Can staying awake beat depression?

http://www.bbc.com/future/story/20180123-can-staying-awake-beat-depression

by IndrekR • 9 years ago

175 73 9 years ago

thecortado• 9 years ago

What about people who have depression and get insomnia because of it?

It's all about circadian rhythm disruption, a key feature of many types of depression. This can result in both hypersomnia and hyposomnia.

Evgeniuz• 8 years ago

Maybe this is natural defense mechanism? Body tries to alleviate symptoms of depression by sleep deprivation :)

kyleschiller• 8 years ago

"once you go to sleep and catch up on those missed hours of sleep, you’ll have a 95% chance of relapse."

Unless you plan on spending the rest of your life severely sleep deprived, this doesn't seem like a great solution.

scythe• 8 years ago

There's a danger in tabbing back to the comments page after the third paragraph. A few paragraphs lower, you would have seen this:

So he and his colleagues turned to the scientific literature for ideas. A handful of American studies had suggested that lithium might prolong the effect of sleep deprivation, so they investigated that. They found that 65% of patients taking lithium showed a sustained response to sleep deprivation when assessed after three months, compared to just 10% of those not taking the drug.

blueprint• 8 years ago

wow that's so much better

hateduser2• 8 years ago

Sustained sleep deprivation by lithium doesn’t sound any better than sleep deprivation by literal lack of sleep.

aidenn02• 8 years ago

too bad lithium is such a hard drug to administer (it's psychoactive at doses very close to harmful doses, so usually there needs to be monitoring of the levels of lithium in the blood)

kaffeemitsahne• 8 years ago

Sounds like:

- induce mania by sleep deprivation

- take lithium to counteract the mania

matt40772• 8 years ago

5% not relapsing is actually more than I would have expected, and an astonishingly high success rate for an intervention as easy as sleep deprivation.

There's also the hope of a sort of "learning effect": Chronically depressed people sometimes don't even know/remember the experience of normal or positive mood. Even short-lived fixes could allow them to find a way to better cope with the disease.

andrewfromx• 8 years ago

I've often wonder what the world record for a human is. Are their competitions? Like can you be the best at staying awake for > 2 weeks?

FeteCommuniste• 8 years ago

The official record is only a bit over 11 days: https://en.wikipedia.org/wiki/Randy_Gardner_(record_holder)

wlesieutre• 8 years ago

Randy Gardner (born August 7, 1949) is the holder of the scientifically documented record for the longest a human has intentionally gone without sleep not using stimulants of any kind. In 1964, Gardner, a high school student in San Diego, California, stayed awake for 264.4 hours (11 days 25 minutes).

https://en.wikipedia.org/wiki/Randy_Gardner_(record_holder)

The article mentions longer records but they aren't so well documented.

aidenn02• 8 years ago

I wonder if there are longer records using drugs like modafinil; I know that the USAF used modafinil to offset losses to mental acuity for wakefulness on the order of 48 hours.

randomfinn• 8 years ago

Randy Gardner was on the Hidden Brain podcast last November. It's a good listen with plenty of reasons to always try to get enough sleep.

https://www.npr.org/2017/11/06/562305141/eleven-days-without...

sp332• 8 years ago

Sleep deprivation can have long-term cumulative effects. If you're not doing it for a good medical reason, it's probably a bad idea for your health.

52-6F-62• 8 years ago

It's not ideal. I can't speak from personal experience, but have a relevant anecdote.

My brother was in SIGOPS in the Canadian military, and they had to run combat and stealth field exercises during periods of sleep-deprivation over the period of days(++). He said by a few days in (I can't recall exactly) they were experiencing vivid, realistic audio-visual-tactile hallucinations that they regularly succumbed to believing.

Until he said he started seeing white rabbits bouncing all over an open field between him and passing enemy actors.

Beside any other negative health effects, I just don't think it would be sustainable. The world is weird enough.

paulcole• 8 years ago

Guinness doesn’t accept new record attempts because it’s too dangerous.

Also, anyone who does this under anything but lab conditions can’t be trusted. They’ll ignore/be unaware of many periods of microsleep which would invalidate any record attempt.

joveian• 8 years ago

I seriously doubt any person with intact sleep regulation could go anywhere near eleven days without microsleep. Wikipedia is wrong in suggesting that was the case with Randy Garnder (Wikipedia is in general not a reliable source on sleep issues). There were at least strong signs of microsleeps before the fifth day (noted in the study[0]) and my guess is that occasional microsleeps would have happened earlier. They did not closely monitor for microsleep.

[0] Gulevich et al. Psychiatric and EEG Observations on a Case of Prolonged (264 Hours) Wakefulness http://dabamirror.sci-hub.mn/f1cafe0b11ce25fef6875f3c55c6652...

The true record for sleep deprevation may be held by someone with fatal familial insomnia, although it sounds like stage 1 sleep is at least sometimes possible with that condition so it might depend how you count that. Morvan's Syndrome is another one that can cause an extended lack of sleep.

https://en.wikipedia.org/wiki/Fatal_familial_insomnia

https://en.wikipedia.org/wiki/Morvan's_syndrome

pubby• 8 years ago

A few people claim to have stayed awake for most of their life:

https://en.wikipedia.org/wiki/Th%C3%A1i_Ng%E1%BB%8Dc

https://en.wikipedia.org/wiki/Al_Herpin

I think they're lying, but it's worth mentioning!

Tade0• 8 years ago

I don't thing you'll find that many people willing to participate in this.

I personally went through 40 hours of sleep deprivation once(we were on a trip and our host "forgot" that we were booked - apparently he expected a bribe) and it was hell, especially since we were a group, because in these circumstances minor misunderstandings turn into major conflicts easily.

maxxxxx• 8 years ago

Interesting. For me being sleep deprived is the number one way to get depression. Especially if it goes on for a few days.

soared• 8 years ago

2-4am used to be pure hell for me.

juol2• 8 years ago

Yep. After being on various prescribed drugs over the years i've settled on one. 25mg of Quetiapine at night when needed to knock myself out. Not being able to get to sleep - when i'm actually tired - and my brain spinning and running loops is not good for me.

lazerpants• 8 years ago

Out of curiosity (not judging), is your doc okay with that and did they prescribe it that way? I've never heard of quetiapine being prescribed on an as-needed basis.

tomsthumb• 8 years ago

IME, not going to sleep causes depression.

Reason077• 8 years ago

This is my experience too (jet lag, staying up way too late, etc), but I would hesitate to call it "depression" out of respect for those who suffer from the real thing.

At least when I'm feeling this way I have the comfort of knowing that I'll feel much better after a good night's sleep.

mratzloff• 8 years ago

As a "healthy" person, if I'm feeling overwhelmed or (situationally) depressed I find that I almost always feel better in the morning after a long sleep. It may recur as the day wears on, but sleep is extremely helpful. That makes sense if people with depression experience the opposite effect.

What I wonder is if those sleep-deprived individuals are experiencing a semi-manic state. I once had severe insomnia for a period of two weeks, and during that time I slept maybe 0-3 hours per night (typically zero). Early on I experienced manic effects. Toward the end, I felt like I was going completely nuts.

IntronExon3• 8 years ago

Sleep deprivation doesn’t make you feel like you’re going nuts, it makes you go nuts. Hallucinations, paranoia, agitation, transient hypnogogic states, memory loss, and eventually psychosis.

I’m glad that you pulled through.

apotheosis• 8 years ago

Can you source? Specifically the "eventual psychosis" part?

freeflight8• 8 years ago

As a "not healthy" person, suffering from bouts of depression and heavy demotivation (especially during winter months), missing out on a night of sleep can put me in quite a positive mood.

But it's mostly a rather "hyped up" feeling, so it feels like the opposite extreme of the depressive phase.

When I was younger I'd regularly miss out on a night of sleep for exactly that reason, but as I get older I notice side-effect of this "treatment" of the physical kind. My teeth, which are already damaged by years of nightly gnashing, will start to hurt easily, with a higher chance of gum infections after I missed out on a night of sleep.

That's sadly something not mentioned at all in the BBC article, while my mind feels like it could be awake for days on end, my body doesn't really like that strain, especially as I get older.

InclinedPlane5• 8 years ago

Sounds like hypomania. Do you find yourself also chatty and more likely to take risks (spend money, do new things, etc.)?

See: https://en.wikipedia.org/wiki/Bipolar_II_disorder#Hypomanic_...

gehwartzen2• 8 years ago

If your still grinding your teeth a lot look into increasing your Magnesium intake (either through food or supliments). It completely eliminated my nightly grinding

hnzix• 8 years ago

My teeth, which are already damaged by years of nightly gnashing

My dentist made me a slimfit mouthguard for teeth grinding. It cost $500 but it's the best dental investment I ever made as it prevents further expensive damage to my teeth.

The first few nights I kept dreaming I had a piece of steak in my mouth though.

phaus2• 8 years ago

I suffer from depression pretty frequently. It gives me insomnia and unfortunately the lack of sleep never really helps me feel better.

matt40772• 8 years ago

What I wonder is if those sleep-deprived individuals are experiencing a semi-manic state.

Yes, of course–in a certain way. It's not even much of a secret. While mania is itself a serious condition and should be avoided, it is fundamentally the same dimension as depression, only opposite. That's why you cannot be manic and depressed at the same time (Manic Depression, or Bipolar Disorder, is alternating between these states).

So it is really that simple: Depression + "semi-mania" = something approaching normalcy, for a limited time, with some cognitive impairment and just a bit too much nervousness.

IC4RUS• 8 years ago

I'm not sure there is much evidence that mania is in "the same dimension as depression, only opposite." And, in fact, mixed episodes can occur in those with bipolar disorder.

https://en.wikipedia.org/wiki/Mixed_affective_state

InclinedPlane5• 8 years ago

In someone with bipolar (I or II) sleep deprivation can indeed trigger a manic or hypomanic state. It will definitely raise your energy level but it may or may not make you happier. Additionally, there are tons of risks involved with going into those states intentionally. Mania ("full-blown bipolar") is particularly troublesome. Hypomanic states are much less extreme and are not necessarily a "problematic" part of ordinary life, if properly managed. However, both come along with things like increased risk taking and hypersexuality that can do things like screw up your finances and budgeting, destroy your relationships, or put you at greater risk of STDs or unintended pregnancies. On top of that there's a risk of developing a psychotic break, especially in conjunction with stress, which will typically result in hospitalization and being placed on psychiatric hold (if you're lucky).

And, as you note, periods of hypomania aren't long-term sustainable. Ultimately you need to learn how to cope with all of your moods and states.

IntronExon3• 8 years ago

I used to work with a brilliant women who really struggled with her manic episodes. She ended up going off her meds and on a weeklong manic state, ending with her walking straight through a plate glass window. She was window shopping and saw a coat she really liked, and she felt so powerful and was so nearly psychotic that she just walked straight through the window.

Cuts all over, dozens of stitches, yet amazingly no permanent injuries. She had to spend a couple of months in inpatient care to stabilize.

jiggunjer• 8 years ago

You make mania sound like "student holiday".

mercer• 8 years ago

From personal experience I can confirm that it does feel manic sometimes. And occasionally that 'mania' kind of bootstrapped me back into feeling better, sometimes after months of 'not leaving the house and constant bombardment of negative self-directed thoughts' depression.

I've also personally experienced how a friend of mine was depressed for years, unemployed but still functional 'enough' to carry on, and what helped him 'snap out of it' was dragging him along on a trip/adventure. Whether it was the change in scenery, the change in behavior as a result, or perhaps just suddenly being too busy to dwell on things in the 'comfort' of home, or something else, I'm convinced this trip was the primary cause of his eventual (but still of course gradual) improvement.

While I think depression is so broad that any advice should not be taken as applicable to every depressed person, I do wish it was an option for more people with depression to try solutions like this. I completely understand that a therapist might not always have the luxury of suggesting this, but I wish we'd experiment a bit more with such approaches.

It also reminds me a bit of the whole rehab/relapse cycle that many people get stuck in. Sometimes I wonder if perhaps we should spend more energy thinking of ways to make the 'rehab' experience more permanent or at least long-term, and more integrated with or at least much less disconnected from 'real life'.

Of course maybe all these things are happening and I'm just not aware of it :). I really hope so.

herbst2• 8 years ago

I often don't go to a bed for a few more hours because I don't want to lose the optimistic productivity I can get. In the morning I generally feel like shit the first X hours. So I try to have fewer but longer sleeping sessions.

Which I realize only works because I am self employed.

InclinedPlane5• 8 years ago

This seems like really bad advice on several fronts. For one, sleep deprivation has severe negative side-effects and is implicated in long term decline of overall health. For another, this is a big risk for people with bipolar, many of whom are unaware of that fact and may think they only have depression. Aggressive sleep deprivation can trigger a psychotic break in people who are susceptible, which is a shockingly high percentage of the population, especially along with other factors like stress and certain kinds of (very common) drug use. That's something you generally want to avoid at all costs.

freeflight8• 8 years ago

For another, this is a big risk for people with bipolar, many of whom are unaware of that fact and may think they only have depression.

Imho this is the biggest issue with this whole complex of psychology. I've struggled with mental issues for pretty much my whole life, in my teens, it was considered "clinical depression", a couple of years later it was supposedly something along the lines of ADHS or maybe I'm somewhere on the spectrum, another couple of years later it's either borderline or bipolar, depending what doctor you ask.

It's just a frustrating situation to be in because it feels like the diagnoses wholly depend on what doctor you ask, what mood they are in, how well you vibe with them on a personal level, or what literature they've read recently. In the end, it all feels like "professionals" who are mostly just wild-guessing around and on the basis of said wild-guess start suggesting some pretty drastic medication.

At this point, I've pretty much given up on getting a "solid diagnosis", it all just feels way too arbitrary which is not at all helpful to my self-perception and my trust in medical institutions.

InclinedPlane5• 8 years ago

Yep. When you start digging into mental health you realize that we're at a very primitive level of understanding of it, in almost every aspect. For one there's this sort of broken model of untainted perfect neurotypicality that is the gold standard and any deviation from that is a disease or a disorder. For another there's a very poor understanding of what different classes of symptoms actually represent in underlying physiology and how they are related. Many times things are described as being "comorbid" when in reality they are just different expressions of the same underlying biology or psychology. Also there's a huge role that culture, education, and so forth play into these things. In general I'd say the best tactic is to learn as much as you can yourself (while remembering to be honest with yourself) and pursue general purpose coping strategies across the board (for example, mindfulness based cognitive therapy).

tinix• 8 years ago

staying awake for extended periods leads to a manic state. sure, it beats depression, but it's not necessarily a good way to persist either.

indeed, a blurb in the article mentions this, only once...

Particularly for anyone who has bipolar disorder, there’s a risk of it triggering a switch into mania – although in his experience, the risk is smaller than that posed by taking antidepressants.

i don't think that's necessarily true only for those with bipolar disorder though, anyone sleep deprived long enough will end up in a manic state. perhaps some are more susceptible to it than others, or others may be more adept at navigating that headspace, than many.

i find some of my most productive hours are late at night, after i've been awake for a while... for one there are less distractions from everyone else, but primarily, it's much easier to get into that "zone" when the brain is tired. or maybe it's just a honing of focus over time, and sleep resets that ability and all the short-term memory that has been built up during the day. shrug

B1narySunset• 8 years ago

Not depression, but I notice that I have less social anxiety when sleep deprived.

sbinthree• 8 years ago

I notice this but with inhibition. I find I do different kinds of coding, more creative and less rigid, when I have less inhibition. Good sleep is good for rigid code, bad sleep is good for creative problem solving and inhibition. I tend to be better on the phone on <6 hours of sleep as well. I think getting a full night's sleep leads to my prefrontax cortex functioning properly, which I find makes me rigid and anxious with all the threads I follow and things I predict. Without a good sleep, that is significantly inhibited, making it easier to go with the flow, on a call or writing code.

xen2xen1• 8 years ago

Sleep deprivation increases serotonin and dopamine directly. Of course it helps with depression.

jbradach• 8 years ago

I've felt that semi-manic state you're referencing when I haven't been sleeping. Several nights lately I've been in bed awake until 5:00 or so when I doze off (only to get up at 6 for work). In these situations, I've felt great considering my lack of sleep. In the long run, lack of sleep (for me) results in depression.

I'm probably not normal. I take three antidepressants and an anxiolytic.

nabla9• 8 years ago

As the article says, sleep deprivation has been used to treat depression for years. It has been used in inpatient care because it often has immediate short term effects and provides relief before the medication kicks in. The attempt to use chronotherapy as a long term treatment seems to be a new development.

The problem with depression is that it easily becomes "trashbin diagnosis" trough diagnosis of exclusion. Depression symptoms are common with many physical and mental problems. After other options are excluded, what is left is depression diagnosis.

It's possible that there are people suffering from depression where the root cause is malfunctioning circadian system. This research direction might end up with real cure for them. For others suffering from clinical depression chronotherapy might ease the symptoms and help with other treatments.

richard___• 8 years ago

Not sleeping induces a state of mania - temporary frenzied relation. So if you're depressed, you'll temporarily feel better the next day, but the relapse comes soon after.

zdragnar• 8 years ago

Strange, I've always found that sleep deprivation decreases my ability to handle stress, increasing the effect of depression. Even now that I'm stable, it sends me into a blue funk the next day or the day after.

shironineja• 8 years ago

Hmm what could people do while trying to stay awake? I know how about some light exercise dancing to some music you enjoy or even don't enjoy but rather go out just to learn about it.

Maybe there are other anti-depression techniques out there as well?

https://www.cnbc.com/2017/09/14/how-a-party-drug-could-becom...

DyslexicAtheist• 8 years ago

it works but not when it becomes routine IMO. pulling 1 or 2 all nighters in a row, gives kind of a once in a while snap-out of it effect. I have no proof other than this worked for me in practice only in the decade and half that I suffered from it.

somberi• 8 years ago

https://en.wikipedia.org/wiki/Wake_therapy

twobyfour• 8 years ago

Yeah, except the effect only lasts past the next good night's sleep for 5% of patients.

And I can't speak for about anyone else, but having experienced moderate depression, I'd rather be depressed than chronically sleep deprived.

Can staying awake beat depression?

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