- Mental Health
Depression And Sleep Deprivation as a Cure For Depression
Depression and Sleep Deprivation
During my research into depression and its remedies, I was amazed at how many times I came across mentions of sleep's effects on depression, and sleep deprivation as a cure for depression.
However when I thought about it, having suffered from mild forms of depression myself, I remembered passing many sleepless nights, unable to sleep at all, and finally climbing out of bed determined not to spend the whole day there. I do remember that on those days I would be more likely to suddenly feel like cleaning the house or wading through a pile of washing and ironing, jobs which on bad days I had no energy for at all. I used to think 'well I must have some nervous energy to burn off, that's why I couldn't sleep'
Now it seems, maybe that wasn't the case. According to studies, sleep deprivation will actually make those with depression feel a lot better the following day, although these studies also show, that the benefits are short lived.
Sleep Deprivation as a Cure For Depression
One theory is that when suffering depression, the process of waking up in the morning leads immediately to thoughts of the very thing that is causing your depression. You wake up feeling a continuing sense of doom and blackness.
The fact is that in depression most people just want to sleep, as when awake they can't avoid thinking about the things that depress them. However when they do wake up, as the day goes on, these things slip further to the back of the mind, and they slowly feel slightly less depressed. As soon as they go back to sleep, the whole cycle starts right over again.
With a full night's sleep deprivation, the patient has then gone most of a 24 hour period without sleep, therefore depressed feelings have been somewhat subdued, and the brain found more stimulation.
Certain studies have shown a difference in reaction, according to the level of depression. Severely depressed patients seem to benefit most from trying sleep deprivation, whereas those who were under psychiatric help, or showing remission, found their symptoms worsened.
Anyone who is depressed should try it for themselves, and see if they benefit or not.
There are two methods of using sleep deprivation as a treatment for depression: total or partial deprivation.
Partial deprivation; sleeping the first half of the night only, and waking up halfway through, proved more effective than going to sleep later, or sleeping only the second half of the night.
It is thought that partial sleep deprivation, sleeping up to 4 hours a night, will have the same antidepressant benefits as total sleep deprivation.
Whereas with total sleep deprivation, the benefits are felt the following day, but are not long-lasting, sleeping four hours can be done continuously, over several days or even weeks, so naturally the benefits here are superior.
Even in patients with bipolar disorder can benefit. Research shows patients with bipolar disorder after sleep deprivation, are pulled from their depressed state to manic state. Manic states can cause sleep deprivation, lasting weeks and even months, so the cycle continues. The patient feels great, lighter in mood, and feel no need for sleep. Of course one should limit this, because of other health risks in prolonged sleep deprivation.
Another benefit of sleep deprivation occurs even when on drugs prescribed by doctors and psychiatrists. The antidepressants will work quickly and more efficiently during bouts of sleep deprivation.
Healthy folk, if deprived of sleep can experience mood swings and irritability. Folk with depression already have mood swings and irritability, so sleep deprivation reverses this.
In study so far, about 60% of patients studied showed immediate recovery after one night of sleep deprivation, although most relapsed following night.
Partial deprivation, up to 4 hours sleep is definitely the way to go for long-term treatment.
The ideal way to try for yourself, seems to be to stay awake a full night the first night, then limit yourself to 4 hours a night after that. Try this for a week or two, and see how you feel. I think in most cases, you will have positive results.
What is clear is that there are definite connections, one way or another, between sleep and depression. Most depressed patients suffer from either hypersomnia, or insomnia, or bouts of both. Depression causes people to want to sleep and nothing else, but it also causes them to lie awake at night tossing and turning.
On the other side of the coin, in patients visiting doctors with insomnia or hypersomnia, about 15% will be found to have depression.
If you know someone suffering with severe depression, who barely has energy to talk to you, and no matter how you try to animate them, you have no success, try visiting them in the evening and keeping them awake all night. You will find the next morning their mood will be elevated, they will be more lucid and talkative, and more likely to want to move around and do things. Try then to convince them to use an alarm clock and wake themselves up after only four hours, they'll see for themselves how much better they feel.
The optimum time for sleep appears in some studies, to be from 10pm-2am, 11pm-3am, or12-4 am, underlining the fact that sleeping only the first half of the night provides the best results.
In other reports, however, 2-6am 3-7am was optimal. It would depend presumably on your normal bedtime.
Sleep deprivation treatment was popular in the 1970s, but with the discovery of new and effective antidepressant medications, it was soon deemed old-fashioned and unhelpful.
Nowadays doctors are reconsidering and endorsing this treatment, finding it helpful even alongside these medications, as the body seemed to accept medication more easily.
Many psychiatrists were convinced by remarkable transformations of severely depressed, psychotic and even suicidal patients, back to relative normality after only a few hours.
Antidepressant medication alongside sleep deprivation, has proven to help prevent relapse into the depressed state, although these studies are still ongoing.
Other benefits of sleep deprivation are also being studied, including the possibility of aiding premenstrual dysphoric disorder, and benefits to elderly patients suffering with dementia, but these studies are also ongoing and inconclusive.
Several sources tell of a case where a severely depressed 80-year-old woman was prescribed a night of sleep deprivation. She was suicidal, spoke little and seldom moved. The remedy appeared to work; by the next morning she was talking and moving around, like a different person. She was quoted as saying that around 2 or 3 am she felt like a black cloud had lifted from her shoulders.
This supposedly happened in 2000, when a Swiss neurobiologist, Anna Wirz-Justice MD. remembered the studies from the 70s, and after trying every treatment at her disposal to help the old lady, decided to give it a try. Further studies and experiments have resulted from this case.
Researchers nowadays are experimenting with ways to use the human biological clock, and time sleep hours to coincide with the movement of certain hormones in the body.
For example, TSH, thyroid stimulating hormone, controls our levels of energy through our metabolism. Some, though not all depressed patients showed low TSH levels.
This is possibly as depressed patients tend to sleep a lot, and it has been shown that sleep inhibits TSH release, while sleep deprivation, all night or at the least in the early morning, is shown to boost the release of TSH.
Researchers will try to manipulate hormonal 'tides' by waking patients in the very early hours during a period of at least a week or two. Then they will try sending them to sleep early, and waking up at midnight. They will try different sleep patterns at different times of the night, and test the presence of different hormones. As this is still ongoing research and study, there are no results to report. It will be interesting to see the outcome.
Patients with severe depression, who only want to sleep, and are capable of sleeping all day and all night for several days or weeks at a time, would most benefit from at least one night of sleep deprivation. The benefits they would experience the following day may not be lasting, but just that short time of feeling 'normal' would show them that there is hope, that it is possible to get out from under that black cloud.
I have to admit that I've always been a person who needed very little sleep, but during bouts of depression I wanted to sleep more and more, but was plagued with insomnia.
When feeling in good health, I again need little sleep.
I for one am extremely interested in this surprising 'remedy' and will be watching with interest the results of any further research and studies.