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#067 Dr. Ashley Mason on Drug-free Approaches for Treating Depression, Insomnia, and Overeating

Sep 1, 2021 1h 49m 21 insights
<p><span style="font-weight: 400;">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.</span></p> <p><strong>In this episode, we discuss:</strong></p> <ul> <li><span style="font-weight: 400;"><strong>(00:00)</strong></span> Introduction</li> <li><span style="font-weight: 400;"><strong>(08:10)</strong> Whole-body hyperthermia (WBH) and sauna use differ</span></li> <li><span style="font-weight: 400;"><strong>(17:06)</strong> Depression causes thermoregulatory dysfunction –</span> <span style="font-weight: 400;">but sauna use may correct it</span></li> <li><span style="font-weight: 400;"><strong>(21:12)</strong> WBH and sauna use may reduce symptoms of depression</span></li> <li><span style="font-weight: 400;"><strong>(33:22)</strong> Heating the body slowly may improve heat tolerance and increase WBH effectiveness</span></li> <li><span style="font-weight: 400;"><strong>(39:35)</strong> Sauna use may benefit people with depression and cardiovascular disease – which often coincide</span></li> <li><span style="font-weight: 400;"><strong>(40:18)</strong> Dr. Mason and Rhonda are collaborating on new research on depression and WBH</span></li> <li><span style="font-weight: 400;"><strong>(44:19)</strong> Sauna bathing and similar practices often provide opportunities for people to connect socially</span></li> <li><span style="font-weight: 400;"><strong>(53:12)</strong> Common causes of insomnia</span></li> <li><span style="font-weight: 400;"><strong>(01:01:26)</strong> Cognitive behavioral therapy, sleep hygiene, stimulus control, and sleep restriction for treating insomnia</span></li> </ul> <p><strong>Looking for more? </strong></p> <p><span style="font-weight: 400;">Join over 300,000 people and get the latest distilled information on sleep, depression, and fasting straight to your inbox weekly:</span> <a href="https://www.foundmyfitness.com/newsletter"><span style="font-weight: 400;">https://www.foundmyfitness.com/newsletter</span></a></p> <p><span style="font-weight: 400;">Become a FoundMyFitness premium member to get access to exclusive episodes, emails, live Q+A's with Rhonda and more:</span> <a href="https://www.foundmyfitness.com/crowdsponsor"><span style="font-weight: 400;">https://www.foundmyfitness.com/crowdsponsor</span></a></p>
Actionable Insights

1. Strict Bed Use for Sleep

Implement stimulus control by reserving your bed strictly for sleep and sex, removing all other activities like reading, watching TV, or worrying, to re-associate the bed with rest. If unable to sleep, get out of bed and return only when sleepy.

2. Restrict Bed Time for Sleep

Practice sleep restriction by maintaining a consistent wake time every day (including weekends) and only going to bed when truly sleepy, restricting your time in bed to the actual hours you sleep to build sleep pressure and improve sleep quality. Gradually increase time in bed by 15 minutes weekly as sleep efficiency improves.

3. Challenge Negative Thoughts (CBT)

Challenge dysfunctional thoughts by creating a ’thought record’ where you identify evidence for and against a thought, then develop a more balanced, adaptive thought that reflects reality to reduce anxiety and improve emotional regulation.

4. Mindfully Observe Unhealthy Habits

Practice mindfulness when engaging in undesirable behaviors like eating junk food or smoking by slowing down, focusing intently on the experience (taste, smell, sensation), and observing the true reward, which can lead to disenchantment and reduced consumption.

5. Control Your Environment

Control your environment to promote healthy choices by removing tempting ‘bad’ foods or addictive substances from your immediate surroundings, making it physically impossible to engage in undesirable behaviors.

6. Pair Heat Therapy with CBT

Combine whole-body hyperthermia with cognitive behavioral therapy (CBT) to potentially enhance engagement in therapy, as heat may make individuals more inclined to talk and participate, creating a powerful mind-body intervention.

7. Slow Heating for Heat Therapy

Begin whole-body hyperthermia from a cool state and gradually increase temperature over a longer period, as this slow heating process may improve endurance and increase the treatment’s effectiveness.

8. Cool Head During Heat Therapy

During whole-body hyperthermia, keep your head outside the heating element and use cool cloths or ice on your head to maintain comfort and enable longer endurance of the session.

9. Slowly Taper Sleep Medication

If tapering off sleep medication, do so extremely slowly by using a gem scale to make minuscule reductions (e.g., 0.1mg at a time) over an extended period (months) to minimize physiological rebound insomnia and reduce anxiety about quitting.

10. Maintain Consistent Wake Time

Establish a consistent wake time every single day, including weekends, to regulate your circadian rhythm and build sleep pressure, which is a fundamental component of effective insomnia treatment.

11. Standardize Sleep Medication Intake

If using sleep medication, standardize its use by taking the same dose at the same time every night, rather than reactively taking it only when you can’t sleep, to avoid perturbing your circadian rhythm and reduce anxious questioning.

12. Heat Therapy for Exercise Alternative

If physical limitations prevent aerobic exercise, consider whole-body heating practices like sauna as an alternative to potentially trigger similar beneficial biological pathways that exercise activates, such as anti-inflammatory changes.

13. Heat Therapy for Depression/CVD

Consider whole-body hyperthermia or sauna use for individuals experiencing both depression and cardiovascular disease, as this treatment may offer benefits for both conditions, which often coincide.

14. Maintain Heat Therapy at Home

After initial intensive whole-body hyperthermia sessions, consider supplementing and maintaining the benefits with at-home sauna tents (with head out) to sustain wellness and reductions in depression symptoms over the long term.

15. Practice Muscle Relaxation

Practice progressive muscle relaxation by tensing and then relaxing different muscle groups throughout your body, moving from one area to another, to shift focus from your thoughts to your physical sensations and aid in relaxation before sleep.

16. Access CBTI Resources

Access Cognitive Behavioral Therapy for Insomnia (CBTI) through self-help books like ‘Quiet Your Mind and Get to Sleep,’ dedicated apps (e.g., Sleepio, Insomnia Coach), or by finding local providers through specialized websites.

17. Sustain CBTI Principles

Maintain long-term sleep wellness by continuously applying CBTI principles, understanding how your behaviors affect your sleep, and making informed decisions about occasional deviations, knowing the potential impact on your sleep.

18. Pre-plan Healthy Food Choices

Make decisions about potentially unhealthy behaviors, such as ordering food at restaurants, ahead of time when you are not in the moment of temptation, to promote healthier choices and avoid impulsive consumption.

19. Visualize Future Health Goals

Use ’episodic future thinking’ by imagining yourself at future health goals or events (e.g., wearing a specific dress in three weeks) to help inform and motivate healthier decisions in the present moment.

20. Mindful Harm Reduction for Treats

Practice mindful harm reduction by consuming unhealthy treats only up to the point of genuine enjoyment, stopping when the pleasure diminishes (e.g., after a few bites), to reduce overall intake without complete deprivation.

21. Address Underlying Physical Issues

If an unhealthy behavior is used to alleviate a physical symptom (e.g., drinking soda for migraines), prioritize addressing the underlying physical issue with appropriate medical treatment first, rather than relying on the behavior.