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Rapid treatment of depression without medications

Summary: It treats depression in a day, but it’s not easy, and it’s hard to keep the benefits going.

Basically, the idea here is to make very large, planned, deliberate shifts in your sleep schedule and your light exposure. Multiple research studies show this can work even without medications, though you can do all this with medications underway as well.

What is chronotherapy? What are the risks? Is there much research behind this?

Usually I’d give you a whole page on this but I can’t give you better answers than John Gottlieb, M.D., a psychiatrist in Chicago who’s become a leading expert on chronotherapy into depression, including bipolar depression (but it can’t be a “mixed state”, bummer).

One thing you won’t find on his website: Can I do this on my own?

Well, here are the main ingredients:

  1. Wake therapy
  2. Sleep phase advance
  3. A light box
  4. A dawn simulator

Wake therapy involves staying up for an entire night. About 70% of people experience a lift in their depression after that, but the problem is that the depression comes barreling back the next day. A more refined technique involves combining wake therapy with light therapy and programmed times of catch-up sleep called triple chronotherapy (some protocols even combine it with lithium for extra boost).Danilenko

Sleep phase advance is complex but it basically means turning a night-owl into a morning-person (“advancing” their bedtime so they fall asleep earlier in the day). That’s what the refined technique sketched out above accomplishes (and yes, being a night owl is strongly associated with depression so the idea makes some biological sense. Aristotle and Ben Franklin were onto something).

Dr. Gottlieb is going to tell you a lot more about each of these elements. But I want you to know: in theory, you could do this with the help of your psychiatrist for guidance and monitoring. (If you’re anywhere near Chicago, use Dr. Gottlieb’s team there).

You’ll need at least one very supportive friend or family member, preferably more like three or four of them, who’ll each take shifts while you do the hard work. I’ve done this on rare occasions instead of putting patients in hospital (things were that bad) and three days later, they didn’t need to consider the hospital at all. But there are significant risks, including bringing on manic symptoms, so don’t do this on your own. Make sure your psychiatrist or primary care provider knows what you’re doing.

When you’re done with Dr. Gottlieb’s website, if you need more information about where to get your own light box or dawn simulator, take these links, and explore the pages on which they are located.

Okay, now go see Dr. Gottlieb’s Chronotherapy website.

Artwork: The Persistence of Memory, Salvador Dali, 1931

(updated 11/2020)

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