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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 29. This is the beginning of the thread.
Posted by Noa on September 4, 1999, at 18:47:56
Sometimes when I am in a low mood, not necessarily in a severe depression, I want to sleep a lot. Lately I have been getting the feeling that sleeping more is actually making me feel MORE depressed. It is a catch-22 for me, because I want to sleep to "get away from it all" but it might be making things worse. It happens a lot on weekends, when there isn't much structure to my life (and I am anxious about the endless mental list of "things to do" that have piled up, and am too passive to make any plans). Because of this, I end up having a weekly "cycle" of sorts that I don't think is innately biological, as in cyclothymia. My mood gets lower as the weekend progresses, and by midweek, after I have been at work a few days, my mood gets better, and so on... Any one else experience this, or any insights to share?
Thanks.
Posted by Thumper on September 4, 1999, at 19:44:00
In reply to Sleep--too much of a good thing?, posted by Noa on September 4, 1999, at 18:47:56
I'd guess comments like yours must make cognitive therapists all twitchy with smiles. Perhaps its the forced social interaction of your weekday life which lifts your mood. It the sort of "homework" my therapist would give me - get out and talk to people. It helps me, although when given the assignment I want to whack Mr. Smartypants Therapist over the head. I'd rather stay in bed too - but lying around in bed all weekend most definately exacerbates my depression. It adds to feelings of low self-worth, and boosts a vicious circle of depression.
T
Posted by Noa on September 4, 1999, at 21:29:03
In reply to Re: Sleep--too much of a good thing?, posted by Thumper on September 4, 1999, at 19:44:00
The thing is, I want to be able to make plans and be active, but it is a vicious circle. I can't seem to muster up the energy to plan to be around people (sometimes I can, sometimes I can't) and then when I am alone I get into this low mood and want to sleep, which makes me feel lower, etc. etc. etc. etc. etc. Geez, I sure sound like I am whining. That makes me feel even more appealing. As Lucy might put it, "Blechhhhh!!!!!"
Posted by saintjames on September 5, 1999, at 16:00:53
In reply to Re: Sleep--too much of a good thing?, posted by saintjames on September 5, 1999, at 15:39:40
> > Sometimes when I am in a low mood, not necessarily in a severe depression, I want to sleep a lot.
James....
You are describing classic signs of depression. Are you seeing a doc about this ?
james
Posted by Noa on September 5, 1999, at 17:37:29
In reply to Re: Sleep--too much of a good thing?, posted by saintjames on September 5, 1999, at 16:00:53
Oh yeah. Have been for years. This low mood, passive thing is the milder form for me. I just passed through a wickedly agitated suicidal depression last month, and have started to feel better. But only when structure is imposed from the outside, like at work. On weekends, I hibernate and get depressed and want to sleep.
Posted by saintjames on September 5, 1999, at 18:33:08
In reply to Re: Sleep--too much of a good thing?, posted by Noa on September 5, 1999, at 17:37:29
> Oh yeah. Have been for years. This low mood, passive thing is the milder form for me. I just passed through a wickedly agitated suicidal depression last month, and have started to feel better. But only when structure is imposed from the outside, like at work. On weekends, I hibernate and get depressed and want to sleep.
James here....
Are you taking taking meds for this or doing coulseling. If not, why ?
james
Posted by Noa on September 5, 1999, at 18:45:52
In reply to Re: Sleep--too much of a good thing?, posted by saintjames on September 5, 1999, at 18:33:08
I take a combo of Effexor (XR), cytomel, synthroid, ritalin, and serzone. Just added the serzone last month, and increased the effexor a few weeks ago from 225 to 300. Also in therapy.
Posted by Dee on September 5, 1999, at 21:26:35
In reply to Sleep--too much of a good thing?, posted by Noa on September 4, 1999, at 18:47:56
I sleep too much when I am depressed, when I notice I'm doing that it's a clear sign that trouble's heading my way. But then there is this 'other' sleep too much. This happens when I have to deal with something, and the anticipation makes me anxious... You know, the space which I call 'The only way out of the burning house is through the fire.'
I find that regardless how mush I sleep, it am so tired when I should get ready to jump in the fire, that it is almost impossible to get up. LIke when I'm without a job and I kknow that I must go out and get one, etc.
I've heard that we create the ways we deal with anxiety, enforcing them a little at the time. Seems like I have trained myself to cope by simply not dealing with things to the point of being unconscious. This is just how I feel about myself, I posted it just in case anyone might relate.
Dee
Posted by Janice on September 5, 1999, at 22:07:09
In reply to Re: Sleep--too much of a good thing?, posted by Dee on September 5, 1999, at 21:26:35
>Noa, Your depression cycle of the week-ends being worse than during the week was exactly my cyclothymic cycle, and i'm positive they started for teh same reasons.I also had highs too.
After discovering the pattern and taking notice of it, the moods came like clockwork, and over time (4 years of working real hard at getting rid of this cyclic depression) they slowly flattened.And recently,I haven't experienced this cycle for 3 months.I'm not certain if it's for good, but hoping. Janice.
Posted by Dee on September 5, 1999, at 22:29:22
In reply to Re: Sleep--too much of a good thing?, posted by Janice on September 5, 1999, at 22:07:09
Thanx, Noa & Janice... I find that this is definitely something I have to look into. I am having weekend fits regardless if I work or not. It always hits me Friday night, and the worst will pass (usually) by Monday. Today, I was to be at work on a Sunday, and I couldn't make it!
I kind of feel that it's more related to weekend in sich that work. I feel the same way when I am not working at all.
Posted by saintjames on September 6, 1999, at 2:14:05
In reply to Re: Sleep--too much of a good thing?, posted by Dee on September 5, 1999, at 21:26:35
> I sleep too much when I am depressed, when I notice I'm doing that it's a clear sign that trouble's heading my way.
James here...
Exactally. Depression effects all of the basic drives (sleep, hunger, sex, thought, mood, ect)
This tells us that depression happens at the root
level because it effects the basic drives that keep us alive and functioning. Not everybody has all basic drives effected when depressed. With sleep it is a question of amount and quality. Sleeping more (esp a lot more) is always a sign to me. More important than the amount of sleep is the quality. The ez way to see if you are getting quality is to ask the question "Do I feel rested
after I sleep" Sometimes I feel rested the min. I wake up, but generally it takes an hour or so b4 I ask this question. If I don't feel rested and there are not major stresses or problems going on it is a sign that the depression is creeping back.
I expect a few nights of the month to not have good sleep....that is normal. Ever 5 yrs or so I go thru a major depression. Each time they happen
the signs were there way in advance. The last time it only took me 2 weeks to realize I was in a major depression, the time b4 I went 3 months (not washing, leaving the house, ect) b4 it occured to me I was in a very major depression.Once I realize i am in a major depression i know what to do. My doc (who is excellent) tells me what is the max dose I can take (effexor, I take 100 to 200 mgs normally but can go as high as 400 if I need to) so his orders are to start taking more asap, then call him and let him now what dose I am on. generally I just leave a voice mail with his service "Hey doc, I crashed so I am going to 300. Call me if there is a problem with this" I have been on AD's since 85 so I am an old pro with dealing with these breakthru depressions, and my doc is very comfortable with me changing my dose, provided I let him know what I am doing. This arrangement really helps me because it puts me in control and indicates to me that my doc trusts me and that we are working together as a team.
The five year breakthru depressions always come with warnings (change in sleep and desire to be involved in life past the couch and TV) and I hope I can read the signs sooner next time and avoid it altogether. About 5-7 days of the year I have a sudden depression that lasts a day or so. Most normal people get these too, so I don't make a big woo about it and change the dose provided they last just a day or so. I consider them part of being human. For me, a depression that comes on w/o warning lifts completly the next day so I drag my sorry ass out of bed and the house because I know the next day will be better. because of good meds, great docs, and lots of personal introspection I am a happy camper 360 days of the year, since 1985.
james
Posted by Noa on September 6, 1999, at 8:22:24
In reply to Re: Sleep--too much of a good thing?, posted by saintjames on September 6, 1999, at 2:14:05
Thanks for all the posts.
My weekend lows don't start right away on Friday night like Dee's. They start with having a hard time getting out of the house on Saturday morning, and becoming increasingly passive and bored. I am bored being here doing nothing, but too passive to call people, make plans. I have a mental list of things I should do that are joyless, like cleaning, etc., which I don't get to either. The weekend passivity, boredom and blahs grow and grow. It gets harder and harder to get myself into the shower and dressed and out into the daylight. By Monday I am really blue. Then, after a couple of good days at work, I feel somewhat better, so my mood is much brighter by Wednesday or so. Janice, do you think this is cyclothymia per se? OR more of a reactive thing, ie, I have a lingering depression, but react positively to a stimulating work environment and structure, and then when I am alone at home, the depression shows itself again.
I keep asking the following question: Do I need more meds? My doctor wants me to add lithium to my cocktail. I wonder whether I should try another increase in the effexor first. I also wonder if I should try the fish oil or other supplement. Then I wonder if meds is the issue at all, or if at some point, I have to take some action (like making calls, plans for weekends) and not expect the meds to do it all.
Any thoughts??? Thanks.
Posted by Noa on September 6, 1999, at 13:47:24
In reply to Re: Sleep--too much of a good thing?, posted by Noa on September 6, 1999, at 8:22:24
I actually made it outside, showered and dressed. Went and bought some birthday presents for my nieces. Didn't enjoy the process as I used to, didn't put much thought into it. Felt a bit low on ideas. But went to a good toy store and looked around until I found something adequate for each. Actually went over to their house to give them their presents (about a week late), but they weren't home. Made plans (!) with my sister to bring over the presents this evening.
Then came home, craving, get this, those little yellow tags that read "new". Only one now, kind of a let down. Am I getting addicted to babble?
Something interesting happened when I was getting dressed. I put my pants on, and felt something on my leg. I touched it through the pants with my hand and it felt something like a fuzzy wad of bunched up scotch tape. For a millisecond, I thought it was a bug, then calmed myself into thinking it was a sticky label or something, then it started to vibrate!!!! I screamed and got out of the pants as soon as I could, and looked inside and there was a big fat bumblebee staring up at me. I managed to free him outside a few minutes later. I don't know if bumblebees--the big, fuzzy type--sting. But I feel so incredible lucky not to have been stung if they do. I have been stung by yellowjacks and know it is pretty awful, but have no experience with the bumblebee. Any way, I thought to myself, what meaning can I make of this unusual event? I am not a beleiver in "signs" or anything like that, but sometimes it helps to play out a metaphor. Any ideas?
Posted by saintjames on September 6, 1999, at 15:43:15
In reply to Newsflash: Noa emerges from her apartment, posted by Noa on September 6, 1999, at 13:47:24
> I actually made it outside, showered and dressed. Went and bought some birthday presents for my nieces. Didn't enjoy the process as I used to, didn't put much thought into it. Felt a bit low on ideas. But went to a good toy store and looked around until I found something adequate for each. Actually went over to their house to give them their presents (about a week late), but they weren't home. Made plans (!) with my sister to bring over the presents this evening.
>
> Then came home, craving, get this, those little yellow tags that read "new". Only one now, kind of a let down. Am I getting addicted to babble?
>
> Something interesting happened when I was getting dressed. I put my pants on, and felt something on my leg. I touched it through the pants with my hand and it felt something like a fuzzy wad of bunched up scotch tape. For a millisecond, I thought it was a bug, then calmed myself into thinking it was a sticky label or something, then it started to vibrate!!!! I screamed and got out of the pants as soon as I could, and looked inside and there was a big fat bumblebee staring up at me. I managed to free him outside a few minutes later. I don't know if bumblebees--the big, fuzzy type--sting. But I feel so incredible lucky not to have been stung if they do. I have been stung by yellowjacks and know it is pretty awful, but have no experience with the bumblebee. Any way, I thought to myself, what meaning can I make of this unusual event? I am not a beleiver in "signs" or anything like that, but sometimes it helps to play out a metaphor. Any ideas?James here....
Yes they do sting ! As a kid I disturbed an underground nest and had several fly up my shirt.
I got like 7 stings. With me when I am depressed
I am hypersensitive to anything that disturbes my
coccon.You are so right about not expecting the meds to do everything. I find that if I can put myself in
better environments the meds really kick it.When I am house bound with depression, I try to take small steps, like going out in the yard first. Then drive to the library, ect. each day doing a little more. I hate dealing with the public when depressed so I plan things I can go and do w/o having to interact, at first ( I don't count driving thru Mc D's as interaction !) It also helps having friends who understand depression, it is ez'er to go see them.
Welcome to the outside world, Noa ! We have all been there at one time (house bound) and we are here for you. perhaps some other people on the list have some other ideas and good small steps to take that have worked for them.
james
Posted by Noa on September 6, 1999, at 15:57:11
In reply to Re: Newsflash: Noa emerges from her apartment, posted by saintjames on September 6, 1999, at 15:43:15
James,
Thanks for the encouragement. You're right about "Baby Steps" (ever see "what about Bob?"). I try to get myself to think of one step at a time, but it is often so hard to do. Today I made it out by first focusing ONLY on the shower, which gave me enough momentum for the dressing and getting out. Actually the bumblebee encounter gave me a shot of adrenalin. Then I focused on one task outside--buying the presents.
I guess if bumblebees do sting, I feel so fortunate that I wasn't. Maybe it will remind me that contrary to my negative outlook on life, not all potentially negative events actually happen. I was in a situation in which the likelihood of being stung was very HIGH, and the bee didn't sting. I'll try to think of that when I find myself having a hard time getting motivated for something because of the depressive "habit" of saying "why bother, it'll only turn out unsuccessfully" or some such negative way of thinking.BTW, I get the feeling that you have the impression that I haven't been out of the house in a long time. Actually, I go to work every weekday. But it is like I am living two lives: During the work week, I can get myself up and out (it isn't easy to wake up and do the morning routine, but I do it). On the weekends (and this is a long one) I hibernate and can't do anything.
Posted by Janice on September 6, 1999, at 19:41:46
In reply to Thanks for the encouragement, James, posted by Noa on September 6, 1999, at 15:57:11
Noa, you're cycle is/was exactly mine. Yes, it's called cyclothymia and lithium helps me alot. I believe some people (most definately me) have extremely sensitive bodies. After working on my cyclothymia for 4 or 5 years now, i only begin to experinece week-end depression now if i sleep in on the week-end, even an hour or 2. I eat, sleep and take my medications at the exact same time on the week-end as i do during the week. ADs didn't help much, lithium has helped tremendously, keeping my highs, that often manifested themselves as irritability, under control, and levelling out my week-end lows. But mostly for me, getting better from this cycle consisted of taking very good care of my body by eating, taking my medications and sleeping regularly, and meditating daily and exercising 3 times a week. Janice.James is right though; intially it's all about baby steps. What I did initially was set my alarm on Saturday and Sunday for 6am (my waking time for the regular week), get up (often by throwing myself in the middle of the room), and then make myself stay up for an hour or two before going back to bed. This is how I started.I hope I have help you somehow. I'm excited about meeting someone with this cycle too. Janice.
Posted by Dee on September 6, 1999, at 20:37:30
In reply to Re: Thanks for the encouragement, James, posted by Janice on September 6, 1999, at 19:41:46
Yes, it makes it definitely easier to have friends that I can talk about my depression and the feelings that I am going through. I for one used to be so embarrassed and ashamed of my condition, that during the down times a simple 'How are you doing' was like an accusation or an attempt to extort some information about how I *really* was feeling. I used to look down as I responded 'Fine', knowing that the other person knew I was lying.
I definitely makes it easier for me to start interacting by having people who know and accept the fact that I may be just sitting there while all others are talking, not saying a word. Through my recovery of crystal meth I spent lots of times with NA, and I learned there that I can expose much more of my self than I previously thought, and will not be judged by it. Like they say back there 'You are as sick as your secrets'.
This board, in many ways, has the same feeling to it. A group of people in war against an enemy we all have in common, and supporting and supporting one another when the battle suddenly seems overwhelming. Here we can learn that it is OK to isolate, we all do it at times, and we shouldn't beat ourselves up for doing so. For me, depression is the hardest, fiercest, most exhausting work that I have ever done, a battle I have to fight every day and every hour... When the time comes that I need to take a break from participating in the world I think we all deserve that break.
I have a tendensy to mentally punish myself for the periods of depression. Sort of like I still believed that it is just sloth and dragging. I have to consciously tell myself that I deserve a pat in the back and a raise for all the hard work I have done.Love
Dee
Posted by Noa on September 6, 1999, at 21:06:29
In reply to Re: Thanks for the encouragement, James, posted by Janice on September 6, 1999, at 19:41:46
Janice, the thing is I don't have any real "ups". How do I know what an "up" is?
Posted by Noa on September 6, 1999, at 21:08:22
In reply to Re: Thanks for the encouragement, James, posted by Dee on September 6, 1999, at 20:37:30
Yes, Dee and Janice, it helps me to come to this board. I feel like I am getting "addicted" to it. I came home today, after finally getting out since Friday afternoon, and I was so looking forward to reading the new posts. I get antsy waiting to read new stuff.
Posted by Yardena on September 6, 1999, at 21:20:02
In reply to Re: Thanks for the encouragement, James, posted by Noa on September 6, 1999, at 21:08:22
I, too, have found this board to be a blessing. So much support. And information.
The cyclothymia question is an interesting one. I don't feel I know enough about the nuances of what constitutes a hypomanic phase. I ask the same questions about myself. There is definitely variation in my mood, but no moods of elation or grandiosity. No spending sprees, or anything. I am irritable sometimes, but it feels more like depression than hypomania. Like Noa, when at work, I am able to function, most of the time (except when in the worst stages of depression). I get involved in stuff at work and briefly forget my own woes. I feel better at those times, but only because I am buoyed by the external structure, the feeling of being needed, the distractions. On my own, my initiative wanes and I become very passive and unmotivated (I read in one of the posts that the hippocampus is involved in motivation...and my hippocampus is probably shriveled up by now after all these years of untreated or partially treated depression). As far as the cyclothymia question, I guess I need to do some reading. Hey, Dr. Bob, it would be great if we could have some Q&A exchanges with an expert on cyclothymia/hypomania, etc. to help us learn more.
Posted by Janice on September 7, 1999, at 23:53:14
In reply to Re: Thanks for the encouragement, James, posted by Yardena on September 6, 1999, at 21:20:02
Hi, it's great to hear this is a pretty common problem. We do better when structure is imposed from the outside. Going to the office on the week-end just doesn't cut it. I definately get mild highs, excitable, very social, inflated sense of well-being, bursting with ideas, love to shop (very rarely a spree - just shopping) unable to sleep, and my senses, Whow!. I notice beautiful things everywhere. Sometimes I just get overwhelmed with 'the good emotions' and I am super sensitive to emotional nuances, and I cry as much as when I'm depressed, just for different reasons. Those are some of my middle hypomania symptoms.My more powerful ones are having supernatural powers (I use them only for the good). These highs are as completely convincing as my lows.
And my most common type of hypomanic symptom and my least favorite, my 'mixed' state which mainly manifests itself as irritability.
I'm wondering if you don't need the highs to be cyclothymic.If cyclothymia can be low to medium in one cycle.
For me I honestly believe the difference in routine started the depression, and I have a very sensitive physical body. Once the cycle started, it just kept snowballing until I figured this all out 4 years ago.I much better now, but not from ADs.Janice.
Posted by Sean on September 8, 1999, at 12:29:50
In reply to cyclothymia, posted by Janice on September 7, 1999, at 23:53:14
>
> Hi, it's great to hear this is a pretty common problem. We do better when structure is imposed from the outside. Going to the office on the week-end just doesn't cut it. I definately get mild highs, excitable, very social, inflated sense of well-being, bursting with ideas, love to shop (very rarely a spree - just shopping) unable to sleep, and my senses, Whow!. I notice beautiful things everywhere. Sometimes I just get overwhelmed with 'the good emotions' and I am super sensitive to emotional nuances, and I cry as much as when I'm depressed, just for different reasons. Those are some of my middle hypomania symptoms.
>
> My more powerful ones are having supernatural powers (I use them only for the good). These highs are as completely convincing as my lows.
>
> And my most common type of hypomanic symptom and my least favorite, my 'mixed' state which mainly manifests itself as irritability.
>
> I'm wondering if you don't need the highs to be cyclothymic.If cyclothymia can be low to medium in one cycle.
>
> For me I honestly believe the difference in routine started the depression, and I have a very sensitive physical body. Once the cycle started, it just kept snowballing until I figured this all out 4 years ago.I much better now, but not from ADs.Janice.Hey everybody -
This sounds like my brain too. Sleep can switch
my moods very quickly sometimes. Too little and
things get wacky, too much and it is awful.I read in Kay Jamison's book that people with
bipolar spectrum disorder have a hypersentitive
pineal/melatonin reaction to sleep. This may be
a trait marker for BP (vs. UP) although melatonin
is certainly not a good therapy.Hypomania is grand. I find that I start some really
good projects that get increasingly ridiculous
until they look like answers to world problems
or secrets of the universe. Usually I get wacked
out on some conceptual "take" on things. I once
did this with UFO's and soon my room was literally
filled with books, computer printouts, clippings
from magazines, and I was not sleeping at all.
Then it got real spooky and I was convinced an
abduction was pending and getting really paranoid.So ridiculous in retrospect but utterly
convincing at the time!
Posted by Noa on September 8, 1999, at 19:17:34
In reply to Re: cyclothymia, posted by Sean on September 8, 1999, at 12:29:50
I don't have any highs similar to what Sean and Janice are describing. But I have had times when I feel "overstimulated", like what I feel like when I have had too much caffeine. I guess I am curious about the diagnostic boundaries of cyclothymia. I don't fit into the DSM description, but it seems that the research nowadays is going in the direction of linking my type of cyclical depression to BP and cyclothymia. My pdoc wants me to go on lithium (or another mood stabilizer) as an augmenter to my ADs. I understand Lithium as a mood stabilizer, but does it work when the person has no real hypomania?
BTW, I really appreciate your discussing the cyclothymia. I know so little about it and want to learn more.
Posted by Susan on September 9, 1999, at 4:32:18
In reply to Re: cyclothymia, posted by Noa on September 8, 1999, at 19:17:34
Has anyone tried Lamictal for cyclothymia? Any experiences on this med would be appreciated. I can totally relate to all these posts. I feel that Effexor is increasing the cycles and my pdoc thinks Lamictal would be good to try. New meds are scarey so all input would be appreciated.
Posted by Sean on September 9, 1999, at 17:01:33
In reply to Lamictal and Cyclothymia, posted by Susan on September 9, 1999, at 4:32:18
> Has anyone tried Lamictal for cyclothymia? Any experiences on this med would be appreciated. I can totally relate to all these posts. I feel that Effexor is increasing the cycles and my pdoc thinks Lamictal would be good to try. New meds are scarey so all input would be appreciated.
I'm going to start at the end of this month. I'm
a bit concerned about the rash thing, but it looks
like the best option out there.
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