title: Circadian rhythms and depression.
abstract: BACKGROUND
  Depression is a common disorder in primary care. Disruptions to the circadian rhythms associated with depression have received little attention yet offer new and exciting approaches to treatment.
  
  
  OBJECTIVE
  This article discusses circadian rhythms and the disruption to them associated with depression, and reviews nonpharmaceutical and pharmaceutical interventions to shift circadian rhythms.
  
  
  CONCLUSIONS
  Features of depression suggestive of a disturbance to circadian rhythms include early morning waking, diurnal mood changes, changes in sleep architecture, changes in timing of the temperature nadir, and peak cortisol levels. Interpersonal social rhythm therapy involves learning to manage interpersonal relationships more effectively and stabilisation of social cues, such as including sleep and wake times, meal times, and timing of social contact. Bright light therapy is used to treat seasonal affective disorders. Agomelatine is an antidepressant that works in a novel way by targeting melatonergic receptors.
authors.affiliation: Discipline of Psychiatry, University of Sydney and Department of Psychiatry, Westmead Hospital, Sydney, New South Wales, Australia. philip.boyce@sydney.edu.au
authors.forename: Philip
authors.initials: P
authors.lastname: Boyce
authors.forename: Erin
authors.initials: E
authors.lastname: Barriball
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D002940:Circadian Rhythm; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D005194:Family Practice / Q000592:standards / Q000639:trends; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008550:Melatonin / Q000378:metabolism*; D019964:Mood Disorders / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D009517:New South Wales / Q000453:epidemiology; D018570:Risk Assessment; D016574:Seasonal Affective Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D008550:Melatonin