Circadian Rhythm Chronotherapy for Depression – Experiment
Do not, and I mean do not try this at home. I’m an idiot. Don’t be like me. Clear?
Today I read about a new therapy known as Triple Chronotherapy. Yes, it’s a big fancy word. Chronotherapy. Quite frankly, it sounds made up.
But it isn’t.
Pronunciation: /ˌkrän-ə-ˈther-ə-pē, ˌkrō-nə-/
pl -pies ; 1 : treatment of a sleep disorder (as insomnia) by changing sleeping and waking times in an attempt to reset the patient’s biological clock
2 : the administration of medication in coordination with the body’s circadian rhythms to maximize effectiveness and minimize side effects
And just in case you’re not familiar:
A daily rhythmic activity cycle, based on 24-hour intervals, that is exhibited by many organisms.
Basically it’s when you sleep and wake. Circadian rhythm as it impacts psychiatry. (Good to know.)
Triple Chronotherapy Components
Triple Chronotherapy, as it is known by Chicago Psychiatry Associates’ Program in Psychiatric Chronotherapy, is a combination of wake and bright light therapy along with sleep phase advance.
Bright Light Therapy
Bright light therapy is a pretty common therapy that I’ve been somewhat using for years. It is the administration of high-intensity flourescent light (fake sunlight) most commonly associated with the treatment of seasonal affective disorder (SAD). A light box is used to accomplish this.
In this case the “sunlight” is dosed in very specific ways at very specific times. Light therapy is used to treat more than just SAD.
Wake therapy is the use of prolonged periods of wakefulness, with intervening periods of recovery sleep.
Wake therapy is best used as an antidepressant response inducer or accelerator; it jump starts the improvement in depression.
I’ll be talking about what wake theory looks like in a bit.
Sleep Phase Advance
Sleep phase advance moves the time of sleep onset and awakening forward.
Sleep phase advance acts to minimize sleep in the critical, 2nd half of the night and correct delays of circadian rhythms found in depression.
Are we having fun yet?
So then, for people who are really depressed, these three techniques can be used together to try to re-regulate a person’s circadian rhythm. You know, theoretically.
I won’t rehash everything the Program in Psychiatric Chronotherapy website talks about, but here are a few point you might like to know:
- This is used for unipolar and bipolar depression
- All individuals with bipolar depression must be on mood-stabilizing medication
- This takes three (grueling) days
- This should theoretically create an incredibly fast antidepressant response
- Can be done with or without medication (given the bipolar proviso above)
- Cannot be used if psychotic features or mixed-moods are present due to risk of inducing mania
- Claims a reduction in depression in 50-60% of patients
- About 7% of patients develop hypomanic symptoms
Check their website as their pages are all fully-referenced. There is lots of science behind this stuff.
The schedule makes it really clear what they’re talking about.
Thursday – stay awake all day and night
Friday – stay awake all day
Friday – 5:00 AM – 7:00 AM – light therapy (time and duration of light therapy depending on patient)
Friday – 6:00 PM – 1:00 AM – sleep
Saturday – 5:00 AM – 7:00 AM – light therapy
Saturday – 8:00 PM – 3:00 AM – sleep
Sunday – 5:00 AM – 7:00 AM – light therapy
Sunday – 10:00 PM – 5:00 AM – sleep
And then you can resume your schedule, basically maintaining sleep between 10:00 PM and 5:00 AM. We’re absolutely not having fun now.
The Chronotherapy Experiment
So yes, I’m trying out this nonsense. I read about chronotherapy this morning on psychEducation.org, and quite frankly, I trust Dr. Jim Phelps. I believe that if he thinks this is credible then it is. Will it work? Well, I have no idea, but I consider that endorsement key.
Again I say, don’t do chronotherapy at home kids.
Not to put too fine a point on it, but I’m extremely experienced and knowledgeable and I can handle things that most people can’t. This is done in a treatment facility for a reason.
I Start Chronotherapy Today
I read about the therapy this morning and I’m starting tonight. Again, I don’t recommend this. People should think out and research a treatment, especially one this highly unpleasant. But for me I don’t have any deliverables due tomorrow and the weekend follows so there’s no time like the present for something highly unpleasant.
And yes, I have drafted a friend of mine into staying awake with me. Yes, he’s a very, very, very good person. I have no idea how I’m going to pay him back for his selflessness.
Feelings on Chronotherapy
In all honesty, the results are just too juicy not to at least try. I might fail. In fact, considering I have to stay up for 36 hours I’d say there’s a high likelihood that I’ll fail, but I think it’s worth a shot anyway. I could be wrong. It could all go horribly wrong and I’ll end up jumping off the roof in mad mania or suiciding in depression. But I’m hoping not.
And I’m rather terrified. Really. I’m serious. I’m so scared that I’m going to get worse I don’t think I can even express it to you. I feel like I used to feel before a skydive. My stomach is clenched in fear. Yeah. Anxious.
My friend will be here shortly. He’ll distract me from how freaked out I feel. And, of course, kill himself in the process by having to stay up too. Sometimes I’m a serious burden.
Documentation of the Chronotherapy Experiment
I plan on posting here and I’ll update Twitter (@natasha_tracy) too.
Thursday, 10:00 PM
…and we’re off…
- Chronotherapy Experiment Check-In 1
- Chronotherapy Experiment Check-In 2
- Chronotherapy Experiment Check-In 3
- Chronotherapy Experiment Check-In 4
- Chronotherapy Experiment Check-In 5
- Chronotherapy Experiment Check-In 6
- Chronotherapy Experiment Check-In 7
- Chronotherapy Experiment Check-In 8
- Chronotherapy Experiment Check-In 9
The conclusion and final thoughts on my chronotherapy experiment for bipolar depression.