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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Peter S. on July 31, 2002, at 18:42:55
Anybody else have an experience where after a good night sleep they feel depressed? Also I have been taking a nap in the afternoon lately and generally feel OK before the nap- but afterwards look out! A major descent into the darkness, death, pain, self-loathing and whatever else fills my depressed mind. I've decided to start using caffeine to avoid the naps.There must be some research as to why this happens. It doesn't seem to happen to all depressive prone people. Maybe there could be some differental diagnosis based on this criteria? I'm beginning to suspect that I'm kind of bipolar II or III.
Just another mystery wrapped in an enigma- like treatment for most mental illness.
Peter
Posted by awake at last on July 31, 2002, at 23:05:33
In reply to Sleep is my Kryptonite, posted by Peter S. on July 31, 2002, at 18:42:55
>
> Anybody else have an experience where after a good night sleep they feel depressed? Also I have been taking a nap in the afternoon lately and generally feel OK before the nap- but afterwards look out! A major descent into the darkness, death, pain, self-loathing and whatever else fills my depressed mind. I've decided to start using caffeine to avoid the naps.> There must be some research as to why this happens. It doesn't seem to happen to all depressive prone people. Maybe there could be some differental diagnosis based on this criteria? I'm beginning to suspect that I'm kind of bipolar II or III.
>
> Just another mystery wrapped in an enigma- like treatment for most mental illness.
>
> Peter
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Welcome to my world, I lived that way for 3 years. Have you ever looked to see if you have a sleeping disorder? I was diagnosed with Narcolepsy, and what you describe sounds very familiar. I would sleep all night and wake up tired and extremely moody. Naps where weird. If I took a short 10-30 min nap, it was hell to pay, I felt horrible. 1hr, felt okay but usually still tired, more than 2 hrs - extremely bad again. I could usually only sleep for 7 hrs, my body would hurt so much I'd have to get up, but I was so tired I wanted to sleep. If I could sleep for more than 7 hrs. I felt so bad when I awoke it wasn't worth it.Narcolepsy totally screws up your REM - nonREM sleep cycles. I found that if I took a nap, I went into a REM period first (dream period), and that gave me no relaxation.
Sleep Apnea will cause this too, any time you sleep your body becomes deprived of oxygen, will definitely leave you tired and depressed.
If interested, take the Epworth Sleepiness Scale Test and see if you think this may be a possibility:
www.provigil.com/patient/sleep_test/index.aspOh...my advice - skip the caffiene, my experience is it only makes things worse in the long run.
Posted by cybercafe on August 1, 2002, at 2:54:56
In reply to Sleep is my Kryptonite, posted by Peter S. on July 31, 2002, at 18:42:55
sleep deprivation is known to have a robust anti-depressant effect ...
Posted by bubblegumchewer on August 1, 2002, at 18:59:37
In reply to Re: Sleep is my Kryptonite, posted by cybercafe on August 1, 2002, at 2:54:56
A good night's sleep does not bother me; in fact it makes me feel pretty good, but daytime naps kill any good mood I have going on. I feel disoriented and anxious after waking from a daytime nap.
I also have REM sleep immediately upon sleeping, whether it is at night or just for a nap. I know from my past employment in a sleep lab that that is not normal; I know I have sleep apnea but I didn't think it interfered significantly with my sleep. Maybe I'm wrong. I do know that I get lucid dreams in which I'm aware I'm not breathing well but can't awaken myself. Eventually of course I do awaken, usually with a huge snort, but after some unpleasant discomfort and anxiety about my obviously dropping oxygen level.
Posted by geno on August 2, 2002, at 1:07:48
In reply to Re: Sleep is my Kryptonite, posted by bubblegumchewer on August 1, 2002, at 18:59:37
I use ghb for sleep on occassion. I have a question. G puts you directly into rem sleep. After taking it, my body is put directly into a dream sleep, i feel like i slept for days and dream vivid. I wake up 1 hr later, with nausea, dysphoria, out of it.
Is this resortitive sleep? Or is this sleep bad due to the rem sleep.
Posted by turalizz on August 2, 2002, at 5:49:31
In reply to Re: Sleep is my Kryptonite, posted by geno on August 2, 2002, at 1:07:48
> I use ghb for sleep on occassion. I have a question. G puts you directly into rem sleep. After taking it, my body is put directly into a dream sleep, i feel like i slept for days and dream vivid. I wake up 1 hr later, with nausea, dysphoria, out of it.
> Is this resortitive sleep? Or is this sleep bad due to the rem sleep.It is not known if REM sleep is essential or not.
Your brain really rests in the deep stages of sleep, while low frequency EEG waves are produced(stage 3 and 4).cem
Posted by awake at last on August 2, 2002, at 11:48:37
In reply to Re: Sleep is my Kryptonite, posted by bubblegumchewer on August 1, 2002, at 18:59:37
> A good night's sleep does not bother me; in fact it makes me feel pretty good, but daytime naps kill any good mood I have going on. I feel disoriented and anxious after waking from a daytime nap.
>
> I also have REM sleep immediately upon sleeping, whether it is at night or just for a nap. I know from my past employment in a sleep lab that that is not normal; I know I have sleep apnea but I didn't think it interfered significantly with my sleep. Maybe I'm wrong. I do know that I get lucid dreams in which I'm aware I'm not breathing well but can't awaken myself. Eventually of course I do awaken, usually with a huge snort, but after some unpleasant discomfort and anxiety about my obviously dropping oxygen level.
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The one major tell-tell sign of Narcolepsy is that ALL narcoleptics fall asleep quickly and that they often or always go into REM sleep first. In Normal sleep people go into non-REM sleep first and don't have the first cycle of REM sleep until 80-90 minutes later.
In my MSLT test, they determined it took me an average of 3 min. to fall asleep (way less than the average of 10-15 min), and that in 3 out of the 4 naps, I went into REM sleep first.
If I were you I'd go talk to a neurologist that specializes in Sleep Disorders. It's very common for someone to have Sleep Apnea along with another sleep disorder as well.
I'm glad I checked it out....finding out I'm narcoleptic and learning how to deal with it has given me my life back.
Posted by bubblegumchewer on August 2, 2002, at 12:39:37
In reply to REM first: classic sign of Narcolepsy - chk it out, posted by awake at last on August 2, 2002, at 11:48:37
Thanks for the info. I just may get it checked out. I don't like getting such things checked out, though, because as a female and a psychiatric patient I have been given the "hypochondriac" treatment too often. In fact, I spoke to at least one doctor about this in the past and was told: "You can't have sleep apnea. This is because 1. You are not male 2. you are young and 3. you are not obese." Great diagnotic skills, huh?
Anyway, when you said that learning to manage your narcolepsy has a made a big difference, what do you mean? Do you mind saying what you do to manage it?
Posted by awake at last on August 6, 2002, at 7:56:53
In reply to maybe I will check it out. Question:, posted by bubblegumchewer on August 2, 2002, at 12:39:37
> Thanks for the info. I just may get it checked out. I don't like getting such things checked out, though, because as a female and a psychiatric patient I have been given the "hypochondriac" treatment too often. In fact, I spoke to at least one doctor about this in the past and was told: "You can't have sleep apnea. This is because 1. You are not male 2. you are young and 3. you are not obese." Great diagnotic skills, huh?
>
> Anyway, when you said that learning to manage your narcolepsy has a made a big difference, what do you mean? Do you mind saying what you do to manage it?
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BBC,
Sorry I took so long to respond, been out of town on business....I don’t mind telling you at all...but let me back track a little and tell you my whole story so it all makes since. It’s a little long but bear with me......I also am a woman, 34, married with 2 young children and a very demanding career. I understand very well the feelings that you get from people thinking you are a hypochondriac; I know I got that treatment as well.
3 ½ years ago I gave birth to my second child, after that nothing ever felt right. I was extremely tired all the time (to the point that I was falling asleep at my computer, I could never watch a TV show or movie without falling asleep); I had heartburn all the time and fainting spells. I went to my GP to have test run to see if they could figure out what was wrong. They ran all the typical blood test did a Holter monitor and EKG and they came back normal. The doctor gave me Prilosec for my heartburn, and told me to get more exercise. He said that I was now 30, and that was the time when women change and become old.....(what an idiot). My mother is 59, diabetic and runs circles around me. I told the doctor that I thought I was probably hypoglycemic, that my mother was diabetic and that I had had the fainting spells on and off as a child and the doctors all then thought it might be related to my blood sugar. Since my blood work had come back at 70, the lowest but “normal” range, he didn’t feel that this was the cause, but at my persistence he gave me a glucose test, well he did a 3 hr. test, which came back normal, I found out a year later that hypoglycemia can only be diagnosed with a 6 hr. glucose test. So what he did was pointless. I obtained a Hypoglycemic diet from our Hospital’s Nutrition department and began following the diet myself and bought a glucometer to track my blood sugar throughout the day. My blood sugar had been falling in the low 60’s quite often. After following the diet for several weeks, my fainting spells went away – and so did my persistent heartburn – I haven’t taken a Prilosec since.
I’ve suffered from environmental allergies all my life; I took shots for 10 years and had been off of them for about 10 years. I decided that maybe this was why I was so tired, so I went to an allergy specialist and was retested – I started taking Zyrtec and restarted the allergy shots. Though my sinuses are better, my fatigue, lack of concentration and motivation were still all the same.
One day I saw a show on how women with low testosterone were being found more often. The side effects described me to a tee. I decided at this point to dump my GP and go see my GYN. Sure enough, my testosterone levels were nil, but all my other hormones were fine. Bummer...I had to go off my BC pills, but my testosterone levels returned to normal. However, it didn’t change the way I felt at all. My GYN decided that he’d like to try me on some anti-depressants. First he tried Celexa, then Wellbutrin, both to no avail. He then decided that my problem had to be something else and sent me to an Internal Medicine doctor. Best move I made. The IM actually listened to everything I told him. I told him that exercise only made me more tired and that I did feel I was hypoglycemic. Well, fortunately I had been keeping my blood sugar reading for some time, and from them he was able to confirm that yes I was hypoglycemic and that I should continue my diet as I had been. Since exercise made me tired he ran all the cortisol levels to make sure that my problem didn’t lie in the adrenal area, but that all came back normal too. However, he did explain that exercise drains my blood sugar and that I should make sure to eat a little something before exercising. I was so frustrated that they couldn’t find out the problem, that I did get teary a couple of times during my visits. I think from this he decided my problem must be depression. I just still wasn’t comfortable with that diagnosis – I knew the two anti-depressants hadn’t worked, and I love my life, and my family. My job is stressful, but I didn’t feel that it was controlling my life. He kept trying to convince me that I didn’t have to “feel” depressed to “be” depressed. I told him that I was tired of being tired, and if I was getting depressed over anything, it was the fact that they couldn’t figure out what was wrong with me.
I caved in and tried one more anti-depressant – Effexor XR – BIG MISTAKE! Didn’t help at all, if I didn’t take it at exactly the same time everyday, I got a headache. When the Doctor upped the dosage to 225 mg, then I couldn’t sleep at all. Took me a month to downsize the dosage so the withdrawal symptoms weren’t unbearable (although they were still there). The IM had finally decided that maybe I should go see a psychiatrist – but this wasn’t the direction I felt I should go. I remembered on my first visit to him that he had explained that my symptoms could be caused from a number of things, he described all the organs, etc... depression...and he mentioned Sleep disorders. So before I’d let him send me to a psychiatrist, I requested that he refer me to a Neurologist to discuss if I could have a sleep disorder. He agreed, but I don’t think he really thought that was the problem. I don’t snore, I slept all night, the only complaint that I had was that I dreamed all night long. My dreams were always good, no nightmares or anything like that, but when morning came, I felt like I had never slept. Well, I went to the Neurologist and he had me take the Epworth test (you can find this on line in many places www.Provigil.com for one). I flunked it with flying colors – I was so excited – so far every test I took seem to come back “normal”, I was elated that maybe I was finally going to find out what was wrong. They scheduled a sleep study and an MSLT, when I went to get the results, he said the sleep study was normal (here we go again I thought), but then he said that my MSLT was very interesting – and that interesting was not good. YAHOO.....he probably thought I was crazy....anyway, on the MSLT, I had taken 4 naps, my average time to fall asleep was 3 min. (compared to the normal 10-15) and I went into REM sleep in 3 of the 4 naps (note the naps are only 20 min. long so a normal person wouldn’t have entered REM at all), thus, the diagnosis of Narcolepsy. Now, about that doctor that told you that you couldn’t have Sleep Apnea because you weren't male, old or obese – he’s an idiot, sleep apnea is much more wide spread than that, as well, typically Narcolepsy sets in on people during their teen-age years, my doctor said that they were just beginning to see another small trend of people in their early thirties. (Probably because previously people weren’t being tested because the doctors thought it couldn’t be Narcolepsy as old as they were) – find a doctor that is open minded.
This doctor put me on Provigil; I love this drug. I actually don’t feel tired during the day, I can do my work and not have to get up and walk around every 15 min. to stay awake. I’ve been watching movies, spending time on my computer, and enjoying my children. I currently take 200 mgs every morning, and on some days I take another 100 at about 11:30 am if I’m feeling tired already. As a pleasant side effect – I’m losing weight as well, I had found that because I was tired, I would eat during the day to boost my energy level so I could stay awake and had started putting on weight. Now those cravings for food are gone. This drug won’t compensate for not managing my Narcolepsy though...and here’s what I mean by that. I have found that for me to truly feel good, I have to follow the best sleep practices. I keep my wake/sleep-cycle consistent; I always get up and go to bed at the same time – 7 days a week. I get 8 hrs a sleep a night (no more, no less – this may vary for some people, you’ll just have to see what works for you). The doctors say that most Narcoleptics will still have to take a couple of 15 min. naps a day, but for me it’s just the opposite – any kind of nap really screws me up, but I really don’t feel the need for them anymore anyway. I stop eating and exercising 3 hours before I go to bed, and I never read or watch TV in bed anymore. (A side note – these alone didn’t work, the Provigil along with them was the key).
Once I started taking Provigil and found I felt like doing things again, I found it easy to deprive myself of sleep, staying up doing things I had been wanting to do, and found that reducing my sleep period made me feel tired again by the end of the week.
Laying down and going to sleep was weird at first, because now it does usually take me longer to go to sleep, I was so use to “being asleep when my head hit my pillow” (as my husband called it) that the 5-10 minutes it takes now seems long.
All this to say, that I think doctors diagnose depression way to easily, and that sometimes I truly believe that you have to find ALL the problems and fix them to finally be well. Doctors are bad about describing medicines to take care of the symptoms rather than finding the cure. I think this is why so many people only find these medicines to work for a short period of time, because the real problem is still getting worse. Who knows, maybe if I’d had the Narcolepsy diagnosed and not the hypoglycemia, I might still be felling bad. But if your gut is telling you that you think there is something wrong and the anti-depressants are only masking the symptoms and not curing the problem, keep searching. Find the Doctor that will listen. Find the root cause, if there is a cure, fix it, if not, then use the medicines to help the symptoms. (Don’t get me wrong – I do believe that depression can be the illness with some people, and the anti-depressants may be the cure to fix the root problem of a chemical imbalance – but if the anti-depressants aren’t working or wear-off over time....then maybe it’s time to look for another problem).Good luck, and don’t listen to those that think you are a hypochondriac, research to find what you think could be wrong, discuss it with the professionals, if they know that you have some idea what you are talking about, they are more likely to listen to you, most of all be persistent.
This is the end of the thread.
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