After a reader pointed me to a New York Times article on chronotherapy — using light exposure and waking times to affect mood — I ordered one of the publications it referred to: Chronotherapeutics for Affective Disorders: A Clinician’s Manual for Light and Wake Therapy. The manual’s authors, three clinical researchers/professors in psychiatric neuro-stuff in Italy, Switzerland, and New York, have been experimenting with chronotherapy on hospitalized bipolar and depressive patients. They themselves do not use prescription drugs in their treatment, but their patients’ other psychiatrists and doctors often do, so the manual includes guidelines on how to incorporate meds into each treatment.
Among the many topics the authors cover — bright light therapy, melatonin, and generally futzing with a person’s circadian rhythms in multiple ways — they mention that they’ve found that their depressed patients often benefit from staying awake all night once or twice a week. Specifically, the second half of the night seems to be key — you stay awake from about 2 a.m. until 7:30 a.m. You can actually go to bed early and wake up at 2 a.m.
The therapy calls for a well-lit environment, moving around a lot to stay awake, coffee or caffeine if necessary, and eating whenever you’re hungry.
The authors say that “the clinical improvement after a single night of wake therapy is remarkable,” but some patients need two or even three nights in a week (not sure if they have to be in a row) to see results. However, a good response seems to be pretty long-lasting. Patients can maintain the effect using light therapy alone or occasional nights of wake therapy.
I recommend this book if you’re looking for non-Rx ways to treat mood disorders. It’s written in normal language and the authors seem to care a lot about their patients. They cover all kinds of depression, all kinds of treatments, and all kinds of combinations of treatments. They cover blue-blocking lenses and something called social rhythm therapy, which involves paying attention to your daily activities and how they affect your internal clock. (That reminds me of Seth Roberts’ discovery that his mood was noticeably better on days when he watched TV shows featuring large faces — that is, with the camera zoomed in, as on talk shows — in the morning.)
Here’s a link to the table of contents on the Swiss publisher’s website, although it’s weirdly formatted. You can get to the order form from that page, too. The manual was about $52, including shipping from Switzerland.