Tag Archives: light therapy

Wake therapy (staying up all night) for depression

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.

Wake therapy for depression adnuther.com

Two months of experiments with melatonin supplements

In another attempt to kill my insomnia I revisited melatonin supplements a few months ago. I had tried them 15 years ago, once, when I was sleeping three hours a night, whereupon I slept for 24 hours. That kept me off the stuff until a few years ago, when I tried them again, using the dosages listed on the labels — 1.5 mg, 3 mg, etc. I could feel it working and I got sleepier and sleepier and then…nothing.

I get the same effect when I use amber light bulbs and amber glasses, which prevent blue light from turning off your melatonin production at night. Especially if I’m reading, I’ll get sleepy and doze-y for about 30 minutes and…nothing happens and I’m wide awake again. Clearly a crucial step is missing somewhere.

When I discovered that some people out there use up to 40 mg (milligrams) with apparently no ill effects, I tried that. (Since melatonin is a hormone, and a prescription-only substance in some countries, there is some worry about big doses.) I spent a couple of weeks building up to 50 mg a night. It had even less effect than the smaller doses. I didn’t even get sleepy. In fact it was kind of weird how little an effect there was. I did notice a few things:

  • hiccups 4 times in 3 days
  • period extended by two weeks
  • two episodes of dreaming while awake

That last effect was entertaining. Early in the morning, I was half awake and dreaming a series of images displaying in my head like a slide show — click, click, click, very fast: photo-realistic images of things like a space station in a nebula, or people I’d never seen before on a picnic, or machines that don’t exist. In other words, definitely not memories. I forced myself to wake up and discovered that by concentrating I could get the images to start again. Woo hoo! The last one stood out, clear as day — a sunset shot of a grand building, like a Carnegie library, with a row of Model Ts or similar old cars lined up on the street outside, which was built on the top of a small dam or causeway.

This is a lovely example of the difference between physiological doses (the dose the body uses in normal operations) and pharmacological doses (the dose that creates a certain effect, usually much larger) of a substance. If you want to read accounts of people who’ve used melatonin for mind-altering as well as traditional applications, visit the Experience Vault at Erowid.org.

Later I remembered a New Scientist? Discover? article on researchers who pointed out that melatonin is only needed in wee little doses, 300 mcg or so, and that using more might be counterproductive. (Sorry, can’t find it, but I swear I tweeted about it.) So I dug out my melatonin bottle and bit off what I hoped was a third, which would be maybe 500 mcg. It seemed to give me a few hours more sleep that night, but I couldn’t repeat the results.

I continued experimenting with difference doses of timed-release melatonin (TRM), and after several months I’ve noticed a few things. Please note that when I say “worked” here, I mean it gave me a few more hours of sleep.

  • More than 1.5 mg of TRM never worked. I only tried two different doses of non-timed release melatonin, with no effect.
  • At first, in late October and early November, 1.5 mg TRM — and no other dose — gave me four more hours of sleep, but ONLY when I also spent 1.5 hours in daylight before 1:30 pm AND 1.5 hours in front of a light therapy lamp. If I skipped any of those steps, I would not get the effect.
  • Eventually that stopped working. I’m assuming it’s because morning daylight got less and less intense, but I’m not sure.
  • Using doses larger than 1.5 mgs TRM made me feel anxious, panicky and depressed for an hour or so at night. Not fun. This matched personal accounts I’ve found of other experimenters who considered it a sign that the dose they had used was too high.
  • If I tried taking more melatonin again after I woke up after several hours, timed release or otherwise, it wouldn’t do anything.
  • At 7 am, after I used a bright light device for an hour, if I sat in the dark after the device turned off, I would get very sleepy and fall asleep for about 20 minutes (unusual for me). Turning on all the lights in the apartment stopped the effect.
  • My period stopped for 45 days after I started experimenting with the lower dose melatonin. This has only happened once in my life. I was very happy.
  • Doses of 2-7 mg seemed to give me headaches and mild cystic acne after a while. It is possible that the 1.5 mg doses did this, too, after several weeks of use.

I’m concluding from this that my insomnia problem is related to light exposure, but not to melatonin production. Light affects melatonin and the circadian rhythm, and melatonin is part of the circadian rhythm, but the influence of light on the circadian rhythm is NOT entirely due to its effect on melatonin, if you follow me. So I’m going to try to get more light into my day.

Things that still mess up my mood

August 13, 2017: My theories on this subject have changed. Until I can get my act together to update this content, please see this post.

This was adapted from a post on my older blog, Blessed Depth.

I’ve written elsewhere about how I threw off the yoke of my decades-long depression about 15 years ago, but a few things still trip me up. Some are culprits familiar to most sufferers, but some were a bit of a surprise.

Insufficient calorie intake. If I undereat for more than two days in a row, my mood will fall. A day of normal eating corrects it.

Vicodin. I don’t know what I’ll do if, heaven forfend, I’m ever in a long-term pain management situation, because even a modest dose makes me feel lousy the next day. Demerol, however, is lovely.

Dehydration. This happened twice, both times during the summer in my un-air-conditioned sweatbox of an apartment. I finally realized the extent of my cluelessness when my laptop coughed, flashed a blue OVERHEATED message, and died.

Large amounts of antagonists to zinc, B vitamins, or magnesium. If I take a whole lot of something that competes with one of these nutrients — for example, my experiments with intravenous thiamine — I’ll have to take supporting supplements to keep my mood from falling. (Another sign that my B vitamin status is suffering: I start dropping things a lot. Weird but true.)

The wrong contact lens prescription. I once spent about a week in lenses that were, say, five percent too weak and became increasingly unsettled until one night at a pub I discovered I was almost despairing at not being able to see the other pub-goers’ faces clearly. I’ve met plenty of people whose eyesight, corrected or not, is worse than mine, so maybe it’s not the exact 20/20 that’s important but that the prescription is what you’re accustomed to.

Watching television. I stopped watching TV in college, because most of it sucked and the moronic commercials drove me nuts. Fifteen years later, I turned the TV on out of boredom while housesitting and felt miserable the next day. Further experiments indicated that content or time of day were not factors, and that the effect was noticeable after about 25 minutes of watching. A poll of my friends revealed two people who had similar reactions, although they reported anxiety, jitteriness and spaciness, not low mood.

Weirdly, watching the same content on DVD, even for six hours at a time, had no effect. From this I logically concluded that either the commercials themselves, or broadcast television’s specific wavelengths, inject some sort of mind-control energy into our brains, which would jibe with my theories about Disney movies and Kit Kat bars. Eventually I did some more formal research, but the studies I found linking TV watching and depression focused on program content, physical inactivity, or the disruption of our circadian rhythms from the bright screen as causes. That didn’t explain my DVD immunity.

I had more luck finding corroborating studies when I looked at it as a multi-tasking issue, and the commercials as repeated distractions. Perhaps my brain can only be interrupted so many times.

Seasonal affective disorder (SAD). It took me a while to figure this out because in high school in the Midwest my mood was such a constant disaster that I couldn’t discern any patterns in it — like sticking your head in a tornado funnel that’s just sucked up your subdivision and trying to spot your house — and after graduation I went straight to Southern California. Back in the Midwest years later, I thought I’d ironed out the whole depression thing, but the first winter knocked my mood back about 50%. I also ate everything in sight, lay awake all night, and was a zombie all day. I got myself a lightbox, which back then looked like a piece of airport runway equipment, and after a week was back to normal. (A few years ago, though, I noticed that light therapy no longer works if I do it after 8 a.m., whereas for years it worked as long as I did it by 9 a.m.)

Seven fomenters of brain fog

Several factors combined together to cause me years of spaciness and difficulty concentrating. Highlights of this period included giving the wrong last name when called on in class and almost getting my head wedged between two floors of a department store while riding the escalator. Most of the causes were ferreted out after I went gluten-free, and now I can face a big project and a tight deadline without sweating it too much, given enough Pepsi.

The problem is that metabolizing an acre’s worth of high-fructose corn syrup when you’re 25 is one thing; now it’s quite another. I’m still looking for the final pieces to this puzzle.

The main causes were:

1. and 2. High histamine, caused at least in part by low iodine

I discovered this by accident when I was working day and night on a project while playing host to a cold. Out of desperation I started mainlining vitamin C — something like 1,000 mg an hour, all day. After two days of that I realized I was thinking a lot better than normal. After some research I discovered that vitamin C lowers histamine; that in some people histamine is too high all the time, and not always with allergy-like symptoms; and that histamine occurs naturally in food, some much more so than others. Now I finally had part of the answer as to why certain foods had recently started making me spacey: eggs, rice, large amounts of protein, kimchee.

The second part of the question was why I had it now, when I hadn’t before. An uncorrected, and thus steadily worsening, iodine deficiency would explain it. According to some experts, it is rampant now that we avoid (iodized) salt. Insufficient iodine will cause a rise in histidine, which the body converts into histamine.

Another theory is that I’m not making enough of a certain enzyme, amylase, that breaks down carbs. Which with a recovering celiac’s innards wouldn’t be surprising.

3. Leaky gut

A classic celiac legacy. A damaged gut can cause dairy to be only partially broken down, and it so happens that some of those only-partially-broken-down particles happen to be in the form of opioids, as in opium, which then escape into the bloodstream and make you loopy.

4. Iron deficiency

Common enough among all women, never mind celiacs. For various reasons though, it was never possible for me to get my levels up to ideal numbers.

5. Folate deficiency

Folic acid, a type of folate supplement, never did much for me so I never investigated it very far. When I learned that it’s not a very efficient form of folate, I tried the superior form (methylfolate) and discovered that large doses made a noticeable difference in my ability to concentrate. However, at a certain amount — which sadly is also the amount that makes my fingernails look REALLY GOOD — it then raises histamine, which leaves me back where I started it made me really spacey, which felt like elevated histamine. I am not clear on what that was — my understanding is that unmethylated folic acid can raise your histamine if you’re a poor methylator, but that methylfolate would not. I really don’t know.

6. SAD, which is probably vitamin D deficiency

If I don’t use my high-intensity lamp in the fall and winter, I turn into a zombie and eat everything in sight. And stop sleeping. And think thoughts that make me look around for Hank Williams.

7. Insufficient essential fatty acids (EFAs)

These helped for about a year, then made my insomnia worse. Now they give me scary headaches AND total insomnia.

Other suspects I’ve looked at in my brain fog investigation were candida, digestive enzymes, vitamin B12, zinc, and calcium and magnesium. The latter two, once I got levels up to normal, reduced jitteriness and listlessness, which made it easier to concentrate. The rest did not seem to be involved. YMMV.

My depression and what I did to end it

August 13, 2017: My theories on this subject have changed. Until I can get my act together to update this content, please see this post.

The text below was last updated February 6, 2012.

My depression lasted from junior high until I was about 31. I realized by ninth grade that it was not event- or environment-based. At around 30, after 18 months on antidepressants, I realized they were a disaster for me and I looked elsewhere for solutions. A few months later, and after two years of unemployment due to my mental state, I found success with a gluten-free diet. At first I thought that all my problems had been solved, and it truly was the end of my despair, but if I had to go back to my mood in those early “I’m cured!” days, it would terrify me. But at the time, it was so much better than my norm that it was a miracle.

It took about two more years of tinkering with my diet and supplements before I realized I was normal. And with no help from any doctor, thank you very much, although they occasionally were of use on other issues. Just a lot of internet searching and a few alternative health books.

Following the logic that since celiac disease (for which a gluten-free diet is the solution) results in malabsorption and thus nutritional deficiencies, that my health problems were caused by nutritional deficiencies, I went in that direction, and with a few exceptions stayed on that road.

Here’s a list of the supplements/treatments/practices that definitely had an effect on my depression, which is about one-tenth of what I actually tried. Mind you, I never took ALL of these at the same time, and only take a few of them now, on occasion.

  • Quit gluten.

  • Quit dairy. Resumed when corrected zinc deficiency.

  • Calcium/magnesium: 1000/500 per day at first? Maybe more.

  • Zinc: 50 mg/day for about a year, then cut back. This had the most noticeable effect of all the supplements. After a few months on it, I could eat dairy again without it lowering my mood. (The casein in dairy binds with zinc.)

  • Iron: Varying amounts.

  • B-complex: Started with B-50 3x/day.

  • Plus more of the following B vitamins, which B-complex doesn’t have enough of, as they are too expensive for the manufacturer. Compare the various RDA percentages on the B-complex label to get an idea of the different amounts.
    — Biotin: 1-2,000 mcg
    — Folic acid: 400-800 mcg. See note below about newer, better form.
    — B12: 1-2,000 mcg. ” “

  • Vitamin D3: 2,000 IU/day. Helped mood a bit, but mostly sleep. I should’ve tried a lot more but at the time the “experts” said that amount was pushing it.

  • Omega-3 EFAs. I took a lot of these for several years.

  • Treated for hypothyroidism. Zinc helped this, as did low-goitrogen diet, Armour thyroid for 18 months, and acupuncture, which I tried after I got tired of being slave to a prescription. After about 15 treatments in nine weeks with an M.D./D.O.M., I was able to stop the Rx.

  • Light therapy in winter for 30 minutes in morning. For me it prevents plummeting mood, insane carb cravings, zombie brain, and near-total insomnia.

Still affecting my mood:

  • Winter (seasonal affective disorder / SAD): I am assuming that lots of vitamin D3 will eventually fix this, but I developed a reaction to vitamin D3 supplements and can’t get my levels high enough. Ideal results for the 25(OH)D test are supposedly 50-80 nmol/L, but I can’t get above 20 nmol/L. Also, I have noticed that the light therapy doesn’t work if I do it after 8 a.m., whereas for the first several years it worked as long as I did it by 9 a.m.

  • Vicodin. (Demerol, however, is lovely.)

  • If I take a whole lot of something that competes with zinc and/or B vitamins — for example, my recent experiments with huge doses of Ca/Mg for energy — I’ll have to take those supplements to keep my mood from falling.

  • Not getting enough calories. I’ll feel it two days later.

  • Assholes.

Notes:

I did not know until this year about the limitations of folic acid and B12 cobalamin/cyanocobalamin supplements (as opposed to methylfolate and methylcobalamin). I wonder if using those better supplements would have sped up my progress.

I’ve never taken a whole lot of things at once, as it makes it difficult to figure out what the heck is doing what, I find it overwhelming and annoying, and I just can’t digest all that much.

I still experiment a great deal with supplements, but not for the depression end of things. Knock on wood.