Sleep Deprivation and Sleep Phase Advance as Treatments for Depression

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.

I have not tried that ever on purpose. But my pdoc told me they used to keep patients awake all night to treat bp depression a long time ago and that it really worked. Pretty interesting. When I'm in the dark depression I would need someone's help keeping me awake to try that, because I can just sleep and sleep and sleep. I get very melancholy late summer too...to me, it makes sense. I don't see why everyone isn't affected as such really.

Yes i have done intentional sleep deprivation and have gotten to ten days feeling great without manic symptons (still maybe hypo). it would range from three to six hours sleep a night and my automatic thoughts went from negative to positive. I felt more outgoing and saw good things in myself I couldnt see normally like more striations in muscles and just overall more clearheaded and social with people.

But evetunally I crashed hard and that was two weeks ago and I am actually on a sleepless night right now to try it and make it work again.

What I would do if I was you is what I'm doing and is a sleep chart. Write the hours you sleep, the mood rating, your thoughts and another Misc. category that will help you identify triggers or things you did that day aka talked to a hot girl she said I was cute, went to gym at 9pm.

I would start this after a sleep deprivation night when things work and follow it through the good then bad then good again so you can know what helps. Also rather after a sleepless night rather then sleep all day or eight hours try to limit yourself to four hours a night for few days then try working up to six to eight. You will probably crash but if you can reconize the amount of hours you need to sleep then it will be worth it months from now.

Also dont be alarmed if some sleep deprivation nights dont work. Mine dont which is why I'm doing the sleep chart to reconize any triggers the day before that made it work.

Thanks!

Surfgod, I've been keeping a comprehensive mood journal for two or three years. It's helped me identify the seasonal pattern of my Bipolar. My episodes never have any preceding stressors or triggers, and my depressive episodes usually include a lack of reaction to stimuli. So positive experiences don't have any effect on my mood. You could hand me a hundred bucks and I'd still feel terrible. I even run every day and it does absolutely nothing for me.

I generally sleep for four to five hours a night and I have never been able to sleep for more than six at a time. Maybe I'll look into the correlation between the exact amount of hours I've slept and my mood. I'll do some statistical analysis or something.

Hopefully this Pdoc will be open-minded enough to listen to me instead of immediately trying to add a fourth medication or up my Seroquel.

Hmmm interesting concept.

Sleep deprivation brings on hypo/mania which several of you said. So, you are trading depression for hypo/mania and rapid cycling of your moods. Keeping a regular sleep schedule helps you stay stable, as my pdoc said.

It's a treatment method previously used / possibly still used (pdoc told me previous method in a pretty casual convo) in hospitals to help pull someone out of a bp depression. She said it actually helped people. But obviously they were safely monitored in case some bad mania or psychosis came on. It makes sense to me theoretically but I'm no doctor and wouldn't want to be one. Interesting topic though.

I have heard of it for major depression. Not for bp. When there is no risk of mania/hypomania, in other words.

I spoke with the Pdoc today. We're getting rid of the Seroquel and Temazepam, adding Wellbutrin, and doing a closely monitored trial of the whole sleep deprivation/sleep phase advance thing.

I'll go through a night of sleep deprivation. After total sleep deprivation, I'll start a sleep schedule from 4 pm to 11 pm, which will be shifted back an hour each night until I'm sleeping from 10 pm to 5 am. Some of the patients who have melancholic depression that improves with a lack of sleep maintain a higher mood level during sleep phase advance. I'm hoping that I fit into that group.

The aim is to blunt the depression long enough for the Wellbutrin to start working. My depression is pretty med-resistant, but I've never tried anything like Wellbutrin before so I'm hoping it works. I really don't feel like getting ect this summer.

I always leave school during the spring because of my depression, so I have time to try this out. My doc and I are gonna stop it if we feel that I'm becoming manic.

hope this works for you... you can only try i guess!

good luck

I noticed it worked well for me in the passed. If I stayed up all night while depressed the next day, I would feel more of a relaxed feeling then a fatigued feeling. And had much more energy over all.

I hope it works out for you.

Sleep deprivation can cause several different chemicals to be release in the brain, inlcuding many of the "feel good" ones.

It is said that at 36 hours without sleep you and your brain are at a cognitive level of "legally drunk," and the feelings of euphoria and delerium increase exponentially from that point.

I am not surprised reading about the sleep deprived - drunk comparison. It is a known issue that sleep deprivation is as bad as alcohol for driving.

" Sleep deprivation is a major cause of motor vehicle accidents, and it can impair the human brain as much as alcohol can. "
Sleep-deprived driving - Wikipedia, the free encyclopedia

I find this awesome that you're pdoc is supporting you with this, very cool! Keep us posted how it goes! Do be careful with welbutrin - I had wayyyy too much of a good time on it.