
Can staying awake beat depression? - IndrekR
http://www.bbc.com/future/story/20180123-can-staying-awake-beat-depression
======
mratzloff
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.

~~~
freeflight
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.

~~~
hnzix
_> 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.

~~~
freeflight
Yeah, I've gotten one of those as well for my upper jaw, sleeping way better
since I got it.

It was also the dentist who unriddled particular nasty tension headaches I
suffer from sometimes. All the nightly gnawing makes my neck muscles sometimes
tense up, which leads to pains in the back of the neck radiating up to the
back of the head.

Sadly that's not something the mouthguard helps with, so I will probably have
to look for a solution to actually end the gnawing itself.

edit: This commenter [0] suggests Magnesium might help with the nightly teeth
gnawing. A quick Google search, sure enough, seems to confirm the relation
[1], awesome!

[0]
[https://news.ycombinator.com/item?id=16219942](https://news.ycombinator.com/item?id=16219942)

[1] [https://sleeptrack.io/2016/03/10/magnesium-rhodiola-
bruxism/](https://sleeptrack.io/2016/03/10/magnesium-rhodiola-bruxism/)

------
nabla9
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.

------
kyleschiller
"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
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.

~~~
aidenn0
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)

~~~
mislankanova
Long term use of lithium may also lead to kidney problems[1][2]. Monitoring of
kidney function is also needed over a long time[3].

[1][https://www.ncbi.nlm.nih.gov/m/pubmed/25735990/](https://www.ncbi.nlm.nih.gov/m/pubmed/25735990/)

[2][https://www.sciencedirect.com/science/article/pii/S008525381...](https://www.sciencedirect.com/science/article/pii/S0085253815326089)

[3][https://www.nhs.uk/conditions/bipolar-
disorder/treatment/#li...](https://www.nhs.uk/conditions/bipolar-
disorder/treatment/#lithium-carbonate)

------
tinix
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_

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

~~~
juol
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
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.

~~~
juol
Yeah the prescription is PRN which means as needed i think. As well as helping
me sleep it helps a bit taking the edge off some other issues. I've got a good
relationship with my doc and he trusts my input. I've got good drug 'insight'
apparently.

------
InclinedPlane
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.

~~~
freeflight
> 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.

~~~
InclinedPlane
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).

~~~
freeflight
> 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).

Yup, that's exactly what I've been doing for years now. I've read through
quite a bit of stuff ranging from Freud, Jung, B.F. Skinner to Edward de Bono
and countless others in addition to lots of Wikipedia surfing and study
reading.

A rather common theme among a lot of them: Many of them went into studying
psychology as an attempt to diagnose their own issues and often it feels more
like reading philosophy rather than actual medical science.

I wonder if we will ever be able to articulate something like a "Grand Unified
Theory of the mind"? Considering how much of this is subjective to the
individual and atop of that the individual's brain physiology, it seems like
an impossible task.

But then I see stuff like talks by Joscha Bach on C3 [0] [1] [2] and it's
quite inspirational as it gives me hope that creating strong AI might actually
help us understand what's going on under our own hoods a little bit better.

[0]
[https://www.youtube.com/watch?v=lKQ0yaEJjok](https://www.youtube.com/watch?v=lKQ0yaEJjok)

[1]
[https://www.youtube.com/watch?v=WRdJCFEqFTU](https://www.youtube.com/watch?v=WRdJCFEqFTU)

[2]
[https://www.youtube.com/watch?v=K5nJ5l6dl2s](https://www.youtube.com/watch?v=K5nJ5l6dl2s)

------
jbradach
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.

------
B1narySunset
Not depression, but I notice that I have less social anxiety when sleep
deprived.

~~~
sbinthree
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.

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

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

------
zdragnar
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.

------
tomsthumb
IME, not going to sleep causes depression.

~~~
Reason077
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.

------
shironineja
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...](https://www.cnbc.com/2017/09/14/how-a-party-drug-could-become-the-
next-big-antidepression-treatment.html)

------
andrewfromx
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?

~~~
wlesieutre
> 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)](https://en.wikipedia.org/wiki/Randy_Gardner_\(record_holder\))

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

~~~
randomfinn
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...](https://www.npr.org/2017/11/06/562305141/eleven-days-without-
sleep-the-haunting-effects-of-a-record-breaking-stunt)

------
twobyfour
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.

------
richard___
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.

------
somberi
[https://en.wikipedia.org/wiki/Wake_therapy](https://en.wikipedia.org/wiki/Wake_therapy)

------
DyslexicAtheist
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.

------
xen2xen1
Sleep deprivation increases serotonin and dopamine directly. Of course it
helps with depression.

