Dr. Matt Walker

In fact, if you look at the data, it's somewhere between 30 to 55% of patients will be responders to sleep deprivation.

The other proportion of those patients don't respond, or if anything, get worse when you sleep deprive them.

And then the question is, well, how would you know?

And right now, and there have been some brain imaging studies, some PET studies done way back at UC Irvine.

and other locations where they were trying to say, is there something about the metabolic activity of your brain that can predict if you're a responder or not to sleep deprivation?

Because at least then we would know who should we push through this quote unquote treatment and who should we not because it's going to be bad for them.

That's the first issue.

And we don't have a clear understanding.

The second issue is that as soon as those patients with depression sleep after the deprivation,

the antidepressant benefit goes away and they go right back to being depressed again.

So yes, it's a mechanistically interesting process.

What is it about sleep deprivation that could alleviate depression?

And I'll explain why I think it can.

But it's not a sustainable one.

It's not a clinically viable one.

Why would it have that effect if it does?

Well, you and I discussed earlier in this episode that when you are sleep deprived, not only does your emotional brain become much more responsive to negative things, it also becomes much more responsive to rewarding positive things.

And one of the interesting things that I think people mistake about depression, they just think that when I'm depressed, I have sad mood, I have negative mood.

That's not entirely true.

One of the principal features of depression is something that we call anhedonia, which is an absence of having the ability to have hedonic responses.