Natália’s section about bipolar people seems to imply that [sleep deprivation’s short-term antidepressant effects] would not be happening.
I disagree. I said,
A night of total sleep deprivation seems to be able to trigger full-blown mania in a substantial percentage of people with bipolar disorder (even those currently depressed) and even cause mania-like behavior in healthy subjects. Moreover, a shift towards mania or hypomania after a short night of sleep seems common in bipolar patients.
Here, I think it was clear that what I said is consistent with sleep deprivation having antidepressant effects, and it could even be interpreted as implying that it does. So I think it’s misleading to suggest that this section implied that the antidepressant effect does not exist.
2. Your section arguing that occasional sleep deprivation is good for health makes no mention of its antidepressant effects, which were addressed separately earlier on in your post. I thought you were making a separate argument in that section, which is why I countered with an appropriate analogy. I merely think that the argument “sleep deprivation causes acute stress, therefore it’s good” is weak, and that was my point in that section. My particular analogy might not have been great, however, I agree.
Separately, I don’t think that association between sleep deprivation and mania is evidence that sleep deprivation is good rather than bad; as my section in this matter showed, manic episodes very often have severe long-term consequences.
3. I apologize, I used poor phrasing here that made it seem like I was claiming something I wasn’t. I didn’t mean to say that you were hypothesizing that 6 hours was causally optimal, in the sense that people should sleep for 6 hours if they want to have the lowest mortality, in that paragraph. I was using the word “optimal” to mean “associated with the lowest mortality.” I’ll rephrase the paragraph to make it clearer that I was not interpreting you as making a causal claim.
Overall, I don’t think the errors you pointed out so far were particularly glaring. The last part of your point (1) seems to be based on a misunderstanding of what I wrote, though perhaps upon further elaboration we’ll find that we do actually disagree on something specific here. Point (2) reflects more of a clash of intuitions between us, rather than a mistake on my part; it’s reasonable to disagree about the strength of my analogy, but it really wasn’t a large part of my argument. Point (3) was merely an error in the sense that I used poor phrasing when describing your position.
I think it’s a little unfair to say “The fact that I spotted these three points after spending ~3 minutes skimming the post do not make me optimistic about the rest of the critique” when your points were individually and together, quite weak. However, I am hopeful that we can have a productive dialogue about this subject soon, and get closer to our cruxes on these issues.
Here, I think it was clear that I pointed out the antidepressant effects of sleep deprivation in at least some subjects (before the “and”). So I think it’s misleading to suggest that this section implied that the antidepressant effect does not exist.
I don’t quite follow. The closest you come in the quote is that it can “trigger full-blown mania,” not that it is a depression treatment.
Guzey says:
Lack of sleep is such a potent trigger for mania that acute sleep deprivation is literally used to treat depression. Aside from ketamine, not sleeping for a night is the only medicine we have to quickly – literally overnight – and reliably (in ~50% of patients) improve mood in depressed patients (until they go to bed, unless you keep advancing their sleep phase ). NOTE: DO NOT TRY THIS IF YOU ARE BIPOLAR, YOU MIGHT GET A MANIC EPISODE.
I did not interpret this as saying sleep deprivation treats depression by causing mania. Instead, I think Guzey is suggesting that sleep deprivation treats depression through a neurological pathway that can also lead to mania in bipolar patients. I think it’s fine to ignore this point if you’re not interested in addressing it, but I don’t think it’s fair to characterize your reference to “trigger full-blown mania” as a clear acknowledgement of sleep deprivation’s therapeutic benefits for some depressed patients. If that was indeed your conscious intent, then my feedback is that your writing was illegible in this area.
As a caveat, it seems like you might have inferred from Guzey’s overall post that he has a positive impression of mania. I think this is belied by phrases like “DO NOT TRY THIS IF YOU ARE BIPOLAR, YOU MIGHT GET A MANIC EPISODE,” but not an impossible takeaway.
Overall, I don’t think the errors you pointed out so far were particularly glaring… I think it’s a little unfair to say “The fact that I spotted these three points after spending ~3 minutes skimming the post do not make me optimistic about the rest of the critique” when your points were individually and together, quite weak. However, I am hopeful that we can have a productive dialogue about this subject soon, and get closer to our cruxes on these issues.
I agree with your assessment, and Guzey really ought to read your article in depth before throwing shade on it. I think your commitment to constructive dialog is admirable here.
Switching to mania from depression usually (though not always) means that the depressive symptoms went away. But I agree that my phrasing was poor and I’ll edit it.
1.
I disagree. I said,
Here, I think it was clear that what I said is consistent with sleep deprivation having antidepressant effects, and it could even be interpreted as implying that it does. So I think it’s misleading to suggest that this section implied that the antidepressant effect does not exist.
2. Your section arguing that occasional sleep deprivation is good for health makes no mention of its antidepressant effects, which were addressed separately earlier on in your post. I thought you were making a separate argument in that section, which is why I countered with an appropriate analogy. I merely think that the argument “sleep deprivation causes acute stress, therefore it’s good” is weak, and that was my point in that section. My particular analogy might not have been great, however, I agree.
Separately, I don’t think that association between sleep deprivation and mania is evidence that sleep deprivation is good rather than bad; as my section in this matter showed, manic episodes very often have severe long-term consequences.
3. I apologize, I used poor phrasing here that made it seem like I was claiming something I wasn’t. I didn’t mean to say that you were hypothesizing that 6 hours was causally optimal, in the sense that people should sleep for 6 hours if they want to have the lowest mortality, in that paragraph. I was using the word “optimal” to mean “associated with the lowest mortality.” I’ll rephrase the paragraph to make it clearer that I was not interpreting you as making a causal claim.
Overall, I don’t think the errors you pointed out so far were particularly glaring. The last part of your point (1) seems to be based on a misunderstanding of what I wrote, though perhaps upon further elaboration we’ll find that we do actually disagree on something specific here. Point (2) reflects more of a clash of intuitions between us, rather than a mistake on my part; it’s reasonable to disagree about the strength of my analogy, but it really wasn’t a large part of my argument. Point (3) was merely an error in the sense that I used poor phrasing when describing your position.
I think it’s a little unfair to say “The fact that I spotted these three points after spending ~3 minutes skimming the post do not make me optimistic about the rest of the critique” when your points were individually and together, quite weak. However, I am hopeful that we can have a productive dialogue about this subject soon, and get closer to our cruxes on these issues.
I don’t quite follow. The closest you come in the quote is that it can “trigger full-blown mania,” not that it is a depression treatment.
Guzey says:
I did not interpret this as saying sleep deprivation treats depression by causing mania. Instead, I think Guzey is suggesting that sleep deprivation treats depression through a neurological pathway that can also lead to mania in bipolar patients. I think it’s fine to ignore this point if you’re not interested in addressing it, but I don’t think it’s fair to characterize your reference to “trigger full-blown mania” as a clear acknowledgement of sleep deprivation’s therapeutic benefits for some depressed patients. If that was indeed your conscious intent, then my feedback is that your writing was illegible in this area.
As a caveat, it seems like you might have inferred from Guzey’s overall post that he has a positive impression of mania. I think this is belied by phrases like “DO NOT TRY THIS IF YOU ARE BIPOLAR, YOU MIGHT GET A MANIC EPISODE,” but not an impossible takeaway.
I agree with your assessment, and Guzey really ought to read your article in depth before throwing shade on it. I think your commitment to constructive dialog is admirable here.
Switching to mania from depression usually (though not always) means that the depressive symptoms went away. But I agree that my phrasing was poor and I’ll edit it.