A possible new subtype of depression caused by people’s “body clocks being out of whack” has been identified by University of Sydney researchers, said New Scientist. Affecting an estimated one in four people with severe depression, circadian depression responds less readily to treatment with standard antidepressants such as SSRIs.
What is it? Circadian depression is “characterized by disrupted sleep, low energy and reduced physical activity during the day,” said Nature. Circadian depression appears to be linked to dysregulation in the body’s internal clock and seems to affect women more than men. Although seasonality can aggravate symptoms, it doesn’t necessarily trigger them, as happens with seasonal affective disorder.
Researchers asked 11,380 people with severe depression about their symptoms and sleep patterns. Nearly a quarter (23%) met at least three of six proposed criteria for circadian depression, which include identifying as a night owl and experiencing significant seasonal changes in sleep, mood, appetite or energy. This correlation is evidence of a “suggested subtype,” said The New York Times.
How can it be treated? What’s “critical” about this circadian type of depression is its “poor response to the standard therapies,” said psychiatrist and study co-author Ian Hickie to The Guardian. Sufferers could benefit instead from treatments, such as melatonin or light therapy, that specifically target the body’s circadian rhythms. The coordination of your body clock “underpins your mood, your metabolism, your concentration, your sleep-wake cycle and many other key factors.” Exposure to daylight in the morning and avoiding artificial light, large meals and exercise after dark can help keep body clocks on track.
What are the caveats? Circadian depression is a “plausible” condition, said chronotherapy expert Michael Terman to The New York Times. But the study findings don’t establish a new diagnosis or prove that circadian depression responds to different types of treatment.
A major limitation of the study, acknowledged by its authors, is that participants’ sleep-wake cycles were self-reported. Also, participants were mostly of European ancestry, so more diverse studies are needed to replicate the findings.
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