Posted by Cece on July 10, 2001, at 21:52:38
In reply to is everything a sign of underlying dep???!!! , posted by delna on July 10, 2001, at 11:28:25
Well, I think that your story is amazing, and I'm glad that you survived such hell. The question that you raise is very interesting.
I second all the suggestions made- monotherapy is out-of-date!
I want to also say that a sleep study (a complete one, which can only be found at a sleep disorders clinic) is a very good idea (ditto thyroid tests- again complete ones). Along the path of dealing with depression/sedation/ sleepiness, trying to sort it all out, I managed to finagle a sleep study at Stanford out of my HMO (doing so was a real coup). They diagnosed me with "Upper Airway Obstructive Disorder" which is a diagnosis that they developed there.
What it meant was, and this completely verified all my own perceptions, that my airway was not totally collapsing during sleep as in sleep apnea, but it was partially closing down and keeping my body on 'alert'. Consequently, I was not able to go into the deepest level of sleep which restores and refeshes the body.
As well as BP depression, I also have fibromyalgia, which from my experience and research I have come to believe is the consequence of disordered sleep. Nortriptyline (and earlier before poop-out, Trazadone) had helped this problem significantly- at its worst I could sleep many hours, wake up exhausted feeling like I had spent the whole night 'working in my dreams', and feeling like I had been run over by a truck- whether I was depressed or not.
The treatment for Upper Airway,etc is the same as for sleep apnea: sleeping at night hooked up to a device called a CPAP machine (Continuous Positive Airway Pressure)- this is not invasive like a respirator, it just maintains enough air pressure so that your airway stays fully open. This helped me a lot- didn't solve all my problems but made a big difference in the quality of my sleep and my alertness. I used it continually for a year, and now use it periodically when I feel an energy/fibromyalgia relapse.
I don't use it all the time anymore because my problem is not so severe (result of other meds? weight loss? I'm not sure), but also because it is a drag: I felt kinda like Bride of Frankenstein (I had no love life at the time, so no witnesses), it was hard for me to find a mask that fit me comfortably, and there is maintenance (you have to clean the mask daily with sterilizer). BUT, I am very grateful to have it, and as I write this, I think that I am due for another round on it.
I hope that you have access to good resources, including a more creative pdoc, and that your progress continues. You have come so very far- go for the whole banana!
Cece
> LONG
>
> Hi
>
> I was wondering what u make of this:
>
> I am on 300mg effexor and am totally fine.
> I mean I used to have severe depression, sleep all day(20hrs at least), never leave the house and had no future plans and was perpetually suicidal . had no job, life, friends for years and no desire to even get a life. SSRIs didn’t help much- I felt less anxious and self destructive but I had no enthusiasm- so I continued the same lifestyle.
> With effexor I love doing stuff eg working making friends and am full of life and plans. I am enthusiastica
> The only crippling problem is feeling sleepy all day. I have always had this prob with sleepiness and hypersomnia which is certainly not being caused by the venlafaxine.
> Overall the drug has changed my life- I feel normal.
> But so sleepy. But I don’t sleep excessively like when I was depressed. I still jump up to go to work in the morning. I just feel sleepy at work and not 100% alert.
> My psych insists that the sleepiness indicates that the depression (atypical) is still there and wants to switch me to parnate. The doctor believes that the parnate should deal with this sleepiness ( although it is sedating in some people- probably me! ) This is a scary process as it involves withdrawing from effexor (which is tough) and going on a drug that may improve the depression as well as effexor but not help with the sleepiness infact it may sedate me more.
>
> I argued that I have no signs of atypical depression any more. I’m sleepy but I am not lethargic, apathetic, tired, sad etc anything. And also when provigil kept me awake those few days that it worked ,I was 100% good. Efficient and functional
>
> I know I don’t have narcolepsy as the symptoms don’t quite match but I feel that if the low mood, apathy, depressive symptoms have gone and I am happy and raring to go, how can he say that the sleepiness is a sign of unresolved depression??
>
> Shouldn’t he just add stimulants to effexor to control the sleepiness?
>
> Thanks for listening
> Any views welcome
> delna
poster:Cece
thread:69599
URL: http://www.dr-bob.org/babble/20010708/msgs/69664.html