Treating Depression With Light And Sleep Deprivation: A 200-Year Old Ancient Method

The story presented here is going to tell you things later can happen to everyone: Jodi, the patient's pseudonym, is a senior white-collar worker in charge of business management, a high-risk job that feels overwhelmed by the pressure of increasing work pressure. Coincidentally, her husband was on a business trip at this time, while he was in a dilemma, Jody had to shoulder all the family chores. In order to squeeze out of time, she gradually began to not pay attention to their own habits - she no longer pay attention to the health of the diet, no longer exercise properly, do not take the time to relax. Not surprisingly, her mental state became very bad.

Soon, the situation has deteriorated. She was no longer interested in activities that used to make Jody happy, either by reading stories to her children, reading books, or chatting with her mother. Although Jody was exhausted every day, she had a poor quality of sleep; she was always lying in bed and was tired even when she was in bed in the morning. Her work performance has also become extremely poor, and even began to work crap during the day - because she simply can not get out of bed.

Insomnia is a common symptom of most depressive patients. However, getting patients to sleep is a potent remedy for the rapid relief of depressive symptoms.
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Jody knew she should have been aware of these warning signs. In fact, she had already experienced two major depressive episodes before the depression, one in college and another at the age of thirty, when she had just ended an affair. However, this time, Jody has been almost 40 years old and has stopped taking antidepressant drugs for many years. But she felt like she was back in the darkness of the past, totally without appetite, unable to concentrate, or even unable to concentrate on reading a short text. She felt her thoughts trapped in the same gloomy years, with fear constantly lingering in her heart, feeling desperate and guilty of guilt.

When Jody came to me for help, I set her in the suspicion that her major depression had relapsed again. Fortunately, Jodie's family and friends have always shown enough care and support for her, so she did not appear self-abusive tendency, do not need hospitalization. I advised her to take an antidepressant medication immediately to ease the illness, and Jody promised me, but she was frustrated when I heard that the drug was about to be effective in about four to six weeks. Her progress has lagged far behind and the holiday season is coming. She does not want her life to stagnate again due to this annoying depression. "Is there any way to get things done sooner?" She lamented.

"Well, if you have to figure it out for me, there's one more way to do that," I replied. "You can try a few days without sleep."

Heard here, Jodie surprised to be out of chin, "you are teasing me doctor at night, just insisted on falling eyelids have been difficult enough for me - you actually also asked me not to night sleep?"

I laughed. "That's it. Even if possible, I hope you will not sleep for two or three nights in a row."

Biological mechanism

Get Rewired: Researchers think that sleep deprivation may stimulate neuroplasticity, or the brain's ability to rewire itself. Depression impairs neuroplasticity, and better neuroplasticity improves a person's chances of overcoming depression
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Today's standard antidepressant therapies are effective in most cases, but both require longer treatment time to see the effect. As a result, recent studies have sought to find new therapies that shorten the duration of treatment, reducing the onset of effect from weeks to days. While it may sound counterintuitive, short-term sleep deprivation is a quick way to improve mood, a way that is old and often forgotten. A review in the 2015 Current Psychiatry Reports cites the notion that sleep-deprivation therapy significantly improves the symptoms of depression. However, this treatment does not apply to all patients: for example, the elderly or some patients with cognitive disorders are not among the applicable users; at the same time the therapy can not be performed without the clinician's supervision. Nonetheless, controlling sleep can still reduce patient pain without taking medication.

Not only is sleep itself a central symptom of depression, it also exacerbates the other two core symptoms of depression - fatigue and cognitive impairment, which make it harder for patients to return to normal life. People usually ease their sleepiness by nodding during the day, but this makes them harder to sleep at night, causing a vicious circle of sleep disorders. These related phenomena have led many researchers to start thinking about what the link between sleep and emotions is and trying to figure out the biological mechanisms underlying this link.

All creatures do need sleep - or at least as per the circadian rhythm based on the Earth's day-night cycle. In animals, the rhythmic nerve cell population is thought to be the basis of the "clock" of the body's source of life. They are mainly located in the suprachiasmatic nucleus in the brain, and if this area is damaged, the circadian rhythms of the body will be abnormal. At the same time, the study also found that in patients with major depressive disorder, circadian rhythm of gene regulation becomes very disorder.

Circuits related to circadian rhythms are also affected by external factors, the most important of which is sunlight. These circuits receive daylight that is projected to the eye through a special cell population on the retina. Such cells exist behind the eye, feel the specific period of time and duration of daylight projection, and transmit this information to the central nervous system (the same happens to blind people).

Treating dipression with sleep deprivation and light therapy
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I believe many people have experienced the "pain" of the biological clock disorder. When we set foot on the land of another time zone from the time zone we are accustomed to, the "inertial" circadian clock in the brain does not match the surrounding circadian environment, and is commonly referred to as "jet lag." Sometimes the body needs to adjust for many days to adapt to the new circadian rhythm; before the adjustment is completed, many people can not sleep well, and there is no appetite at the time of eating and the mental state is also negatively affected.

So we can not help but ask: If we adjust these circadian rhythms, we can reset our emotions to solve the emotional problems. In fact, as early as 200 years ago, people knew that "sleep deprivation" is a rapid treatment of depression (the therapy is included in the 1818 German psychiatrist John Christian Auguste Heinling's Textbook of Disturbances of Mental Life.) Since the 1960s, a large number of clinical studies have shown that symptoms of depression can be alleviated even if only a single night of absence; a 2015 study more pointed out that the therapy in 50% -80% of the subjects In patients with rapid onset.

Sleep has always been considered to stabilize emotions. Therefore, starting from the sleep problems, with the use of drugs to alleviate the suffering of patients with depression has always been one of the primary directions of clinicians. Further research found that sleep deprivation can play a similar effect with drug treatment, regulating neurotransmitter activity in the brain. In 2015, scientists from the University of Freiburg Medical Center in Germany, the University of Bonn in Germany, Frederick II in Naples, Italy, and the National Institutes of Health found that sleep deprivation, tricyclic antidepressants and ketamine (a tranquilizer) May all be targeted at the same molecule - a receptor protein expressed on the frontal lobe of the brain - whose function will affect the neural circuits involved in mood regulation.

Prolong the curative effect

Unfortunately, if purely sleep-deprivation therapy is used, the efficacy of the treatment does not last long. Under normal circumstances, the symptoms of depression will comeback in only a week, and if taking antidepressant drugs at this time, patients still need four to six weeks to gradually get rid of depression.

But do not have to be discouraged, and there is another way you might be able to keep sleep deprivation therapy with the ultimate Boss that regulates our circadian rhythms - sunlight. In one of the earliest completed experiments combining sleep and full-wave visible (simulated daylight) therapy, psychiatrists at the University of Vienna invited 20 volunteers who had symptoms of depression to complete two separate sets of experiments. In both groups, patients were deprived of sleep and taking certain antidepressants; the only difference was that the treatment was in a dimly lit environment (control group) for one group while the other group was bright environment of. According to the experimental results published by the experimental group in 1996, patients with effective sleep deprivation therapy maintained their antidepressant effect throughout the seven-day experimental period.

Now, my collaborators and I are trying to see if the positive effects of light on sleep deprivation can last longer. So I invited Jody to participate in a new experiment we named wake therapy, which combines traditional sleep deprivation therapies, a modified sleep schedule that changes every day Sleep time) and light therapy. Jody was still a bit hesitant, but she thought for a moment - her sleep was bad enough now, could it be worse than it is now?

To avoid being tired at work, Jody started applying a new treatment that weekend after I promised me. Strict compliance with our schedule tailor-made for her, she remained awake for a long period of time (sleep all night), then she in accordance with the specified schedule for sleep, adjust her sleep time. In the meantime, she also had to eat breakfast in the full wave of light every morning.

A week later, when I saw Jody again, she was excited to tell me that while staying up late was a painful experience, her symptoms of depression had been significantly improved: she was no longer always depressed, nor was she already depressed Being able to return to work well is also more handy in the face of all the pressures in everyday life. We went on experimenting, and a few weeks later, with the combination of medications, "awake therapies" and psychotherapy, Jody recovered again - just as the holiday season came.

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References for further reading:

• http://www.ibtimes.com/sleep-deprivation-can-cure-depression-study-shows-2591887
• https://health.spectator.co.uk/can-sleep-deprivation-be-used-to-treat-depression/
• https://www.sapphiria.com/blog---en/treating-depression-light-therapy-and-sleep-deprivation
• http://www.dailymail.co.uk/health/article-4904644/Sleep-deprivation-CURE-depression-day.html
• https://www.forbes.com/sites/alicegwalton/2017/09/24/sleep-deprivation-may-treat-depression-but-would-it-ever-be-prescribed/#187079bb6f16

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