[HN Gopher] Staying awake to treat depression (2018)
       ___________________________________________________________________
        
       Staying awake to treat depression (2018)
        
       Author : softwaredoug
       Score  : 217 points
       Date   : 2021-04-04 00:31 UTC (22 hours ago)
        
 (HTM) web link (mosaicscience.com)
 (TXT) w3m dump (mosaicscience.com)
        
       | kennethh wrote:
       | For me as a parent, I found this snippet from the article
       | interesting:
       | 
       | It may also work as a prophylactic: recent studies suggest that
       | teenagers whose parents set - and manage to enforce - earlier
       | bedtimes are less at risk of depression and suicidal thinking.
       | Like light therapy and sleep deprivation, the precise mechanism
       | is unclear, but researchers suspect a closer fit between sleep
       | time and the natural light-dark cycle is important.
       | 
       | I have an 8 year old girl and notice that every time the bedtime
       | routine is delayed her behaviour gets worse both in the evening
       | and the day after.
        
         | Jolter wrote:
         | Behavior in an 8-year old who deviated from her regular bed
         | time does not seem like a good analog for teenager depression.
        
           | multjoy wrote:
           | No worse than any of the rest of the anecdotes being thrown
           | about.
        
       | jamesgreenleaf wrote:
       | You can certainly try this method, especially when you're
       | younger, and you'll probably feel exhilarated and your mood will
       | improve... until you finally go to sleep again. The effects don't
       | last very long, and losing sleep continually is very bad for your
       | health.
       | 
       | I would recommend to anyone with depression that you first change
       | your diet. Stop eating refined carbs & processed foods of any
       | kind. Stick to basic fruits & vegetables with some whole grains,
       | and beans for protein. Adapt this as your personal needs vary,
       | and as you see fit. I think you'd probably be amazed how much
       | eating well affects your mood, especially if you've never done it
       | before for any long period of time.
       | 
       | Here's some more info on a good, simple, science-backed diet to
       | follow: https://www.hsph.harvard.edu/nutritionsource/healthy-
       | eating-...
        
         | tom_mellior wrote:
         | > your mood
         | 
         | Depression is not about "your mood". Depression is not the same
         | as feeling slightly unhappy. By all means, everyone should eat
         | healthy foods. But if you have a medical condition
         | (depression), get medical help.
        
         | seibelj wrote:
         | I started suffering from depression at 18 and it got
         | progressively worse, with periodic bouts putting me in bed for
         | days. True misery. I switched to a very disciplined lifestyle
         | of exercise and a diet as suggested above and it helped a lot,
         | but it did not cure me. I just suffered less.
         | 
         | What cured me was SSRI medication (Lexapro). I still try to
         | maintain healthy diet and exercise but the SSRI was night and
         | day. I had minimal side effects and it completely changed my
         | life. My 2 cents.
        
           | cgriswald wrote:
           | For me, an SSRI worked wonders, but was just a short term
           | band aid. I had to adjust my dose or switch medications
           | pretty early on. I also felt like I lost something ephemeral
           | while medicated.
           | 
           | Diet and exercise also helped tremendously and had lasting
           | effects. I not only felt better, but it was earned. It took a
           | lot of discipline to make this happen while depressed.
           | 
           | Therapy is what worked. Everything else was great at
           | relieving symptoms, which gave me the capacity to work
           | through therapy. But, for me, they didn't act as a cure any
           | more than cough syrup and chicken soup cure a cold.
        
             | seibelj wrote:
             | I tried years of therapy but honestly never found a
             | therapist that clicked. I am a very corporate, achievement,
             | "work 80 hours a week" type person and therapists didn't
             | understand and constantly identified my lifestyle as a
             | source _or_ symptom of my depression which is 100% not
             | true.
             | 
             | The human brain is enormously complex. You can be depressed
             | by patterns of thought, past trauma / historical issues, or
             | simply a chemical imbalance. I firmly believe I had a
             | chemical imbalance and the SSRI fixed it. It was seriously
             | a night and day difference in my life.
             | 
             | I think there are many varied causes of depression and this
             | is why the same techniques don't work for everyone. But for
             | my situation the drugs worked.
        
               | herbst wrote:
               | I get depressed from 36 hour weeks. Maybe the therapists
               | arent wrong thinking that 80 hour weeks aint healthy,
               | even if you love your job lessure is super relevant too
        
         | pottertheotter wrote:
         | I think everything involved with trying to change your diet is
         | a pretty difficult hill to climb for most depressed people.
        
           | pope_meat wrote:
           | "I'm just not going to eat" is usually where that ends up for
           | me. Simple solutions for complex problems.
        
           | erikerikson wrote:
           | I find that any change I would like, I think about the change
           | and how it fits into my values structure over a few days and
           | change my mindset on the matter. Then I slowly shift in
           | little steps towards that goal. When I experience barriers, I
           | take those seriously and incorporate the insights into my
           | mindset and maybe adjust my it accordingly. In a sense the
           | initial mindset work is asking myself to be serious about
           | what I really want and how it fits holistically into my ways
           | of being. Then I am more motivated because it's not just -I
           | have this idea that it's what I want" it is "I want that" so
           | I trust I'll get there and allow myself to work through the
           | full complexity of the change.
           | 
           | In particular, this gets rid of the "I must exert energy to
           | do this" dynamic that can be an unbreakable barrier in a
           | depressive state.
        
         | scsilver wrote:
         | Seriously even before food, drink more water. Seriously.
        
           | cyberlurker wrote:
           | Agreed but drinking the recommended amount of water is harder
           | than I thought it would be! For one, it's a lot of water.
           | More than I would have thought. And second, if I'm ever going
           | to be out and about or not able to use the restroom
           | frequently I find it impossible.
           | 
           | I highly recommend more people hydrate properly but I don't
           | blame people who have a hard time, especially if they don't
           | work tech jobs where bathroom breaks are plentiful. Some of
           | my teacher friends have it rough.
        
           | weird-eye-issue wrote:
           | I drink more than the recommended amount of water every day
           | and yet I'm still depressed. It is almost like water can't
           | cure depression. Seriously.
        
             | klyrs wrote:
             | Me too, but when I forget to drink water, I feel awful and
             | my mental/physical wellbeing tend to spiral. An easy thing
             | to forget when I'm depressed and focusing on anything but
             | my own existence.
             | 
             | Compared to "depressed? Just make nutrition an even taller
             | barrier with an extra heap of guilt if you soft-fail!",
             | it's at least benign, and beneficial for me
        
             | [deleted]
        
             | cmehdy wrote:
             | Thank you.
             | 
             | "oh, have you tried more sunshine?", "try taking vitamin D,
             | it's probably just a seasonal affective disorder", "just
             | sleep well, eat well, drink well, don't do anything else
             | and you're good to go"
             | 
             | How about just go see some damn doctors first, and who
             | knows if they'll find something off with your thyroid, if
             | they can't do anything but diagnose a severe depression, if
             | your super-healthy-diet-2.0 is lacking in something and
             | it's in your blind spot, etc.
             | 
             | This trend of lifestyle coaches telling obvious things is
             | getting on my nerves quite frankly. I've drank your 3
             | liters of water per day, I've taken your vitamin D
             | supplements in the winter, I've done the five kinds of
             | fruit and veggies per day, I've done the low to no carb
             | diets, I've done full years of thorough tracking on
             | myfitnesspal, I've done the running frequently and lifting
             | often. I've followed proper sleep habits that didn't budge
             | even on weekends in order to retain a rhythm. I've gone on
             | walks. And so on.
             | 
             | What I haven't done is get proper help with people who knew
             | what the hell they were talking about, because everybody
             | else was trying to be a damn doctor and telling me that the
             | lemon in their hot water in the morning is probably the
             | difference between my messed up self and their stable life.
             | Proper treatments made the difference between life and
             | death. Thanks everybody else..
             | 
             | SEE PEOPLE WHO ACTUALLY KNOW WHAT THEY STUDIED.
        
               | [deleted]
        
               | mkr-hn wrote:
               | Doctors are too expensive and there are too many gaps in
               | social safety nets that allow some people to access
               | medical care who otherwise couldn't. Sometimes people who
               | can access medical care have had bad experiences with
               | doctors. I think most people who go to woo, life coach
               | hell, and different medical traditions were driven there
               | by terrible doctors or desperation.
        
               | cmehdy wrote:
               | And I was too. But I wasn't taken out of that hell by the
               | lifestyle coaches, I was taken out of that hell when
               | "good" (knowledgeable and empathetic and available)
               | doctors, who do exist, brought their actual knowledge and
               | experience to my problem. After about 20 excruciating
               | years.
               | 
               | The point is, you don't know if you have a small cut or a
               | fracture. While the bandaid can help the lesser problem,
               | you're going to have a very bad time if you let people
               | advise you to just put bandaids on your fracture.
               | 
               | I'm not saying people shouldn't apply at all general
               | tips, but people need to realize that it should
               | mandatorily come with "and go seek professional help if
               | your suffering is increasing or if it is hard to bear, no
               | matter how long it takes". It should be encouraged,
               | because people who are suffering from various kinds of
               | issues like depression or bpd are likely already not
               | wanting to go due to both psychological factors
               | (anhedonia, anxiety disorders about what they'll find or
               | how their finances affect them, self-abandonment) AND the
               | state of their lives.
               | 
               | High-functioning depression? well there can be a degree
               | of delusion to operate well enough ("It's not that bad"
               | until you flip out). Or not functioning at all? then your
               | income is likely lower than if you were feeling well,
               | thus the financial stress and lack of access to
               | convenient solutions for medical support. And then you
               | just read people saying how they went from couch to being
               | a CEO because they wake up at 5 every day and drink lots
               | of water.. well cool for you, but if you were lucky that
               | it wasn't a fracture that doesn't change the lack of
               | diagnosis of MY thing!
        
               | [deleted]
        
           | holoduke wrote:
           | That's not true. Diet had much much greater impact on your
           | brains.
        
             | scsilver wrote:
             | Depends, try not drinking for 4 days and see how you feel,
             | now try without eating.
        
       | 11235813213455 wrote:
       | We shouldn't need to say it, but the most simple things like sun
       | exposure, outdoor activities, organic food help a lot against any
       | mental issues, and sleep only when you need it!
        
         | herbst wrote:
         | I agree with the other poster, this does not simply work for
         | everyone.
        
         | tom_mellior wrote:
         | The reason we shouldn't say these things is because they are
         | _wrong_ in general. There is no magic silver bullet against
         | depression. Especially not a one-size-fits-all one. And telling
         | depressed people to go out and exercise can be _actively
         | harmful_ because it puts even more pressure on people who find
         | it hard to cope with everyday pressures.
        
           | 11235813213455 wrote:
           | definitely, what I mean is refocusing on the very basic
           | things humans do and exiting the excessive social pressure
           | help to regenerate ourselves. By "outdoor activities" I don't
           | mean something with other people, with schedules etc.. no
           | just very simple things, like walking alone, around trees,
           | and releasing all that pressure
        
             | tom_mellior wrote:
             | > walking alone, around trees
             | 
             | You don't understand depression, and you are not qualified
             | to make suggestions to people with depression. Please stop.
             | 
             | We are talking about people who find it hard to get out of
             | bed in the morning, and to motivate themselves to do the
             | most basic tasks, let alone putting on clothes, going out,
             | possibly going among people to ride public transport to
             | where the nice trees are. Ugh. Also, the season/weather
             | might be all wrong for enjoyment outside. Also, even
             | temporary enjoyment outside might not cure _a medical
             | condition that you obviously do not understand_.
             | 
             |  _" Just motivate yourself" is not a solution for not being
             | able to motivate oneself._ Please stop.
        
               | 11235813213455 wrote:
               | To take an analogy, I feel like I'm suggesting someone
               | should try and fix himself his bicycle flat tire, and
               | you're reponding: "No, don't, you could injure yourself.
               | Make sure you go see a professional and don't listen to
               | those personal experiences"
               | 
               | I know it's a serious topic, I've been diagnosed with
               | depression several years ago, that's why I just let my
               | simple experience with it, that goes well with ideas
               | developed in the article, of natural & risk-free
               | drug/treatments alternatives
        
       | thelastestate wrote:
       | Yup, too embarrassed to admit it, but this... People love me when
       | I'm in that state, which, I guess who I am when not going through
       | (waves arms this), so I make sure to give it to them. I tested
       | myself and besides some extremely light loss in agility and
       | mental acuity (then again more social when tired) my work's the
       | same... except for the flashes of insight, drive, energy and
       | hmmm... Given the MASSIVE gains to productivity, wealth creation
       | and global competitiveness any sane government should be
       | investing incredible sums into mental health.
        
       | xvedejas wrote:
       | It's very strange to me that this is the case for those with
       | clinical depression; I personally feel great each morning and by
       | the late evening my mood tends to be nearly as low as it was when
       | I did have a bout of clinical depression. I wonder if this
       | suggests a different mechanism for my melancholy.
        
         | [deleted]
        
         | pottertheotter wrote:
         | This is so interesting to read. I'm not always in a deep
         | depression, but I'm trying to recall a period of my life where
         | I could say "I generally feel great in the morning" and I can't
         | think of one. I'm not saying I generally feel bad, but never
         | great.
        
           | xvedejas wrote:
           | The "great" is after maybe a half hour of grogginess. Then I
           | feel like I have peak motivation and am ready to take on the
           | world, for the rest of the morning. I sure would love to have
           | that perspective for the rest of the day. Caffeine kind of
           | enhances it.
           | 
           | Possibly relevant, I regularly get about 9 hours of sleep
           | each night.
        
           | inakarmacoma wrote:
           | Agreed. I can't remember ever feeling great or well rested
           | upon waking. It's depressing. Or depression, as it were.
        
             | darkerside wrote:
             | Exercise immediately upon waking. After a week of this, you
             | wake fully primed. No coffee needed.
        
       | thomasfromcdnjs wrote:
       | I got a bit of an existential creative mind, and I love sleep
       | deprivation because it kicks me into lucid dreaming a lot.
       | 
       | I have incredibly intense waking dreams for hours on end, I fall
       | asleep and wake up up to 15 times in a row.
       | 
       | They are more intense then most psychedelic trips I've had. Lucid
       | dreams feel like I'm some where between the material and
       | metaphysical world.
       | 
       | I use the WILD or Wake-Initiated Lucid Dream method. It can be
       | annoying sometimes because you essentially have to go through
       | sleep paralysis every time, which can be terrifying if you don't
       | know about it or aren't in the mood for it.
       | 
       | Copying this from another website but it sorta works like this;
       | 
       | > "Wake yourself up after 4 to 6 hours of sleep, get out of bed
       | and stay up for anywhere between a few minutes to an hour before
       | going back to bed. It is preferable that you do something related
       | to lucid dreaming during this time, but it is not required.
       | 
       | Go back to bed and lie absolutely still, as if your body is
       | melting into the mattress and losing all sensation. Silence your
       | inner monologue if it starts to chime in. You may hear hypnagogic
       | sounds, echoes of voices and other sounds in your head.
       | 
       | Once in the half-dream state, you will experience hypnagogia as a
       | mixture of patterns and colors that take over your vision in the
       | darkness. Observe your hypnagogia and stay relaxed, allowing it
       | to hypnotize you and draw your awareness away from the outside
       | world into the internal dream world that is starting to evolve
       | now."
        
         | Taylor_OD wrote:
         | Why would you want to do this? I have some sleep paralysis like
         | experiences from time to time and have never found them
         | enjoyable. Even more so when the dream only leads me into
         | another dream and on and on.
        
           | dorkwood wrote:
           | It's hard to describe if you've never experienced it. It's
           | like the most powerful psychedelic drug you can take. It
           | allows you to manifest an entirely new world into existence.
           | It's the ultimate power trip. True autonomy. But it's
           | addictive, and will fuck up your sleep habits if you fall
           | under its spell too much.
        
           | samhain wrote:
           | I discovered the technique he's talking about on my own back
           | in maybe 2016. He has some extra fluffy language around it
           | that makes it seem more than it is. It's really just falling
           | back asleep after you've already woken up at a specific time.
           | For me, it was 4 AM. The point is that you can control your
           | dreams. So I was using it to have sexual dreams. Which is why
           | the other guy says it can be addictive (which I'd argue is
           | also hyperbole).
        
           | andai wrote:
           | I really enjoy flying. I do it almost every night.
        
             | jmiskovic wrote:
             | A weird question, but what are the flying mechanics in your
             | dreams? Like superman, ironman, or more bird-like? How much
             | in control are you?
        
         | TeeMassive wrote:
         | I've experienced similar things using this pattern, but also
         | using melatonin before going to sleep. Not only I get to sleep
         | 12+ hours, the dreams I do are so lucid it's crazy. I get to
         | explore the world as I know it and sometimes I can even fix
         | nightmares. This has helped me a lot.
        
       | AltruisticGapHN wrote:
       | Not intensely depressed, though I am still heaming trauma.
       | 
       | From my teens to mid thirties, I often stayed up very late well
       | until 4 am. Usually I'd find it very difficult to restore my
       | sleeping hours so I would keep shifting forward, like sleeping at
       | 11am, getting up at 8pm... until i was again up at like 5 am...
       | then i managed normal waking hours for a few weeks and the cycle
       | would repeat.
       | 
       | In hindsight I always felt safer at night. When the world seems
       | to be asleep, i felt less pressure, it was quiet...
       | 
       | I also remember when staying awake longer or sleeping a few
       | hours, it was pleasant in some ways, i didn't feel as anxious,
       | like sailing on a cloud.
       | 
       | The research doesn't surprise me but sadly it is always a
       | clinical perspective. These people are not genuinely cured of
       | "depression" whatever is the clinical description. We know a lot
       | more about the physiology of trauma these days, and there is
       | almost always some type of trauma involved, meaning an experience
       | of physical / emotional overwhelm, and a nervous system that
       | never quite returned to normal. Usually there is a history of
       | developmental trauma and / or tramatic events like violence, or
       | serious accidents. Sometimes a stay in hospital can be traumatic
       | as well, invasive procedures, lack of connection, etc.
        
       | stereoabuse wrote:
       | I only have anecdotal evidence. Long time depressive, combination
       | of several SSRI and atypical antidepressants with cyclical
       | efficacy, about 1 decade of varying treatment approaches. One
       | weekend in summer 2016 was the changing point between "old very
       | depressive me" and "new just regular depressive me" - involved
       | intercontinental travel, zero sleep for somewhere 48+ hours, and
       | some socialization and 'partying' in a culture new to me. My
       | first response to feeling this change a couple days later after I
       | had returned to my home country was too look up research on sleep
       | deprivation's use in depression treatment. Was pleasantly
       | surprised when there seems to be some marginal evidence for its
       | efficacy. That being said, staying awake for that long was a
       | misery in itself and I'm not looking to repeat that in the future
       | so I'll stick to the couple pills I take in the morning to tame
       | everything for now.
        
         | m463 wrote:
         | I will say that the best sleep - the deepest and most
         | satisfying sleep - it happens for me after staying awake for
         | too long.
         | 
         | I suspect a good lifestyle for me would be to have 26 hour
         | days.
        
           | dnate wrote:
           | it is possible: https://xkcd.com/320/
        
           | zemvpferreira wrote:
           | I'm just like you. Left to my devices I will go to bed 2
           | hours later each day.
           | 
           | Taking sub-1mg doses of melatonin every night has helped me
           | cope with a 24 hour day tremendously. Have you tried that?
        
             | stefandesu wrote:
             | Do you know anything about long-term consequences of taking
             | melatonin supplements? I remember the results being
             | inconclusive when I looked it up once.
             | 
             | I'm currently trying to get off melatonin and also get to a
             | natural sleep cycle (meaning I won't have an alarm in the
             | morning). But that usually means that I won't be able to
             | fall asleep at night and I'll sleep forever in the morning
             | if nothing external is waking me up. I'm not sure if I
             | should continue or if I should just start taking melatonin
             | again because it helps tremendously.
        
               | zemvpferreira wrote:
               | I haven't found anything that would point to total safety
               | or the opposite. Then again, there are plenty of studies
               | on the dangers of sugar and I still eat a bit of
               | chocolate every day. Same for red meat, plastics touching
               | food, caffeine, beer, being slightly overweight, driving,
               | not using sunscreen regularly, stress, lack of sleep.
               | 
               | Is the risk of taking a small amount of melatonin every
               | day really something to worry about in the bigger
               | picture, if it helps you and has a long history of being
               | used for this purpose without problems?
               | 
               | Like lots of people here I just can't beat my tendencies
               | to stay up late despite massively good sleep hygiene. I
               | end up missing sleep, being cranky and depressive, and
               | generally having a lower quality of life because I just
               | don't feel like going to bed - and when I do make it to
               | bed I ruminate for a long time before falling asleep. If
               | no new information presents itself, I plan on keeping
               | good habits and being on melatonin for the rest of my
               | life.
        
               | Pyramus wrote:
               | I don't have an answer for long-term melatonin
               | unfortunately.
               | 
               | In most folks circadian rhythm is not exactly 24 but
               | slightly more or less. In this case it is helpful to
               | force the sync by getting exposure to sun light (or a
               | source of similar quality) in the morning and religiously
               | cut off exposure to light several hours before going to
               | bed.
               | 
               | Ideally you completely filter out both blue and green
               | wavelength (which trigger the suppression of melatonin)
               | and keep overall levels low.
               | 
               | For more information see shift workers' strategies - they
               | have to change their rhythm on a weekly basis.
        
               | TedDoesntTalk wrote:
               | Congratulations on trying this.
               | 
               | It is worth mentioning that lifelong sleep deprivation is
               | linked to different types of dementia in the elderly, so
               | I'm not sure which is worse: persistent sleep problems or
               | nightly hormone supplements.
        
             | aklemm wrote:
             | I'm the same but I've long suspected our bodies need more
             | physical activity. Any day that I work hard in the woods or
             | around my house, I sleep well.
             | 
             | It's doubtful to me that pre-industrial folks had a ton of
             | trouble going and staying to sleep.
             | 
             | And fwiw, "working out" helps, but isn't the same as a
             | day's manual labor.
        
               | zemvpferreira wrote:
               | I should note that I often spend my days working
               | construction and regularly average 3 hours of exercise
               | per day. Doesn't help me that much. Big exception made
               | for the first day spent surfing if I haven't surfed in a
               | while, that knocks me out cold.
               | 
               | It makes sense to me that if we stimulate ourselves
               | through sugar, caffeine, artificial light, information,
               | worry etc that we can benefit from a mild depressive to
               | balance the stimulus. The other option is a monk-like
               | existence that I haven't been able to keep going for more
               | than a few months at a time and wouldn't want to go back
               | to.
        
             | m463 wrote:
             | Apart from taking vitamins irregularly I usually put my
             | body in charge of generating the pharmaceuticals. :)
        
               | zemvpferreira wrote:
               | I'd ask you to consider that whenever you turn on a
               | lightbulb or a computer screen you're already interfering
               | with your body's agency over this particular chemical.
               | Don't spend 10 hours every day outdoors? You are well out
               | of natural parameters already.
        
         | amelius wrote:
         | > involved intercontinental travel, zero sleep for somewhere
         | 48+ hours, and some socialization and 'partying' in a culture
         | new to me
         | 
         | Those are quite some experiences, each of which could have
         | contributed to some form of recovery.
        
         | pram wrote:
         | I know that exact feeling. In 2010 I went from pretty crippling
         | depression to a higher-functioning (lol) depression/anhedonia.
         | It involved a nonstop drive from eastern Washington to south
         | Texas. Never thought about it but it might have been the sleep
         | deprivation and adrenaline.
        
       | Tildey wrote:
       | Here's my anecdotal experience as a relatively young person. I
       | have some form of untreated (and admittedly self diagnosed) long
       | term depression, and experience depressive episodes in addition
       | to that (yes, I've tried exercising. Yes I have a good diet. Yes
       | I try get enough sleep)
       | 
       | If I skip a night, I find I feel very productive and ready to
       | work starting around 6am. I have a generally more positive
       | outlook on things, I feel like I can achieve my goals etc. Mental
       | clouding isn't too bad until the late afternoon, at which point I
       | turn into a depressed lump incapable of doing things that require
       | much mental effort. Mental health at this point basically returns
       | to normal.
       | 
       | If I supplement this with additional (prescription) ADHD
       | medication (taking it at around 1am, and at prescribed intervals
       | until bedtime the next day) I'm actually in a pretty good place
       | for an entire day. I feel barely physically impaired at all. I
       | probably wouldn't operate heavy machinery or drive long distances
       | (or with other people), but I can function quite well.
       | 
       | In either case, the next day is horrible. Oversleeping, feeling
       | tired all day no matter what, sever brain fog, measurably worse
       | reaction times. The improved mood is not worth it, especially
       | when I'm already so used to dealing with it. I don't think I
       | could physically stay up for two nights (three full days) in a
       | row.
        
         | thelastestate wrote:
         | How did you break out of the funk!? And I found a way to
         | mitigate the 'punishment' via prescribed SSRis anti-anxiety.
        
           | thelastestate wrote:
           | serotonin?
        
           | Tildey wrote:
           | What do you mean my the funk? Without meaning to sound
           | melodramatic, I've been depressed for so long I can cope
           | quite well with it. The additional depressive episodes mostly
           | come and go of their own accord
        
       | scottshea wrote:
       | Oh my God, THANK YOU! I have used this for years but my
       | psychologists think I am nuts
        
       | bobbiechen wrote:
       | If you're interesting in learning more, Scott Alexander recently
       | discussed research on this topic with a lot of links to papers:
       | https://astralcodexten.substack.com/p/sleep-is-the-mate-of-d...
       | 
       | > _But forget the practical side of this for now. It looks like
       | sleep is somehow renewing these people 's depressions. As if
       | depression is caused by some injury during sleep, heals part of
       | the way during an average day (or all the way during an extra-
       | long day of sleep deprivation) and then the same injury gets re-
       | inflicted during sleep the next night. _
        
         | taeric wrote:
         | With that phrasing, I can't but muse that it is not the sleep
         | that causes issues, but the "starting fresh" in the morning.
         | 
         | Hypothesis being that something about a well rested mind lets a
         | waking person check off more of a list of things to consider
         | first thing in the morning.
        
           | kiba wrote:
           | I have depression/anxiety and procrastination issue in the
           | morning. It gets better especially once I decided to do
           | something for the day. Then it's all momentum all the way.
        
             | sn41 wrote:
             | Making a timetable for the next day helps, I have found.
             | The downside is that I tend to say no to anything that
             | deviates from the timetable.
        
               | Shugarl wrote:
               | I had a similar issue, and I found a solution : Rather
               | than aiming to follow my plan, I aim to do a
               | predetermined amount of tasks (25 in my cases),
               | regardless of whether or not they are in my schedule. I
               | use an app to keep track of the amount of tasks done, and
               | it has been surprisingly effective!
        
               | yellowapple wrote:
               | Which app? Definitely curious if it'll help with my own
               | procrastination (and possibly undiagnosed depression).
               | 
               | The last time I made some headway on why I seem to
               | endlessly procrastinate (said headway being enabled by,
               | er, "self medication"), I came to the conclusion that
               | it's because my brain sees a whole bunch of things to do,
               | and instead of taking the rational approach of "well take
               | things one at a time", it instead gets into a whirlwind
               | of indecision, panics under the stress of all these
               | things to do, and immediately starts reaching for an
               | escape, thus compounding the problem. In the "self
               | medicated" state my brain was more able to get into a
               | groove of "okay, do $N more things" and actually make
               | some headway, but only until the nausea caught up to me
               | (at which point I had to force myself to call it a day).
               | 
               | My hope is that it's just a matter of tooling, and that a
               | better toolset will help me get out of ruts without
               | needing to rely on mind-altering substances.
        
               | Shugarl wrote:
               | I just downloaded one of the first apps that I found on
               | the Google Play Store when I searched for "incrementor".
               | I think any app where a number goes up when you press a
               | button will do the trick.
        
               | dwaltrip wrote:
               | My understanding is that procrastination most commonly
               | stems from emotional disregulation. I've definitely
               | experienced that myself.
        
               | dageshi wrote:
               | I wish something like that would work for me. I would
               | immediately begin to analyse what counts as a task. I'd
               | set myself tasks, realise they're much more difficult
               | than I thought they were and realise there's no way for
               | me to complete this task and also hit my 25 goal.
               | 
               | Then I'd get frustrated with myself and probably go surf
               | reddit for the rest of the day.
               | 
               | No system of any type has worked for me consistently.
        
               | Shugarl wrote:
               | I also tend to overanalyze things, but books like "Atomic
               | Habits" and "The Slight Edge" were really helpful. It
               | made realize that there's no point to try to properly
               | define what a task is, as what I can do at any given day
               | depends on my physical and mental state.
               | 
               | How I perform when I have a bad day is completely
               | different from my performance on a good day. Something
               | that's a task today might not be considered like one
               | tomorrow.
               | 
               | There'll be days where I'll only do 25 small things then
               | call it a day, and that's okay.
        
               | taeric wrote:
               | I feel you on this. I have found that no system lasts for
               | me. I have also found that any system can help to get me
               | going. Such that now I try not to use anything to plan
               | his things will end, but only how I will begin them.
               | 
               | Similar problems hit me with exercise. About the only
               | system I have there is too obligate myself to finish
               | something. For example, if I walk the dog a mile out, I
               | have to walk the mile in, as well. Bike to work? I have
               | to bike home now.
        
               | webmaven wrote:
               | _> I wish something like that would work for me. I would
               | immediately begin to analyse what counts as a task. I 'd
               | set myself tasks, realise they're much more difficult
               | than I thought they were and realise there's no way for
               | me to complete this task and also hit my 25 goal._
               | 
               | Can you permit yourself to subdivide those tasks that
               | turn out to be more difficult?
        
               | taeric wrote:
               | Subdividing in total doesn't work for me. Unless it is
               | something I already know how to do. Identifying the next
               | thing works ok.
        
               | webmaven wrote:
               | So, if something is taking longer because you're
               | identifying previously unanticipated subtasks, does doing
               | the yak-shaving count toward your count of tasks, or not?
        
               | intricatedetail wrote:
               | Any sort of table, plan or a roadmap makes me more
               | depressed, because I cannot stick to it and that
               | amplifies feeling of guilt. Best results I had when my
               | plan was to do just one thing, even if it was only one
               | line of code throughout the day and even doing nothing at
               | all I had coded as doing resting. I had incredible
               | progress with this approach.
        
               | pope_meat wrote:
               | this is so relatable. it takes so much effort to commit
               | to any sort of plan in the first place, and then life
               | circumstances happen and the plan has to change, and I'm
               | left completely defeated by that development. this sucks.
        
             | [deleted]
        
             | dazc wrote:
             | Is it possible for you to have something already planned
             | the previous day?
        
           | phobosanomaly wrote:
           | I've had panic attacks during loosely-structured periods in
           | my life where sitting in the shower after waking up in the
           | morning and having to decide _what to do_ with that day was
           | absolutely overwhelming. Sometimes when you have a lot going
           | on and you 're under a lot of stress there's a lot of
           | pressure associated with deciding how best to allocate your
           | time.
           | 
           | In contrast, I find a relative peace at 3am, since it's
           | merely a continuation of what I had been doing earlier that
           | day. I'm in a groove, and there's no major decisions to make
           | regarding my resource allocation.
           | 
           | Waking up is absolutely one of my least favorite parts of the
           | day. It comes with a tremendous burden, especially when
           | living alone and not having a fixed schedule or a boss.
        
             | tarsinge wrote:
             | I'm glad if you feel better know. It's interesting to know
             | oneself because I have exactly the opposite experience. The
             | more the day pass the more I am stressed, with sometimes
             | panic attacks before sleep. I feel refreshed in the
             | morning, the best part of the day for me. The exception is
             | when I have a fixed schedule, a boss (also a long commute
             | and a job I don't like), then sure I don't like waking up,
             | because I know exactly what the day will be without
             | surprise and it's shitty.
        
               | phobosanomaly wrote:
               | Out of curiosity, what is it that gets you before you go
               | to sleep? What is running through your mind when you
               | experience the panic attack? (I mean, not specifics, but
               | in a general sense.)
        
               | tarsinge wrote:
               | I think it's general anxiety from the accumulated
               | "thinking fatigue" during the day. There is a correlation
               | with periods where I lacked a clear plan and spent too
               | much time of the day in my thought planning the future.
               | The process at sleep then is something like I feel tense
               | -> I become hypersensible -> I notice each heartbeat
               | accelerating -> maybe something is wrong -> ... Sometimes
               | it was more sudden like waking up panicked in the middle
               | of the night. Meditation helped because now I notice when
               | I loose myself too much in my thought. The effect is not
               | immediate but it makes a difference at the end of the
               | day.
        
           | tgv wrote:
           | I can't help thinking that Scott Alexander has no clue what
           | he's talking about, or more more benevolently, is writing
           | quasi-poetic nonsense. Which is bad for someone with that
           | many followers.
           | 
           | I can give another off-the-cuff alternative: sleep
           | deprivation reduces self-awareness, and thus self-report of
           | depressed feelings. It might be that at this point the
           | "brain" is more susceptible to treatment, but that's an
           | entirely different matter.
        
             | coldtea wrote:
             | > _I can 't help thinking that Scott Alexander has no clue
             | what he's talking about, or more more benevolently, is
             | writing quasi-poetic nonsense. Which is bad for someone
             | with that many followers._
             | 
             | Note how you haven't pointed to a single thing that's bad
             | with his post, but nonetheless managed to sling several
             | condescending accusations (has no clue, quasi-poetic,
             | nonsense) at him...
             | 
             | And all that for a point where he doesn't even pretend to
             | give any specific explanation or causual relationship or
             | anything, just wants recap with a description of the
             | outward appeareance of the phenomenon, precisely to show
             | that we have no clue about it yet:
             | 
             | "It looks like sleep is somehow renewing these people's
             | depressions. As if depression is caused by some injury
             | during sleep, heals part of the way during an average day
             | (or all the way during an extra-long day of sleep
             | deprivation) and then the same injury gets re-inflicted
             | during sleep the next night".
             | 
             | In TFA this is not an explanation of what happens, but an
             | "it looks as if somehow" to highlight exactly the current
             | lack of an explanation, an explicitly presented as such.
        
             | starpilot wrote:
             | Scott's explanation at least makes sense with a causal
             | chain of reasoning. "Self-awareness" is more a
             | philosophical concept that has no psychiatric meaning, sort
             | of like like "fairness" in economics. "It's all placebo
             | here!" sounds lazy and like a cheap shot.
        
             | hellbannedguy wrote:
             | I knew a Psyc. nurse years ago, and she said they prevent
             | certain depressed patients from sleeping. I knew her 17
             | years ago, and she was a nurse since the 80's.
             | 
             | She said it was for the patients whom were brought in
             | because they just tried to kill themself's, or told
             | admittance they wanted to die.
             | 
             | I had the idiotic idea I could cure my dysthymia (Minor
             | depression) by sleep deprivation, and it didn't work at
             | all.
        
             | bawolff wrote:
             | If you're going to say someone is talking nonsense, maybe
             | back it up with specific reasons how and why. (Not
             | necccesarily saying he isn't, just without specifics we
             | might as well just be calling people names)
        
             | Smithalicious wrote:
             | Scott is a practicing psychiatrist (now with his own
             | clinic!) and is very well-read on depression specifically
        
             | herbst wrote:
             | I dont know this guy. But his idea definitly works for me.
             | The effect lasts longer than a day so i would argue its not
             | the sleep deprevation itself
        
               | webmaven wrote:
               | _> I dont know this guy. But his idea definitly works for
               | me. The effect lasts longer than a day so i would argue
               | its not the sleep deprevation itself_
               | 
               | It is generally accepted that the negative effects of
               | sleep deprivation last longer than a day too. If you are
               | sleep deprived you can't 'catch up' by sleeping in for a
               | night or two (for example on the weekend).
        
             | DyslexicAtheist wrote:
             | fwiw I've used it on and off as a last resort and it saved
             | my life.
             | 
             | The first few times I happened to do it was not because I
             | was aware of the link (20 years ago nobody wrote about it).
             | It was by accident because I've stayed up so late that dawn
             | surprised me during a night of insomnia. So it made more
             | sense to just power through the day with coffee rather than
             | mess up my sleep pattern. It certainly works for me like
             | some kind of reset.
        
             | mckirk wrote:
             | He's a psychiatrist and generally researches everything he
             | writes about quite thoroughly, so I'd be surprised if he
             | had no clue what he's talking about in this case.
        
           | PragmaticPulp wrote:
           | That might play a role, but sleep deprivation is also a
           | trigger for hypomanic or even manic episodes in bipolar
           | patients. There's something about sleep deprivation that
           | alters mood in certain mental disorders.
        
             | hnick wrote:
             | Interesting, I've noticed for a while if I have a late
             | night the next day I'll often be extremely energetic and
             | more social than normal. The crash comes the day after.
        
             | andai wrote:
             | Based on my experience I figure the "reasoning" behind this
             | mechanism is that if my anxiety is bad enough to be keeping
             | me awake, I clearly need more energy to deal with my
             | problems (and, graciously, it is provided).
        
       | pixel_tracing wrote:
       | Seriously if you have clinical depression go get actual clinical
       | help, like medication. It saved my life.
        
       | thelastestate wrote:
       | What's to stop someone conducting safe, ethical trials into the
       | random 'forbiddens' such as magic mushrooms in a far off country?
       | Deal with their FDA system?
        
         | herbst wrote:
         | Because far of country still has laws :/ but yeah mushies
         | definitly hold a key that could help many people. Starting with
         | migraines where for some nothing else helps, bit mushies do
        
       | redmorphium wrote:
       | In the US, the only controlled clinical setting I know of that
       | performs wake therapy (in the form of "triple chronotherapy") to
       | treat depression is in Chicago:
       | http://www.chicagochronotherapy.com/protocol.html
        
       | dang wrote:
       | Discussed at the time:
       | 
       |  _The antidepressant effect of sleep deprivation_ -
       | https://news.ycombinator.com/item?id=16557500 - March 2018 (155
       | comments)
        
       | endisneigh wrote:
       | A long time ago I used to play World of Warcraft for days at a
       | time taking naps every 30 minutes or so every 4 hours. Needless
       | to say I was tired as hell.
       | 
       | Interestingly though, my mood was excellent - and not from
       | playing the game. It was almost as if the fact I had been awake
       | for so long itself is what made me happy.
        
       | rl3 wrote:
       | Despite the article's title, its subtitle qualifies it as a
       | possible treatment for _severe_ depression.
       | 
       | Ideally under supervision, at that. Near the very end:
       | 
       | > _In the case of wake therapy, Benedetti cautions that it isn't
       | something people should try to administer to themselves at home.
       | 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. Keeping yourself awake overnight is also
       | difficult, and some patients temporarily slip back into
       | depression or enter a mixed mood state, which can be dangerous.
       | "I want to be there to speak about it to them when it happens,"
       | Benedetti says. Mixed states often precede suicide attempts._
       | 
       | Sleep deprivation is nothing to fuck around with. If you're
       | emotionally unstable, it'll usually make that worse.
        
         | codethief wrote:
         | > Sleep deprivation is nothing to fuck around with. If you're
         | emotionally unstable, it'll usually make that worse.
         | 
         | Exactly. My experience has been exactly the opposite of
         | lessening depressive tendencies.
        
           | x86ARMsRace wrote:
           | It can also worsen any other symptoms -- sometimes the
           | depression itself too. For example, people who experience
           | anxious depression may end in a much worse situation as a
           | result of sleep deprivation.
           | 
           | This study always needs to be qualified with "your mileage
           | may vary".
        
           | GordonS wrote:
           | Same for me. If I spend the whole next day exhausted after
           | sleep deprivation, my emotional state feels really fragile,
           | my decision making is impaired, and everything just feels
           | harder.
        
       | jariel wrote:
       | Often, after 24 hours of being awake, I've noticed a weird
       | euphoria on he second morning day. Intellectually quite useless,
       | but nevertheless a kind of bliss. I've always associated it with
       | a kind of 'ignorance = bliss' related to the total inability to
       | mentally linger on the issues of the day. But the types of
       | 'issues of the day' for people who are depressed may be the
       | problem.
        
         | adrianmonk wrote:
         | It's an interesting thought. Excessive rumination is generally
         | pretty bad for your state of mind. Maybe with sleep
         | deprivation, you don't have the spare brainpower to spend
         | ruminating.
        
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