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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Delphine on November 11, 2001, at 17:55:55
If I understood correctly, early-morning waking accompanied by depressed mood (improving as the day progresses) is characteristic of melancholic depression whereas the opposite (optimistic awakenings, depressed evenings) are more typical of neurotic/anxious depressions.I am only interested in this to the extent that it could point to a more effective treatment for me. This is how my day goes: I wake up very late (around noon), I start feeling better in the evening, I have trouble falling asleep (I don't want to sleep, this is the best time of my day and the only time I can think). That said, I still feel bad in the evening, only not AS bad. I fall asleep around sunrise and I wake up depressed at noon again.
Is anybody else familliar with this particular pattern and if so, what is to be done about it? Is it more of a melancholic-type depression, a reactive depression, SAD? What? I need to know what can be done to fix this.
Thank you.
Posted by Kathleen6674 on November 11, 2001, at 20:00:59
In reply to Circadian rythms and mood fluctuations, posted by Delphine on November 11, 2001, at 17:55:55
I have EXACTLY the same sleep pattern - it seems rather intractable at this point, with me.
I've been taking Ambien on the nights I before I need to get up early (i.e., the same time as most people - in the morning rather than the afternoon). Still, no matter how much sleep I've gotten the night before, I'm horribly down and sluggish in the morning, and I often don't resist the temptation to stay in bed.
It could be a number of things: my circardian rhythms could just be off - delayed sleep phase syndrome (my biological clock is inherently "shifted"); my depression could be the melancholic type, or I could be lazy.
Personally, I prefer the first two explanations, and given the repeated attempts to change my cycle, I'm pretty convinced it's hard-wired, and hence always going to be a struggle to make my schedule like everyone else's.
I'm not even sure that it's ONLY characteristic of melancholic depression - in my therapy group, I'd say a majority of the people have this kind of sleeping pattern if they don't consciously do something to alter it; it's pretty characteristic of bipolars as well as melancholics. Also, general lethargy is pretty much a hallmark trait of depressives, so I imagine that even if were biologically a morning person, I probably still would lie around most of the day.
What to do about it? That is the question. Other than the sleeping pill thing (which sucks because, like you, I feel like taking a sleeping pill in the evening is just shutting myself down at precisely the time I feel my best and most productive), I'm not sure what can be done.
Posted by christophrejmc on November 11, 2001, at 21:42:38
In reply to Circadian rythms and mood fluctuations, posted by Delphine on November 11, 2001, at 17:55:55
I have the same problem as well. The only thing I've found to work is to stay up all night and go to sleep at an earlier time the next day.
Posted by bob on November 12, 2001, at 0:00:35
In reply to Circadian rythms and mood fluctuations, posted by Delphine on November 11, 2001, at 17:55:55
I too have suffered from this "malady" for quite a long time. I was never an early riser to begin with, but while in college, I started having a harder and harder time waking up. It got so that if I didn't absolutely HAVE to get up, I wouldn't be up and about until 11:00am or noon, and sometimes even later -- especially on weekends. Then when my depression/irritability got worse and I started meds, it shifted my sleep cycle severely. Basically, it seems like any med that affects serotinin for me caused me to go into a "sleep coma" in the morning. Some of the medecines have been so bad (Effexor) that I eventually began rising about mid-afternoon, and sometimes even later than that! Nothing I have ever tried has shifted my med-induced sleep cycle back to rising in the morning. I've been trying for 10+ years. It has really damaged my life. It doesn't matter when the heck I go to bed, I will still sleep late. I've tried stimulants, light boxes, sleeping pills, forcibly shifting my cycle by adjusting when I go to bed, etc. Sometimes, through sheer will power, I've gotten up and taken a shower, only to get back in bed after that because I was so tired. I'm out of possible solutions.
Bob
Posted by Else on November 12, 2001, at 10:55:35
In reply to Circadian rythms and mood fluctuations, posted by Delphine on November 11, 2001, at 17:55:55
I was thinking it had something to do with SAD based on my own experience mostly because this is happenning now, in november. I was sleeping very regularly (midnight to 8) for the whole summer and then recently I started having trouble falling asleep even though I still had to wake early and was still taking Klonopin at bedtime. Then I remembered how much trouble I had waking up in the morning and falling asleep at night last spring until things improved almost by magic in May. I barely noticed at the time, it just happenned. I am looking for information on this but it's hard to find something really helpful.
Posted by michael on November 12, 2001, at 17:38:52
In reply to Re: Circadian rythms and mood fluctuations, posted by bob on November 12, 2001, at 0:00:35
ever try melatonin?
> I too have suffered from this "malady" for quite a long time. I was never an early riser to begin with, but while in college, I started having a harder and harder time waking up. It got so that if I didn't absolutely HAVE to get up, I wouldn't be up and about until 11:00am or noon, and sometimes even later -- especially on weekends. Then when my depression/irritability got worse and I started meds, it shifted my sleep cycle severely. Basically, it seems like any med that affects serotinin for me caused me to go into a "sleep coma" in the morning. Some of the medecines have been so bad (Effexor) that I eventually began rising about mid-afternoon, and sometimes even later than that! Nothing I have ever tried has shifted my med-induced sleep cycle back to rising in the morning. I've been trying for 10+ years. It has really damaged my life. It doesn't matter when the heck I go to bed, I will still sleep late. I've tried stimulants, light boxes, sleeping pills, forcibly shifting my cycle by adjusting when I go to bed, etc. Sometimes, through sheer will power, I've gotten up and taken a shower, only to get back in bed after that because I was so tired. I'm out of possible solutions.
>
> Bob
Posted by bob on November 12, 2001, at 23:42:48
In reply to Re: Circadian rythms and mood fluctuations, posted by michael on November 12, 2001, at 17:38:52
> ever try melatonin?
>
Like I said... I tried just about everything -- Melatonin included. I was on Melatonin for months. It helped a little at first, and then nothing.Bob
Posted by paxvox on November 13, 2001, at 10:08:19
In reply to Circadian rythms and mood fluctuations, posted by Delphine on November 11, 2001, at 17:55:55
Do you work or go to school? What do you do with your days? I think that would help us understand a lot more about your rythms. I have a similar pattern as yours, as I mentioned on a different thread, however, I am just the opposite of your supposition that one would be melancholic (or however that is spelled). I am MUCH more the anxious, nervous type. Wheras you say you DREAD going to sleep, that is my santuary.
There is a lot to be said about circadian rythms, and even how the SLIGHTEST time change can affect it. However, this is really more a PSB conversation than a medical one, so let's move it over to PSB.PAX
Posted by michael on November 13, 2001, at 22:48:49
In reply to Re: Circadian rythms and mood fluctuations, posted by bob on November 12, 2001, at 23:42:48
bob,
don't mean to be nosey, but just wondering if you're the same bob from quite a while back/last year...? (was doing - I think - some rsch regarding the pb site)
either way, Hi.
michael
> > ever try melatonin?
> >
> Like I said... I tried just about everything -- Melatonin included. I was on Melatonin for months. It helped a little at first, and then nothing.
>
> Bob
Posted by Else on November 15, 2001, at 22:38:22
In reply to Re: Circadian rythms and mood fluctuations » Delphine, posted by paxvox on November 13, 2001, at 10:08:19
hi Pax,
Let me once again point out that Delphine=Else. Just so you know.
> Do you work or go to school? What do you do with your days?I was in a work-reinsertion programm. I got kicked out because I could keep up. They answer to the government and I was not promissing. They told me I know longer belonged there, that they could not offer the help I needed. I don't disagree but I still resent them for going behind my back and kicking me out before I could say anything even though these people are supposed to help me. So now I do nothing and sleep until 2 o'clock in the afternoon. November is very cold, dark and rainy where I live and the wheather is like a slap in the face. It paralyses me.
>I think that would help us understand a lot more about your rythms. I have a similar pattern as yours, as I mentioned on a different thread, however, I am just the opposite of your supposition that one would be melancholic (or however that is spelled). I am MUCH more the anxious, nervous type. Wheras you say you DREAD going to sleep, that is my santuary.
I don't believe I am melancholic. I know what melancholia is ( from drugs) and I know my presen state is not melancholia. I don't know what it is though. I don't relish going to sleep because I do feel better in the evening, I jus feel the sleep will make it go away. It does make it go away.
> There is a lot to be said about circadian rythms, and even how the SLIGHTEST time change can affect it. However, this is really more a PSB conversation than a medical one, so let's move it over to PSB.
I am not so sure about that but whatever. See you there, then.
> PAX
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