Why Sleep Deprivation Eases Depression | Hacker News Reader

Why Sleep Deprivation Eases Depression

scientificamerican.com

161 pointsyoungerdryas66 comments

There is a long line of research on mood disorders and the ways to deal with those behaviorally and medically.

http://www.amazon.com/Manic-Depressive-Illness-Disorders-Rec...

It has been known for quite a while that if a person is in a prolonged depressed mood state, simply shortening that person's periods of sleep (usually by getting the person up earlier, to bright light) can do a lot to boost the person's mood state.

On the other hand, for the many people who have bipolar mood disorders (so that they have abnormally elevated mood as well as abnormally depressed mood not related to immediate events in the people's lives), sleep deprivation can be dangerous, as it can trigger mania. Severe sleep deprivation can result in all the psychotic symptoms of florid mania even for most people without a medical history of mood disorders, and it is particularly dangerous for people who have already been through an episode of mania. So as other people here have already commented, regularity of sleep (sleep while it's dark, and get up while it's day) is helpful for mood disorders, up or down, and sleep deprivation by itself will not be a cure-all for all cases of depression.

AFTER EDIT: I appreciate HN participant falcolas reminding all of us, in a first reply to this comment, that the submitted article is about an animal model of a proposed drug treatment that may have some of the effects of sleep deprivation without having other effects. Yes, that is what the article is about, and I acknowledged that even after reading the article, the first part of this comment's text (above) had as much to do with other comments here as it had to do with the actual article, maybe more. That said, as investigation of new drug treatments moves from animal models to human clinical trials, the thing to look for in any drug proposed to treat "depression" (depressed mood) is whether it might trigger mania (elevated mood) in the patient receiving the treatment. It's tough to develop an animal model of the psychotic symptoms of mania, which is why this is not an easy problem to solve--how to develop a drug that makes depressed patients enjoy normal mood states without breaking through to florid mania.

From TFA:

"This finding points to a promising target for new drug development because it suggests that mimicking sleep deprivation chemically may offer the antidepressant benefits without the unwanted side effects of actually skipping sleep."

So no, they aren't recommending sleep deprivation as a method to combat depression. It has, however, given them other lines of research to follow.

Nowhere does he claim that sleep deprivation is a recommended treatment. Simply that it has been found to boost depressive moods.

Caffeine works by blocking adenosine receptors. If build up of adenosine can alleviate depression, can its opposite cause or aggravate depression? Is my coffee making me sad?

From what I've read, when you block your adenosine receptors with caffeine, your body responds by creating more receptors and more adenosine. Hence why you need to drink more coffee to get that 'kick' over time. I would think you would have to look up at what point your adenosine maxes out and what amount of daily caffeine intake that requires. I still get crazy tired later in the day despite my large caffeine intake, so, for me, it seems the adenosine has won. Need to go cold turkey soon and reset everything :)

That's a long-term adaptive effect (you almost make it sound as if caffeine is ineffective at blocking adenosine, which is obviously false). I'm interested in the immediate effect.

That's what I was getting at though, the "immediate" effect could be non-existent because you already have adapted a tolerance (early as 10 days by some studies). If not, you should be able to test easily just by judging your mood about 45 minutes after your coffee.

Interesting. I've never had any damn idea what's definitely up with my brain, but I've experienced depression before. OTOH, I spend most of my actual life alternating between the managed hot-blooded mania I call normality and the managed lethargy of sleep-deprivation.

I actually have to semi-plan my workweek based on when I wake up each day and how much sleep I get, because only on days I've actually slept do I have the mood to deal with people or the energy and concentration to properly get anything done.

bi-polar mood disorders tend to be quite different to depression. The medication for BPD is very different - putting someone on regular anti-depressants if they're bipolar would be a bad idea.

Dan, yes, your statement is correct. But a new patient who is depressed and needs treatment for depression is not necessarily distinguishable from a bipolar patient who first seeks treatment during a depressed mood state and has no medical history of elevated mood symptoms. That's the rub: many people with a bipolar mood disorder pattern haven't seen the worst aspects of elevated mood until after they seek treatment for depression.

It's been known for quite some time now, centuries, maybe millenia, among people practicing intensive meditation (monks, basically) in many different cultures and religion, that mild sleep deprivation (really, just keeping sleep at a minimum without impairing normal functioning) acts as a safeguard against depressed mood.

It's a constant advice in many different schools of meditation: "don't sleep too much, keep your sleep duration at a minimum, wake up early, and meditate".

Hi TA,

You may already know this but generally it is contraindicated to prescribe antidepressants in bipolar (manic-depressive illness) because of the risk of triggering mania. Contra-indicated, but not unknown.

Bipolar and depression are, of course, very different illnesses.

As an aside, this basic research (binding adenosine receptors) is interestingly at odds with the very interesting drug modafinil which partially works by increasing reuptake/clearing adenosine from the brain, which has been thought to be responsible for its wakefulness promoting and antidepressant effects

Thought you would find that interesting

Anecdotally I can definitely say my depression seems to get worse when I'm sleeping more and it almost becomes a feedback loop because I want to sleep more therefore making it even worse. It might also have something to do with a sense of productivity feeding back into the depression but that's a different story. Ultimately this makes me want to do a better job of recording sleep patterns and seeing if that correlates with my depression. Anyone suggest using a tool like fitbit for this purpose?

I would go for a Jawbone Up if your using it mainly for sleep tracking. The sleep tracking on a fitbit is a bit of a hassle since you have to get it out and put it in its own separate arm band.

I used an early version of http://www.sleeptracker.com/ and it worked well.

"It might also have something to do with a sense of productivity feeding back into the depression but that's a different story."

I don't suffer from depression but FWIW I have noticed lack of productivity leading to a down mood in the same way simply accomplishing something (even getting the room cleaned up) can lead to an up mood.

Potentially pointless anecdote: I've noticed sleep deprivation narrows my capacity for attention - to make an analogy with sight, it's like tunnel vision. As long as I have something to hold what's left of my attention span (e.g, work), I can't help but live in the moment, as I can't focus on (or even perceive, really) depressive thoughts at the same time.

My theory is that before going to sleep different parts of the brain shut down not in one single moment, but at different moments. Therefore before sleep some parts of the brain is already sleeping. That would explain why so often ideas that seem good before sleep look silly when you wake up. As in this case, maybe before sleep parts of the brain that produce depression shut down sooner and "temporarily cures" the depression.

May I suggest that you measure that, even by your own definition on "parts of the brain" (perhaps a choice of unrelated cognitive functions?) in a way that allows you to make predictions?

At face value, it seems like this flies in the face of the commonly-held wisdom that regular patterns of sleep (as well as eating and other habits) help minimize depression over time. It seems like the research is actually referring to the short-term effect of sleep deprivation on brain chemistry, which makes sense in an evolutionary sense. Maintaining alertness in the face of sleep probably has a hard-wired association at quite a deep level with self-preservation, and I can see how that would explain in some way these findings.

"Although the mice continued to sleep normally, after 12 hours they showed a rapid improvement in mood and behavior, which lasted for 48 hours."

Does anyone know how we measure moods in mice? At first glance it seems like a very subjective exercise.

Checked because I remember hearing about the somewhat horrific forced swim test. Idea is mice are trapped in a container fall of water; depression is when they give up and let themselves drown.

http://en.wikipedia.org/wiki/Animal_models_of_depression#Des...

The Wikipedia article doesn't mention anything about drowning, just "an immobile posture".

/hopes that we're not torturing mice for our own benefit.

i could be mistaken, but i'm pretty sure we do all kinds of horrific tests on mice, specifically for our own benefit.

Someone I knew once explained how their lab had a machine to give mice precisely calibrated amounts of brain damage through impact. The control group had their skull fractured without causing any direct injury to the brain.

This has always struck me as the ickiest thing I've heard, but I'm sure there's much worse out there.

Are there better reasons for torturing mice?

Mice float. All the forced swimming test does is measure the time it takes for them to stop paddling.

As far as "torturing" goes, in the US academic studies require submission of protocols to an Institutional Animal Care and Use Committee with proof that any harm caused to an animal is necessary for the study and meets federal guidelines for animal care (and because funding tends to come from federal sources, there is good incentive to meet these requirements). For studies involving pain, nerve regrowth after an insult, or other similar lines of research, injury may be unavoidable in asking the research question, but how the injury is applied must be approved by these committees. Protocols that involve harming an animal tend to be the most stringently regulated by these bodies, even more so than protocols requiring euthanasia. Furthermore, it is usually in the interest of the scientists performing the research to treat their animals consistently well, lest they find themselves with some inexplicable variables to account for.

Now, whether all or any of that merely constitutes "permitted" torture for our own benefit is a different question, but we do try to ensure that animals are treated as well as possible in a given research context.

Being depressed made me sleep less, which in turns made me feel even less powerless and my depression got even worse... at least in my personal experience

I agree, I have to watch my sleep patterns because when I don't get enough sleep, it's much easier for depression to kick in.

Agreed as well. Nothing makes the day WORSE than not enough sleep; and it never feels like enough.

Edit: And, as is the style of the day, we've had links on HN/SA and others that not enough sleep hampers cognition, weight control, and stress (which are all triggers/symptoms for depression in many people). So, you need to sleep more, and less, simultaneously?

Similarly, I find my depression is fueled by lack of sleep and a strong sleep regimen(sleeping in bouts rather than settling down for 4-6 hours before getting up to go to the bathroom, etc).

You may be confusing depression for anxiety.

Depression is a collection of symptoms—he could very well be depressed with a different underlying cause.

A rule of thumb is "can't go to sleep in evening == anxiety; wake up too early == depression". It's a very rough rule. Once disrupted sleep patterns kick in it can be hard to get them back to normal and they go all over the place.

Depression comes in a few different forms, and often people learn to live with it for so long before seeking treatment that they have different lists of symptoms.

I don't think there's enough stuff popping up on my screen for me to fully enjoy this article.

The Hines article that this article is written about is open access, and worth a read, especially because the Introduction and Discussion sections look to be fairly comprehensible for people outside the field:

http://www.nature.com/tp/journal/v3/n1/full/tp2012136a.html

I have noticed this myself - I'm unemployed and frequently go to job interviews. If I slept badly, I'm much more calm and easy going. I may not be the sharpest knife in the shed when it happens, but I no longer care.

But I avoid sleep deprivation. It can't be good in the long run.

I have bought 1 year ago Zeo product and since than I have noticed that if I sleep more than 6h30 hours than I am tired and feel more depressed. With over 10 months result, I have DEEP sleep only in the first 2 hours of sleep, then I am moving between REM and light the rest of the night. I guess that, for me, too mush REM is making me more tired.

Could it be that you are not using the SmartWake feature or are waking up in the middle of a REM cycle? That does bad things to your alertness and how you feel.

This is one of the things that you know instinctively and you can relate immediately when somebody puts it out in a formal way.

Myself and a friend of mine suffer from depression and we both feel much better when we are somewhat tired late in the night.

Anecdotal evidence was there, so we both used to get things done just before sleep.

From personal experience, I would say it was the opposite. Being overly tired and sleepless lead to depression.

But I guess being busy and active can move your mind off from depression and make things better for some.

I've seen studies where college students were shown a series of images. The sleep deprived students were more likely to recall the negative images. Focusing on the negative appears to be a hallmark of depression.

However, a depressed person can't seem to get enough sleep. Is it a snowball effect? Maybe the balance isn't about sleep deprivation, but finding the correct amount of sleep, waking to bright light, and keeping a consistent schedule.

> However, a depressed person can't seem to get enough sleep.

This has not been my experience. If you mean that a depressed person continues to be tired after waking up from a full night's sleep, then sure, but that's not sleep deprivation.

It's important to note that the studies show that the short term effects of sleep deprivation can reduce the symptoms of depression. The long term effects are the opposite and being chronically sleep deprived can aggravate and severely worsen someone who is suffering from depression.

I want to believe it yet every shorten night sends me to lengths of hellish angry letargious time.

Personal experience, I'd agree. If I stay up all night and then do not go to sleep, I'm more likely to enter a manic mode and continue to get little sleep for the next few days. But things usually crash not too long after.

this is complete bullshit. Lack of sleep makes (my) depression worse.

simply put, everyone is different

except me!

Not necessarily. They say it works 70% of the time.

I'm a Bayesian, and looking at the posts here, I'd say the probability distribution of this probability is beta(5,2). The HDR runs from around 40 to 97 percent and it peaks around 0.8 so what you and the other guys are saying, plus a non-informative prior, agrees with what they say.

You're just one of the unlucky beta(2,5). Too bad.

Acute sleep deprivation can apparently make depression better, but the effect only lasts until you go to sleep. That's what this article is about. Chronic sleep deprivation is very different and can cause depression.

This article is not describing a treatment, just progress in understanding a mental illness.

> This article is not describing a treatment, just progress in understanding a mental illness.

If the article's thesis is correct, if depression can be modulated by way of brain chemistry, the it's not a mental illness, it's a physical illness with mental symptoms.

I say this because over time, more and more "mental" illnesses have been recategorized as physical or genetic conditions that happen to have mental symptoms, including schizophrenia and bipolar syndrome, both of which respond dramatically to neurological treatments, and not at all to psychological treatments.

This change in the status of "mental" illnesses was recently recognized by the director of the NIMH, who in Scientific American said, "In most areas of medicine, doctors have historically tried to glean something about the underlying cause of a patient's illness before figuring out a treatment that addresses the source of the problem. When it came to mental or behavioral disorders in the past, however, no physical cause was detectable so the problem was long assumed by doctors to be solely "mental," and psychological therapies followed suit. Today scientific approaches based on modern biology, neuroscience and genomics are replacing nearly a century of purely psychological theories, yielding new approaches to the treatment of mental illnesses."

Reference: http://www.scientificamerican.com/article.cfm?id=faulty-circ...

If the article's thesis is correct, if depression can be modulated by way of brain chemistry, the it's not a mental illness, it's a physical illness with mental symptoms.

I bet there are few here that don't already believe that. Further, whether the article is correct or not, depression is a physical illness with mental symptoms.

And I'm very glad the medical world has moved past the idiocy of the early and mid-20th century beliefs around mental illness. Maybe now we can get to some effective treatments.

My money is on pharmacology being only a single piece of the treatment, with many required (diet, exercise) to achieve full health. But hopefully a pill will help people have enough hope and energy to fulfill the rest of the treatment.

But it's trivially true that any "mental" state can at least be modulated by brain chemistry. Unless you posit some kind of free-floating mind that operates magically, all mental states supervene on physical, biological processes, whether we're talking about depression or programming ability or personality or food preferences.

Not every computer problem is a hardware problem, even though the software is running on some hardware. Whether the "mind" is emergent or external, it is not particularly useful to ignore it.

Brain injuries and hormonal problems are hardware.

Post-traumatic stress disorder is a database problem.

Illogic and a tendency to over-simplify or rely on metaphors are software bugs. grin

Of course, the software and database are built in self-modifying firmware, so physical and mental issues do interact in interesting ways.

I agree with that as well. My point was the more limited one that showing "when I poke at the hardware the observed behavior changes" isn't particularly surprising, or on its own evidence of a uniquely "hardware" etiology for the behavior, since any behavior can be modulated by poking at the hardware, if you figure out exactly how to poke. In other words, it does successfully show that the behavior is "hardware-mediated", but then all behavior is hardware-mediated.

> Whether the "mind" is emergent or external, it is not particularly useful to ignore it.

Certainly. But psychology's track record in identifying and "treating" mental illnesses is such that many are now looking toward neuroscience for (what they hope will be) more effective methods.

So I agree that ignoring the "mind" is unwise, but on the other hand, I don't think it should be given the status of a physical organ or assume (as many psychologists do) that it can lead to empirical science.

> Not every computer problem is a hardware problem, even though the software is running on some hardware.

Well, there is a level on which it is, in that "software" is just hardware writ small. That is, all software that exists and actually runs on a computer exists in the form of physical configuration of states of matter, not as some non-physical entity. This was obvious in the case of some early computers where "programs" were macroscopic wiring configurations, but it is no less true of modern computers.

The artificial distinction between hardware and software can be a very useful tool in thinking about computer issues, but it isn't really true in the fundamental sense.

I guess not every human is the same. Saying it's a complete bullshit seem to be irrational.

> this is complete bullshit. Lack of sleep makes (my) depression worse.

Science isn't usually about the experiences of individuals, it's about the experiences of populations. This effect isn't true for each individual in the population.

Same here. This article is utter nonsense. I've battled depression for years (successfully) and one of my top rules is 'get enough sleep'.

I would say that the bulk of the work product of the depression industry is bullshit.

Well, it makes mine better. Shall we continue with battle-of-the-anecdotes, or maybe permit science to continue doing its thing with the understanding that statistical results apply statistically?

And some people respond to medications in vastly different ways than others. That doesn't mean the medications don't work.

Maybe during the 4-5 hours that you spend resisting sleep.

But the next day you will wake up in a bad mood from not sleeping well.

At least this is what happens to me.

So in general it's a bad idea.

On the other hand, I've found that if I sleep for too long I also get a bad mood the next day.

8 hours of sleep seems to be the sweet spot that puts me in a decent mood.

It causes early death too...

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