I've been on the prowl for non-pharmacological ways to address my annual bouts of spring/summer pharmacoresistant melancholic Bipolar 1 depression (late summer/early fall mania always follows).

Around this time of the year, I start to hate sleeping because I feel less depressed after being awake for twenty hours than I do after waking up in the morning. It's the difference between having a small paper cut and a gaping wound. I believe this type of pattern is called diurnal mood variation.

I have always been aware of the anti-depressant effect that sleep deprivation seems to have on me. In fact, a single night of total sleep deprivation leaves me mildly hypomanic until I succumb to sleep. Once I wake up, I'm back where I started -- severely depressed. I am certain that it was this realization that led me to take my bed apart and toss it out of the front door during my senior year of high school. Well, that may have been mania. In either case, I never slept.

A few years ago, I developed the hypothesis that extended wakefulness may contribute to an improvement in mood. I did some research at Shields Library and found a TON of journals and articles confirming my suspicion. I have decided to bring up Sleep Deprivation Therapy during my Pdoc appointment on Monday.

Has anyone else considered trying SDT and/or Sleep Phase Advance? Discussed it with your Pdoc? Tried it? Do you have other suggestions?

Any and all thoughts are welcome.