#067 Dr. Ashley Mason on Drug-free Approaches for Treating Depression, Insomnia, and Overeating
Sep 1, 2021
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Dr. Ashley Mason, a clinical psychologist and director at UCSF’s Osher Center, dives into innovative drug-free treatments for depression, insomnia, and overeating. She highlights sauna therapy's surprising benefits, linking heat exposure to improved mental health and cognitive behavioral therapy. Dr. Mason also discusses chronic insomnia, practical strategies for better sleep, and how mindfulness can transform unhealthy habits. Listeners gain insight into the interconnectedness of body temperature, mental well-being, and effective therapy approaches.
Whole-body hypothermia shows promise in treating depression through heat exposure.
Research on hypothermia therapy aims to uncover molecular mechanisms improving depression symptoms.
Insights into different chronotypes and environmental factors contribute to chronic insomnia management.
Cognitive behavioral therapy for insomnia focuses on sleep hygiene, stimulus control, and cognitive techniques for lasting improvements in sleep quality.
Deep dives
The Potential of Whole Body Hypothermia in Treating Depression
Whole body hypothermia, combined with cognitive behavior therapy (CBT), is being researched for its potential in treating depression. Studies have shown promising results with a significant decrease in depression symptoms after a single hypothermia session. The treatment involves continuous heat exposure to reach core body temperatures, potentially lasting effects up to six weeks post-treatment. This therapy offers a non-pharmacological approach with opportunities to engage patients who struggle with traditional therapies by utilizing heat-induced social interactions and potential adaptation mechanisms.
Enhancing Insight Through Comprehensive Biomarker Analysis
The upcoming studies will delve into the effects of whole body hypothermia on individuals with major depression, focusing on key biomarkers related to inflammation, heat shock proteins, and brain-derived neurotrophic factor (BDNF). By combining whole body hypothermia sessions with cognitive behavior therapy and analyzing various biological markers, researchers aim to assess the treatment's impact at a molecular level, potentially uncovering mechanisms behind the therapy's efficacy in improving depression symptoms.
Advancing Research on Insomnia and Chronotypes
In addition to exploring whole body hypothermia for depression, research also extends to chronic insomnia management and understanding different chronotypes. Differentiating between chronic insomnia and genetic predispositions like night owl tendencies, the discussion encompasses environmental factors affecting sleep, such as caffeine consumption, stress, and melatonin regulation. Insights into circadian rhythms, chronotypes, and sleep disturbance factors provide a comprehensive approach to addressing sleep disorders.
Implications for Future Treatment Modalities
The research on whole body hypothermia offers potential avenues for future mental health treatments, emphasizing adaptability, sustained therapeutic effects, and patient engagement. By investigating the feasibility of at-home heat therapies and maintaining treatment benefits, such approaches could revolutionize mental health care delivery. The studies' design and analyses also pave the way for exploring alternative therapeutic interventions and optimizing treatment outcomes for a diverse range of individuals.
Understanding Chronotypes and Insomnia
Some individuals perform best in the evening due to their chronotypes, which can differ from morning-oriented individuals. Insomnia, on the other hand, poses its challenges regardless of one's chronotype. Insomnia is characterized by difficulty falling asleep, staying asleep, or early morning awakening, which can be distressing if experienced frequently. Changing one's chronotype is not easily achievable, but strategies like cognitive behavioral therapy for insomnia can be effective in managing sleep issues.
Identifying Causes and Maintenance of Insomnia
Insomnia can stem from various factors, including significant life changes like retirement, relationship status alterations, job loss, or increased stress levels. While such events may trigger initial sleep problems, it's often the individual's subsequent behaviors, like poor sleep hygiene and habits, that maintain insomnia. Insomnia caused by stress or life changes can lead to maladaptive sleep behaviors, perpetuating the sleep issue.
Effective Strategies for Insomnia Treatment
Cognitive behavioral therapy for insomnia (CBT-I) focuses on improving sleep hygiene, implementing stimulus control, practicing sleep restriction (not deprivation), utilizing cognitive techniques to address worries and thoughts, and engaging in relaxation techniques. Stimulus control involves associating the bed exclusively with sleep or sex, avoiding activities like using phones or watching TV in bed. By gradually adjusting sleep time and addressing negative thought patterns, CBT-I can lead to lasting improvements in sleep quality and habits.
Behavioral Modification and Rewriting Thought Patterns
Behavioral modification techniques, such as mindfulness, can help individuals address maladaptive behaviors related to eating, smoking, or engaging in other rewarding yet detrimental habits. By slowing down and observing the rewards associated with certain behaviors, individuals can gain insight into their choices and potentially reduce their reliance on unhealthy habits. Moreover, the practice of episodic future thinking can assist individuals in envisioning the outcomes of their actions, aiding in decision-making regarding long-term goals and behaviors.
Dr. Ashley Mason is a clinical psychologist and director of the Sleep, Eating, and Affect Laboratory at the Osher Center for Integrative Medicine at UCSF. Her research centers on nonpharmacological approaches for treating depression, insomnia, and overeating.
In this episode, we discuss:
(00:00) Introduction
(08:10) Whole-body hyperthermia (WBH) and sauna use differ
(17:06) Depression causes thermoregulatory dysfunction – but sauna use may correct it
(21:12) WBH and sauna use may reduce symptoms of depression
(33:22) Heating the body slowly may improve heat tolerance and increase WBH effectiveness
(39:35) Sauna use may benefit people with depression and cardiovascular disease – which often coincide
(40:18) Dr. Mason and Rhonda are collaborating on new research on depression and WBH
(44:19) Sauna bathing and similar practices often provide opportunities for people to connect socially
(53:12) Common causes of insomnia
(01:01:26) Cognitive behavioral therapy, sleep hygiene, stimulus control, and sleep restriction for treating insomnia
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