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As a "healthy" person, if I'm feeling overwhelmed or (situationally) depressed I find that I almost always feel better in the morning after a long sleep. It may

As a "healthy" person, if I'm feeling overwhelmed or (situationally) depressed I find that I almost always feel better in the morning after a long sleep. It may recur as the day wears on, but sleep is extremely helpful. That makes sense if people with depression experience the opposite effect. What I wonder is if those sleep-deprived individuals are experiencing a semi-manic state. I once had severe insomnia for a period of two weeks, and during that time I slept maybe 0-3 hours per night (typically zero). Early on I experienced manic effects. Toward the end, I felt like I was going completely nuts.

IntronExon 9y ago
Sleep deprivation doesn’t make you feel like you’re going nuts, it makes you go nuts. Hallucinations, paranoia, agitation, transient hypnogogic states, memory loss, and eventually psychosis. I’m glad that you pulled through.
- apotheosis 9y ago
  Can you source? Specifically the "eventual psychosis" part?
  - IntronExon 9y ago
    I can, but it’s not just one source with one clear answer. https://www.uni-bonn.de/Press-releases/sleep-deprivation-leads-to-symptoms-of-schizophrenia https://www.uni-bonn.de/Press-releases/sleep-deprivation-lea... http://www.jneurosci.org/content/34/27/9134.short http://www.jneurosci.org/content/34/27/9134.short Lighter reading: https://www.scientificamerican.com/article/can-a-lack-of-sleep-cause/ https://www.scientificamerican.com/article/can-a-lack-of-sle... https://www.theatlantic.com/health/archive/2013/12/how-sleep-deprivation-decays-the-mind-and-body/282395/ https://www.theatlantic.com/health/archive/2013/12/how-sleep... I should admit that there is still some debate around this issue, with key points being: 1. Do people who experience a psychotic break or symptoms during sleep deprivation represent a vulnerable group? 2. Sleep deprivation is often seen in the context of stimulants, from caffeine to methamphetamine, and they are known to potentially lead to psychosis when abused. Personally I’m in the camp who believes that sleep deprivation is more than capable of leading to transient psychosis without preexisting risk factors. The problem is that long term sleep deprivstion studies can’t be done for ethical reasons, so it’s hard to know for sure. Ultimately it comes down to a combination of studying more limited sleep deprivation, and evidence gathered in the field over time. It is all highly suggestive though.
freeflight 9y ago
As a "not healthy" person, suffering from bouts of depression and heavy demotivation (especially during winter months), missing out on a night of sleep can put me in quite a positive mood. But it's mostly a rather "hyped up" feeling, so it feels like the opposite extreme of the depressive phase. When I was younger I'd regularly miss out on a night of sleep for exactly that reason, but as I get older I notice side-effect of this "treatment" of the physical kind. My teeth, which are already damaged by years of nightly gnashing, will start to hurt easily, with a higher chance of gum infections after I missed out on a night of sleep. That's sadly something not mentioned at all in the BBC article, while my mind feels like it could be awake for days on end, my body doesn't really like that strain, especially as I get older.
- InclinedPlane 9y ago
  Sounds like hypomania. Do you find yourself also chatty and more likely to take risks (spend money, do new things, etc.)? See: https://en.wikipedia.org/wiki/Bipolar_II_disorder#Hypomanic_episodes https://en.wikipedia.org/wiki/Bipolar_II_disorder#Hypomanic_...
  - freeflight 9y ago
    In my good moods, I'm very chatty, annoyingly chatty to some people, I like risks of the physical kind (bungee jumping/skydiving) but "social risks" are my bane, I've become very careful about being too open when meeting new people, needing time to open up until I open up "too much" for some. As a kid, I was pretty much constantly very social, lively and chatty, without any of these apathetic down phases. I kinda trained myself into these due to negative social feedback to my "liveliness". By now I feel somewhat guilty/out of character when I'm "too happy", as I fear I might annoy my social surroundings. I like doing new things, up to a point where I dread any routine, but at the same time, I notice how not having routine makes me anxious. It feels like a trade-off between "stable but uncreative routine" and "creative/volatile let's try everything". As you might notice: I'm a bit all over the place, which doesn't make a diagnosis very easy, especially once it starts factoring in my, rather unconventional, upbringing in two different languages across three different countries.
matt4077 9y ago
> What I wonder is if those sleep-deprived individuals are experiencing a semi-manic state. Yes, of course–in a certain way. It's not even much of a secret. While mania is itself a serious condition and should be avoided, it is fundamentally the same dimension as depression, only opposite. That's why you cannot be manic and depressed at the same time (Manic Depression, or Bipolar Disorder, is alternating between these states). So it is really that simple: Depression + "semi-mania" = something approaching normalcy, for a limited time, with some cognitive impairment and just a bit too much nervousness.
- IC4RUS 9y ago
  I'm not sure there is much evidence that mania is in "the same dimension as depression, only opposite." And, in fact, mixed episodes can occur in those with bipolar disorder. https://en.wikipedia.org/wiki/Mixed_affective_state https://en.wikipedia.org/wiki/Mixed_affective_state
InclinedPlane 9y ago
In someone with bipolar (I or II) sleep deprivation can indeed trigger a manic or hypomanic state. It will definitely raise your energy level but it may or may not make you happier. Additionally, there are tons of risks involved with going into those states intentionally. Mania ("full-blown bipolar") is particularly troublesome. Hypomanic states are much less extreme and are not necessarily a "problematic" part of ordinary life, if properly managed. However, both come along with things like increased risk taking and hypersexuality that can do things like screw up your finances and budgeting, destroy your relationships, or put you at greater risk of STDs or unintended pregnancies. On top of that there's a risk of developing a psychotic break, especially in conjunction with stress, which will typically result in hospitalization and being placed on psychiatric hold (if you're lucky). And, as you note, periods of hypomania aren't long-term sustainable. Ultimately you need to learn how to cope with all of your moods and states.
- IntronExon 9y ago
  I used to work with a brilliant women who really struggled with her manic episodes. She ended up going off her meds and on a weeklong manic state, ending with her walking straight through a plate glass window. She was window shopping and saw a coat she really liked, and she felt so powerful and was so nearly psychotic that she just walked straight through the window. Cuts all over, dozens of stitches, yet amazingly no permanent injuries. She had to spend a couple of months in inpatient care to stabilize.
- jiggunjer 9y ago
  You make mania sound like "student holiday".
  - InclinedPlane 9y ago
    That's the thing, they can easily fit into the normal range of human behavior, even in bipolar I. Popculture puts out this image that bipolar people are bonkers crazy and that manic/hypomanic episodes are extremely noticeable, dramatic, and also obviously destructive. The reality is that, especially with bipolar II, things can be much more nuanced and subtle. Hypomania can manifest as being really interested in something, working on projects, and just being generally productive, maybe while staying up late a few nights in a row, or even just one. It can be as simple as progressing through a challenging but fun video game. And the risk taking and impulsiveness aspects might seem perfectly normal as well. It might just mean that you buy that thing on amazon that you've been putting off for a few months because you didn't really need it. That can make it hard for people to see their behavior as in any way "abnormal". However, it's still incredibly important to understand whether or not you have these behavioral changes because they can often have a negative impact on your life if you don't understand them and develop coping skills for them. Your behavioral controls might be calibrated to who you are day to day rather than who you are when you're hypomanic. And that can lead to a lot of problems, spending too much money, taking irrational risks, etc. Being able to step back and realize that your feelings and impressions are being filtered by basically a mood altering state (just as you'd realize that you act differently when drunk and need to compensate for that) will help you navigate those behaviors better and be able to retain your ability to act rationally and in your own future best interests.
deleted 9y ago
[deleted]
mercer 9y ago
From personal experience I can confirm that it does feel manic sometimes. And occasionally that 'mania' kind of bootstrapped me back into feeling better, sometimes after months of 'not leaving the house and constant bombardment of negative self-directed thoughts' depression. I've also personally experienced how a friend of mine was depressed for years, unemployed but still functional 'enough' to carry on, and what helped him 'snap out of it' was dragging him along on a trip/adventure. Whether it was the change in scenery, the change in behavior as a result, or perhaps just suddenly being too busy to dwell on things in the 'comfort' of home, or something else, I'm convinced this trip was the primary cause of his eventual (but still of course gradual) improvement. While I think depression is so broad that any advice should not be taken as applicable to every depressed person, I do wish it was an option for more people with depression to try solutions like this. I completely understand that a therapist might not always have the luxury of suggesting this, but I wish we'd experiment a bit more with such approaches. It also reminds me a bit of the whole rehab/relapse cycle that many people get stuck in. Sometimes I wonder if perhaps we should spend more energy thinking of ways to make the 'rehab' experience more permanent or at least long-term, and more integrated with or at least much less disconnected from 'real life'. Of course maybe all these things are happening and I'm just not aware of it :). I really hope so.
herbst 9y ago
I often don't go to a bed for a few more hours because I don't want to lose the optimistic productivity I can get. In the morning I generally feel like shit the first X hours. So I try to have fewer but longer sleeping sessions. Which I realize only works because I am self employed.

IntronExon 9y ago

Sleep deprivation doesn’t make you feel like you’re going nuts, it makes you go nuts. Hallucinations, paranoia, agitation, transient hypnogogic states, memory loss, and eventually psychosis. I’m glad that you pulled through.

apotheosis 9y ago
Can you source? Specifically the "eventual psychosis" part?
- IntronExon 9y ago
  I can, but it’s not just one source with one clear answer. https://www.uni-bonn.de/Press-releases/sleep-deprivation-leads-to-symptoms-of-schizophrenia https://www.uni-bonn.de/Press-releases/sleep-deprivation-lea... http://www.jneurosci.org/content/34/27/9134.short http://www.jneurosci.org/content/34/27/9134.short Lighter reading: https://www.scientificamerican.com/article/can-a-lack-of-sleep-cause/ https://www.scientificamerican.com/article/can-a-lack-of-sle... https://www.theatlantic.com/health/archive/2013/12/how-sleep-deprivation-decays-the-mind-and-body/282395/ https://www.theatlantic.com/health/archive/2013/12/how-sleep... I should admit that there is still some debate around this issue, with key points being: 1. Do people who experience a psychotic break or symptoms during sleep deprivation represent a vulnerable group? 2. Sleep deprivation is often seen in the context of stimulants, from caffeine to methamphetamine, and they are known to potentially lead to psychosis when abused. Personally I’m in the camp who believes that sleep deprivation is more than capable of leading to transient psychosis without preexisting risk factors. The problem is that long term sleep deprivstion studies can’t be done for ethical reasons, so it’s hard to know for sure. Ultimately it comes down to a combination of studying more limited sleep deprivation, and evidence gathered in the field over time. It is all highly suggestive though.

freeflight 9y ago

As a "not healthy" person, suffering from bouts of depression and heavy demotivation (especially during winter months), missing out on a night of sleep can put me in quite a positive mood. But it's mostly a rather "hyped up" feeling, so it feels like the opposite extreme of the depressive phase. When I was younger I'd regularly miss out on a night of sleep for exactly that reason, but as I get older I notice side-effect of this "treatment" of the physical kind. My teeth, which are already damaged by years of nightly gnashing, will start to hurt easily, with a higher chance of gum infections after I missed out on a night of sleep. That's sadly something not mentioned at all in the BBC article, while my mind feels like it could be awake for days on end, my body doesn't really like that strain, especially as I get older.

InclinedPlane 9y ago
Sounds like hypomania. Do you find yourself also chatty and more likely to take risks (spend money, do new things, etc.)? See: https://en.wikipedia.org/wiki/Bipolar_II_disorder#Hypomanic_episodes https://en.wikipedia.org/wiki/Bipolar_II_disorder#Hypomanic_...
- freeflight 9y ago
  In my good moods, I'm very chatty, annoyingly chatty to some people, I like risks of the physical kind (bungee jumping/skydiving) but "social risks" are my bane, I've become very careful about being too open when meeting new people, needing time to open up until I open up "too much" for some. As a kid, I was pretty much constantly very social, lively and chatty, without any of these apathetic down phases. I kinda trained myself into these due to negative social feedback to my "liveliness". By now I feel somewhat guilty/out of character when I'm "too happy", as I fear I might annoy my social surroundings. I like doing new things, up to a point where I dread any routine, but at the same time, I notice how not having routine makes me anxious. It feels like a trade-off between "stable but uncreative routine" and "creative/volatile let's try everything". As you might notice: I'm a bit all over the place, which doesn't make a diagnosis very easy, especially once it starts factoring in my, rather unconventional, upbringing in two different languages across three different countries.

matt4077 9y ago

> What I wonder is if those sleep-deprived individuals are experiencing a semi-manic state. Yes, of course–in a certain way. It's not even much of a secret. While mania is itself a serious condition and should be avoided, it is fundamentally the same dimension as depression, only opposite. That's why you cannot be manic and depressed at the same time (Manic Depression, or Bipolar Disorder, is alternating between these states). So it is really that simple: Depression + "semi-mania" = something approaching normalcy, for a limited time, with some cognitive impairment and just a bit too much nervousness.

IC4RUS 9y ago
I'm not sure there is much evidence that mania is in "the same dimension as depression, only opposite." And, in fact, mixed episodes can occur in those with bipolar disorder. https://en.wikipedia.org/wiki/Mixed_affective_state https://en.wikipedia.org/wiki/Mixed_affective_state

InclinedPlane 9y ago

In someone with bipolar (I or II) sleep deprivation can indeed trigger a manic or hypomanic state. It will definitely raise your energy level but it may or may not make you happier. Additionally, there are tons of risks involved with going into those states intentionally. Mania ("full-blown bipolar") is particularly troublesome. Hypomanic states are much less extreme and are not necessarily a "problematic" part of ordinary life, if properly managed. However, both come along with things like increased risk taking and hypersexuality that can do things like screw up your finances and budgeting, destroy your relationships, or put you at greater risk of STDs or unintended pregnancies. On top of that there's a risk of developing a psychotic break, especially in conjunction with stress, which will typically result in hospitalization and being placed on psychiatric hold (if you're lucky). And, as you note, periods of hypomania aren't long-term sustainable. Ultimately you need to learn how to cope with all of your moods and states.

IntronExon 9y ago
I used to work with a brilliant women who really struggled with her manic episodes. She ended up going off her meds and on a weeklong manic state, ending with her walking straight through a plate glass window. She was window shopping and saw a coat she really liked, and she felt so powerful and was so nearly psychotic that she just walked straight through the window. Cuts all over, dozens of stitches, yet amazingly no permanent injuries. She had to spend a couple of months in inpatient care to stabilize.
jiggunjer 9y ago
You make mania sound like "student holiday".
- InclinedPlane 9y ago
  That's the thing, they can easily fit into the normal range of human behavior, even in bipolar I. Popculture puts out this image that bipolar people are bonkers crazy and that manic/hypomanic episodes are extremely noticeable, dramatic, and also obviously destructive. The reality is that, especially with bipolar II, things can be much more nuanced and subtle. Hypomania can manifest as being really interested in something, working on projects, and just being generally productive, maybe while staying up late a few nights in a row, or even just one. It can be as simple as progressing through a challenging but fun video game. And the risk taking and impulsiveness aspects might seem perfectly normal as well. It might just mean that you buy that thing on amazon that you've been putting off for a few months because you didn't really need it. That can make it hard for people to see their behavior as in any way "abnormal". However, it's still incredibly important to understand whether or not you have these behavioral changes because they can often have a negative impact on your life if you don't understand them and develop coping skills for them. Your behavioral controls might be calibrated to who you are day to day rather than who you are when you're hypomanic. And that can lead to a lot of problems, spending too much money, taking irrational risks, etc. Being able to step back and realize that your feelings and impressions are being filtered by basically a mood altering state (just as you'd realize that you act differently when drunk and need to compensate for that) will help you navigate those behaviors better and be able to retain your ability to act rationally and in your own future best interests.

deleted 9y ago

[deleted]

mercer 9y ago

From personal experience I can confirm that it does feel manic sometimes. And occasionally that 'mania' kind of bootstrapped me back into feeling better, sometimes after months of 'not leaving the house and constant bombardment of negative self-directed thoughts' depression. I've also personally experienced how a friend of mine was depressed for years, unemployed but still functional 'enough' to carry on, and what helped him 'snap out of it' was dragging him along on a trip/adventure. Whether it was the change in scenery, the change in behavior as a result, or perhaps just suddenly being too busy to dwell on things in the 'comfort' of home, or something else, I'm convinced this trip was the primary cause of his eventual (but still of course gradual) improvement. While I think depression is so broad that any advice should not be taken as applicable to every depressed person, I do wish it was an option for more people with depression to try solutions like this. I completely understand that a therapist might not always have the luxury of suggesting this, but I wish we'd experiment a bit more with such approaches. It also reminds me a bit of the whole rehab/relapse cycle that many people get stuck in. Sometimes I wonder if perhaps we should spend more energy thinking of ways to make the 'rehab' experience more permanent or at least long-term, and more integrated with or at least much less disconnected from 'real life'. Of course maybe all these things are happening and I'm just not aware of it :). I really hope so.

herbst 9y ago

I often don't go to a bed for a few more hours because I don't want to lose the optimistic productivity I can get. In the morning I generally feel like shit the first X hours. So I try to have fewer but longer sleeping sessions. Which I realize only works because I am self employed.