An Epidemic of Fatigue

Several of my patients reported odd changes in their sleep and  their energy level this past week, as though there was an epidemic of fatigue going around. They noted that their sleep was a bit more disrupted and that they didn’t feel as rested in the morning and, for the first time in months, they began taking afternoon naps. Going …

Circadian Rhythms and Food

Scientists are uncovering a fascinating relationship between circadian rhythms and food consumption. It looks as though when you eat can have a big impact on how your body metabolizes the food and on whether or not you gain weight. It has long been clear that light exposure plays an important role in setting a number of circadian rhythms in the …

Jet Lag Explained

What is “jet lag” and why do most people feel worse when they travel around the globe in one direction, rather than the other? An article in the journal Chaos, summarized in the New York Times, suggests an answer. And offers some hope that you can reduce the severity and duration of the symptoms. For people with mood disorders, this …

Sleep Apps Reviewed by the New York Times

Apps to monitor and improve sleep were recently reviewed in the New York Times. Using an app to try to improve your sleep is a strategy that many people try. Some have found that it can be helpful in the long run, and it helps to use a well designed program. The New York Times reviewed SleepBot (available free on Android …

Online Therapy for Insomnia Reduces Depression

“If only I could get a good night’s sleep my mood would be much better.” Many people who suffer from chronic depression are aware of the relationship between the quality of their sleep and their levels of mood and anxiety. A study published in the April 2016 addition of the British journal, Lancet Psychiatry, supports this view. 1100 internet users (aged …

How to Nap

For many people with depression the idea of taking a nap makes a lot of sense. On the other hand, staying in bed at the wrong times of day can be associated with worsened depression and increased fatigue. An article in June in the New York Times entitled, “How to Nap” seemed like an interesting introduction to the topic. In …

Best Treatment for Chronic Insomnia

What is the best treatment for chronic insomnia? The American College of Physicians has just published the results of a careful review of all of the research in this area. The preferred treatment for insomnia is cognitive behavioral therapy (CBTi) which we offer through this website – read about it at the bottom of this page. In their review, ACP …

Insomnia Causes the Munchies

In an article that appeared in the journal SLEEP in February, 2016, and which was summarized in a New York Times post entitled “Poor Sleep Gives You the Munchies,” researchers report that one way that poor sleep and insomnia may lead to weight gain is that insomnia increases activity of the endocannabinoid system in the brain, the part of the …

Sleep Deprivation in Western Society

In February the National Sleep Foundation announced the publication of new guidelines for the amount of sleep that we should be getting based on a rigorous review of the literature. The guidelines suggested that adults should be getting between seven and nine hours of sleep. The results were widely distributed and commented on. It was noted that many people in our …

Getting Up Early

Getting up early is one of the best ways of counteracting depression. And having a strong circadian rhythm is especially important for people with bipolar depression because their internal “clock” may be less powerful. But it can be a challenge making a change in your sleep cycle, especially if you have always been a late riser. This article will talk about …

Chronic Insomnia Treatments

A recent study confirms that cognitive behavioral therapy is effective for chronic insomnia and is often more effective than medications. “What surprises us is that there isn’t more awareness of this treatment’s effectiveness and that there haven’t been more attempts to make the treatment more available to patients,” James M. Trauer of the Melbourne Sleep Disorders Centre in Australia told …

Chronotherapy for Depression

Chronotherapy for depression was recently shown to be effective in a fairly large and well designed study from New Zealand. What is chronotherapy? As discussed in the article, which appeared in Acta Scandanavica Psychiatrica, chronotherapy involves some combination of three separate sleep and wakefulness related interventions: Wake therapy. Wake therapy (previously known as “sleep deprivation” therapy, a harder sell to patients) …

CBT for Insomnia Reduces Suicidal Thoughts

CBT for insomnia (CBTi) is clearly preferable to taking sleeping medications for most people. Studies show that cognitive behavioral therapy is associated with greater improvements in sleep quality than sleeping medications, and that those improvements are more durable, and, particularly in the elderly, sleeping medications are associated with significant adverse effects, including an increase in mortality. But it can be a hard …

Sleep Fatigue and Depression

Yesterday I gave a presentation at UCSF to the Mood Disorder Clinic psychiatrists and residents: An Update on Bipolar Depression.  Much of that material is focused on psychopharmacology and so I will be writing about that on the gatewaypsychiatric.com blog. However, one important pearly derives from a series of studies that identify a strong link between sleep and depression. There is frequent …

Sleeping at the Right Time

Sleeping can become a major preoccupation at times of stress, or when one is depressed, or when the seasons change, as they are doing now. We tend to think about sleep as being something that is good for you. The more sleep and the better the quality of that sleep the better off you are. Elsewhere in this blog I’ve …

Fatigue and Depression or Bipolar

Fatigue is a common symptom in people with recurrent depression or bipolar. And in fact a common symptom in the general population. It is estimated that up to 10% of otherwise healthy people suffer from fatigue. And it is a more common symptom in women than in men. Sometimes fatigue may persist well beyond other symptoms of depression. First, it …