Category Archives: Clinical Depression

Why do depressed people wake up exhausted?

Just another plug for Ivan Tyrrell’s (Principal of MindFields College) YouTube video on the link between depression and dreaming – if you haven’t already seen it!

For further information on why depressed people wake up exhausted see here: www.why-we-dream.com/depression.htm

Posted by: Eleanor

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The Dreamcatcher – New Scientist interview with Joe Griffin

Here is an oldish interview with Joe Griffin answering questions on REM sleep, depression, psychosis, trauma, conflict and cult behaviour, published in New Scientist in April 2003:

JOE GRIFFINWe live in mad times. The WHO predicts depression will soon rank second in the global disease burden, suicide rates are rising, and the trauma caused by war, conflict or domestic abuse is everywhere. The toll is horrific: mental illness costs Britain alone £32 billion a year. And people looking for therapy face a confusing tower of psychobabble, with 400-plus often warring schools of thought. Enter JOE GRIFFIN, who says there is a way to lift depression in a day, and told BARBARA KISER he can prove it.

How can you deal with serious depression in just a day?

The important thing is to know how depression is manufactured in the brain. Once you understand that, you can correct the maladaptive cycle incredibly fast. For 40 years it’s been known that depressed people have excessive REM sleep. They dream far more than healthy people. What we realised – and proved – is that the negative introspection, or ruminations, that depressed people engage in actually causes the excessive dreaming. So depression is being generated on a 24-hour cycle and we can make a difference within 24 hours to how a person feels.

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How do you manage your sleep?

A study on sleep shows that rats who have less sleep have a higher level of stress hormone corticosterone, and produces less braincells in the region of the hippocampus. Another indication of the importance of getting the right amount of sleep – well in rats at least.

a rat

We constantly inform people about the importance of sleep and warn that inadequate amounts of REM sleep, either too much or too little, is related to the development of depressive feelings at one end of the spectrum and states of psychosis at the other – but when applying this knowledge to your own life, how can you be sure that you personally are managing your sleep effectively? This is an area in which no clinical study will be able to help you, as each and every person is unique, with thousands of different variables which influence the amount and quality of REM sleep you might need.

As I experience it, despite my awareness and all I have learned about the importance of REM sleep and dreaming – I still have days where I know I would feel better if I had managed my sleep with more care.

I have never been someone who relishes early mornings, and I prefer to stay up late than get up early.  My sleeping pattern is thus: I go to sleep later and later during the week (normally anywhere between 12 and 2am – while waking up at 8.00am) and I mostly sleep in until 11 or so at least one day at the weekend (this is a habit left over from University!).

However, I do now notice that when I have slept and dreamt too much, even if it’s only for one night, I really feel unmotivated, miserable, listless and my head aches for the rest of the day. I now account for this and have learned to recognise when to force myself to not go back to sleep or stay in bed for a few extra hours. So many times I have kidded myself that a lie-in would be nice, and have woken up feeling awful and regretting it.
I’d go so far as to say that one day of too much REM sleep affects me more than a few nights of sleep deprivation, so personally, I monitor my sleeping to accomodate this need. I can see that low periods in my life (not depression, just natural ebs and flows) correlated with times where I wasn’t sleeping properly or getting my emotional needs met.

The one thing that cemented a healthy sleeping pattern for me was having a job and a routine – and I have definitely benefitted from and improved my life through understanding how REM sleep can affect your state of mind.

Posted by: Eleanor

Scientology?

tom cruise crazy

I must admit I don’t know much about Scientology at all, apart from vague unformulated ideas about aliens and pictures of Tom Cruise looking positively manic, so I have only recently noticed that Scientology is very associated with the idea that mental health problems can be treated without drugs.

I had previously dismissed Scientology as some strange cult that I had no need to think about but now I see all over the internet such phrases as “contrary to the lies spread by Scientology, depression is a real physical illness with physical causes.” and there also seems to be an “anti-psychiatry movement” going on, which is also associated with Scientologists.

I can see that this topic is far more prominant in the US than the UK though of course thanks to the internet, geography is no longer a boundary in discussing and learning about approaches to mental health.
Living in the UK myself, I feel like I am more removed from these perceptions of Scientology and I am mildly concerned (probably due to my own ignorance) about this growing “two camp” situation in the US, the pharmaceuticals vs the scientology no-drugs-treatment. By default I am also concerned about where Human Givens fits into all this, especially for say, an American who chances upon this blog or our websites and doesn’t know anything about us.

I say this as I have noticed in my online prowlings HG being suspected of an association with Scientology (!?!), I suppose because of our more ‘holistic’ method of therapy and our openness to accept that drug treatments are not always necessary, and our advancement of the idea that depression is not always simply a chemical imbalance.

Is anyone more knowledgable about Scientology than me, could provide some more insight into this thought or tell me where I am going wrong in my assumptions? I will do some more research but I thought I’d throw it out here as well to see if anything interesting comes up.

Posted by: Eleanor

Seroxat Secrets

I’ve been reading Seroxat Secrets, a blog about the pharmaceutical industry (specifically GlaxoSmithKline) and how research surrounding the anti-depressant is often misrepresented.

Worth a look if this interests you.

Posted by: Eleanor

How the link between REM sleep and depression affects the treatment of Bipolar Disorder

Psychotherapy is a specialised branch of education and feartheseeds has hit the nail on the head by asking a question on the comments for this post about how knowledge of the link between REM sleep (the brain state in which dreaming occurs) and depression can be used to help treat and manage bipolar disorder, in which a (most likely genetic) predisposition for mania precedes and follows intensely depressive episodes in a destructive swinging pattern.

Rather than reply further in a comment, I thought I would consider this in a post by itself because it’s an interesting and valid topic that we haven’t yet addressed on this blog.

feartheseeds asks:

“Essentially: If I have a disease that prevents me from either wanting to get better (mania) or being able to actually seek treatment (depression), and then causes long lasting natural depressions via lack of sleep, how can I (or: can I) modify my sleeping patterns without medications specifically prescribed to do so?”

Firstly it’s important to stress that we really don’t advocate treating bipolar disorder without medication. Having said that however, we know people who have developed ways of managing their bipolar disorder without drugs. It obviously depends on the individual state of the sufferer and their access to support and resources that they can use to help them.

In order to organise what I want to say about how the human givens approach and knowledge about the importance of sleep can help someone manage bipolar disorder, I’m going to descend into bullet points:

1) Sleep and depression.

For the reasons described in Ivan’s youtube video, and detailed in this article, we now know why depressed people dream more than non depressed people. It is because dreaming evolved to dearouse the autonomic nervous system from unacted out emotions and worrying during the day produces an enormous amount of arousals that the brain has to dream about. By doing more dreaming in the REM state, which burns up energy, than having recuperative slow wave sleep, which energises the brain and mind/body system, the sleep pattern becomes distorted. This is the reason why depressed people, however much they sleep, always wake up feeling exhausted.

In addition, the orientation response, which fires continually during dreaming, is firing excessively because of the extra amount and intensity of a depressed persons dreaming, and so it gets tired out too. This is the same neuronal pathway we also need to focus and motivate ourselves to do anything during the daytime. Since it is doing things that make our lives feel meaningful, this lack of motivational energy (the orientation response drives motivation) makes life seem meaningless. This should not be underestimated, human suffering cannot get any worse that severe depression: it can even lead people to take their own life.

2) Sleep and Mania

Mania can be seen as the opposite to depression with regards to REM sleep. Someone in a manic phase sleeps less and therefore has less REM sleep to dearouse the autonomic nervous system. In depression they do too much REM sleep. Staying awake all night, intense euphoria, all the symptoms of mania, are not conducive to healthy sleeping patterns.

Just as ordinary sleep deprivation leads to hallucinations (as in the case of Peter Tripp, the radio DJ who in 1959 stayed awake for 8 days as a sponsored “wake-a-thon” stunt before the truly dangerous effects of sleep deprivation were widely known. Tripp suffered severely disturbing hallucinations and delusions and was thought to have suffered more long-term side effects.) Sleeping less through a manic phase can quickly create a severe psychotic state.

Perception distortions occur in waking life because, quite literally, the distinct difference between waking reality and dreaming reality has been blurred, the person literally is dreaming during waking to compensate for the lack of good quality dreaming at night, which we all need a certain amount of to survive…

3) Managing sleep.

So while it is generally agreed now that bipolar disorder has a genetic component, it is obvious that individual sleeping patterns (brought on by the disorder or not) do play a part in the severity of the depression and mania, and my point is, that by managing sleep patterns (and by managing I mean trying hard in a depressive phase to limit your sleep to a healthy amount, waking up at a healthy time every morning, not sleeping in when you feel tired etc, and in a manic phase, doing everything you can to get the REM sleep you need) at the very least reduce symptoms of both bipolar moods and improve your quality of life. Drugs are not the only way of regulating REM sleep, although some of them do, and this is why they work.

Doing this on your own may be hard work, so making sure you and everyone around you knows the signs of when you might be slipping into depression or rising into mania and learns how to help you manage your sleep and also meet your emotional needs (this needs a whole bullet point to itself!) will help a lot.

4) The importance of meeting essential emotional needs.

When someone with bipolar disorder starts swinging towards a depressive phase, they start over compensating for the REM sleep they have missed out of during the manic phase.

A depressive phase is a sign for themselves and people around them to look at what is causing them to worry, boost emotional support and get help to get the emotional needs met (see here for a list of essential emotional needs, or “human givens”). This is so obvious but is incredibly important and can’t be said enough times. Anything to do with not meeting an innate emotional need will trigger anxiety and a depressive episodes and more REM sleep, and bipolar people obviously have a particular sensitivity for this. People do not have mental health problems when their innate emotional needs are met so ensuring they are is the best therapy anyone could have.

Accordingly, someone swinging towards a phase of mania is (among other things) not doing enough dreaming – and everything must be done to remedy that and get enough sleep, or the manic person will reach a stage where the balance will tip, and to compensate they will fall back into REM sleep and depression again.

Meeting emotional needs also reduces arousal levels, which is crucial for arousal levels (which need to be de-aroused nightly during dreaming) in waking life.

So, if emotional needs are met and the importance of REM sleep is understood and managed, bipolar mood cycles become less intense and more manageable, as someone who has experienced years passing before a bipolar episode begins again, can affirm.

Therapists, GP’s and anyone who works, lives with, suffers from or knows someone with bipolar disorder need to be aware of, and learn to work with, this information. I see a great deficit in the knowledge of how to treat bipolar disorder and depression, and a severe lack of services in the NHS that provide this information to people who need it.

Thanks so much to feartheseeds for bringing this subject to attention on this blog.

Comments, questions, personal experience, criticisms, suggestions are welcome.

Posted by: Eleanor

Why CBT doesn’t help GP’s to treat depression

TEACHING GPs the skills to offer brief cognitive behaviour therapy (CBT) to patients with depression has “no discernible impact” on outcome for the patients, a recent randomised controlled trial has found.[1] But, alas, instead of questioning whether there might be a more effective way for GPs to offer brief therapy for depression within their time constraints, the researchers appear to conclude that GPs need much more training to acquire cognitive behaviour therapy’s “complex skills”.

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