0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

Improvement of Depression and Triggering of Mania by Sleep Deprivation

Thomas A. Wehr, MD
JAMA. 1992;267(4):548-551. doi:10.1001/jama.1992.03480040096038.
Text Size: A A A
Published online

SELECTED CASES 

CASE 1.  —William Styron, author of several novels, including Lie Down in Darkness, The Confessions of Nat Turner, and Sophie's Choice, became clinically depressed in 1985 at the age of 60 years. In his book, Darkness Visible (the title of which was taken from Milton's description of hell in Paradise Lost), he provides an extraordinary account of the symptoms and course of his illness. I have chosen to include a few of his observations herein because they seem to illustrate important connections between depression, sleep, and a classic symptom of depression—diurnal variation in mood.Styron's depression began when he stopped drinking alcohol. Gradually, he developed anhedonia and feelings of worthlessness and had thoughts of death. Ultimately: "The act of writing itself, becoming more and more difficult and exhausting, stalled, then finally ceased. "1(p46) As is typical in depression, the severity of Styron's symptoms had a striking daily rhythm:

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();