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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Sarah on January 2, 2000, at 21:57:45
I sleep all the time. sometimes it's definitely an escape (i have been major depressive since i was a kid) but the other times, i am doing whatever in my day and i will just HAVE to go to sleep. I can't tell if it's the depression, or the medications (SSRI's), or maybe i am just a sleepy person!?!?, or maybe i have some condition? Does anybody have this problem too? and what can i do about it?
it's not as simple as just keeping busy. i could have a day packed full of appointments and it won't wear me out because i simply would miss the appointments because i could not stay awake that long. i could be having dinner with the president and i'd have to say "excuse me, i need to go take a nap...".
so here's the deal: i can't get up in the morning; if i do, i need to go back to sleep usually within two hours of getting up (ex- i'll get up, have breakfast, take a shower, look over what i need to do that day, and then it's time for sleep again); then, when i finally do get up, i absolutely positively fall asleep around 2:30 pm. i can't for the life of me stay awake in the middle of the day! then i'll get up around 5 or 6 pm and do something until 8 or so when i will have to lay down for a bit if i am planning to stay up past 10pm. like today, i went to see my boyfriend this morning after not seeing him for two weeks. despite my excitement to see him and even though i really wanted to spend time with him, i had to take a nap in the morning after i got there, one around 2:30pm, and one before i drove home this evening. i don't think i am just a lazy person. i am just TIRED ALL THE TIME. in addition to being incredibly irritating, it is really hurting my personal life, i am doing really badly in college (because of never getting out of bed and going to class and sleeping through two alarm clocks and missing exams...) and i really don't know what to do anymore. i've had all the thyroid tests done, switched depression medications to see if that would help, and i've tested negative for lyme disease and mono.
does anybody share these problems? does anybody have any suggestions on what i can do? i would greatly appreciate any input that you might have. thank you, sarah
Posted by Cass on January 2, 2000, at 23:33:10
In reply to Tired ALL the Time, posted by Sarah on January 2, 2000, at 21:57:45
Have you been tested for Anemia? A friend of mine had undiagnosed Anemia for a period of time and had to sleep all the time like you do. What about Chronic fatigue? Do you have any other symptoms? I'm not a doctor, but I'd be interested to know. I'm wishing you the best.
Cass
Posted by saint james on January 3, 2000, at 0:17:53
In reply to Re: Tired ALL the Time, posted by Cass on January 2, 2000, at 23:33:10
> Have you been tested for Anemia? A friend of mine had undiagnosed Anemia for a period of time and had to sleep all the time like you do. What about Chronic fatigue? Do you have any other symptoms? I'm not a doctor, but I'd be interested to know. I'm wishing you the best.
> CassJames here agreeing with Cass....
Perhaps you should get with your pdoc to 1) decide if your depression is really under control
2) could your meds be causing this problem and 3)get a consult with your primary to see if there is something non-mental going on. Feeling tired all the time is not normal and indicates something is up.j
Posted by DJ on January 3, 2000, at 0:48:52
In reply to Re: Tired ALL the Time, posted by Cass on January 2, 2000, at 23:33:10
> What about Chronic fatigue? Do you have any other symptoms? > Cass
Some place or other I've read that chronic fatigue is considered by some to be just a variation on depression, which there may well be some validity to...I've battled differing levels of depression since my teens. Back in about grade 10 or so I got into drinking coffee to keep me going. I often found myself feeling fatigued in classes and when I hit university I found that I often felt like nodding off when at the library, which is still a challenge some 25 years later, though generally I didn't experience the degree of fatigue Sarah is describing.Over the past few years though I have experienced fatigue more approaching that described and find that it is often linked to stressful or depressed periods. However, I also find that the SSRIs I've tried cause me to be extremely fatigued at times, both mentally and physically often to a degree worse than when depressed, though I'm generally in a somewhat better mood even though I may feel like SHIT on a stick, kinda like a very, bad flu at times and other times I feel great. Generally I find that the SSRIs screw my metabolism up as much as they help, despite whatever the pharmo-hype would have us believe.
In one of the threads above (about multi-pharm. combos) Cdn.Michelle references http://www.biopsychiatry.com which appears (from a quick glance) to be some valid rather straightshooting analysis (written in a comphrensive and generally understandable tone unlike so much of the pseudo-scientific gibberish which usually leaves me scratching my head in con-comphrension)of some of the chemical options. From what I gather of what the author of that web site notes (and some other reading) the SSRI problems which I experience, which also may be the source of your frustrations, seem to have to do with shotgun stimulation of serotonin sources while generally ignoring dopamine levels. Bottom line seems to be that the so-called selective (SRI)s select and stiumulate some useful receptors and ignore others that may be even more useful or that's my interpretation at least. Perhaps some of the more chemically literate (who also can type non-jargonistic English translations) might care to comment...There may be some answers on that web site as well as here. I'm still trying to make heads or tales out of it too, with far less comphrension, energy and enthusiasm than I would prefer most of the time. Here's hoping that there will be some more useful, more selective meds or better yet non-med solutions available real soon!!!!!
Posted by jamie on January 3, 2000, at 2:57:52
In reply to Tired ALL the Time, posted by Sarah on January 2, 2000, at 21:57:45
i could be having dinner with the president and i'd have to say "excuse me, i need to go take a nap...".
With this president, wouldn't just about everybody say that? Actually, if he came knocking on my door I wouldn't even invite him in. I don't think I've ever seen such a sorry excuse for a human being. And talk about a broken record. His ways are so fake, predictable, repetivtive, and self-glorifying. The antithesis of 'humble'. Our great economy has flourished DESPITE his efforts, not because of them. And his contributions to our "children" have been absolutely disasterous.Sorry. I know I'm way off subject here. Sorry for the detour. Back to your post about being tired all the time. If you think about the president just for a moment each day, that by itself can make anyone TIRED ALL THE TIME. :-) jamie
Posted by Noa on January 3, 2000, at 6:08:23
In reply to Re: Tired ALL the Time, posted by jamie on January 3, 2000, at 2:57:52
Do you snore?
Posted by andrewb on January 3, 2000, at 14:08:17
In reply to Tired ALL the Time, posted by Sarah on January 2, 2000, at 21:57:45
Sarah,
I'm so sorry that you are sufferring so. i know how difficult it can be to pull yourself through the day when you are tired all the time. There are so many things that can cause fatigue; disrupted sleep patterns, sub-clinical hypothyroidism, low adrenal function, hypoglycemia, magnesium deficiency.... and the list goes on. So you see it is vital to get a proper diagnosis. May I suggest that you to a sleep center to have your sleep patterns evaluated. Also a doctor who specializes in treating chronic fatigue syndrome may be able to help you.
Posted by Noa on January 3, 2000, at 15:34:16
In reply to Re: Tired ALL the Time, posted by andrewb on January 3, 2000, at 14:08:17
I agree a sleep eval may be in order. I asked about snoring because, tho there are something like 80 different kinds of sleep disorders, one of the most common, and the one I am most familiar with, is obstructive sleep apnea. But a good sleep eval will pick up on anything that might interfere with good sleep. Sometimes we think we are sleeping all those hours, but our brains are not truly asleep, or are not achieving sufficient amounts of all needed sleep stages.
Posted by MA on January 3, 2000, at 19:49:53
In reply to Tired ALL the Time, posted by Sarah on January 2, 2000, at 21:57:45
Sarah,
You didn't mention how long this tiredness has been present. Has it just been present since you have been on SSRI's or ever since you have been depressed?
Also, what SSRI are you on, dosage and what time of day do you take it? Sometimes the tiredness of SSRI's can be alleviated by taking the meds at night, reducing the dosage, switching meds or adding an energizing med to the one that causes the tiredness.
My depression always made me very tired. When I was in college, premedication, I would sleep all the time. I did have mono at one point, but I believe the depression was the real culprit. Also, I tend to require more sleep than most people I know and I take naps when I can. As I have gotten older, my need for sleep has diminished. I'm in my 40's now, but in my 20's and 30's, I slept alot, so I can relate to your post.
I'm on SSRI's and I know they can make me sleep alot. Celexa is alot less sedating for me than Prozac or Paxil, but I also take Wellbutrin for it's energizing effects. It seems to be helping.
Your doctor should be able to help you with this problem. What does he/she say??
MA
Posted by Sassy on January 3, 2000, at 20:32:24
In reply to Tired ALL the Time, posted by Sarah on January 2, 2000, at 21:57:45
Sarah,
This sounds like something I've been through and still working on.
I was diagnosed with Epstein Barr which is the same virus related to mono. They have all kinds of names out there. Some times they call if Chronic Fatigue syndrome and now have some new names for it.
I don't know if mono is based on a higher level of this blood test they take or what, but you may ask the doctor if it's the same test for Epstein Barr.
My understanding is we all carry the virus as an immunity, however when our immune system breaks down it over takes us.
I went through the phase as you, got a little better and now much better. Yes, stress has a lot to do with dealing with it.
Some doctor's for some strange reason don't believe in it and won't treat you and some will treat you with SSRI's.
I was reading st james comments on the receptors and I have been placed on effexor which deals with more than serotin. I do feel a bit better, and if I have a will to do something, I'll do it even if I'm tired whereas before I wouldn't do anything. I'd make it to work and that's it.
I would always have interrupted sleep. Now my doctor is putting remeron with the effexor.
It didn't seem to make sense because remeron knocks you out, but this morning, after a few days on it, I actually felt wide awake instead of wanting to go back to bed. Effexor also made me tired at first.
I'm now inquiring about the Wellbrutin in place of remeron if the tireness persist.
If you do have epstein barr you eventually do feel better, but you need to eat healthy.
Think good thoughts and hang in there.
Sassy
> I sleep all the time. sometimes it's definitely an escape (i have been major depressive since i was a kid) but the other times, i am doing whatever in my day and i will just HAVE to go to sleep. I can't tell if it's the depression, or the medications (SSRI's), or maybe i am just a sleepy person!?!?, or maybe i have some condition? Does anybody have this problem too? and what can i do about it?
> it's not as simple as just keeping busy. i could have a day packed full of appointments and it won't wear me out because i simply would miss the appointments because i could not stay awake that long. i could be having dinner with the president and i'd have to say "excuse me, i need to go take a nap...".
> so here's the deal: i can't get up in the morning; if i do, i need to go back to sleep usually within two hours of getting up (ex- i'll get up, have breakfast, take a shower, look over what i need to do that day, and then it's time for sleep again); then, when i finally do get up, i absolutely positively fall asleep around 2:30 pm. i can't for the life of me stay awake in the middle of the day! then i'll get up around 5 or 6 pm and do something until 8 or so when i will have to lay down for a bit if i am planning to stay up past 10pm. like today, i went to see my boyfriend this morning after not seeing him for two weeks. despite my excitement to see him and even though i really wanted to spend time with him, i had to take a nap in the morning after i got there, one around 2:30pm, and one before i drove home this evening. i don't think i am just a lazy person. i am just TIRED ALL THE TIME. in addition to being incredibly irritating, it is really hurting my personal life, i am doing really badly in college (because of never getting out of bed and going to class and sleeping through two alarm clocks and missing exams...) and i really don't know what to do anymore. i've had all the thyroid tests done, switched depression medications to see if that would help, and i've tested negative for lyme disease and mono.
> does anybody share these problems? does anybody have any suggestions on what i can do? i would greatly appreciate any input that you might have. thank you, sarah
Posted by Zeke on January 3, 2000, at 23:52:09
In reply to Re: Tired ALL the Time, posted by Sassy on January 3, 2000, at 20:32:24
Of course fatigue concurrent with a viral infection such as Epstein Barr can also be an autoimmune reaction -- your immune system attacking your nervous system. This is similar to the role of elevated cortisol levels 'attacking' (effecting) the CNS in depression. But that's not really practical here, and I'm not aware of any meds that are effective against the Epstein Barr virus either.
If no physical causes are found (low grade chronic infection, apnea) there are several medical options...
Antidepressants which are energizing include protryptline (Vivactil), Wellbutrin, and the MAO inhibitors. Of those, only Wellbutrin could (should) be added to an SSRI.
Someone suggested having thyroid levels checked. (A good idea.) But even if they are in the normal range -- as you say they are -- thyroid hormone could be added and should have an energizing effect.
Lastly, a stimulant such as Ritalin, Dexedrine or Adderall could be added. An online chapter from a psychopharmcology textbook states, "Stimulants have been used to counteract anergia secondary to SSRI therapy in depression." (http://www.appi.org/books/schatze/as08.html) Whether your doctor is willing to do this -- or willing to use a sufficient dose -- is another matter. However, this would likely be the safest, fastest method to counteract anergia either from depression or antidepressants. Indeed the afore mentioned article also says, "Stimulants also have a place in the crisis management of individuals whose functioning is impaired by depression and whose life situation will deteriorate rapidly if they are not able to resume functioning within a few days. In such situations a trial of methylphenidate, D-amphetamine, or magnesium pemoline is worth initiating to attempt to get a patient through a crisis where failure to function might result in getting fired from a job or flunking out of college."
If your doc is closed to these options, you should get a second opinion.
As for college, let your instructors know what your situation is, and that you might need some accomodations. You should also provide some documentation to your college's disabilities coordinator (your responsibility under the Americans with Disabilities Act). Depression is certainly covered under ADA.
Just out of curiosity, does your depression and anergia become worse in the winter months? (Right now we are in the period of shortest daylight.) If so, you might have Seasonal Affective Disorder. SAD is often responsive to light therapy.
Posted by Zeke on January 4, 2000, at 0:04:46
In reply to Tired ALL the Time, posted by Sarah on January 2, 2000, at 21:57:45
Sarah, these are links to the disabilities services office at PSU...
http://www.lions.psu.edu/ODS/text/ods.html
http://www.hbg.psu.edu/studaf/Nontrad/disabilities.html
http://www.lions.psu.edu/ODS/text/documentation.html#psychological
http://www.lions.psu.edu/ODS/text/accommodations.html
Posted by juniper on January 4, 2000, at 0:41:02
In reply to Re: Tired ALL the Time, posted by Zeke on January 4, 2000, at 0:04:46
you did not mention when this tiredness began...have you had this problem for as long as you can remember or was there a definate beginning?
Posted by S. Suggs on January 4, 2000, at 5:40:30
In reply to Question for Sarah, posted by juniper on January 4, 2000, at 0:41:02
Have you considered a sleep study? (If not already mentioned in one of the above posts). Best of luck and blessings,
S. Suggs
Posted by sandi on January 10, 2000, at 19:48:03
In reply to Tired ALL the Time, posted by Sarah on January 2, 2000, at 21:57:45
> I sleep all the time. sometimes it's definitely an escape (i have been major depressive since i was a kid) but the other times, i am doing whatever in my day and i will just HAVE to go to sleep. I can't tell if it's the depression, or the medications (SSRI's), or maybe i am just a sleepy person!?!?, or maybe i have some condition? Does anybody have this problem too? and what can i do about it?
> it's not as simple as just keeping busy. i could have a day packed full of appointments and it won't wear me out because i simply would miss the appointments because i could not stay awake that long. i could be having dinner with the president and i'd have to say "excuse me, i need to go take a nap...".
> so here's the deal: i can't get up in the morning; if i do, i need to go back to sleep usually within two hours of getting up (ex- i'll get up, have breakfast, take a shower, look over what i need to do that day, and then it's time for sleep again); then, when i finally do get up, i absolutely positively fall asleep around 2:30 pm. i can't for the life of me stay awake in the middle of the day! then i'll get up around 5 or 6 pm and do something until 8 or so when i will have to lay down for a bit if i am planning to stay up past 10pm. like today, i went to see my boyfriend this morning after not seeing him for two weeks. despite my excitement to see him and even though i really wanted to spend time with him, i had to take a nap in the morning after i got there, one around 2:30pm, and one before i drove home this evening. i don't think i am just a lazy person. i am just TIRED ALL THE TIME. in addition to being incredibly irritating, it is really hurting my personal life, i am doing really badly in college (because of never getting out of bed and going to class and sleeping through two alarm clocks and missing exams...) and i really don't know what to do anymore. i've had all the thyroid tests done, switched depression medications to see if that would help, and i've tested negative for lyme disease and mono.
> does anybody share these problems? does anybody have any suggestions on what i can do? i would greatly appreciate any input that you might have. thank you, sarah-Sarah, I agree that you should be checked out for any physical cause of your tiredness. If your workup is negative, talk with the dr. that prescribes your SSRI and see if he/she will give you a stimulant. I have taken Elavil for years in slowly increasing dosages. By the time I got to 225 mg, I could barely get out of bed and by the time I "woke up", (which was usually late in the evening,) it was time to take more and go back to bed. I was miserable!!!! In discussing this with my pdoc, he put me on a low dose of Ritalin and the effect has been tremendous!!!!! I now have energy and can function the way "normal" people do. I haven't felt this good in a long time. Discuss it with your doc and good luck ---------------------------------------sandi
Posted by S. Suggs on January 12, 2000, at 3:44:38
In reply to Re: Tired ALL the Time, posted by sandi on January 10, 2000, at 19:48:03
Sarah, I feel a sleep study is the way to go. I learned a lot during the process. Even though I was "dreaming" - indication of REM sleep, I discovered that actually during the night I only had around 15-20 minutes of REM!! I had no concept of time (as all of us - probably) during sleep. Some meds were changed and my sleep improved. They usually check for sleep apnea and narcolepsy if necessary. Let me know if you have any questions on the study (what to expect etc...)I'm no expert, but if I can help, I will. Blessings,
S. Suggs
This is the end of the thread.
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