So we’ve already established that the circadian rhythm has a tremendous effect on depression and taking all of the above together, we can safely say that resetting our circadian rhythm will have some pretty impressive effects on our mood.
So here’s a simple guide to get you sleeping properly, and getting your circadian rhythm back in sync.
• Go to sleep when you get tired. Not when you think you should go to sleep.
• Avoid caffeine within several hours of bedtime.
• Do something low in stimulation an hour before bed, like reading a book.
• Try to take a hot shower immediately before bedtime.
• Avoid blue and green light from your phone, computer and lights as they suppress melatonin (256). iPhones have a “night mode” that can be turned on, android has blue blocking apps. Basically, they remove all of the blue light at night-time. Install f.lux on your computer, as it does the same thing. Turn the brightness down on your TV.
• Don’t turn the lights on in your bathroom when you brush your teeth.
• Cover up any LED lights on anything in your room. Complete darkness is best. Use blackout curtains or an eye mask to block light from outside your room.
• If you really want to go that extra mile, you can purchase something called blue blockers. They basically look like safety goggles in an orange tinge. You put them on an hour or two before bed and they filter out the blue or green light.
• Try to use your bed only for sleep (sex is fine, though). You want to associate the bed with sleep and only sleep. So watching TV in bed is not a good idea.
In The Morning:
Surprisingly, your morning ritual may have just as big of an influence on your sleep as what you do at night. If melatonin production is properly shut off in the morning, then more effectively turned on at night.
• Get some bright light exposure in the morning, whether from a light therapy lamp, going for a walk or eating breakfast outside in the sun (no sunglasses!). You could even increase your phone’s brightness all the way up and look at it for about 10 minutes, though this won’t be as effective as the other two.
• Ideally, you would wake up naturally when your body is ready to wake up. If you must wake up with an alarm clock, try to set it a bit earlier than you normally need to wake up. Make sure you pair this with going to sleep when you are tired. What we are trying to do here is train your body to wake at roughly the same time and sleep at roughly the same time every day. But we let your body decide what it optimal for it.
If all of this fails, then you could consider wake therapy (or chronotherapy). Wake therapy should only be done under the supervision of a doctor, as it’s a pretty hardcore therapy and quite disrupting to life. It’s best to use this after you’ve tried all else. Not everyone will respond to wake therapy, but the only way to tell is to try it, so google wake therapy or chronotherapy and find a clinic near you.
Wake therapy involves staying awake for 36hrs. No coffee. If you can’t handle the full 36 hrs awake then partial sleep deprivation can be attempted where you wake at 1:30 and stay up. If you feel better then you are a responder. If not you may need to try one more night as it does take some people 2 nights to see effects.
If you are a responder then go to sleep at 5 pm, then 6 pm the next night and onwards until you get back to your normal sleep patterns.
Add in light therapy in the morning regardless of if you are a responder or non-responder.
There are wake therapy centers around the world. Google to find one near you.
In contrast to other therapies in depression, Bipolar depression seems to react the best to sleep deprivation. Not to be used if psychotic features or mixed moods are present in bipolar due to risk of inducing mania