I found in college that lack of sleep significantly reduced my anxious and depressive thoughts, but it also reduced my ability to think deeply about things, I think it was sort of a less thinking has both negative and positive side effects type of thing
I think this in part drives the depression / mania cycle, At least it did for me.
Staying up coding or working on a project would life my depression, but then I’d go off in the other direction and end up in psychosis as I chased the sleep deprivation high.
Also why concerts, festivals, even cool conferences were so attractive.
That said, it seems possible to leverage this as a tool — certainly more useful than SSRIs, etc. which just punt the issues and tend to make things worse.
As for me, I ultimately healed so called manic psychosis, bipolar, schizoaffective, Anxiety through Transpersonal approaches, psychedelics, gratitude, meditation, nature and learning to regulate my nervous system. Without medications despite what the doctors said was possible.
Serotonin is overrated, SSRI's and weed create unmotivated, pliable people. It is the hormone of bears going into hibernation. That's partly why it'll make you a sexless individual...
One theory about the beneficial impacts of psychedelic is that they have such power affinity for serotonin receptors that the body downregulates their expression as a result. However, this effect did not bear causative fruit in a swim-stress coping experiment with mice [1].
I saw this yesterday, and IIRC correctly "in mice" wasn't at the end. Well done to whoever updated that. Should be mandatory!
Anger and hostility are opposites of depression. Doesn't mean it's good to induce those feelings..
Has anyone read the book “Brain Energy”. I think it can be life changing for some people with mental illness. Even if you just have minor depression from time to time.
I’ve worked only two places my whole life: a tech company and an investment bank. Each had the work life balance you’d expect. When I started at the investment bank my depression stopped entirely. I always wonder if depression is something you experience if your hierarchy of needs is completely met. It’s like a switch flipped and I went from searching for meaning to animalistic survival mode.
Tangentially related, my religion has a strict health code and teaches to refrain from oversleeping. Not the inverse.
Relationship of sleep and depression is a very interesting topic that despite decades of observation and research is still poorly understood.
As other comments point out, the potential beneficial effect of sleep deprivation (SD) has been noted for a long time. It's also correct that effects tend to be transient and quite varied among study subjects.
A recent comprehensive meta-analysis [0] showed that overall, extant studies of sleep deprivation in depression are too inconsistent to allow drawing firm conclusions regarding its merit. To quote the authors, "...it is uncertain whether SD affects quality of sleep, health‐related quality of life, everyday functioning or length of hospital stay. Generally, the method is well‐tolerated, although the risk of switch to mania exists. Albeit the low grade of evidence, the treatment method of SD should be considered an important part of the future research in rapid relief of depression".
For clinicians, the careful scientific approach emphasizes need to accumulate clear evidence of efficacy and safety before prescribing SD to those suffering major depression.
Too tired to be sad!
> researchers induced mild, acute sleep deprivation in mice
How can sleep deprivation be both mild and acute?
In medicine, describing a disease as “acute” denotes that it is of recent onset; it occasionally denotes a short duration, as opposed to “chronic”.
This duplicates research that is at least 20 years old.
Also, depressed people (and people with similar mental conditions) resist sleep also partially because being tired means that you feel less, and thus are relieved from the pain you feel more acutely when more awake.
I think I’ve been self “medicating” this way for at least 30 years.
My body does insanely badly with poor sleep. The worst feedback loop is when nighttime eczema itchiness kills my sleep quality which increases my stress which increases my eczema symptoms...
But I've also been chronically depressed since childhood.
With all these studies, we're going to be very well prepared to address any future mental health epidemics among mice
> "You can imagine certain situations where there is a predator or some sort of danger where you need a combination of relatively high function with an ability to delay sleep."
I think these predator vs. human situations are sometimes exaggerated to prove a point. Not that it can't be, it's just that these articles go straight into it with no pondering on sight. Similar analogies and misconceptions apply to fasting and paleo diets, sparking controversy on how prehistory behavior, human evolution and healthy habits in the 21st century all link up (or don't).
Humans have been naturally selecting on so many things - it's just as easy to say the brain responds with dopamine giddiness to protect itself from psychosis after a sleepless night caused by... eating bad food, hunger, insect bites, thirst, etc. No need to bring saber-tooth cats into the equation just for the clickbait.
In my life, I've observed occasional sleepless nights (one night per 1-3 month period) to coincide with positive moods, abundant activity, and a general sense of fulfillment. And when my mood and motivation drops, I reflect back and recall that it's been a while since I've enjoyed a sleep-free night.
I've always conceived of this as a consequence of being highly dynamic – my system is being stretched/pushed/twisted/strained by skipping sleep [1] – and a correlation to generally being enthusiastic about what's going on (I stayed up all night in the first place because I was obsessed with a fun problem). Of course, it is difficult to parse cause/effect/correlation, so I'm aware of the limits of these observations [2]. However, from the beginning I've felt confident that these sleepless nights were part of a broader pattern of good health.
[1] – As a general rule, I find "stress" to be healthy if it is acute (but survivable!) and unhealthy if it is chronic. This case (sleep) fits the rule... infrequent sleepless nights have a net positive effect, and prolonged sleep deprivation (even mild) is absolutely terrible for pretty much all aspects of health.
[2] – In observing my sense of happiness, I consider "seasons," or 3-6 months periods, so the previous analysis is actually quite feasible. Do I wake up motivated? Do I feel pleasure lying down to sleep? Am I being kind to the people in my life? Do I enjoy interacting with acquaintances? Do I feel capable? To me these questions offer clarity on some rough level of happiness, and makes possible an imperfect analysis of the effects of something like a sleepless night or other lifestyle change. It's not perfect – but it doesn't need to be perfect, as it is already a more effective analysis than the alternative (no analysis at all).
Now that I'm thinking about this, you can pull in an all-nighter on Thursday then wfh on Friday and just catch up on sleep over the weekend. People at work won't mind and the wife and kids will be okay as long as you're caught up for Saturday. This was timely advice.
I am bipolar and when I am in an depressive episode I use the same technique the lift the burden a bit
The impact of sleep restriction on depression has been known for decades (though most of the research I'm seeing is from late 2010s on [1], this link says "from the beginning of the last century [2])
However, sleep deprivation as a treatment needs to be balanced with the health impact of sleep deprivation itself.
A single night of lost sleep can have significantly detrimental impact on long-term health. Insulin response tanks, cortisol levels increase, HRV decreases, and this becomes a viscious cycle. In addition to increased beta-amyloid deposits associated with Alzheimers [3].
[1] https://www.pennmedicine.org/news/news-releases/2017/septemb... [2] https://www.minervamedica.it/en/journals/minerva-psychiatry/... [3] https://www.nih.gov/news-events/nih-research-matters/sleep-d...
Yes, and we've also known for a long time that the effects are temporary and unsustainable. It also doesn't work for everyone and can induce or worsen depression in others.
It is interesting, though. There have been some attempts to use sleep deprivation to kick off antidepressant treatment.
There have also been attempts to extend the effect by using a single night of sleep deprivation followed by a slightly altered sleep schedule.
Many people can even benefit from simpler alterations of going to bed earlier and getting up earlier. A lot of people discover that if they adjust their sleep schedule to go to bed earlier and get early (enough to be awake by sunrise) they feel substantially better. Convincing people to actually do this and maintain it is often difficult.
Certain medications with depression-altering properties might act through alterations of circadian rhythm. Lithium inhibits GSK-3, which has significant effects on circadian rhythm. Agomelatine, a newer antidepressant, has significant interactions with the Melatonin receptor. It should go without saying that medications like these are infinitely more sustainable than sleep deprivation.
Ironically, I've had several bouts of depression kicked off by pulling an all-nighter.
Exactly, sleep deprivation can also cause a loss in willpower and thus move oneself closer to the depression/apathy end of the spectrum. Nothing new, really, but as it so happens I listened to Andrew Huberman's podcast on "willpower & tenacity" last night where he spends a good amount of time addressing this topic.
For those that enjoy sleep, smoke salvia instead!
Isn't that just a hypomanic episode?
We have known about sleep deprivation causing a remission in suicidal ideation for a while - we have inferred a depression benefit as well, but it’s nice to have it quantified.
However, we also know resumption of sleep pretty quickly ends the effect. It’s not a sustainable intervention, so much as it an interesting finding for hypothesis generation.
We also see the reverse effect in mania; on balance, regular healthy sleep wins the day.
Huh, so maybe that's why I felt like my depression was better in my younger years, cause I slept less?
Not for me. I think this will vary by person, especially as causes of depression vary and the whole phenomena is not fully understood.
But for me, depression can be bouts of fatigue and lethargy, but also are sometimes accompanied by crippling thoughts off.. well, things that keep me awake. And losing an entire nights sleep like that was not at all helpful. I felt just as bad or worse, only with some additional things related to sleep loss mixed in.
That said, I also know (not from experience) that even in "normal" people, skipping too much sleep can produce minor bouts of mania (where mania can vary from highly unpleasant to highly energetic/productive/euphoric) so it does make sense to me that some depressed patients response positively to it.
Not for me either. But my insomnia is incredibly bad.
I have experience with this and commented on a similar thread in 2018.
https://news.ycombinator.com/item?id=16557500#16558442
Update if anyone cares: I feel like I'm damn near 100%.
None of that worked for me but the important thing is... WONDERFUL that you're still on track! Thanks for sharing and congrats.
So sleep well and avoid dementia but stop sleeping to avoid depression
I used to love Mondays, I would work hard during the week studying and working, then Friday I would stay up until sunrise with friends drinking or gaming. I kept this up while working in the corporate world and thought "this is what people mean by feeling refreshed"
It wasn't until I met someone who bent me to be on her schedule, early to bed early to rise on the weekends, where I started feeling depressed by the end of the week, getting Sunday scaries, and having late onset insomnia.
Complete anecdata, but I'm going to start practicing this again on Fridays to see what happens.
Same. I'm completely anhedonic by Friday when I box myself into a schedule like this, which makes enjoying the weekend feel like a chore.
The mice's symptoms when sleep deprived sound very similar to hypomanic symptoms. The same electrochemical circuits are likely involved, in one case a chemical imbalance inducing sleeplessness, and in another sleeplessness inducing a chemical imbalance.
If you've never tried a Ragnar race, you should consider it. It's a 36 hour-ish team relay race, with non runners driving in a van to meet runners at the next relay spot. You barely sleep, but the 1-2 hours you get are probably the deepest you'll ever feel. The next day you are exhausted and yet feel amazing at the same time.
nice to know, kind of suspected that. for me, a good non sleep night = bye cockroach mode and hello overenthusiastic maniac for a week. quite a ride. 100% recommended.
It's just anecdata, and I am delighted to say that other lifestyle changes have eliminated most of my anxiety/depression, but this was definitely I hack I learned on my own and used at times.
Well that's good news. Hate sleep
Periodically skipping-a-sleep (in order to shift the next bedtime) is also one approach to treat Delayed Sleep Phase Syndrome (DSPS), which is also correlated to depression.
Whenever I feel down, I binge watch something usually late into nights and I feel better next day. I wonder if it's due to the lack of sleep.
Same for me. I don’t feel stress in the typical way, in fact for years I don’t think I got stressed. My wife eventually correlated me “checking out” for a few evenings in a row and smashing through a TV series or two as my stress relief valve. To me I just thought I wanted to watch TV, to her she noticed it always happened when events around me would be making other people “be stressed out”.
> Chronic sleep loss is well studied, and it’s uniformly detrimental effects are widely documented,” Kozorovitskiy said.
I believe he didn't say "it's", he probably said "its".
sort of interesting how your/you're, its/it's, shrimps/softwares and others sort of unconsciously makes what you're reading less authoritative in a 4th wall way.
Not even unconsciously, I stop reading anything I've been reading once I meet one of these. It's disrespectful to the reader to not even check what's the correct spelling of a word you are using, and in my opinion indicates that the writer is not intelligent enough to recognize patterns in text, it really isn't that hard to see how a word is used in the wild. Kind of a hot take
You can't put all people on a scale like that, less intelligent vs more intelligent. Some people are great with letters and words and spot typos quickly, some just don't see it as easily. They can still be very intelligent in other aspects. People are different.
You know, you are right. I agree, but it still drives me nuts seeing this, maybe it's just ignorance? I expect a higher standard from a .edu website
If this helps any, Siri NEVER seems to get this right, always preferring the contraction over the possessive. As a syntax/grammar fanaticist who is also old I rely on Siri for dictation and she has sunk embarrassingly low these last few years. I have to spend a long time correcting any message of reasonable length for this reason.
It has made me much more sympathetic to errors like this, but I cannot begin to tell you how offended I too feel when so-called educators don't proofread.
Don't get me started on emails from middle and high schools.
This is tragic, how many people will doubt Siri? It definitely contributes to the problem
And can promote mania/psychosis, which seem related (higher energy levels)
the problem with this is that sleep loss has myriad other consequences; something I often discover when I take ADHD medication. it's all well and good being productive for a day, but when you wake up the next day at 2pm, things start to fall apart
I'm not depressed but just in case, time to go clubbin' like I'm nineteen again.
Weirdly I am in my 60s and have no trouble pulling all-nighters. I went clubbing like twice in my 20s and found it dull af, but coding all night is still not a problem for me.
I have always been an atrocious sleeper.
You get rid of depression but acquire dementia.
The article actualy says that if it's a routine thing then other problems will start to set in, obviously. They also mention that your probably better off going for a walk or going to the gym. This is just another possible tool that we could use strategicaly, but very rarely, to combat depression or feeling down.
The article "One Sleepless Night Can Rapidly Reverse Depression for Several Days" is a fascinating and promising piece of research. The findings suggest that sleep loss could be a potential treatment for depression, which is a debilitating condition that affects millions of people worldwide.
I am particularly interested in the implications of this research for many people. I believe that this research could lead to new and innovative treatments for depression, which would be a major breakthrough in the field of mental health.
However, I am also aware of the potential risks associated with sleep loss. Sleep is essential for physical and mental health, and sleep deprivation can have a number of negative consequences, including cognitive impairment, increased risk of accidents, and worsening of existing mental health conditions.
Therefore, I believe that it is important to carefully consider the potential benefits and risks of sleep loss before using it as a treatment for depression. More research is needed to determine whether sleep loss can be safely and effectively used in a clinical setting.
I am optimistic that this research will lead to new and effective treatments for depression. I am also hopeful that this research will raise awareness of the importance of sleep for both physical and mental health.
Was this written by an LLM?
If you mean the comment, I think so. That's why it is probably flagged
No, it was not written by a language model (LLM). I know one of the authors, Mingzheng Wu, and have followed his work closely, including his papers on the rapid enhancement of glutamate-evoked dendritic spinogenesis in the medial prefrontal cortex through dopaminergic mechanisms, and the suppression of neuropathic pain through inhibition of YAP/TAZ activity in the spinal cord.
https://www.reddit.com/r/hangovereffect/
This sub-reddit is dedicated to people who've noticed this effect for ADHD and probably depression as well. Drinking alcohol somehow causes the same 'reversal' of symptoms, either motivation or other mood problems. Lots of discussion as to what causes it - and questions/theories on how to reproduce without alcohol.
Alcohol causing sleeplessness, or sleep that's not the usual quality might be an explanation.
This is interesting, I have adhd and - other than the headache - I like the doziness that a hangover brings, now that I'm almost 50 though they do tend to be multi-day events so I don't drink as much.
Some people with CFS/ME also report that some symptoms are much better when they are sick with a cold or flu.
I have ADHD, did never tried it with alcohol, but sleep deprivation works. I used it when working on important projects with deadlines. You kind of feel like in a parallel universe after a couple of a day if it's a interesting subject for you, ADHD gives you hyper focus, and sleep deprivation gives you this energy to push thru. It's like you don't even need the medication. If you combine it with ADHD medications it's like delirium. But anyway it comes all crashing after couple of days and you have to pick yourself up. I did it for import projects, but don't recommend it.
I definitely remember a couple times in school pulling absolutely heroic crunches to get a semester's worth of work done in a couple days. Worse one was Freshman year finals week, didn't sleep for just shy of 4 days, fueled by a mountain of caffeine, amphetamine, and sleepless delirium. During day 3 I started wearing an eye patch so that I could give each eye a temporary rest from the strain.
Finished everything, flew home, and slept for 18 hours straight.
Shame that I cannot view that without the app
Weird, whenever I pull an all nighter my mood is usually noticeably depressed for the following two days.
I also used to be a bit of an insomniac, and one sleepless night could easily throw off my circadian rhythm, creating all sorts of extra anxiety, which translates into demand avoidance, stress and furthering depression.
Yes, the 'sleep hangover': the after-effect that told me that what I was doing to myself by regularly staying up for 48 hours was similar to drinking a quart or two of scotch.
This is like me too. I'm normally not depressed, but every time sleep is affected, it throws me off and leads me down to viewing the world negatively.
Is your normal state depressed though? I don’t think it works for “normal” people.
I was diagnosed with dysthymic depression a little over 20 years ago. Therapy helped reset my expectations for myself, meds keep me regular.
I had a stint of a few years off of medication to see how it went, thinking that I was sufficiently practiced at introspection to know if I needed to start again.
I was very wrong, and put it off far too long. I've been back on medication for about 7 years and don't plan on stopping, ever.
What meds worked for your dysthymia?
The standard first-pass type SSRIs (i.e. fluoxetine) just gave me side effects, ranging from bad to very bad.
Wellbutrin and effexor both worked alright, but I felt like I needed to keep ramping the dose. It is also possible that I was poorly managing my stress in high school and college. Ultimately I topped out at the highest dose, and ended up getting anxiety issues (never medicated) on top.
I don't recall what I switched to after, but that was the point I tapered off of meds entirely for a few years.
I ended up back on Lexapro and it has been a life saver. I also started up therapy with the Lexapro, which I realize in retrospect I should have been doing to much sooner. After a few months my therapist said I didn't need regular sessions any more, and I haven't been back since.
That said, I'm aware enough to know it is a bit of a balancing act. Managing my stress levels is the biggest thing, and if something significant and negative in my life were to happen, I'd probably start up again.
The study was done on mice. Are there depressed mouse that are used in such experiments or is this just an opinion on why zdragnar might not feel these effects? This is a genuine question.
It is possible to artificially induce depression in mice, yes. Obviously, the whole field is insanely fraught with ethical dilemmas.
Ah god to know. I missed the mice part… I feel the same as OP. Whenever I miss a night I’m in a terrible mood. It was just my opinion.
Having suffered from severe depression for over forty years, this reminds me of when I was 17, 18, etc. and suddenly discovered that if I stayed up for two days, the problem went away. So I knew this a very long time ago; but it always seemed to me that, besides smoking, this was just about one of the worst habits you could develop. By my mid-twenties, I had stopped.
Try the carnivore diet for 30 days. Eat eggs, beef, butter, plenty of salt, greek yoghurt, blueberries, walnuts. Drink only water (with a slice of lemon to break the monotony) and green tea.
Thank me later.
Stop coffee/tea/other stimulants maybe, change eating habits maybe, fasting for 1-3 days, change start of sleep, observe the effect. Change one thing at a time.
I usually start to feel normal late into the night. After 11pm the depression and disassociation fades away. My mood brightens. I feel like I have infinite energy and easily stay up until 5am. It’s a strange rollercoaster.
It really isn’t sustainable…as I lost a really good job over it. Now I’m sticking to a schedule with 8 hours of sleep but I don’t ever get that “feel good” kick. Just perpetually drained and unmotivated.
[Look for|Make a] night job and merge your favorite parts in life?
Seems that I'm in the opposite. If I don't get enough sleep I would have noticeable bad mood.
The depression altering effect requires total sleep deprivation, or at least missing most of certain part of the night.
Getting 4-6 hours of sleep generally won't do it. You really have to upset the whole system to trigger the effect.
Which is also why it's completely unsustainable. More of a novelty and research topic, not an actual treatment.
>More of a novelty and research topic, not an actual treatment.
Sleep deprivation can be legitimately useful in crisis situations. Before the discovery of ketamine as a rapid-acting antidepressant, sleep deprivation was one of the only effective treatment options for an acutely suicidal patient. It doesn't solve anything long-term, but it can at least give the patient a bit of respite from their distress and perhaps engender a little hope.
I think, here, there is an effect from "zero sleep" that you don't get from "not enough sleep" (which I'm guessing is at least a couple of hours).
Bad mood isn't the same as chronic depression though...
I recently was forced off of SSRIs after nearly ten years because I lost my psychiatrist and couldn't get a new one because the waitlists were ridiculous.
After 10 years on them, the next 6 months were absolute hell (i legit thought at one point I might go full Joaquin Phoenix in Joker) but I made it through, no small part thanks to my wonderful amazing wife.
Rebound depression have been an issue - though in general I feel like I am much better off without the antidepressants now than with them - and I've also noticed that pulling an all nighter would actually fix the rebounds for a bit. A small dose of melatonin before bed worked wonders for me now. I sleep better and the rebounds are extremely rare.
I’ve yet to meet anyone who didn’t eventually do better off the SSRIs and the data supports this as well.
You need to right plan and support, but it’s worth it in my opinion.
Have you tried any trauma work or Transpersonal work?
Sometimes I wish I wasn't so cynical, but I've suspected that SSRIs are a preferred treatment because it is almost impossible to get off of them. They say "It can take up to a month for it to work" is just a way to make sure dependency is strong enough by that point to make withdrawal unbearable. Many people don't fully understand the concept of withdrawal or chemical dependency, and will think the "medicine" works because they feel awful without it.
You just discovered most prescriptions in the US. Big example, insulin, once you take it, ooof, never going back...
> Sometimes I wish I wasn't so cynical, but I've suspected that SSRIs are a preferred treatment because it is almost impossible to get off of them.
That is indeed very cynical! However, it's not correct. SSRIs are actually much easier to quit than our previous generation antidepressants. The first "S" in SSRI stands for "Selective", meaning they more or less selectively work on the serotonin transporter. Older medications were less selective and worked on a lot of different systems, which often meant withdrawal was even more difficult as multiple different systems were in rebound all at once.
The older medications can be more effective for resistant cases, but due to the higher side effect profile and more difficult withdrawal they are second line treatment.
> They say "It can take up to a month for it to work" is just a way to make sure dependency is strong enough by that point to make withdrawal unbearable.
Quite the conspiracy theory.
But again, it's unfounded. SSRIs are known to take up to a month to work because the antidepressant effect is the result of a sequence of changes that happens over time. The brain has to arrive at a new equilibrium with medication, and the various systems and feedback loops don't immediately recalibrate.
The biggest flaw in the theory that “they” prescribe SSRIs to get people addicted is that most SSRIs are cheap. $4/month at Walmart cheap, or $10 every 3 months. The common ones are long off patent.
I hope nobody takes the parent comment too seriously. If you're suffering from major depression, don't let HN conspiracy theory comments scare you away from trying treatments that work well for many people (though not everyone, but you don't know if you don't try)
SSRIs replaced older-generation antidepressants because they're similarly effective and much safer - that's not to say that they don't have side-effects, but they probably won't kill you. TCAs are extremely toxic in overdose (an obvious and serious shortcoming in patients with elevated suicide risk) and MAOIs come with a really difficult set of drug-drug interactions and dietary restrictions.
We know from the data that SSRIs work about as well as psychotherapy. We also know that SSRIs and psychotherapy work considerably better than either treatment alone. SSRIs don't work nearly as well as we'd like, they can cause significant side-effects, but they do deliver very important benefits for many patients and they're an important tool in the psychiatric arsenal with no adequate substitute yet. We need more and better treatment options, but we shouldn't unfairly denigrate the treatment options we have right now.
I don't mean to diminish anyone's lived experience, but I've always been slightly sceptical of claims about withdrawal effects of antidepressants. I suffer from TRD and have withdrawn cold turkey from maximum doses of several antidepressants with no ill-effects, but I didn't get any significant benefits when I was taking those drugs. If you stop taking a drug that was effectively reducing your depressive symptoms and you feel terrible, there's a fairly obvious explanation.
I strongly agree with everything you say, but...
> but I've always been slightly sceptical of claims about withdrawal effects of antidepressants.
Even the manufacturers warn against discontinuation effects. See the "If you stop taking venlafaxine" paragraph here: https://www.medicines.org.uk/emc/product/764/pil#gref
The UK NICE has advice about stopping antidepressant meds: https://www.nice.org.uk/guidance/ng215 and the UK BNF will mention withdrawal for some meds: https://bnf.nice.org.uk/drugs/venlafaxine/#treatment-cessati...
The Royal College of Psychiatrists has advice about stopping anti-depressants: https://www.rcpsych.ac.uk/mental-health/treatments-and-wellb...
Clearly, it's not a problem that affects everybody, and it's more common with some meds than others, but that doesn't mean these effects are not real.
Well no, SSRIs (essentially) work by becoming tolerant to their effects, which takes 3 weeks to 3 months. It's not a conspiracy, it's just how they work.
They're a preferred treatment because they're usually effective and they're far safer than other medication classes for depression.
Interestingly enough, SSRIs are only slightly but statistically significantly better than active placebos. While early trials showed a big difference between antidepressants and placebos, more recent studies have significantly narrowed that gap. FDA data shows a reduction of symptoms of about 30% in placebo vs 40% in antidepressants. [1]
[edit] Doctors note that the difference between antidepressants and placebo isn't clinically significant. They do something, but not much which is why the revival and breakthrough drug designation of psychedelics in the treatment of - especially major - depression is so exciting.
Contrarians and cynics have been trying the "barely better than placebo" angle for decades, but antidepressants are indeed superior to placebo.
You can find articles and reviews that play games with statistics, cherry pick studies, and use various thresholds for effect size to try to downplay it, but they do work for a lot of people.
> While early trials showed a big difference between antidepressants and placebos, more recent studies have significantly narrowed that gap.
The part you're leaving out is that the placebo effect is quite strong in studies for depression and even pain. It's misleading to say "barely better than placebo" without explaining that placebo works quite well in those studies.
Placebo effect is also getting stronger over time: https://bigthink.com/health/placebo-effect-worse/
> Contrarians and cynics...
I don't think they're contrarians and cynics although some undoubtedly are. They seem to be study authors. The fact is treatments, even broadly used ones, aren't always super effective. Sometimes they're just the only ones we have, and we as humans have a bias towards action being over inaction in medical care.
I may be contrarian and cynical in a lot of things, but modern medicine isn't one of them. I just like to be data driven.
> ... but they do work for a lot of people.
They work for most of those people just about as well as a sugar pill would, yes. Slighly better. There's a real mismatch in terms of public perception of how much better they actually work.
> Contrarians and cynics have been trying the "barely better than placebo" angle for decades, but antidepressants are indeed superior to placebo.
The study that I linked showing the 30%-40% numbers are from FDA data. There's no games played, the study authors got the FDA data by FIOA.
The fact that placebo effect is strong doesn't really mean much other than depression is something that you can treat through things like therapy, which the data shows is exactly as effective as antidepressants. A psychosomatic angle, even if that's not the right word. The desire to heal is sufficient to change the way you think about your situation, and that exists no matter what you're taking.
If taking your conclusion to an extreme, the placebo effect was exactly as strong as an antidepressant - or stronger - why wouldn't we just prescribe sugar pills instead? In fact since the delta between SSRIs and sugar pills is clinically insignificant - while SSRIs have tons of side-effects - why wouldn't we just prescribe sugar pills now? Does that mean sugar pills are effective against depression, or are SSRIs treating depression largely through placebo?
Putting it another way, the placebo effect doesn't treat punch biopsy wounds. [1]
>The study that I linked showing the 30%-40% numbers are from FDA data. There's no games played, the study authors got the FDA data by FIOA.
Most people who take SSRIs and swear by them have had to try multiple of them to find one that works (usually very well) for them. A study that only looks at one drug will have a much lower rate of success than a study that looked at SSRIs as an entire class of medicine.
I mean, obviously removing a serotoninergic med will change your homeostasis.
The real reason SSRIs are so popular is that they work (not always, but often to some extent) and for depression it's much cheaper to make a pill than book a therapists time
I get them (sertraline and escitalopram) pretty much on demand from Hims and Lemonaide.
That's terrible man.
I hate being dependent on a doc. Try to reduce this horrible risk by going up and down on dose to get a little stock pile to feel a bit safer.
But changes little I guess
I'm totally off the SSRIs now and will never go back. Rebounds used to be frequent, then like 6-12 months apart now - now I don't remember when my last one was...
Going cold turkey was absolute hell, but it worked out well for me because of my excellent support system.
Would not recommend at all for anyone else though, absolutely not: tapering with a doctor is 100% the best course of action.
> would actually fix the rebounds for a bit.
I can't prove it, but even dumb teenage me felt instinctively that extreme sleep deprivation was likely to take a long and possibly permanent toll. I don't think anything that extreme can really be practiced in moderation, because it's more like taking heroin than eating too many cakes, etc., i.e., it's not a 'granular' indulgence.
I would hesitate to call this a hot take on my part, since I am guessing that in that period of my life, I probably stayed up for two days on several hundred occasions, if not more.
For anyone else suffering from severe depression, this is an easy answer, maybe; but there are better easy answers than this. Cannabis (I am not a partaker since I was an student) would be better than this.
Really, do anything but this. It's not 'free'; nothing that works is free.
Just a side note for anyone reading: you can get an SSRI prescription from your GP (general practitioner i.e. normal doctor) you don’t need to go through a psychiatrist.
This is especially true if you are at risk for withdrawal, they will want to prevent that.
My pharmacist can even prescribe a month’s supply if I’m running out. Stopping an SSRI cold turkey is a really bad idea.
Indeed, and this easy availability is potentially a double edged sword.
In Australia it’s standard for a GP to prescribe SSRIs.
I tried this once, Family Doctor actually ended up giving me a dose that was twice the maximum anyone is ever supposed to take. Thankfully the Pharmacist told me that was an extremely bad idea and he just gave me my normal dose and I continued on for a bit.
After that was when I ended up cold turkey because I lost my doctor and psychiatrists during a big move and couldn't get a refill at any clinic in the new town.
It ended up working out, but it took about a year of absolute torture and probably about another year of just "weirdness". But these days I'm "normal" and off the drugs and never been happier.
2 years of recovery just sounds scary
Those drugs you used contains benzodiazepine [1]. It's addictive and if used long, do more harm than helping. I'm glad you get rid of it.
Benzos and SSRIs are different things. The former is a CNS depressant that acts instantly. The latter builds up in your system over a month to increase the seretonin levels in your brain. They’re not really related except that someone with, e.g., anxiety might be prescribed both
Why would you think they're taking benzos on a thread about SSRIs?
This works unless you GP is a huge jerkface in which case find a new one.
Just be honest: tell your GP that your previous provider quit/retired/changed insurance. Bring your prior RX bottles or paperwork. Let them know you have an appointment with your new provider on X date and ask them to cover you until then.
I've done this when changing insurance (twice) and when moving states (New provider had a waitlist. First time she wrote one month then when I reported the waitlist situation she ended up covering it for 3-4 months).
any medical doctor of any specialization can legally prescribe anything. that doesn't make it a good idea. a piece of supporting evidence is that the doctor's malpractice insurance may not cover any "cowboy" prescribing tendencies.
If all you need is a refill on a prescription you’ve been taking for 10 years, how is that “cowboy” prescribing? Also, these are trained professionals with years of education we’re talking about, not some random dude off the street.
anti depressants (and other drugs) have side effects, both in the short term and the long. Patients who want drugs may lie. Trained professionals, yes exactly, but need to have practical experience in an area of medicine to be an effective advocate for the patient.
I can't even believe I'm having to defend this position in front of this crowd, but now many GP's dismissed the symptoms of women's post-partum depression before it become a topic of mainstream discussion on television talk shows? Doctors are not perfect and are not free from various biases, and having had experience with your particular condition is invaluable to you.
This is one topic that used to surprise me but I learned better. Hackernews readers seem to be a higher percentage than typical on SSRIs. That and I think we have no idea just how many people are really on them.
> but now many GP's dismissed the symptoms of women's post-partum depression
Weird example given you're arguing against GPs prescribing antidepressants because patients may lie.
And I'd like to see someone lying to get SSRIs out of all the possible choices.
I'm arguing that in the US doctors can prescribe all medications regardless of their specialty (because it's true) and that it's not always a good idea, for example if the doctor is not familiar with recognizing the side effects which are outside of his specialty. (because that's also true) Your shrink is not going to prescribe you statins, as an example, but they could. It's important for a GP to recognize depression, but that doesn't mean they should treat depression, just as they should not give you a heart transplant.
You're arguing like something as at stake for you or you have bone to pick, I'm saying very generic anodyne things, i'm arguing for sober reasonableness.
We are talking about SSRIs here, not highly addictive substances. They're among the most prescribed drugs worldwide, I can guarantee you a GP knows very well how they work. Comparing that to a heart transplant is absurd.
> I'm saying very generic anodyne things, i'm arguing for sober reasonableness
You're saying vague things that are roughly as controversial as "water is wet" when read literally, but are out of place and tone-deaf in the context of above discussion.
In the US it’s common for a GP to prescribe SSRI’s. https://bmcprimcare.biomedcentral.com/articles/10.1186/s1287...
More broadly, in rural settings specialists are often impractical to access. So, the best possible standard of care is effectively off the table.
As other comments said, GPs routinely prescribe SSRIs. Moreover, it's not remotely cowboy to ensure continuity of care arising from exigent circumstances.
I didn't say it was "cowboy" which I put in quotes and you didn't, I simply said what I said, that insurers can put restrictions on doctors based on their specialties (true fact), that you (as a doctor) fear your insurer considering you to be a cowboy (also a true fact). Malpractice is something to worry about, including whoever educated you :) to look for the worst possible interpretation of what somebody says.
That’s fair. But I’ll note that the “General” in “General Practitioner” means they specialize in the wide range of health problems that occur frequently in the general population. That includes things like depression, anxiety, ADHD, etc.
I wouldn’t advocate you get a prescription for antipsychotics from your orthopedist, but SSRIs from a GP is probably pretty safe.
Obviously, it depends on the doctor and the symptoms. But a good GP will also refer you out to a specialist when needed. That’s a big part of their job: assessing when to call in a specialist.
GPs routinely prescribe SSRIs. Even pediatricians. At least in the US.
A lot of non-psychiatrist doctors prescribe SSRIs around the world, and that's a very good thing. These drugs are safe.
Please don’t make such blanket statements. They can have many harmful side effects, including sexual dysfunction.
I think OP meant to say, these are not drugs is not something you can OD with easily and kill yourself, not that they are side effect free .
In many cases they have induced suicide. There are many ways something can be unsafe.
There are many ways to regulate too. SSRIs are not OTC for the same reason.
There are many drugs a GP can prescribe that are just as dangerous or more so.
There is a reason SSRI are schedule 4 and not schedule 2 . They cannot kill you the same way [1]
---
[1] While there is a lot of politics in the classification and putting weed or LSD in schedule 1 is very questionable the list is generally medically accurate.
Agreed.
My anxiety now is that using THC to sleep will cause issues long term. But without it I literally cannot get to sleep anymore.
Edit: I regret pulling focus off parent comment and OP, but also deeply appreciate everyone’s comments.
Look into weaker THC analogues like delta-8-THC or delta-10-THC. They have weaker binding profiles and half-lives than normal THC does.
Same thing with CBD and its analogues.
CBN will knock me out and it isn't active at CB1 like THC is, so it doesn't get you high.
Don't use delta 8 none of that stuff is purified it is a giant mess. There are a ton of articles on the analysis of d8.
I had a period when I used THC (edibles) for sleep every night. This was one of the worst things I have ever done to myself. At first, you don't notice much side effects, but slowly it creeps up on you. It makes you depressed, depletes of any motivation, gives brain fog and you may just feel weird over all. When I quit I was amazed by how much better I started feeling and by how much my cognitive function improved.
I would highly recommend getting off it asap. Maybe taper off if you can't quit right away. First nights will be tough: sleepless, cold sweats, crazy dreams, but then it should get much much better. Be well!
It is really hard to get people to understand that. And there is a lot of false beliefs about thc being safe and being overall good. Maybe in small occasional amount, but I keep seeing disasters around me with heavy consumers.
> It makes you depressed, depletes of any motivation, gives brain fog and you may just feel weird over all.
Meh, I was like that prior to using THC. I will admit that it can sometimes increase brain-fog the next day. But I'd say the pros and cons are pretty 75/25 split for me.
Its odd to me that the "logical" and "scientific" types, or self-styled types, sing the praises of cannabis, but there's no mechanism in evolution to make this a healthy drug for us. Its just an accident of history it makes us high and that obviously comes with many costs as the blind watchmaker of evolution had no template for any of this.
Of course the drug war was a classist and racist thing and ultimately a failure because its propaganda couldn't keep up with people's desire for cannabis and the truth on how its far less dangerous than they were told. But to win politically you need to go big, so now we've over-corrected into cannabis being entirely harmless or even being a wonderdrug and cure-all, which obviously isn't true.
I see people on reddit recommend it for any number of health issues which I think is reckless and ignorant. A lot of these people have health issues that need to be treated. Covering up these issues with cannabis isn't going to help in the long run. Worse, almost zero discussion on how cannabis can trigger lifelong schizophrenia for people who have schizophrenia in their family and have latest schizophrenia that otherwise would have remained dormant for a long time, even the rest of their lives.
It reminds me a bit of the crony capitalism that kept stevia from being used as a sweetener. Society over-corrected with that as well, and honestly it tastes kinda terrible. And like all sweetners, who knows if its healthy. I don't think the blind watchmaker was expecting sweetness with no calories the same way she didn't expect being able to artificially shoot up your dopamine and serotonin with things like cannabis.
I don't think modern people realize how unbelievably delicate our bodies and mind are and how many 'ordinary' things are reckless and risky experimentation on us. I think we're still in this 19th century mindset of "conquering nature with science," which is obviously a pretty flawed premise and poor social philosophy. I'm not sure if its even possible for a capitalist technological society to leave that mindset.
>It makes you depressed, depletes of any motivation, gives brain fog and you may just feel weird over all
YMMV. That's me after a sleepless night.
~10 years from now we’re going to have better data on chronic THC consumption and after being a heavy user I’m pretty confident it’s going to shock a lot of people with negative externalities.
Tip for getting off weed - start by lowering the damn dosage. A lot of commonly used products are the equivalent of a triple shot. And folks do it daily.
I used to use THC heavily, but the negative effect was noticable in multiple aspects. So I stopped for a while. Now I take full spectrum CBD oil that I make myself. It has a low amount of THC in it, which boosts the overall effects. It's a much better experience than taking high THC strains imo.
You'll get plenty of advice and it's worth evaluating it all (as we're all different), but trazodone has been a miracle worker in aiding sleep. It's cheap, well understood, and the only negative aspect I've encountered is the risk of priapism (which can sound like a joke but should be taken very seriously)
Did nothing for me
Same. All it did was give me an incredible hangover the next day, blurry vision, tremors, and — scariest of all — made me feel sad. Had to quit within a week. Glad it works for others, but easily one of the worst things I've ever tried.
Trazodone felt like a Nuke to me, tried it for sleep but whew what a crazy strong (bad) feeling it gave me.
I’m glad to be seeing this because I went down all the way to 25mg. My doctor said there was no way I was getting side effects at that dose, but I felt awful every morning for the first 4 or 5 hours of the day.
Everybody has different side effects. My ADHD meds have basically had horrible effects for me that slowly crept in over a matter of months. Like it was so slow I had no idea it was from the meds. I was on low doses that should not have caused any side effects according to my doc.
If you can, try Semaglutide.
I am a top % light sleeper - hard to sleep, inconsistent, never could sleep outside of basically ideal conditions.
Was prescribed Tirzepatide (similar to Semaglutide) and it fixed my sleep like nothing else has - I actually feel tired at a normal hour and doze off, two thing I never really did before. At the lowest dose you won't lose weight beyond the first few months, and you can maintain weight with small effort even still. So even if you are completely healthy weight, it could be useful.
I wouldn't normally think recommending a totally unrelated drug for sleep issues would be sane, but it also happens to have a ton of other positive effects for me at least. And the safety profile seems solid, esp compared to other sleep drugs. Plus not psychoactive and actually reduces your addictive behaviors especially in terms of nicotine/THC. Certainly a lot better side effect profile than THC (imo, from research).
I appreciate this greatly. After reading a lot of these comments I think I’m smart enough to realize it’s time to get help. I’ll speak with them about this idea and others.
A lot of "help" in this space are things like z-drugs, benzos, antihistamines like hydroxyzine, low doses of atypical antipsychotics like Seroquel, and antidepressants like Trazodone and mirtazapine.
IMO, THC can be the lesser of two evils in comparison.
Tapering off very slowly (over weeks or months) will probably work better than cold turkey.
I’m just now sure how to taper off. They don’t come in smaller doses than 5mg and that’s where I’m at.
What form is it in? If its a capsule with dissolved oil, break the capsule and dilute the oil.
If it's a solid, just break it.
If you can buy a THC tincture, you can easily use dilution and volumetric dosing to titrate your doses down over time.
Hang on, is it working? Didn't you say you take 5mg and it's been working for years at that level? I'd rank that as a win...
Split it until it’s 0mg.
My brother basically needs THC to sleep.
Or strenuous physical activity all day.
> Or strenuous physical activity all day.
The lack of strenuous physical activity all day is a real problem with modern life. We did not evolve to be sedentary.
I’ve added an hour of exercise to my day and while it hasn’t solve my sleeping problems, I can’t live without it anymore. It just makes everything else feel easier.
Same. Nor does all-day physical activity
I can get to sleep without it. I just can't be sure I'll be able to get to sleep without it. Like 30%-40% odds I'll have serious sleep trouble if I don't take it, so I take it most nights.
Amazing stuff, much better than the sleeping pill prescription I had years back (Lunesta).
Being unable to sleep is a common withdrawal symptom for cannabis use disorder. Congratulations, you are habituated, and long-term problems are likely accumulating as you are losing out on REM sleep and probably developing emotional and physical conditions related to cannabis use. Good luck!
Yes, unfortunately that's part of the things that are not told by the people pushing cannabis as a safe drug to use. Maybe it is not deadly, but it is still habit forming and can have extremely negative consequences. I wish people would know more about them.
damn, so I'm screwed and I don't even get to enjoy the upsides of cannabis. Rough world.
I’ve smoked weed before bed most nights for at least a decade, and if I happen to skip a night I… still sleep fine, unless I’ve had no exercise that day.
What if you skip two weeks? For me skipping one night was always easy, but after a few days that's when I ran into trouble. After one or two weeks it gets better.
Yeah. I used to smoke a tiny bit every day and it really fucked me up.
If you cannot fall asleep without a drug then I'd say the drug has already caused issues
well the issue was not being able to fall asleep without a drug
so falling asleep with a drug is an improvement
So I feel like you exactly identified the long term problem in the same paragraph.
I learned years ago that any chemical that helps you sleep ensures that you can't sleep without it. I've used everything from thc to Benadryl to lavender and everything in between.
It all had the same effects: slowly degrading effectiveness and sleeplessness without it.
Pro-tip: find the source of your insomnia. Is it chemical or is it electrical or is it just habit? Doing a real sleep test and working with doctors was life changing. Mine was habit and anxiety. Meditation and therapy have helped.
Anecdotal, I know. But what happens when the thc runs out? You crash. That's what I did.
> any chemical that helps you sleep ensures that you can't sleep without it
Except melatonin, because that's what your body natural produces as a signal for sleep.
I’m getting a kick out of how this is the same “because” for every drug that becomes a dependency for the exact same reason
Not really. Melatonin has decades of long-term studies behind it, no serious issues. The biggest problems are dosing. Many supplements include way too much.
it wasn't a rebuttal, it was an observation
do people really not know how to debate anymore? your argument would get an F at Harvard Debate Club because of the strength of your argument, not the accuracy of it.
Getting to the source certainly sounds ideal, but I wonder - if you find a variety of substances help though develop tolerance, couldn't you rotate them to try and keep them effective?
Yeah. I’ve tried. My problem is that 3-4 days of no sleep and I’m just about ready to sign off from this life.
I’ve managed with 5mg THC pills for years. Never had to increase the dosage. I’ve never ever slept well. But back before kids it was easier to just sleep in if I had to.
As best as I can tell, the cause is my adhd or related. My brain will simply. Not. Stop. Racing.
I'm with you - I have a few hits of some low-grade stuff maybe an hour or two before bed, and then I doze off naturally when it's dark out.
i also eat well, and make sure to not have blue light exposure for the last hour of my day.
But what really helped me, especially since I have crazy ADHD, is exercise. I lift when I get up, and do 1-2 hours of hard HIIT in the evenings after work. My body is absolutely shot by the time I'm done so I really don't have the energy to have my brain go all over the place. This coupled with a nice cold plunge in the evenings after said workouts (and another cold shower before I sleep), and good nutrition has helped me big time.
The THC does help, especially if I do it at the right time. If I smoke in the afternoons I am absolutely destroyed by sundown. I do fear it's creating an addiction or a physical dependence, but I value my sleep considerably.
See my profile if you'd like to create a tiny support group. I have had horrifically bad insomnia for half a century. At the moment I'm having luck with 600mg gabapentin + 20mg Belsomra but that's only a couple weeks gold.
This sounds familiar, I got to a point a few years ago where even if I could get to sleep I'd wake up at 3-4am with every last problem racing around my mind, but have never felt good with any amount of sleep.
In the end I went to the GP for anxiety and came out with a depression diagnosis and a bottle of Lexapro. Lucky for me I didn't get the crazy side effects and in combination with melatonin at least getting to sleep is no longer a problem.
In the past I've also found that deliberately clearing my thoughts is a way to slip from 'day mode' to those dozy random thoughts, but its often hard to remember in the moment and doesn't always work.
I was in the same boat with the racing mind at bedtime preventing me from getting much if any sleep. I have been a pretty aggressive exerciser but that only improved things part way. I finally got a prescription for a 50mg dose of Seroquel (https://www.drugs.com/seroquel.html) which i was told is an anti psychotic but at the 'low' dose of 50mg i would only get the 'side effect' of being drowsy. It was a lifesaver (literally). At least for me it got me off the no sleep hamster wheel which made just getting through every day such a challenge because i was tired and groggy. Everything felt very difficult to deal with. I got immediate benefit from taking the generic version of this med nightly. Now not being able to fall asleep or waking up in the middle of the night and not getting back to sleep are anomalies instead of normal. I also try to keep a consistent sleep/wake up time so my body is trained to expect these things to happen at a specific time. Obviously YMMV but for me this was a spring board to a new chapter in my life. I'm not super creative so i just called it 'Chapter 2'.
I used to have the same sleep problem (head won't stop racing), and mindfulness exercises throughout the day have greatly improved things for me. In a way it feels like the ability to turn it down for a time, long enough to get so tired it doesn't start back up again.
One trick I found myself is to visualise things in the noise from your closed eyes. Try to interpret something you can vaguely see, and then try to visualise it. This imposes a kind of clear image for a short duration for me, from which I try to see and visualise something else in there and so on, kind of like a visual association chain. That really gets me sleepy after a couple of minutes!
Body scan meditation is one particular form of meditation that I’ve found effective for sleep.
> visualise things in the noise from your closed eyes
Ooh, the visualization whirlwind. This is the first time I’ve ever hear anyone talk about it or had to give it a name. At least for me it’s just tons of images flashing before my eyes, rapidly changing, only tenuously guided by my mind.
That's a great name!
Imposing the images works for me similarly to when you "can't unsee" something. Like when you start seeing something specific in a generic shape or pattern, like with clouds. I tell myself that I see something, which makes me actually visualise it.
I highly recommend the podcast Sleep With Me. It’s extremely weird and the guy’s voice isn’t exactly “comforting” the way most sleep-inducing things try to be, but give it a few tries.
It’s basically bedtime “stories” that are more like improvised narrative mazes that are just interesting enough to keep your interest (and exhaust your brain) but not interesting or meaningful enough to keep you awake.
I went from laying awake for hours and hours as a general nightly routine to falling asleep reliably in 10-20 minutes. I didn’t even know it was possible to fall asleep that fast.
As a tip: There’s nothing to “get” about the podcast. It’s just a treadmill for the overactive parts of your brain.
I’m loving this podcast. The only thing I wish is that I could turn on an effect to make it sound like he’s on a medium quality FM radio signal as I’m driving.
> just interesting enough to keep your interest (and exhaust your brain) but not interesting or meaningful enough to keep you awake
Exactly. Back when I read more, I would have books to stimulate (daytime/commute reading) and 'bedtime books', which had to be interesting enough to read, but also effortful and ultimately tiring enough to promote sleep.
Now I do the same with TV shows in Plex, late at night. Unusually, it's the documentaries that stop me sleeping, and the classic US TV shows (that I like) that help me drift away.
This sounds right down my alley!
Have you tried exercising (>2h before you go to bed, IME), staying away from screens 4h before bed, and dimming the lights 1h before bed?
That was a life-changer for me.
Having to quarantine in a small sauna house after travelling introduced me to the delights of crappy internet, multiple daily cold river swims, and no real lighting outside of a few candles.
Needless to say I went from awful sleep to going to bed as the sun went down (in summer), and not waking up until sunrise, all in the matter of days.
Thinking back on it, I really should get back into that.
Almost as if we’re not really built to do anything else :)
Try Type III cannabis (high cbd hemp). Nowadays it looks and smells like Type I cannabis (the high thc standard variety of weed). It has all the various combinations of cannabinoids, terpenes, and flavonoids that contribute to the entourage effect except for THC (<0.3%). In many if not most cases it can do what Type I medical cannabis can do.
i.e. amongst non-psychoactive hemp flower there are relaxing indicas for insomnia, functional hybrids for chronic pain, sativas for a pick-me-up, etc.
I've not tried it yet, but CBN seems to be the winner in this category. It's legal in all states if pure. Black Friday is coming and I plan on getting some from a vendor I've used in the past. Ping me for that info if you wish. YMMV.
Try buying a quarter pound of CBD hemp and turn it into a small amount of concentrated oil. I want to spread the word, this is the way. The best bang for your buck and highest quality oil you can get, better than most commercially available edible products. I wrote some more info and my process on another comment on here. If your interested, I can write more here too.
I've bought CBD distillate and augmented regular tincture provided by a friend. I used to smoke a lot of weed and can no longer do so (lungs and head have had enough). For actual "head space" it's hard to beat inhaling but one must do what the body needs...
I saw your other comment and am intrigued. What do you use to extract with? Ethanol? Glycerine? Link to the tek?
As to your other comment about pharma -- I'm a believer in the right tool for the job. "Natural" is always preferred but sometimes the lads in the lab can deliver results too.
I don't have a link to a tek, as I've combined my findings to make the best quality oil with my current understanding and available technology. It's evolved over the batches and is pretty good I think now. Though you could find something similar on the internet. It does use food grade grain alcohol, close to ethanol.
I start by grinding the flower to small pieces, or use shake which is significantly less expensive and of similar quality, and matters less if your not gonna smoke it.
Next I take 3-3.5 ounces and cook it in the oven. I've tried a few different things. Mason jar or a Pyrex pan. I've done some smaller batches in the past, but now I do 4 ounces at once, a normal size mason jar doesn't usually fit everything. Ive used pickle jars and jalapeno jars which are larger and can fit everything. I heat the oven to 245, and put it in there for an hour, rotating and shaking it every 15 to 20 minutes. Don't cover the jar too tight, as it can explode from pressure. If you use a mason jar, you can use foil with the lid instead of the normal metal cap. I also use a temperature gun on my oven to check on it, many ovens will not be accurate.
I only cook 3 ounces because I keep the rest uncooked to use later. Heating the CBDa will turn it into CBD. You probably won't get everything converted, so there will be a little bit left. You'll keep some of the terpenes if you cover what your heating. Some people believe that the terpenes in cannabis, which give it flavor and taste, can be helpful. Personally, I believe that some of them may be helpful, but some of them are harmful, especially when inhaled. Helpful in the way that they could boost the effects or create strain specific effects.
Now to the uncooked 0.5-1 ounce, I keep that so I can have CBDa and a little THCa. It's commonly thought that you need to heat these acidic cannabinoids to make them useful, but this is not the case. The acidic version like CBDa and THCa have their own effects, such as a much more powerful anti inflammatory effect, stronger anxiolytic effects, and different serotonin effects. I would also like to add that normal CBD is excellent for blood pressure. If your goal is to get high, then youll probably want to turn your THCa into THC. Leaving some uncooked will also make the final product taste very strongly of the original strain, if your into that. There's another cannabinoid called CBGa, which is the precursor to CBD and THC, when the plant is growing it goes from the enzymes it produces, to CBGa, to THCa (or CBDa), the THCa will then degrade into THC, then finally into CBN. You could make your own CBN by heating THC for a long period of time. Another cool thing you could do is convert CBD into D8-THC with citric acid. I'll also note that CBG/a is supposedly good for your gut health, inflammation, and protects your brain. Ive taken higher doses of CBG, and experienced some irritability when taking it, but I can't confirm that it was from that, I'll have to experiment more in the future.
Now onto the next step.
Next I take all of the material in the jar, cooked and uncooked, and cover it with 95% food grain alcohol. I use this because it's safe to consume. I assume I can't get 100% of the solvent out later, and using isopropyl or butane would not be safe to consume. So I cover it, shake it up, and stick it in the freezer. Shaking it every so often. You could leave it in for a few hours or days, you might get a little more out. If you leave it for more than a few minutes, you'll get a lot of chlorophyll, which will make the final product very dark due to how light interacts with it. I put it in the freezer to try and reduce this a little bit, but it probably doesn't help too much, nor does it really bother me.
After letting it soak in the solvent, I take it out and strain it into a bowl using a nut milk bag, then transfer it to a beaker. Now here is where my process can definitely be improved. Currently, I put the beaker in a pot with a small amount of water, to evaporate off the alcohol. This is kind of wasteful, as you lose the alcohol after now. Instead, and in the future, I would like to set up a distillation apparatus so that I can catch all the evaporating alcohol to use again. I just haven't got the equipment yet.
Now you should let all the alcohol be removed from the solution. I keep it at about 120-150 degrees fahrenheit. When it's done, you'll have a small amount of black oil, 15 to 20 grams of pure concentrate. I assume the efficiency is about 85-90% from what we started with. But this isn't all, the oil that is now in the beaker is very thick, it's hard to get it out in its current form. So, take the amount of concentrate you have now, and subtract it from the final amount you want to have. I turn 4 ounces into a 60 ml bottle. Usually I have about 20 grams of concentrate. So Ill use 40 grams here. I have another measuring cup, I fill this with a mixture of MCT oil, grape seed oil, and sunflower lecithin. MCT oil vs grape seed oil is a choice you can make, some people's bodies don't react to MCT oil well (nausea, usually from large doses, 1+ tbsp at once, especially if you've never had it before). I use a combination of all three. The MCT may help with absorption into your body later as well as bind together in the final product better. The sunflower lecithin is an emulsifier, which will help your body absorb it when you take it. Use at least 1/3 sunflower lecithin. These 2 oils also can have positive effects on your health.
Now you take this mixture, and heat it up until it's homogeneous. Then dump that into the existing black oil concentrate while still heating it to dilute it to your desired dosage and overall amount. Carefully shake the beaker in a circlular motion to help mix it in. I estimate that with 4 ounces, you'll get about 250-350mg of cannabinoids per gram in the oil. That range depends on your starting material potency and amount.
Something else to mention is that eating cannabinoids provides a different effect than smoking them. Your body digests and metabolizes them differently. When it comes to THC, which there will be a small but notable amount of, especially if you have no tolerance, your body will turn it into 11-hydroxy-THC. Depending on your genetics and how well you absorb it (some people can't absorb edibles at all), it will be about 5x stronger than the same amount smoked, while lasting longer. If you don't want any THC, make sure what your getting has none or very little in it. Personally, I don't like taking pure THC strains anymore, but the tiny bit that does occur in CBD dominant hemp, does boost the overall effects in good way unless I take too much.
To respond to a few other things you said. Inhaling can have a different head space effect, yes. With that said, eating it does produce a more powerful, sometimes more sedative effect, more psychedelic. The first time I made THC edibles and took them, it felt like the first time I smoked, everything was hilarious and I talked a lot. I also stopped smoking due to my lungs, unfortunately from covid, but I've found now that taking oil is a lot easier to do consistently (primarily CBD), and is much less addictive than smoking (because the act of smoking itself can be addictive), so it feels like less of a "drug".
My other comment about pharma may have come off a little harsh. I do believe there is good, but also bad. Some doctors are more empathetic and understanding, while others are there for their job, don't research outside what they already know, and push what they are told to. To be the best, you must have a genuine interest and desire to know more, maybe even an obsession, with whatever it is. Pharmaceuticals certainly have their place, as not everything can be solved with nature. Though I also believe many drugs produced by pharma are designed to be sold and make money, not to cure and help people, which is a conflict of interest.
Thanks for sharing. My only comment is that if extraction is your goal, putting it in the freezer will not necessarily help you there. If you see less chlorophyll being extracted that way, it likely means lies off the other stuff as well. It may be the case that the loss is negligible though.
Freezing bursts cell walls and makes trichromes more weakly attached. This in theory increases ease of entering solution? Thanks to GP for the write-up!
I have a prescription for ketamine and when I take it at night it causes poor sleep and noticeable lethargy the next day. It's not a great thing.
But I think "reversing depression" is codeword for manic and euphoria sensations. It's not targeting the core of what is depression.
Waking up in the mornings helps reset my mental state sometimes. I wonder if it's related. If I have an early morning, I usually find that I'm more productive and have more energy to work out or focus on tasks. There's nothing more depressing than a cycle of waking up at 2pm because you stayed up until 5am. Waking up so late makes me feel like I'm wasting my life.
I’ve found that too
Somehow I feel really energized if I wake up like 2-3 hours before my regular time
But only if I haven’t done it in a while
Something about disrupting the pattern seems to throw off the usual morning grogginess
it's my favorite part about early morning flights. i don't fly often, but when i do travel the following two weeks where i practically jump out of bed at 6-7am are amazing.
Can't wait to read about how bio-hackers are using this tool with their optimal morning routine ice-baths and lunchtime cocaine.
>and lunchtime cocaine.
In fact, forget the ice baths
I have some experience with this. But what can happen is sometime you overdo it and burn out physically, and depression hit at the same time. And you will be worse off.
Happiest time of my life was when I was going to gym regularly (about 3 - 4 days per week)
It doesn't work for multiple sleepless/almost-sleepless nights in a row, ask me how I know.
>It doesn't work for multiple sleepless/almost-sleepless nights in a row, ask me how I know.
In other news, beneficial effects of a single cup of coffee don't seem to show up after you have a dozen of them.
>Chronic sleep loss is well studied, and it’s uniformly detrimental effects are widely documented
Once I hit my 40s, staying up too late causes a sleep hangover that would last a couple of days.
Gone are my days of playing Ultima IV all night and feeling giddy in the morning.
Nearing 40s and I can’t imagine how I used to live with gaming all nighters either. But I have found recently that not just a late night, but a full night without sleep, and pushing through the next morning did bring about a lot of mental clarity the following day.
One of the cruelest aspects of whatever kind of insomnia I have is that while I normal get only 2-3 hours of sleep per night and feel disabled most of the day, every 3-5 years I get maybe 8-9 hours, and I have a pounding headache for the first 10 or so hours after I wake up.
The "morning hormonal" dump that gets offset by not sleeping could easily shift neuro-chemistry.
For (sufficiently) depressed people, any perceived shift is likely going to be a improvement.
Related, similar studies have postured that nights with occasional stirrups lead to a more rested day, un-intuitively.
The variation in sleep requirements within groups may have more obvious evolutionary benefits; the security of camps overnight depend on those who stay up overnight to stand guard or occasionally tend to the fire.
My entire life, I've been a night owl. I'm prone to depression in the mornings. I prefer to avoid doing anthing in the AM. In the evenings, I can have a lot of get-up-and-go energy and can be positive about a lot of ideas, but when I wake up the next morning, my entire mood has shifted and I'm often quite negative.
Staying up all night (or only getting a few hours of sleep) avoids that mental reset that causes my entire mood to shift.
I wonder if this is related to the phenomenon studied.
What about all the other studies claiming that poor sleep causes depression? Not sure what to trust these days. Gut tells me poor sleep won't make you ahem "your brain feel slap-happy, loopy and almost giddy" (very scientific).
>What about all the other studies claiming that poor sleep causes depression?
What about them?
This is about one sleepless night every several days/week for an already depressed person.
Not about non-depressed people continuously sleeping poorly (which is where poor sleep would cause depression).
I guess just one sleepless night is not the same as chronic poor sleep patterns.
Also, it's interesting because sleepless nights are kind of a sign in bipolar disorder patients that an (hypo)-manic episode is about to occur or is actually occurring.
From the article
>Chronic sleep loss is well studied, and it’s uniformly detrimental effects are widely documented,” Kozorovitskiy said. “But brief sleep loss — like the equivalent of a student pulling an all-nighter before an exam — is less understood.
I guess it also depends on what your past has been.
After going through a "sleep-deprived burnout cycle", I found that any all-nighter will pull me back into the emotions I got at that time, even if I feel originally great physically & mentally.
So, YMMV!
Once I go past 24hr I get really loopy and giggly.
Not sleeping for over 72 hours is the threshold for insanity.
I had a long tech writing session once and at about 48 hours I started to hallucinate. Mentioned it to my girlfriend, and she drove the 70+ miles to my job to keep me company.
I was awake that long once. I can understand why that threshold exists
i have noticed i have a sleepless night every once and a while, maybe once a month, and i usually have been feeling bad emotionally leading up to it. and i do usually feel better the next day, despite expecting to feel bad from no sleep
I always thought it was related to anxiety. After staying up late it feels like I'm forced to focus on what's important because I don't have the mental capacity to let my mind wander and worry about stuff.
... in mice.
Indeed. Inmiced. Thanks!
Are we talking about that small mammal that is a nocturnal species?
> In a new study, researchers induced mild, acute sleep deprivation in mice and then examined their behaviors and brain activity. Not only did dopamine release increase during the acute sleep loss period, synaptic plasticity also was enhanced — literally rewiring the brain to maintain the bubbly mood for the next few days.
What’s a mouse like when it’s in a bubbly mood?!
Further in the article they discuss monitoring activity of dopamine neurons and modifying individual neurons in the brains of these mice (which has parts analogous to human in many ways including emotion) and describing the behavior of sleep deprived mice which sort of implies what the normal behavior is.
Perhaps we misread, and "their" refers to the researchers, not to the mice!
It is very well established in humans too. https://en.wikipedia.org/wiki/Wake_therapy
Indeed, the article title is a little misleading! Sleep depravation producing short-term improvements in human depression has been well known for some time. What the authors actually propose is an underlying mechanism to that improvement, in mice...
This must be why new parents always seem so bubbly and happy!
But seriously, that’s very interesting and explains what I’ve experienced. I’ve been in a depression since quitting my phd a couple months ago and not having a direction in life, but whenever I have trouble sleeping I end up feeling better the next day. Maybe I’ll trying utilizing it to get my portfolio looking better.
I don’t know.
Seems very correlated with people having a good reason to pull an all nighter.
Whether kids or business.
Meaning makes us tick
It's an experimental study not an observational study. So that correlation won't have an effect here
Not so sure; the whole article is about people having a reason to pull an all nighter. Students mostly. That’s intense motivation breaking a stereotype, recipe for a high
... it's a mouse study
Yeah I feel like this is probably a big part of it. Nothing does away with my depressive existential dread better than just having any kind of work to do, be it working on a personal skill or employment related work.
Yeah, meaning is great, or you know, having something exciting or enjoyable to look forward to... but also, I used to heavily experience this type of emotional lift from lack of sleep but when I started taking Beta Blockers a decade ago the benefit stopped overnight never to return.
Adrenaline and the bodies "stress" responses really are a wonder drug, you have to completely reconfigure your life and processes when it goes away.
There's something about getting 2-3 hours of sleep that makes me feel like I'm on top of the world throughout the day. I've always assumed it was a kind of wild delirium.
Sounds like I used to. Did it too many days in a row and had a full blown manic episode.
For a while there have been theories stating that monophasic sleep 8 hours a night is actually disordered sleep. Maybe that’s worth looking at again.
The sleep quality is super lossless and actually gainful when you compress it by allowing a slight sleep debt to accrue
Are you claiming that 2-3h of sleep is enough or healthy?
There's also sometimes this very strange time dilation that occurs in this 2-3h sleep such that it "feels" much longer and almost impossibly drawn-out psychologically as opposed to the much smaller true anount of time it constitutes
Why don't you try it and see? Some of my best sleeps were after a sleepless night and for only like 1-3 hours, caffeine or other stimulants in the blood be damned
Edit: also make sure you have bright blue light during wakeup/morning/day and mellow non-overhead orangey/amber/yellow light (nothing east of yellow) at evening/night. Red 2 hours before bedtime for bonus "points"
Not to be flippant, but that’s called sleep deprivation. I did this daily for 18-24mo straight, sleeping a 3h block early morning (~4:30-7:30) and a 27min nap aligned with my sleep/wake cycle during mid-afternoon. I did this without caffeine, stimulants, sugar, etc. After having more kids I couldn’t keep the daily consistency required and scaled back to 1-3x a week. I spent years convinced that it elevated my coding, insights, etc., and there was a degree of truth to it, as it did mitigate the worst of my ADHD. Then I got medicated and suddenly everything in the world that had always screamed for my attention 24/7 started quieting down a little. It took me another decade or two to break more of the coping mechanisms I’d developed in my late teens for ADHD and dyslexia. I could ramble down several tangents for paragraphs here, but I’ll just throw out my personal note that while there were clear cognitive benefits (note: I’m sidestepping the increasingly clear long term cognitive risks indicated in recent research), the muscular-skeletal costs we’re greater.
As they say, adrenaline is a hell of a drug.
Also: paragraphs ;)
Its def not a lifestyle, I don't feel like I made that super obvious. I'm talking about a once in a blue moon type deal where you need a hard reset. Sorta like how most people rarely turn off their phones, things get fucky with it eventually, and it needs a hard reset or reboot. Don't get too hung up on the metaphors, but I've experienced it working and I'm not exactly an n=1
Its more like stochastic sleep deprivation without the randomness.
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> Why don't you try it and see?
I feel great after a few beers, but keeping that state is a very bad idea. "try it and see" is not a great idea when it comes to your brain.
I don't think you build up a "Beer Debt" that grows as it depletes like sleep and hunger. Cute wrong example but there's really nothing all that malevolent or irresponsible about the suggestion. Maybe keep it to the weekend (like don't start till Friday/Sat night) and obviously you need the set it up so you don't have to be places or hold meaningful convos although Im not going to rule them totally out
I have extensive experience with it. I would disagree that there’s nothing irresponsible. I don’t recommend anyone try skipping a night just to see. Blood pressure, heart rate, and glucose levels can easily go to shit and exacerbate underlying any conditions. FWIW it would take me 1-2 weeks after shifting to a polyphasic before seeing any benefits (which makes sense, respective to jet lag). I can easily skip a single night (without stimulants, etc) and run off adrenaline the next day, but the day after sleeping again I’m useless state of sleep-lag-wtf.
Mediocre analogy: something like polyphasic sleep with extremely disciplined sleep-hygiene is like using a stack of high-interest credit cards for the rewards/benefits, but if you make a mistake then there’s a high cost and it’s not really tenable forever. Skipping a night of sleep outright is basically a pay-day loan.
> there's really nothing all that malevolent or irresponsible about the suggestion
You are underestimating the impact of sleep deprivation, and the ability for a person to recognize the impacts while sleep deprived.
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s...
"It was concluded that sleep deprivation has a greater impact on driving performance than a BrAC of 22 μg/100mls of breath, as measured by driving simulation. Coffee is not an effective countermeasure for sleep deprived driving and drivers’ ability to judge this impairment is suggested to be limited."
Can I ask how heavily everyone desire I pre-caveat the main lede here in order to get the discussion centered more on the idea itself and competing views on the extent to which folk's have found some usecase or success with it? Like, obviously if you're a pilot who needs to be able to thread needles and sew while you're able to still control the plane should maybe wait till they're relieved of duty for the weekend or some amount of time allowing the latitude to try this thing out but I feel like there's an amount of obtuseness and ridgidity on display here.
Edit: also, Polyphasic is insane so anyone making a false equivalence here can simply stop. I'm referring to an occasional all-nighter for the joint purposes of resetting ones mental slate and also helping prime oneself for a better quality and faster easing-into the next sleep
> in order to get the discussion centered more on the idea itself and competing views on the extent to which folk's have found some usecase or success with it?
So you only want "competing" views if they line up with your views?
The study was about driving, something many/most of us do on a regular basis. It shows that:
1. Sleep deprivation while driving is comparable to being intoxicated while driving.
2. Those who are sleep deprived are not reliably able to recognize their impairment.
If you think it's "obtuse" to bring this up, then I don't know what you're trying to do here. Those are extremely important pieces of information to bring up.
My experience does not match up with yours here.
Given work deadlines I have a lot of experience with full all-nighters and 1-3 hour nights.
Can you comment on sleep hygiene and the stuff i mentioned about light? Do you sleep in complete darkness in a slightly cooler ambient setting and really get a lot of bright line first thing at waketime?
I noticed something similar (see also: my comment about using magnesium and getting better sleep on the thread about deep sleep yesterday).
When I get ~5ish hours of sleep one night a week I am surprisingly more alert the next day but I also crash much harder by night. I cannot sustain multiple days of little sleep but one short night doesn't seem to have such a detrimental effect.
One of my teachers told us to make sure we’re getting a good amount of sleep two nights before an important event (exam, job interview, competition, you name it). One can easily cope with a single sleepless night, but not with two in a row.
I wonder if this is why ADHD people struggle with sleep.
We have many reasons aha. Always good to start chipping away at the list ;)
I went several years more or less depressed and observed this phenomenon and utilized it. Night of Kerbal Space Program and next day the world is much better. For a while. Also, a lot fuzzier. And I couldn't code very well (just good enough to do my job so everyone was happy but I could feel slipping).
Therapy and SSRI:s worked much better in the end.
But, for sure in a pinch it does alleviate unbearable darkness. The problem is it gives some, and takes a god damn lot - especially when entering middle age, when you (or I at least) can't shrug off sleep debt as easily.
The interesting thing is that this apparently was not well known during my therapy. I discussed this effect with my therapist, and she was skeptical and non-plussed. No hard feelings there, I'm super pleased she was robustly evidence based. But very happy to read these results in any case to validate my personal discovery.
> Therapy and SSRI:s worked much better in the end.
How did you find that therapy helped you? I've started therapy a few months back and so far I can't find all that much value in it. They can't fix any of the stuff that is making me depressed, so it mostly feels like I'm mainly getting self help style advice.
My therapy probably saved my life, and I'm not exaggerating.
While it may take a while to sync with your therapist, it's plausible the chemistry between you two just isn't working, or, that the style of therapy is not helpfull to you. There are tons of different types of therapies. Some try to figure out what makes you tick, and work through that. Others just try to analyze your current state and then simply offer actionable tactics to modify your current mood and thinking. I used the latter. Would have absolutely hated the former. But suitability seems to be really personal.
My therapist was purely interested in objective actionable items, negative thought patterns, underlying trauma, etc, and what strategies we could use to try to help me. These things are deeply personal and subjective, but similar issues come again and again between different people, and an experienced therapist can try many different things.
One aspect of depression feels that there are bunch of negative thought patterns and their strong negative associations, which feed eachother. A part of my healing was not giving energy to these things - letting them pass over me so to speak, and find ways to alleviate occasional bad spots (deep breathing etc). We worked with therapist with many of these things. Lots and lots of small actionable nudges.
"They can't fix any of the stuff that is making me depressed, "
I don't know your situation so I would not imagine trying to offer suggestions. I can tell what my bad stuff was though. My parents died, my wife became sick and unable to work and my son turned out to have really bad adjustment problems at school. More or less at the same time. And, I was fairly displeased with my job. That came on top of childhood trauma of parental alchoholism, depression and suecide attempts.
My therapist really could not fix any of that, nor did they try. What we worked instead was trying to give slight adjustments to my thinking and perception, lifestyle and relationships. Small nudges, here and there, over a long period, in combination with SSRI:s.
None of the issues have been fixed. None of them can be fixed. But at least for myself I can again find joy and happiness in a broken world. I truly hope the same for you.
I was really lucky finding a suitable therapist early on, but I understand finding suitable therapist can take some time. To my understanding ”therapist shopping” is a normal part of the process, and if you feel your therapist relationship is not working out right now, it might be a good idea to raise this topic with them.
In my experience, therapy mainly seems to be a validation and enablement service, on a very big scale. If this is something you're not necessarily seeking, you'll find therapy useless. But a lot of people want it, feel better because of it, and are therefore willing to fork over not insignificant sums to receive it.
This is not my experience at all. There are different types of therapy with wildly different approaches. What I worked with my therapist were recurring negative thought patterns, the associations and actionable concepts to get better, as well as going through my moderately traumatic family history. Part of that is self-validation, for sure. It helps to hear from a professional that the stuff you've gone through and feel has traumatized you, has been pretty bad and yes, probably has traumatized you. It does not cure the trauma, but naming a condition helps to recognize it's effects in ones thinking, which again helps in modifying ones thought patterns around it.
It's really hard to recognize and work on your own negative thought patterns. Like, you can't clean your face without a mirror. You can't comb your hair very well without a mirror. A good therapist in a way works as mirror to your thought, and helps you to clean that stuff up.
If one is moderately well functioning then there is nothing left to fix and yes, a therapy may seem somewhat useless.
Therapy helped me when I did it in a group. Mostly in making me realize how good I had it.
People that weren’t able to drive, weren’t able to go outside at all etc. I was just permanently afraid.
What I gained from my other sessions was mostly a ‘get out of jail’ free card to unload all of my thoughts. You can only do that on your family and friends so many time before it starts to wear on them hearing the same things again. But my therapist is paid for that shit, so I have no compunctions.
SSRI worked much better on a daily basis, but the therapy was nice when things were bad.
This is one aspect of therapy for sure. Just discussing your bad stuff with someone who is a talented listener is a very important component IMO to get your stuff together.
And I concur. Don't use your friends or family as therapist as a default option. That stuff is hard. Unloading a bunch of negative emotions to a non-professional can be hurtfull and poisonous. There are of course situations were you can share bad stuff with someone but that's a case by case situation.
You might not have a good fit with your therapist. It took me a few tries but once I found someone with a similar mode of thinking I got a lot more out of the discussions because she said things (often the same things as the prior shrinks) in a way that resonated with my brain better.
In that regard, therapy never fixed my problems, but it did help me recognize unhealthy thinking patterns and provide mechanisms for handling them, both of which have helped me avoid spirals and getting trapped in negative thought processes.
That’s my experience as well- though my therapy was a while ago. I had worked a stretch of utterly miserable jobs back then and conversation would always drift back to the work mess I likely left just prior and only frustrate me more. I saw several, mostly because I’d be on different insurance plans, etc. But not once did anyone say “maybe you need a new career path?” If anyone of them had followed that up with “and since procrastination is a problem why don’t we work on helping you get there”, I’d be singing the praises of the field.
I’m not hating on the profession or anything and I have friends who swear by it. But each of them, after a bunch of these sessions I could almost see a hint in their eyes of “damnit… none of this crap is working.” Like I slightly felt bad for them in a way. Slightly.
And honestly, given the trajectory of the world, I’d be more concerned if many people weren’t depressed.
Out of the field, personally I did like Acceptance and Commitment Therapy (ACT), but it mostly reinforced what I’d learned from a decade of meditation and my buddhist practice.
While I def got more from therapy, I concur regarding ACT being the methodology that worked best for me and that it’s wild how much it overlaps with mindfulness and Buddhist practices.
I've been in therapy over six years, and also did it for a shorter spell in the early 1990s.
A few months is really the start of the relationship - it usually takes that long for most people to establish trust with their therapist. That doesn't mean you have the right therapist, but it is hard to know this early on.
Seconding everything you wrote.
Emphasizing:
- "The problem is it gives some, and takes a god damn lot"
- "Therapy and SSRI:s worked much better in the end"
Still resort to this sometimes when I'm not on a schedule (i.e. between jobs).
Queue people blogging about their monthly “sleep fast” for optimized mood and focus.
That's exactly where my brain went. Now I need a Huberman Labs podcast telling me how I can incorporate this with my supplements and cold showers to achieve my maximum potential.
I know you're joking but I'm seriously wondering how the OP fits the research Huberman regularly cites (sleep is good for dopamine levels, willpower etc.)
Don't forget to microdose shrooms as well, please.
Forget the microdose, sleep deprivation and macrodose shrooms go together like PB&J. Never met someone who could fall asleep under the effects of psychedelics.
plenty of people force themselves to stay up all night once in a blue moon for mental health reasons, all without blogging about it.
this runs counter to what i understood, we had allnighters for productivity or bonding among friends. But i never wouldve guessed not sleeping for a night would make you feel better under some circumstances, always figured the health drawbacks would worsen the issue
Just sharing an anecdote - I noticed this effect in college for myself. Since then i do one or two all nighters a year specifically for this
Really, this is a thing? I’ve never heard about it.
I used to stay up late sometimes when I was younger, but that was because the world went to sleep and I felt at peace doing my own thing. It wasn’t because I was trying to feel better the next day, in fact it tended to screw the next day up.
the second day, you slept poorly, mistakes don’t matter. and that’s just an added bonus on top of the biological changes.
it is more about the third day.
not surprising to not hear about it. it isn’t permanent, so catching a “practitioner” in the right moment to bring up the topic, while being in the right moment, is unlikely.
plus, bodies are weird, and laws are scary. should everyone do this? probably not, and probably for differing reasons.
There's something to it. Also with dissociatives. Something about these substances or practices can help "reset" you like pulling the plug on an electrical device and forcing it to reboot with refreshed state
pushing the system to a point where it flips over to a different operating mode. overheating your phone until it reboots. ctrl+alt+del.
it usually feels a little precarious. maybe not for others. but there’s definitely an aspect of futzing with your mortality, with your primary systems.
but if it works…
I think there's some shared aspect of "too many background processes running—must reboot in safe mode!". Its also a bit impairing to the point you're not exactly "you" so you have a better chance of viewing things with different eyes which might be all it takes for someone to get to that point where they are aware and able to act on incremental changes in-line with that which appears in such a state
For me it's forcing myself to only sleep 6 hours so I get through my day with loud music, caffeine and self hate.
What's your secret? I'm always manic
As someone with (not diagnosed) depression and (diagnosed) insomnia I have never thought about it but I think this tracks with my experience sort of. I regularly go 24 hours or more without sleep and tend to feel only tiredness - not my other symptoms of depression.