Someone very close to me was dealing with pretty severe depression during their medical residency in a very intense program. They were having trouble finding the time to talk to someone about it let alone to go see a proper psychiatrist.

Finally they spoke to one of their preceptors. The advice? Double up your shifts for a week and grind yourself down until you absolutely are sleep deprived (they are all generally sleep deprived in this program, but have stretches of 3 or 4 days off). It seemed almost sadist to me, but they did it.

We were all surprised when it more or less worked. I would say it bought them a month here, a month there when needed. It seems like a terrible strategy over the long term but something was definitely going on. They called it a "big reset" and also insisted that they had an overall sense of euphoria for a week or so following each "dosing".

They don't do it anymore, after trying a few different medications a particular SSRI really seemed to click and it's been 20 years now without a major recurrence.