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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by ItsHowdyDudyTime on November 27, 2002, at 21:27:40
How many of you have ever thought that much of your severe depression problems was somehow, ultimately rooted in screwed up sleep cycles? I mean REAlLY screwed up sleep cycles. Im not talking about the usual insomnia everyone gets from time to time when stressed out or if they drank too much coffee that day. Im talking about something different here. An altogether different kind of insomnia most non mentally ill people have luckily never experienced.
When I was first hit by the "big one" years ago, one of the first symptoms I developed was severe insomnia. I found I couldnt easily fall asleep despite feeling exhausted and extremely tired at night. Id lay in bed and just couldnt fall asleep. I wasnt thinking about anything, wasnt worrying about anything. It was more like a physical deteroriation in my bodies sleep mechanism, complicated and misunderstood as that is. Id never experienced anything like it before in my life.
Then the early morning awakening problems hit, Id "jerk awake" repeatedly right before dawn...what a miserable, nasty feeling. Then try to fall back asleep, unsuccessfully til I broke down and took a sleeping pill like a Xanax or a benadryl. Which would knock me into a shallow, crappy quality sleep for a few more hours. Then Id awaken early, never able to sleep late anymore. Id sleep maybe a total of eight hours, but wake up and feel like I had only gotten an hour of shoddy sleep and was totally unrested and unrecovered.
I personally believe the real solution to severe depression is sleep. I believe that if I could once again sleep totally normally, get into a deep nice sleep again my depression would eventually go away. I once read that sleep is your body's "damage control" system and sleep is where your body recovers at. No good sleep and its impossible for your body and brain to fully recover. The result being that you live in a state of severe depression all the time.
Also, I was told by a psychiatrist that severe insomnia is one of the things that can cause psychosis, particularly psychotic depression.
What are your thoughts on this? Have any of you ever wondered if severe depression is somehow related to inability to fully recover due to the fact clinically depressed people have severely messed up sleep cycles, they dont cycle in and out of REM sleep normally, etc.
I have seriously wondered if the problem we describe as major depression is not so much a problem of needing to be activated or stimulated as is the common thinking, but more a problem of inability to recover properly like a healthy person does. Recovery is a very important and underrated thing.
Also, human growth hormone is released during deep sleep and this hormone is critical to recovery. Somes studies indicate that severe depressives have lower levels of human growth hormone.
Howdy Doody.
Posted by bluedog on November 28, 2002, at 3:50:23
In reply to Question for you about sleep cycles and mood, posted by ItsHowdyDudyTime on November 27, 2002, at 21:27:40
> How many of you have ever thought that much of your severe depression problems was somehow, ultimately rooted in screwed up sleep cycles? I mean REAlLY screwed up sleep cycles.
>
I found I couldnt easily fall asleep despite feeling exhausted and extremely tired at night. Id lay in bed and just couldnt fall asleep. I wasnt thinking about anything, wasnt worrying about anything. It was more like a physical deteroriation in my bodies sleep mechanism, complicated and misunderstood as that is. Id never experienced anything like it before in my life.
>
>
> I personally believe the real solution to severe depression is sleep.
>
> I have seriously wondered if the problem we describe as major depression is not so much a problem of needing to be activated or stimulated as is the common thinking, but more a problem of inability to recover properly like a healthy person does. Recovery is a very important and underrated thing.
>
> Also, human growth hormone is released during deep sleep and this hormone is critical to recovery. Somes studies indicate that severe depressives have lower levels of human growth hormone.
>
> Howdy Doody.
I completeley agree with you on this one. Your post almost perfectly describes many of the symptoms of Chronic Fatigue Syndrome (CFS).I have my own theories that depression, screwed up sleep and CFS are intimately related and in some cases can be one and the same thing.
Therefore, to treat your crappy sleep and your depression my personal advice is to commence a treatment program that would be used by experts for the treatment of CFS.
Here is a link that provides a very good starting point to a web site that deals with CFS.
see http://www.immunesupport.com/library/showarticle.cfm/ID/3157/searchtext/sieverling/T/CFIDS_FM
bluedog
Posted by ArthurGibson on November 28, 2002, at 7:14:15
In reply to Question for you about sleep cycles and mood, posted by ItsHowdyDudyTime on November 27, 2002, at 21:27:40
I sypathise with you, but I think this is a chicken and egg situation and you might have got the chicken before the egg. Or the cart before the horse, if you see what I mean.
I found that my sleep patterns recovered AFTER my depression started to lift, not BEFORE. Those little PROZAC pills saved my life.
I think that something chemical does go wrong in our brains when we get depressed and it might be the serotonin thing, but I expect that there are many other chemicals involved as well. Nothing in nature works the "E Lilly" simple mode.
I found that coming off the sleeping pills helped the PROZAC to work more strongly. I slept less, but it was useless sleep anyway on pills.
As the PROZAC took hold, my sleep improved.
I suspect that PROZAC is a mild drug and that PAXIL (SEROXAT)is much stronger for those with resistant depression. But this is just my observation of people I know who have taken both.
I found hot milk useful in promoting sleep. But when I say "useful" I mean like a spoon is "useful" to empty a bucket of water. But then we have to clutch at straws.
Perhaps the best help to the sleep of any person out there that cannot get enough of this prescious thing, is to lie in your bed and know that thousands of people who read this message board are deeply sympathetic to your plight and we, your friends are praying for your recovery. And you WILL recover!
I'm sorry I can't contribute anything more useful than this. I am very interested in the subject, but like you, I am searching for answers.
Posted by Mr Cushing on November 28, 2002, at 9:03:24
In reply to Question for you about sleep cycles and mood, posted by ItsHowdyDudyTime on November 27, 2002, at 21:27:40
I've suffered from insomnia pretty much since I was born, before I can even begin to chart my mood swings (I'm Bi-Polar). The only drug that I've taken so far, as an add-on to whatever else I was/have been taking, that helped with this was Clonazepam (Klonopin). If I have like .5mg of that before bed, I sleep like a baby. Otherwise, I toss and turn for hours before sleep, wake up like every hour upon the hour, and usually wake up fully hours before I've had enough restorative sleep. This didn't matter whether I was in a depression, manic, or relatively normal state of being. No matter how I was feeling, the insomnia remained.I do know this however... if I don't get enough sleep, Damn... just stay out of my way the following day. I'm VERY irritable without my normal 7-8 hours of sleep. In fact, a few nights of this could push me into another cycle pretty quickly. Thank God for Clonazepam as it's the only drug that I've found that works without my having to increase the dosage every few weeks to like HEAVY doses. I've still never gone over 1.5mg in a day no matter how bad that day was.
I'm supposed to be going to a Sleep Clinic (?) sometime over the next few months to get some tests done. Maybe that will give a better answer to my insomnia problem.
Posted by Larry Hoover on November 28, 2002, at 9:28:08
In reply to Question for you about sleep cycles and mood, posted by ItsHowdyDudyTime on November 27, 2002, at 21:27:40
> How many of you have ever thought that much of your severe depression problems was somehow, ultimately rooted in screwed up sleep cycles? I mean REAlLY screwed up sleep cycles. Im not talking about the usual insomnia everyone gets from time to time when stressed out or if they drank too much coffee that day. Im talking about something different here. An altogether different kind of insomnia most non mentally ill people have luckily never experienced.
I think Bluedog's reference to CFS is appropriate. I don't like the diagnostic compartmentalization that is rampant in Western medical thought.
One poster mentioned clonazepam as a sleep aid. Personally, I'd suggest temazepam. It has a narrower action, and is used in sleep disorder treatment protocols. It restores sleep architecture, leading to restorative sleep.
I think you're right on the money; until you address the sleep problems, you aren't going to be able to address the mood problems adequately.
Lar
Posted by Kari on November 28, 2002, at 14:54:11
In reply to Question for you about sleep cycles and mood, posted by ItsHowdyDudyTime on November 27, 2002, at 21:27:40
Hi,
Could it be that your insomnia is partly due to depression rather than the other way around? Sometimes the early symptoms of a depressive disorder can be the kind of disrupted sleep which you described. Have you tried an SSRI? Perhaps it would help you more than sleeping pills.
Every once in a while I suffer from severe insomnia due to problems of extreme arousal and overstimulation. The last time this happened, after sleeping only a couple of hours per night for over a week (on the nights in which I could sleep at all), I developed psychotic symptoms as well as severe physical distress. Taking Celexa enabled me to sleep again and surprisingly took away all my psychotic symptoms quite quickly (I realized on my own that I had been delusional).
Another thing which might help you is taking calcium and magnesium at night. This combo seems to be as effective as a tranquilizer but without the side effects.
Take care,
Kari.
Posted by ItsHowdyDudyTime on November 28, 2002, at 23:45:29
In reply to Sleep cycles and mood, posted by ArthurGibson on November 28, 2002, at 7:14:15
> I sypathise with you, but I think this is a chicken and egg situation and you might have got the chicken before the egg. Or the cart before the horse, if you see what I mean.
Hmmmmmm really? Sure about that?>
> I found that my sleep patterns recovered AFTER my depression started to lift, not BEFORE. Those little PROZAC pills saved my life.Not me, the first thing that improves with me is sleep.
>
> I think that something chemical does go wrong in our brains when we get depressed and it might be the serotonin thing, but I expect that there are many other chemicals involved as well. Nothing in nature works the "E Lilly" simple mode.Really? Thats odd because serotonin is the primary brain neurotransmitter affected by SSRIs. Did you know that serotonin is heavily involved in sleep regulation? Too little serotonin and we develop severe insomnia and also become meaner as hell, ornery, irritable.
>
> I found that coming off the sleeping pills helped the PROZAC to work more strongly. I slept less, but it was useless sleep anyway on pills.Im not talking about sleeping pills here. Sleeping pills such as hypnotics or benzos are just short term adjunct treatments, designed to get you to live thru another day until the full effect of the antidepressant kicks in. Reliance on "sleeping pills" is a very poor way to get sleep. The antidepressant once kicked in fully, should provide you with sleep. If its not, say if its causing you severe insomnia a month or two into the drug, is a bad sign and could point possibly to bipolar tendencies. The one exception here is MAOIs and stimulants, which tend to cause insomnia even in non bipolar individuals, due heavily to their dopaminergic profiles.
But if an SSRI keeps you away past say, the third of fourth week, you probably got probs beyond depression.
>
> As the PROZAC took hold, my sleep improved.Thats how it is supposed to be.
>
> I suspect that PROZAC is a mild drug and that PAXIL (SEROXAT)is much stronger for those with resistant depression. But this is just my observation of people I know who have taken both.
>
> I found hot milk useful in promoting sleep. But when I say "useful" I mean like a spoon is "useful" to empty a bucket of water. But then we have to clutch at straws.
>
> Perhaps the best help to the sleep of any person out there that cannot get enough of this prescious thing, is to lie in your bed and know that thousands of people who read this message board are deeply sympathetic to your plight and we, your friends are praying for your recovery. And you WILL recover!LOL HAHAHAHA!!! Thats funny! Im afraid it doesnt work that way in severe depression. "Knowing" that people care about you or are praying for you to fall asleep doesnt fix you in severe depression. A person who is truly severely depressed is beyond caring what others think about them. You WILL recover when you get on the correct drug or treatment, such as ECT. I had all kinds of people praying for me, hoping I was going to get better and it never worked. The only thing thats worked was drugs. Exercise helps some also.
May I ask what type of "depression" that you have? Have you been told your exact affective disorder? Do you have access to your psychiatric records where you can tell me for yourself what your dx is?
>
> I'm sorry I can't contribute anything more useful than this. I am very interested in the subject, but like you, I am searching for answers.I dont believe you understood what I was talking about very well, but thats OK because it doesnt sound as if you have had really severe depression before. And therefore dont have the same frame of reference as I have with regards to severe mental illness. Thats understandable.
If Prozac made you manic, you might have better luck with mood stabilizers and atypical anti-psychotics. Like I told you in another post, dont blame yourself, blame clinical psychiatry for their shoddy, halfassed diagnostic methods and lack of technological sophistication when diagnosing new patients.
Howdy Doody
Posted by Tabitha on November 29, 2002, at 3:40:22
In reply to Re: Sleep cycles and mood, posted by ItsHowdyDudyTime on November 28, 2002, at 23:45:29
> > Perhaps the best help to the sleep of any person out there that cannot get enough of this prescious thing, is to lie in your bed and know that thousands of people who read this message board are deeply sympathetic to your plight and we, your friends are praying for your recovery. And you WILL recover!
>
> LOL HAHAHAHA!!! Thats funny! Im afraid it doesnt work that way in severe depression.It's OK to express disagreement, but I'm afraid this part of your post could come off as a put-down. Could you please be more careful to keep things civil while Dr Bob is away? Here's a link to the civility guidelines for this site http://www.dr-bob.org/babble/faq.html#civil
Tabitha (filling in for Dr Bob)
P.S. Responses to this post should be directed to Psycho-Babble Administration
Posted by Larry Hoover on November 29, 2002, at 9:13:12
In reply to Re: Sleep cycles and mood, posted by ItsHowdyDudyTime on November 28, 2002, at 23:45:29
> Im not talking about sleeping pills here. Sleeping pills such as hypnotics or benzos are just short term adjunct treatments...
No, they're not just for short term use. I was on temazepam for over two years, and it provided me restful restorative sleep. I know people who've used clonazepam for over twenty years for the same purpose.
I fear you've closed your mind to an appropriate therapy. Sleep studies have clearly shown that both temazepam and clonazepam restore sleep architecture, which is to say, promote the proper amount of restorative stage 3 and 4 sleep most often missing in subjects who awake feeling unrested. Oxazepam is another alternative, as it is a precursor to temazepam.
Posted by Dinah on November 29, 2002, at 9:22:14
In reply to Re: Sleep cycles and mood, posted by Larry Hoover on November 29, 2002, at 9:13:12
I'm in a depressed phase of my cycle right now, and after a few days of sleeping really nonstop, I now find myself falling asleep easily but waking very early in the morning totally unable to go back to sleep. An extra klonopin will sometimes get me back to sleep but not until after a fair amount of time. I'm not anxious or energetic. I'm just awake.
When I'm hypomanic, and when I'm in a nasty agitated depression, I have trouble falling asleep and trouble staying asleep. It seems all parts of my cycle involve either under or over sleeping.
I do find that when I'm depressed, sometimes a sleepless night improves my mood. And when I'm hypomanic, a full night's sleep inevitably brings on a crash. So usually I associate good mood with little sleep and depression with too much sleep.
Posted by turalizz on November 29, 2002, at 9:46:04
In reply to Re: Sleep cycles and mood, posted by Larry Hoover on November 29, 2002, at 9:13:12
> I fear you've closed your mind to an appropriate therapy. Sleep studies have clearly shown that both temazepam and clonazepam restore sleep architecture, which is to say, promote the proper amount of restorative stage 3 and 4 sleep most often missing in subjects who awake feeling unrested. Oxazepam is another alternative, as it is a precursor to temazepam.Just quick note: trazodone also promotes slow wave sleep.
cem
Posted by Mr Cushing on November 29, 2002, at 10:33:43
In reply to Re: Sleep cycles and mood, posted by Larry Hoover on November 29, 2002, at 9:13:12
I have to agree with Larry Hoover 100%. I've suffered from insomnia for damn near 25 years (all my life). It got to the point where on average I was getting "maybe" 3-4 hours of sleep a night done in shifts. Let's just say that about 6 months of this took a huge beating on my body and on my mind.I've been on Clonazepam now for about 4 years off and on. When off of Clonazepam, I barely sleep, it's back to the original problem. When I take Clonazepam before bed, I sleep soundly for about 7-8 hours and wake up feeling rather good. A bit of a morning hangover, but I just have a cup of coffee and I'm ready.
I've never had to increase my Clonazepam dosage either during the 3-4 years that I've been on it in order to get a proper night's sleep. .5mg of it is all I need, which calms my mind down, and which allows me to get into periods of deep sleep that I've never before even knew that I could achieve.
I'm supposed to be going to a Sleep Clinic sometime in the next few months to have some tests done and to see if they can recognize what the overall problem is to my insomnia. But if that doesn't fix it, I have absolutely no intentions of ever coming off of Clonazepam. Insomnia is like a slow torture that will eventually drive you mad.
Posted by bluedog on November 29, 2002, at 10:43:54
In reply to Re: Sleep cycles and mood » Larry Hoover, posted by Mr Cushing on November 29, 2002, at 10:33:43
>
> Insomnia is like a slow torture that will eventually drive you mad.
>
>The best illustration I have ever seen of insomnia slowly driving you mad was portrayed by Edward Norton's character in the movie "Fight Club"
Posted by Alara on November 29, 2002, at 20:30:03
In reply to Re: Question for you about sleep cycles and mood, posted by Kari on November 28, 2002, at 14:54:11
>
> Another thing which might help you is taking calcium and magnesium at night. This combo seems to be as effective as a tranquilizer but without the side effects.
> Take care,
> Kari.
Kari,
Have you found that this combination works on a one-off basis, or does it only work when you take the calcium and magnesium nightly over a period of time? I would be interested in adding this to my little bag of sleep tricks. :-)Thanks,
Alara
Posted by Alara on November 29, 2002, at 21:02:53
In reply to Question for you about sleep cycles and mood, posted by ItsHowdyDudyTime on November 27, 2002, at 21:27:40
>
> I personally believe the real solution to severe depression is sleep. I believe that if I could once again sleep totally normally, get into a deep nice sleep again my depression would eventually go away. I once read that sleep is your body's "damage control" system and sleep is where your body recovers at. No good sleep and its impossible for your body and brain to fully recover. The result being that you live in a state of severe depression all the time.
>
>
Hi Howdy,These are my thoughts exactly. Deprive me of good sleep and my anxiety levels will go through the roof, resulting in depression.
During the last few months I have been working on more natural solutions to my sleeping problems and have gradually realised that the quality of my sleep is directly related to my quality of self-trust and self-care. A Xanax by itself will allow me to fall asleep in the first place, but unless I am in the right emotional place, the quality of sleep will be questionable. For truly restorative sleep, I need a certain degree of inner peace.
How do I achieve inner peace? If something is troubling I force myself to face the problem by sitting down for half an hour and writing down the problem. I then use cognitive behavioural techniques to put the problem into perspective and, amazingly, my anxiety levels go down. I then zone out in front of the TV.
Pre-bedtime rituals also help to promote a sense of calm. A cup of herbal tea and a good shower before bed work wonders for me. I also try to make sure that I have made my lunch and sorted my clothes for the next day so that I don't lie awake panicking about getting to work on time the following day. These things sound like common sense - but you'd be amazed at how much I used to avoid doing all these things. (In the past, I believed that doing these things would heighten my anxiety at the time when I most wanted to switch off and recover from the day. It has taken me a long time to learn this lesson!)
Of course we would love to discover and conquer the physiological phenomenon that makes us struggle so much with getting a good night's sleep. Meanwhile we have drugs and natural remedies. However, I also believe that we underestimate the power of psychological factors. If we tackle the mind, we have already won half the battle.
Good luck,
Alara
Posted by bluedog on November 29, 2002, at 21:09:16
In reply to Re: Question for you about sleep cycles and mood » Kari, posted by Alara on November 29, 2002, at 20:30:03
Alara
I have found that magnesium together with 100mg of Phosphatydil Serine at night about half an hour to an hour before bed has a definite sedating effect on me. In fact I have had to reduce my magnesium dose as it worked too well and I was feeling a little groggy in the mornings.
If you can find the right dosage for you I'd highly recommend giving it a try.
Posted by Kari on December 1, 2002, at 6:24:34
In reply to Re: Question for you about sleep cycles and mood » Kari, posted by Alara on November 29, 2002, at 20:30:03
Hi Alara,
It seems that taking calcium and magnesium might help even if you don't take it regularly. I am not certain, since I have had to stop taking them every now and then and adjust the dosage. In any case, it is best to ask your doctor before adding any supplements, as some people may be harmed by the excess calcium.
Take care,
Kari.
Posted by syringachalet on December 10, 2002, at 19:05:35
In reply to Re: Please be civil » ItsHowdyDudyTime, posted by Tabitha on November 29, 2002, at 3:40:22
Tabitha,
Thanks for reminding us all of the boundaries of action on this website.
I had stopped posting for awhile because I felt that anything I posted here would be scrutinized and redirected by someone who felt they needed to set me straight.If we cant feel safe to share our feelings here(AS LONG AS IT DOESNT HURT ANYTOME ELSE) in our own way, what is the use of a support and inform website like this...?
Just a thought...
syringachalet
This is the end of the thread.
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