4 ms·

Fighting Depression by Staying Awake

52 points by tekacs 10y ago

GavinMcG 10y ago
I'm all for news about novel treatments to common difficulties such as depression. That said, it would be best if there were substantive support for something before it's spread around as a solution. Especially given the reproducibility questions that have come up in a range of fields lately, it seems a little premature to publish this anecdote. Even more so because this is exactly the sort of thing people may try at home. This time, that might not be so terrible. And there is the disclaimer that you shouldn't pull an all-night without clinical guidance. But that's not likely to be heeded, and it's a bad practice to be contributing to in terms of scientific literacy and trust.
- marmaduke 10y ago
  Do you think incumbent drugs companies with significant interest in keeping their expensive drugs on the market would let a free, anyone-can-do-it therapy see the light of day? Sunlight is a perfect and free remedy for jaundice and vitamin D deficiency, and yet the pediatrician will prescribe blue light therapy and vitamin D medicine and tell you to keep the baby out of sunlight. Scientific literacy and trust are conflated with industry interests, especially in medicine.
  - WalterSear 10y ago
    It's not 'perfect'. Vitamin D deficiency has been detected in Hawaian professional surfers.
- QUFB 10y ago
  It isn't just one anecdote: there are dozens of studies spanning decades that demonstrate TSD (total sleep deprivation) and PSD (partial sleep deprivation) are effective in treating depression depression in the short term.
- benevol 10y ago
  > this is exactly the sort of thing people may try at home. I would actually strongly urge people who suffer from depression to experiment (while observing and adjusting diligently) with all kinds of things. Usually, when you suffer from depression, it's because you have lost some sort of balance - a happy life is about a rich mix of a lot of things, and sometimes you need to search and experiment to discover what is/was missing in your life for too long (and no doctor is ever equipped and able to give you the full solution you personally need). So go on, experiment and search until you find your way back to your equilibrium.
  - DanBC 10y ago
    > I would actually strongly urge people who suffer from depression to experiment Do you say the same about eg cancer? > (while observing and adjusting diligently) Depression is an illness that affects a person to observe and adjust.
    - benevol 10y ago
      > Depression is an illness that affects a person to observe and adjust. This is true to some extent. I'd say it depends on the severity of the case. Yes, sometimes you depend on strong guidance from a doctor, because your brain is just completely out of order. But this is never the full and only answer to the source of the problem.
      - DanBC 10y ago
        I haven't said that treatment needs to be guided by a doctor. For clarity: I think telling people with depression to experiment with hallucinogens is fucking dangerous.
        imagist 10y ago
        Why? Can you describe the dangers you're thinking of?
        benevol 10y ago
- intralizee 10y ago
  Are you arguing that the information should be held from the public or what exactly would have you done differently if writing the public report?
  - GavinMcG 10y ago
    Given that it's not completed research, yes. If were the "public report" of completed research, I wouldn't have commented on not spreading information around until it's substantively supported.
- spangry 10y ago
  Yeah I'm not so sure that this could be a sustainable treatment, even if we assume it has some temporary mood-lifting effect. Speaking as someone who's now suffered through a series of major depressive episodes over the past year and a half, the only effects 2 nights+ sleep deprivation has had on me are: worse mood, dis-inhibition (sort of like being drunk), and mild auditory hallucinations. No long-term benefits that I've noticed, other than a bit of insight into the nature of (mild) hallucination (difficult to explain, but they're more like 'misinterpreting' things, rather than straight up imagining things that are not there). EDIT: I really would advise who is suffering from depression, if you're hell-bent on the DIY approach I wouldn't start with this one. Frankly, it could be dangerous. Maybe start with one of the more proven approaches: exercise, diet, mindfulness meditation or regular and sufficient sleep.
- imagist 10y ago
  There is nothing unscientific about anecdotes. The problem with anecdotes isn't that they are unscientific, it's that the scientific claims they allow you to make are very, very small. Anecdotally, I've found that Vitamin D3 helps me with motivation. That's a very small claim, but it's a scientific claim because I've experimented extensively with supplements to improve my motivation. However, "I've found that Vitamin D3 helps people with motivation" would not be a scientific claim, because I've only experimented on myself, and don't have enough evidence to extrapolate to the rest of humanity. Personal experimentation is a useful tool. It's how we know our personal preferences, fears, and hangups, which nobody else can tell us. Applying scientific process to it allows us to avoid some of our biases. We just have to be careful not to extrapolate our results to other people.
benevol 10y ago
If you suffer from depression, don't rely on only 1 method (therapy, mindful meditation, the Wim Hof method, nutrition, sleep hygiene, yoga, spiritual quest, sports, meds, etc.), combine as many as you can, especially if you're in a deep hole. Certain psychedelics such as psilocybin [0] and LSD (very similar) do have a positive effect, if you have fully educated yourself on the matter and follow each and every one of the rules. [0] https://www.theguardian.com/society/2016/dec/01/magic-mushroom-ingredient-psilocybin-can-lift-depression-studies-show https://www.theguardian.com/society/2016/dec/01/magic-mushro...
- magic_beans 10y ago
  The best things that work for my depression are: daily exercise and weed.
- Fricken 10y ago
  That's all good if you have the blues. When I was clinically depressed just putting on my shoes was too much effort. Chewing and swallowing food was exhausting. There wasn't really a cure except to wait until I was ready to start climbing out of the hole I was in. Once you have at least a rudimentary capacity to self-actualize, the rest is gravy. Use the Wim Hof method, become a whirling dervish, it doesn't matter so long as you're reinforcing that you have the ability to do anything at all.
  - benevol 10y ago
    > just putting on my shoes was too much effort It such cases, you clearly need one of the chemical kickstarters mentioned above, but, if you can, avoid those that "require" you to depend on them long-term. If you wait too long, you risk reinforcing your "depressive neurological pathways", thought patterns, etc. and it may become much harder to reverse the spiral.
EpicBlackCrayon 10y ago
I'm currently sitting in an airport after just getting back from Seattle. I had an interview for an internship with Microsoft. It was proably one of the best experiences of my life. Alone, in a big city, everything paid for, you couldn't beat it. Leading up to it, though, and after it I have had some of the worst thoughts, doubtfulness, strife, pain, and headaches that I have ever felt. I couldn't concentrate when reading, my appetite was way out of wack, and I really couldn't sleep at night. I haven't been able to sleep at night for a while now, perhaps a few months, and I'm tired of it. I lay there and toss and turn, and even when I do sleep I don't feel refreshed like I used to, or a refreshed feeling lasts only for a few minutes after I wake up. It's a little scary to think that this crept up on me without me even noticing. I trailed away a little there, sorry about that. Anyway, I always like to leave "red-eye" when I go on trips. I'm only 19, this is only the second time I've ever flown, but I quite like red eye. Because I made the decision to do that, I'm inadvertently pulling an all-nighter. I hope it works out.
- hiddencost 10y ago
  I've found that all nighter euphoria kicks in around 30 hours. It's nice as a momentary reprieve, and gives you a notion that you can feel different, which gives you motivation to get better. But if you're legit suffering from major depressive disorder it still takes years of hard work. On the other hand, if you're experiencing acute anxiety, this approach ends up hurting more than it helps. Try meditation, yoga, massage, muscle relaxation, exercise. Pretty much anything that gets you more in touch with your body.
romanows 10y ago
tl;dr, sleep deprivation can help quickly alleviate symptoms of major depression but symptoms return after a few days. Author thinks that using light therapy may extend the symptom relief, long enough for antidepressant meds to start working. Wouldn't bother reading the article, honestly, it doesn't go into details on any of this.
DanBC 10y ago
> nor should people try it without a clinician's guidance. Sleep deprivation increases some people's risk of suicide. > She was hesitant—but then again, she was already sleeping poorly, so what did she have to lose? It may have made her suicidal, and she could have lost her life. It's great that he's doing some research (because there doesn't appear to be much around at the moment) but it's a bit worrying that he's writing this article as if this treatment works before the research is in. Especially because mainstream media is going to report this as if bright light therapy and sleep deprivation definitely works as a treatment for depression.
- benevol 10y ago
  > Sleep deprivation increases some people's risk of suicide. Got a source for this?
  - DanBC 10y ago
    It's not a controversial claim! The Link between Suicide and Insomnia: Theoretical Mechanisms - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3791319/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3791319/ > Insomnia has been established as a risk factor for depression and mental illness for decades, but a growing body of evidence has recently exposed insomnia to be an independent risk factor for suicide that encompasses all age ranges. This discovery has invigorated investigation to elucidate the relationship between insomnia and suicide, and over 20 studies reinforcing this association in adults have been published since 2010 alone.
    - benevol 10y ago
      The link with insomnia is pretty clear, because it's a structural, long-term and uncontrolled problem. But I'm not sure that (controllable/wanted) short-term sleep deprivation can be directly compared to it.
- lexhaynes 10y ago
  The patient underwent this therapy under the guidance of a doctor. Any increase in suicidal thoughts would have been caught. This is a much riskier therapy to try on your own, true.
etiam 10y ago
Nice to see. I was surprised to notice it's already been so long since we had the post with Terry Sejnowskis chronicle on the topic. https://news.ycombinator.com/item?id=1251879 https://news.ycombinator.com/item?id=1251879
stared 10y ago
Maybe it works different for different people, but for me hallucinations and paranoia induced by heavy sleep deprivation (then into some existential dread panic + strong derealisation) were a trigger for depressive episodes (especially during my religion-losing phase in my life, but not only). I don't mean sleeping too little, but not sleeping at all for a night or two. I know it is anecdotal, but for this reason it seems that taking this advice may be risky for some.
Kenji 10y ago
I think this is very very dangerous advice. So much so that I flagged this article. Sleep deprivation is harmful in most cases and is very likely to worsen depression and work performance significantly (not to mention - you shouldn't drive cars and operate heavy machinery when you're deprived of sleep, it has similar effects as being drunk). Don't do sleep deprivation. Get your sleep schedule in order, rather than devastating it even more.
- reddytowns 10y ago
  Come on, what's wrong with a little extra depression now and then!
- zepto 10y ago
  I assume you have no evidence to support your idea that sleep deprivation will worsen depression. The fact that depression is correlated with poor sleep doesn't support your claim. Telling people to get their sleep schedule in order isn't likely to help either. Some people might have control over that, but there is no reason to suppose that people with depression can simply change their sleep schedule any more easily than anyone else. For what it's worth, when I experienced depression, even a temporary interlude from it was valuable in working out how to get out of it.
  - Kenji 10y ago
    Sleep deprivation helping with depression is among the dumbest things I've ever heard and "doctors" who advise this strategy and harm people as a result should be held liable as harshly as possible. I am serious: This idea could cause serious harm. You have to be highly educated to be this far from common sense and the real world.
    - zepto 10y ago
      Again, you have stated no evidence whatsoever to support your desire to violently censor the spread of an idea. I am simply asking how you come to this intensely held belief?
seibelj 10y ago
Completely anecdotal, but my depression and severe anxiety was put under control with healthy diet, exercise, mindfulness practice, and a low dose of Lexapro. I was very hesitant to use medication but it totally changed my life. Hang in there if you are struggling, I know it's so hard.
dakull 10y ago
I know this is highly anecdotal but for me reading the works of Nietzsche, Camus, Cioran, Kierkegaard et al does help in moving me a couple of steps back from getting myself into that deep dark hole from which it's really hard to climb back. I guess reading (not necessarily just philosophy) can have a cathartic effect and thus relieving some of the symptoms of depression. And clearly, having a good therapist to talk to when nothing else works. This may sound cliché but the "trick" is to try being aware of that threshold and when you pass it take some action or better yet stay away from it as much as you can using whatever works for you.
Neliquat 10y ago
Where is the science? I see a method, but no study.

52 points by tekacs 10y ago

I'm all for news about novel treatments to common difficulties such as depression. That said, it would be best if there were substantive support for something before it's spread around as a solution. Especially given the reproducibility questions that have come up in a range of fields lately, it seems a little premature to publish this anecdote. Even more so because this is exactly the sort of thing people may try at home. This time, that might not be so terrible. And there is the disclaimer that you shouldn't pull an all-night without clinical guidance. But that's not likely to be heeded, and it's a bad practice to be contributing to in terms of scientific literacy and trust.

marmaduke 10y ago
Do you think incumbent drugs companies with significant interest in keeping their expensive drugs on the market would let a free, anyone-can-do-it therapy see the light of day? Sunlight is a perfect and free remedy for jaundice and vitamin D deficiency, and yet the pediatrician will prescribe blue light therapy and vitamin D medicine and tell you to keep the baby out of sunlight. Scientific literacy and trust are conflated with industry interests, especially in medicine.
- WalterSear 10y ago
  It's not 'perfect'. Vitamin D deficiency has been detected in Hawaian professional surfers.
QUFB 10y ago
It isn't just one anecdote: there are dozens of studies spanning decades that demonstrate TSD (total sleep deprivation) and PSD (partial sleep deprivation) are effective in treating depression depression in the short term.
benevol 10y ago
> this is exactly the sort of thing people may try at home. I would actually strongly urge people who suffer from depression to experiment (while observing and adjusting diligently) with all kinds of things. Usually, when you suffer from depression, it's because you have lost some sort of balance - a happy life is about a rich mix of a lot of things, and sometimes you need to search and experiment to discover what is/was missing in your life for too long (and no doctor is ever equipped and able to give you the full solution you personally need). So go on, experiment and search until you find your way back to your equilibrium.
- DanBC 10y ago
  > I would actually strongly urge people who suffer from depression to experiment Do you say the same about eg cancer? > (while observing and adjusting diligently) Depression is an illness that affects a person to observe and adjust.
  - benevol 10y ago
    > Depression is an illness that affects a person to observe and adjust. This is true to some extent. I'd say it depends on the severity of the case. Yes, sometimes you depend on strong guidance from a doctor, because your brain is just completely out of order. But this is never the full and only answer to the source of the problem.
    - DanBC 10y ago
      I haven't said that treatment needs to be guided by a doctor. For clarity: I think telling people with depression to experiment with hallucinogens is fucking dangerous.
      - imagist 10y ago
        Why? Can you describe the dangers you're thinking of?
      - benevol 10y ago
intralizee 10y ago
Are you arguing that the information should be held from the public or what exactly would have you done differently if writing the public report?
- GavinMcG 10y ago
  Given that it's not completed research, yes. If were the "public report" of completed research, I wouldn't have commented on not spreading information around until it's substantively supported.
spangry 10y ago
Yeah I'm not so sure that this could be a sustainable treatment, even if we assume it has some temporary mood-lifting effect. Speaking as someone who's now suffered through a series of major depressive episodes over the past year and a half, the only effects 2 nights+ sleep deprivation has had on me are: worse mood, dis-inhibition (sort of like being drunk), and mild auditory hallucinations. No long-term benefits that I've noticed, other than a bit of insight into the nature of (mild) hallucination (difficult to explain, but they're more like 'misinterpreting' things, rather than straight up imagining things that are not there). EDIT: I really would advise who is suffering from depression, if you're hell-bent on the DIY approach I wouldn't start with this one. Frankly, it could be dangerous. Maybe start with one of the more proven approaches: exercise, diet, mindfulness meditation or regular and sufficient sleep.
imagist 10y ago
There is nothing unscientific about anecdotes. The problem with anecdotes isn't that they are unscientific, it's that the scientific claims they allow you to make are very, very small. Anecdotally, I've found that Vitamin D3 helps me with motivation. That's a very small claim, but it's a scientific claim because I've experimented extensively with supplements to improve my motivation. However, "I've found that Vitamin D3 helps people with motivation" would not be a scientific claim, because I've only experimented on myself, and don't have enough evidence to extrapolate to the rest of humanity. Personal experimentation is a useful tool. It's how we know our personal preferences, fears, and hangups, which nobody else can tell us. Applying scientific process to it allows us to avoid some of our biases. We just have to be careful not to extrapolate our results to other people.

benevol 10y ago

If you suffer from depression, don't rely on only 1 method (therapy, mindful meditation, the Wim Hof method, nutrition, sleep hygiene, yoga, spiritual quest, sports, meds, etc.), combine as many as you can, especially if you're in a deep hole. Certain psychedelics such as psilocybin [0] and LSD (very similar) do have a positive effect, if you have fully educated yourself on the matter and follow each and every one of the rules. [0] https://www.theguardian.com/society/2016/dec/01/magic-mushroom-ingredient-psilocybin-can-lift-depression-studies-show https://www.theguardian.com/society/2016/dec/01/magic-mushro...

magic_beans 10y ago
The best things that work for my depression are: daily exercise and weed.
Fricken 10y ago
That's all good if you have the blues. When I was clinically depressed just putting on my shoes was too much effort. Chewing and swallowing food was exhausting. There wasn't really a cure except to wait until I was ready to start climbing out of the hole I was in. Once you have at least a rudimentary capacity to self-actualize, the rest is gravy. Use the Wim Hof method, become a whirling dervish, it doesn't matter so long as you're reinforcing that you have the ability to do anything at all.
- benevol 10y ago
  > just putting on my shoes was too much effort It such cases, you clearly need one of the chemical kickstarters mentioned above, but, if you can, avoid those that "require" you to depend on them long-term. If you wait too long, you risk reinforcing your "depressive neurological pathways", thought patterns, etc. and it may become much harder to reverse the spiral.

EpicBlackCrayon 10y ago

I'm currently sitting in an airport after just getting back from Seattle. I had an interview for an internship with Microsoft. It was proably one of the best experiences of my life. Alone, in a big city, everything paid for, you couldn't beat it. Leading up to it, though, and after it I have had some of the worst thoughts, doubtfulness, strife, pain, and headaches that I have ever felt. I couldn't concentrate when reading, my appetite was way out of wack, and I really couldn't sleep at night. I haven't been able to sleep at night for a while now, perhaps a few months, and I'm tired of it. I lay there and toss and turn, and even when I do sleep I don't feel refreshed like I used to, or a refreshed feeling lasts only for a few minutes after I wake up. It's a little scary to think that this crept up on me without me even noticing. I trailed away a little there, sorry about that. Anyway, I always like to leave "red-eye" when I go on trips. I'm only 19, this is only the second time I've ever flown, but I quite like red eye. Because I made the decision to do that, I'm inadvertently pulling an all-nighter. I hope it works out.

hiddencost 10y ago
I've found that all nighter euphoria kicks in around 30 hours. It's nice as a momentary reprieve, and gives you a notion that you can feel different, which gives you motivation to get better. But if you're legit suffering from major depressive disorder it still takes years of hard work. On the other hand, if you're experiencing acute anxiety, this approach ends up hurting more than it helps. Try meditation, yoga, massage, muscle relaxation, exercise. Pretty much anything that gets you more in touch with your body.

romanows 10y ago

tl;dr, sleep deprivation can help quickly alleviate symptoms of major depression but symptoms return after a few days. Author thinks that using light therapy may extend the symptom relief, long enough for antidepressant meds to start working. Wouldn't bother reading the article, honestly, it doesn't go into details on any of this.

DanBC 10y ago

> nor should people try it without a clinician's guidance. Sleep deprivation increases some people's risk of suicide. > She was hesitant—but then again, she was already sleeping poorly, so what did she have to lose? It may have made her suicidal, and she could have lost her life. It's great that he's doing some research (because there doesn't appear to be much around at the moment) but it's a bit worrying that he's writing this article as if this treatment works before the research is in. Especially because mainstream media is going to report this as if bright light therapy and sleep deprivation definitely works as a treatment for depression.

benevol 10y ago
> Sleep deprivation increases some people's risk of suicide. Got a source for this?
- DanBC 10y ago
  It's not a controversial claim! The Link between Suicide and Insomnia: Theoretical Mechanisms - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3791319/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3791319/ > Insomnia has been established as a risk factor for depression and mental illness for decades, but a growing body of evidence has recently exposed insomnia to be an independent risk factor for suicide that encompasses all age ranges. This discovery has invigorated investigation to elucidate the relationship between insomnia and suicide, and over 20 studies reinforcing this association in adults have been published since 2010 alone.
  - benevol 10y ago
    The link with insomnia is pretty clear, because it's a structural, long-term and uncontrolled problem. But I'm not sure that (controllable/wanted) short-term sleep deprivation can be directly compared to it.
lexhaynes 10y ago
The patient underwent this therapy under the guidance of a doctor. Any increase in suicidal thoughts would have been caught. This is a much riskier therapy to try on your own, true.

etiam 10y ago

Nice to see. I was surprised to notice it's already been so long since we had the post with Terry Sejnowskis chronicle on the topic. https://news.ycombinator.com/item?id=1251879 https://news.ycombinator.com/item?id=1251879

stared 10y ago

Maybe it works different for different people, but for me hallucinations and paranoia induced by heavy sleep deprivation (then into some existential dread panic + strong derealisation) were a trigger for depressive episodes (especially during my religion-losing phase in my life, but not only). I don't mean sleeping too little, but not sleeping at all for a night or two. I know it is anecdotal, but for this reason it seems that taking this advice may be risky for some.

Kenji 10y ago

I think this is very very dangerous advice. So much so that I flagged this article. Sleep deprivation is harmful in most cases and is very likely to worsen depression and work performance significantly (not to mention - you shouldn't drive cars and operate heavy machinery when you're deprived of sleep, it has similar effects as being drunk). Don't do sleep deprivation. Get your sleep schedule in order, rather than devastating it even more.

reddytowns 10y ago
Come on, what's wrong with a little extra depression now and then!
zepto 10y ago
I assume you have no evidence to support your idea that sleep deprivation will worsen depression. The fact that depression is correlated with poor sleep doesn't support your claim. Telling people to get their sleep schedule in order isn't likely to help either. Some people might have control over that, but there is no reason to suppose that people with depression can simply change their sleep schedule any more easily than anyone else. For what it's worth, when I experienced depression, even a temporary interlude from it was valuable in working out how to get out of it.
- Kenji 10y ago
  Sleep deprivation helping with depression is among the dumbest things I've ever heard and "doctors" who advise this strategy and harm people as a result should be held liable as harshly as possible. I am serious: This idea could cause serious harm. You have to be highly educated to be this far from common sense and the real world.
  - zepto 10y ago
    Again, you have stated no evidence whatsoever to support your desire to violently censor the spread of an idea. I am simply asking how you come to this intensely held belief?

seibelj 10y ago

Completely anecdotal, but my depression and severe anxiety was put under control with healthy diet, exercise, mindfulness practice, and a low dose of Lexapro. I was very hesitant to use medication but it totally changed my life. Hang in there if you are struggling, I know it's so hard.

dakull 10y ago

I know this is highly anecdotal but for me reading the works of Nietzsche, Camus, Cioran, Kierkegaard et al does help in moving me a couple of steps back from getting myself into that deep dark hole from which it's really hard to climb back. I guess reading (not necessarily just philosophy) can have a cathartic effect and thus relieving some of the symptoms of depression. And clearly, having a good therapist to talk to when nothing else works. This may sound cliché but the "trick" is to try being aware of that threshold and when you pass it take some action or better yet stay away from it as much as you can using whatever works for you.

Neliquat 10y ago

Where is the science? I see a method, but no study.