imagine it would do so at the expense of other N/T's. I would kill to sleep even 6 hours straight. If it increased my depression I would simply exercise more (because then I would actually have the energy 2.....)

 

 

 

 

[[Li...]]

This is interesting Holly, thanks for sharing!

 

Libby

[[cr...]]

Now i have to eat my words somewhat, last night, after exercising vigorously, no sleep whatsoever.  Two days straight.  I'm betting it's because i have such little of my benzo left in me and im ready to jump that it's affecting me a bit more.  oh well i'll keep exercising and get back to normal here soon.

[[Gl...]]

Pretty interesting, but I don't think it applies to the severe insomniac because the longer we go without sleep the more depressed we seem to get.

[[cr...]]

Glynn I agree, I think you get a mania high from it for a few days, then when you get a good nights rest, you wake up even more depressed.

[[Fl...]]

It's the same with anxiety. I never had a problem with depression (except from the benzo) but I have had social anxiety most of my life, and I noticed that whenever I was SUPER tired, the social anxiety went away completely. I felt completely at ease around people and I was able to interact with them in a way that felt completely normal.

[[sw...]]

That was an extremely interesting read, Holly.  Thanks for sharing!

 

[[Gl...]]

Well, for me, I get a "mania" like feeling in a way, but I feel tons better when I finally get some sleep and wake up.  Like new life has been breathed into me and I feel like a new man.  I've been up for 2 and a half days now and hoping I get some sleep soon.  I don't have depression regularly so it's probably a different case with me.  It's crazy that sleep deprivation can actually be used as therapy.  For a long term insomniac it's just a waking nightmare.